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Sample records for patient transfer biomechanics

  1. Development of custom measurement system for biomechanical evaluation of independent wheelchair transfers.

    Science.gov (United States)

    Koontz, Alicia M; Lin, Yen-Sheng; Kankipati, Padmaja; Boninger, Michael L; Cooper, Rory A

    2011-01-01

    This study describes a new custom measurement system designed to investigate the biomechanics of sitting-pivot wheelchair transfers and assesses the reliability of selected biomechanical variables. Variables assessed include horizontal and vertical reaction forces underneath both hands and three-dimensional trunk, shoulder, and elbow range of motion. We examined the reliability of these measures between 5 consecutive transfer trials for 5 subjects with spinal cord injury and 12 nondisabled subjects while they performed a self-selected sitting pivot transfer from a wheelchair to a level bench. A majority of the biomechanical variables demonstrated moderate to excellent reliability (r > 0.6). The transfer measurement system recorded reliable and valid biomechanical data for future studies of sitting-pivot wheelchair transfers.We recommend a minimum of five transfer trials to obtain a reliable measure of transfer technique for future studies.

  2. Patient-specific models of cardiac biomechanics

    Science.gov (United States)

    Krishnamurthy, Adarsh; Villongco, Christopher T.; Chuang, Joyce; Frank, Lawrence R.; Nigam, Vishal; Belezzuoli, Ernest; Stark, Paul; Krummen, David E.; Narayan, Sanjiv; Omens, Jeffrey H.; McCulloch, Andrew D.; Kerckhoffs, Roy C. P.

    2013-07-01

    Patient-specific models of cardiac function have the potential to improve diagnosis and management of heart disease by integrating medical images with heterogeneous clinical measurements subject to constraints imposed by physical first principles and prior experimental knowledge. We describe new methods for creating three-dimensional patient-specific models of ventricular biomechanics in the failing heart. Three-dimensional bi-ventricular geometry is segmented from cardiac CT images at end-diastole from patients with heart failure. Human myofiber and sheet architecture is modeled using eigenvectors computed from diffusion tensor MR images from an isolated, fixed human organ-donor heart and transformed to the patient-specific geometric model using large deformation diffeomorphic mapping. Semi-automated methods were developed for optimizing the passive material properties while simultaneously computing the unloaded reference geometry of the ventricles for stress analysis. Material properties of active cardiac muscle contraction were optimized to match ventricular pressures measured by cardiac catheterization, and parameters of a lumped-parameter closed-loop model of the circulation were estimated with a circulatory adaptation algorithm making use of information derived from echocardiography. These components were then integrated to create a multi-scale model of the patient-specific heart. These methods were tested in five heart failure patients from the San Diego Veteran's Affairs Medical Center who gave informed consent. The simulation results showed good agreement with measured echocardiographic and global functional parameters such as ejection fraction and peak cavity pressures.

  3. Assessment of Knowledge Transfer in the Context of Biomechanics

    Science.gov (United States)

    Hutchison, Randolph E.

    2011-01-01

    The dynamic act of knowledge transfer, or the connection of a student's prior knowledge to features of a new problem, could be considered one of the primary goals of education. Yet studies highlight more instances of failure than success. This dissertation focuses on how knowledge transfer takes place during individual problem solving, in…

  4. Upper-limb biomechanical analysis of wheelchair transfer techniques in two toilet configurations.

    Science.gov (United States)

    Tsai, Chung-Ying; Boninger, Michael L; Bass, Sarah R; Koontz, Alicia M

    2018-06-01

    Using proper technique is important for minimizing upper limb kinetics during wheelchair transfers. The objective of the study was to 1) evaluate the transfer techniques used during toilet transfers and 2) determine the impact of technique on upper limb joint loading for two different toilet configurations. Twenty-six manual wheelchair users (23 men and 3 women) performed transfers in a side and front wheelchair-toilet orientation while their habitual transfer techniques were evaluated using the Transfer Assessment Instrument. A motion analysis system and force sensors were used to record biomechanical data during the transfers. More than 20% of the participants failed to complete five transfer skills in the side setup compared to three skills in the front setup. Higher quality skills overall were associated with lower peak forces and moments in both toilet configurations (-0.68 perform these skills correctly (p ≤ 0.04). In the front setup, positioning the wheelchair within three inches of the transfer target was associated with reduced peak trailing forces and moments across all three upper limb joints (p = 0.02). Transfer skills training, making toilet seats level with the wheelchair seat, positioning the wheelchair closer to the toilet and mounting grab bars in a more ideal location for persons who do sitting pivot transfers may facilitate better quality toilet transfers. Published by Elsevier Ltd.

  5. Biomechanical evaluation of heel elevation on load transfer — experimental measurement and finite element analysis

    Science.gov (United States)

    Luximon, Yan; Luximon, Ameersing; Yu, Jia; Zhang, Ming

    2012-02-01

    In spite of ill-effects of high heel shoes, they are widely used for women. Hence, it is essential to understand the load transfer biomechanics in order to design better fit and comfortable shoes. In this study, both experimental measurement and finite element analysis were used to evaluate the biomechanical effects of heel height on foot load transfer. A controlled experiment was conducted using custom-designed platforms. Under different weight-bearing conditions, peak plantar pressure, contact area and center of pressure were analyzed. A three-dimensional finite element foot model was used to simulate the high-heel support and to predict the internal stress distributions and deformations for different heel heights. Results from both experiment and model indicated that heel elevations had significant effects on all variables. When heel elevation increased, the center of pressure shifted from the midfoot region to the forefoot region, the contact area was reduced by 26% from 0 to 10.2 cm heel and the internal stress of foot bones increased. Prediction results also showed that the strain and total tension force of plantar fascia was minimum at 5.1 cm heel condition. This study helps to better understand the biomechanical behavior of foot, and to provide better suggestions for design parameters of high heeled shoes.

  6. Biomechanical CT Metrics Are Associated With Patient Outcomes in COPD

    Science.gov (United States)

    Bodduluri, Sandeep; Bhatt, Surya P; Hoffman, Eric A.; Newell, John D.; Martinez, Carlos H.; Dransfield, Mark T.; Han, Meilan K.; Reinhardt, Joseph M.

    2017-01-01

    Background Traditional metrics of lung disease such as those derived from spirometry and static single-volume CT images are used to explain respiratory morbidity in patients with chronic obstructive pulmonary disease (COPD), but are insufficient. We hypothesized that the mean Jacobian determinant, a measure of local lung expansion and contraction with respiration, would contribute independently to clinically relevant functional outcomes. Methods We applied image registration techniques to paired inspiratory-expiratory CT scans and derived the Jacobian determinant of the deformation field between the two lung volumes to map local volume change with respiration. We analyzed 490 participants with COPD with multivariable regression models to assess strengths of association between traditional CT metrics of disease and the Jacobian determinant with respiratory morbidity including dyspnea (mMRC), St Georges Respiratory Questionnaire (SGRQ) score, six-minute walk distance (6MWD), and the BODE index, as well as all-cause mortality. Results The Jacobian determinant was significantly associated with SGRQ (adjusted regression co-efficient β = −11.75,95%CI −21.6 to −1.7;p=0.020), and with 6MWD (β=321.15, 95%CI 134.1 to 508.1;p<0.001), independent of age, sex, race, body-mass-index, FEV1, smoking pack-years, CT emphysema, CT gas trapping, airway wall thickness, and CT scanner protocol. The mean Jacobian determinant was also independently associated with the BODE index (β= −0.41, 95%CI −0.80 to −0.02; p = 0.039), and mortality on follow-up (adjusted hazards ratio = 4.26, 95%CI = 0.93 to 19.23; p = 0.064). Conclusion Biomechanical metrics representing local lung expansion and contraction improve prediction of respiratory morbidity and mortality and offer additional prognostic information beyond traditional measures of lung function and static single-volume CT metrics. PMID:28044005

  7. Biomechanical Analysis of Suture Anchor vs Tenodesis Screw for FHL Transfer.

    Science.gov (United States)

    Drakos, Mark C; Gott, Michael; Karnovsky, Sydney C; Murphy, Conor I; DeSandis, Bridget A; Chinitz, Noah; Grande, Daniel; Chahine, Nadeen

    2017-07-01

    Chronic Achilles injury is often treated with flexor hallucis longus (FHL) tendon transfer to the calcaneus using 1 or 2 incisions. A single incision avoids the risks of extended dissections yet yields smaller grafts, which may limit fixation options. We investigated the required length of FHL autograft and biomechanical profiles for suture anchor and biotenodesis screw fixation. Single-incision FHL transfer with suture anchor or biotenodesis screw fixation to the calcaneus was performed on 20 fresh cadaveric specimens. Specimens were cyclically loaded until maximal load to failure. Length of FHL tendon harvest, ultimate load, stiffness, and mode of failure were recorded. Tendon harvest length needed for suture anchor fixation was 16.8 ± 2.1 mm vs 29.6 ± 2.4 mm for biotenodesis screw ( P = .002). Ultimate load to failure was not significantly different between groups. A significant inverse correlation existed between failure load and donor age when all specimens were pooled (ρ = -0.49, P Anchor failure occurred mostly by suture breakage (n = 8). Adequate FHL tendon length could be harvested through a single posterior incision for fixation to the calcaneus with either fixation option, but suture anchor required significantly less graft length. Stiffness, fixation strength, and load to failure were comparable between groups. An inverse correlation existed between failure load and donor age. Younger specimens with screw fixation demonstrated significantly greater failure loads. Adequate harvest length for FHL transfer could be achieved with a single posterior incision. There was no difference in strength of fixation between suture anchor and biotenodesis screw.

  8. The effect of pharmacological treatment on gait biomechanics in peripheral arterial disease patients

    Science.gov (United States)

    2010-01-01

    Background Pharmacological treatment has been advocated as a first line therapy for Peripheral Arterial Disease (PAD) patients suffering from intermittent claudication. Previous studies document the ability of pharmacological treatment to increase walking distances. However, the effect of pharmacological treatment on gait biomechanics in PAD patients has not been objectively evaluated as is common with other gait abnormalities. Methods Sixteen patients were prescribed an FDA approved drug (Pentoxifylline or Cilostazol) for the treatment of symptomatic PAD. Patients underwent baseline gait testing prior to medication use which consisted of acquisition of ground reaction forces and kinematics while walking in a pain free state. After three months of treatment, patients underwent repeat gait testing. Results Patients with symptomatic PAD had significant gait abnormalities at baseline during pain free walking as compared to healthy controls. However, pharmacological treatment did not produce any identifiable alterations on the biomechanics of gait of the PAD patients as revealed by the statistical comparisons performed between pre and post-treatment and between post-treatment and the healthy controls. Conclusions Pharmacological treatment did not result in statistically significant improvements in the gait biomechanics of patients with symptomatic PAD. Future studies will need to further explore different cohorts of patients that have shown to improve significantly their claudication distances and/or their muscle fiber morphology with the use of pharmacological treatment and determine if this is associated with an improvement in gait biomechanics. Using these methods we may distinguish the patients who benefit from pharmacotherapy and those who do not. PMID:20529284

  9. Computational biomechanics for medicine fundamental science and patient-specific applications

    CERN Document Server

    Miller, Karol; Wittek, Adam; Nielsen, Poul

    2014-01-01

    One of the greatest challenges facing the computational engineering community is to extend the success of computational mechanics to fields outside traditional engineering, in particular to biology, the biomedical sciences, and medicine. The Computational Biomechanics for Medicine titles provide an opportunity for specialists in computational biomechanics to present their latest methodologies and advancements. This latest installment comprises nine of the latest developments in both fundamental science and patient-specific applications, from researchers in Australia, New Zealand, USA, UK, France, Ireland, and China. Some of the interesting topics discussed are: cellular mechanics; tumor growth and modeling; medical image analysis; and both patient-specific fluid dynamics and solid mechanics simulations.

  10. The biomechanical assessment of the cervical inter-vertebral kinematics, between DDD patients ICR based study

    Science.gov (United States)

    Saveh, Amir Hossein; Zali, Ali Reza; Seddighi, Amir Saeed; Zarghi, Afsaneh; Chizari, Mahmoud; Hanafiah, Yussof

    2012-01-01

    Abstract: It is very important to pay more attention to spine from the biomechanical perspective. It would allow the analysis of initial conditions of the vertebral disc degeneration syndrome and adopting of normal spine kinematics to compare and match it with a degenerated disc and providing a biomechanical index as an indicator for the conduct of any surgical intervention including arthroplasty to maximize restoring spinal biomechanical motion. It is clear that the head movement is possible with the help of muscles. However, the shape and type of motion depends on the structure and shape of the cervical spine and the interaction between them. Cervical spine kinematics depends on the anatomy of the bones and joints. Bazhdok et al (2000) investigated the cervical kinematics and mechanical behavior of the spine and its anatomical connections. They have examined the atlanto- occipital joint motion during flexion-extension and rotation as well as the mechanism of paradoxical motion of atlanto- axial joint by radiography. Bifalkou et al (2011) studied the inter-vertebral motion based on arc kinematic commentary of video fluoroscopy. They showed that the diagnosis of biomechanical instability can be done based on the kinematic examination of the spine obtained in sagittal images. They also declared that the fluoroscopy can be used as a tool for study. Using an automated algorithm, image adaption was carried out and the motion direction of vertebrae was tracked. In the present study, some patients were selected among patients with cervical disc degeneration. Following imaging by fluoroscopy, the instantaneous center of the spinal action was calculated. It was used as a biomechanical criterion and the treatment group was compared with the healthy group. The loci of the instantaneous centers of the two groups were compared and its difference with the value of healthy group was calculated. A biomechanical criterion was introduced as a basis for comparison of normal and

  11. Sequential compression biomechanical device in patients with critical limb ischemia and nonreconstructible peripheral vascular disease.

    LENUS (Irish Health Repository)

    Sultan, Sherif

    2011-08-01

    Critical limb ischemia (CLI) patients who are unsuitable for intervention face the dire prospect of primary amputation. Sequential compression biomechanical device (SCBD) therapy provides a limb salvage option for these patients. This study assessed the outcome of SCBD in severe CLI patients who otherwise would face an amputation. Primary end points were limb salvage and 30-day mortality. Secondary end points were hemodynamic outcomes (increase in popliteal artery flow and toe pressure), ulcer healing, quality-adjusted time without symptoms of disease or toxicity of treatment (Q-TwiST), and cost-effectiveness.

  12. Transfer Out Patient Not Abandon The Patient

    Directory of Open Access Journals (Sweden)

    Deepak Gupta

    2015-12-01

    does not encompass part of deserting patients but rather appropriate transferring of patient care to accepting/receptive fellow brethren/colleagues. The transfer of care does not mean that a particular physician has failed to perform his/her duties for his/her patients rather that the particular relationship with a particular patient has failed to meet its ends. Therefore without abandoning the patient, the patient is given ample and honest opportunity to be transferred out to another physician with the sincere hope that the discharged patient will be able to achieve relief of his/her suffering with the new physician-patient relationship meeting their goals and means-to-the-ends. The one thing that need not be forgotten is that the terminated physician-patient relationship can always be revived if the causative concerns have been resolved in the interim and if the medico-legal laws and ethical practices allow the relationships’ revival. In summary, it is prerogative of the patient (whose suffering made him/her to reach out to a physician and enter in a physician-patient relationship in the first place when he/she wants to and decides to terminate physician-patient relationship; whereas the prerogative of the physician is to recognize a dysfunctional physician-patient relationship early-on so that corrective measures (if possible can be executed, and if that is not possible, then instead of patient abandonment, patients may be appropriately and timely transferred out off failed physician-patient relationship.

  13. Assessment of Corneal Biomechanical Properties by CorVis ST in Patients with Dry Eye and in Healthy Subjects

    Directory of Open Access Journals (Sweden)

    Qin Long

    2015-01-01

    Full Text Available Purpose. To investigate corneal biomechanical properties in patients with dry eye and in healthy subjects using Corneal Visualization Scheimpflug Technology (CorVis ST. Methods. Biomechanical parameters were measured using CorVis ST in 28 eyes of 28 patients with dry eye (dry eye group and 26 normal subjects (control group. The Schirmer I test value, tear film break-up time (TBUT, and corneal staining score (CSS were recorded for each eye. Biomechanical properties were compared between the two groups and bivariate correlation analysis was used to assess the relationship between biomechanical parameters and dry eye signs. Results. Only one of the ten biomechanical parameters was significantly different between the two groups. Patients in the dry eye group had significantly lower highest concavity time (HC-time (P=0.02 than the control group. Correlation analysis showed a significant negative correlation between HC-time and CSS with marginal P value (ρ=-0.39, P=0.04 in the dry eye group. Conclusions. The corneal biomechanical parameter of HC-time is reduced in dry eyes compared to normal eyes. There was also a very weak but significant negative correlation between HC-time and CSS in the dry eye group, indicating that ocular surface damage can give rise to a more compliant cornea in dry eyes.

  14. A smart mobile pouch as a biomechanical energy harvester towards self-powered smart wireless power transfer applications.

    Science.gov (United States)

    Chandrasekhar, Arunkumar; Alluri, Nagamalleswara Rao; Sudhakaran, M S P; Mok, Young Sun; Kim, Sang-Jae

    2017-07-20

    A Smart Mobile Pouch Triboelectric Nanogenerator (SMP-TENG) is introduced as a promising eco-friendly approach for scavenging biomechanical energy for powering next generation intelligent devices and smart phones. This is a cost-effective and robust method for harvesting energy from human motion, by utilizing worn fabrics as a contact material. The SMP-TENG is capable of harvesting energy in two operational modes: lateral sliding and vertical contact and separation. Moreover, the SMP-TENG can also act as a self-powered emergency flashlight and self-powered pedometer during normal human motion. A wireless power transmission setup integrated with SMP-TENG is demonstrated. This upgrades the traditional energy harvesting device into a self-powered wireless power transfer SMP-TENG. The wirelessly transferred power can be used to charge a Li-ion battery and light LEDs. The SMP-TENG opens a wide range of opportunities in the field of self-powered devices and low maintenance energy harvesting systems for portable and wearable electronic gadgets.

  15. BIOMECHANICAL INDICES OF STANDING AND GAIT IN PATIENTS AFTER TOTAL KNEE REPLACEMENT USING COMPUTER NAVIGATION

    Directory of Open Access Journals (Sweden)

    Y. A. Bezgodkov

    2011-01-01

    Full Text Available Several biomechanical parameters of standing and walking in 50 patients with osteoarthrosis after total knee arthroplasty were evaluated. The patients were randomly divided in two equal groups: in the first group the surgery was performed with computer navigation system and in the second - with traditional instruments. After TKA with computer navigation centers of common body pressure and legs pressure during standing phase improved significantly better than in traditional group. Walking parameters like step length, ground contact time and rhythm coefficient improved in both groups of patients but without significant difference. Thereby more precise orientation of implant that achieved during computer assisted TKA leads to better functional performance at 6 and 12 month after surgery.

  16. [Anlysis of foot biomechanics characteristic in 303 patients with type 2 diabetes mellitus].

    Science.gov (United States)

    Li, Wen-Xia; Cao, Ying; Zou, Meng-Chen; Huang, Ying; Hu, Ping; Luo, Xiang-Rong; Jiang, Ya; Xue, Yao-Ming; Gao, Fang

    2016-10-20

    To investigate foot biomechanics characteristic of patients with type 2 diabetes mellitus. This study was conducted among 303 patients with type 2 diabetes. The whole foot was divided into 10 regions, namely the first toe (T1); the second to fifth toes (T2-5); the first, second, third, fourth, and fifth metatarsals (M1, M2, M3, M4, and M5, respectively); midfoot (MF), and the heel medial (HM). Foot arch index, foot angle and maximum peak pressure (MPP) of the 10 regions were measured using a Footscan gait system. The maximum peak pressure of 10 regions decreased in the order of M3>M2>HM>M4>HL>M1>M5>T1>ML>T2-5 for the left foot, and in the order of M3>M2>HM>M4>HL>M1>M5>T1>ML>T2-5 for the right foot. The MPP in M1 region was higher in the right than in the left foot (Ppatients. Foot flat phase was extended and forefoot push-off phase shortened in stance phase in the patients. Compared with the right foot, the left foot showed a significantly increased foot arch index and increased low and high arch rates with a decreased normal arch rate. Total plantar pressure was higher in of the left high arch foot than in normal arch foot. The foot angle was significantly larger on the right than on the left. The bilateral total plantar pressures were significantly greater in male patients (Ppatients have obvious alterations in foot biomechanics with abnormalities of the plantar pressure, and the percentage of high-risk foot increases in overweight and obese patients, suggesting the need of body weight control in these patients when administering offloading treatment for prevention of diabetic foot ulcer.

  17. Impaired physical function, loss of muscle mass and assessment of biomechanical properties in critical ill patients

    DEFF Research Database (Denmark)

    Poulsen, Jesper Brøndum

    2012-01-01

    Intensive care unit (ICU) admission is associated with muscle weakness and ICU survivors report sustained limitation of physical capacity for years after discharge. Limited information is available on the underlying biomechanical properties responsible for this muscle function impairment. A plaus......Intensive care unit (ICU) admission is associated with muscle weakness and ICU survivors report sustained limitation of physical capacity for years after discharge. Limited information is available on the underlying biomechanical properties responsible for this muscle function impairment....... A plausible contributor to the accentuated catabolic drive in ICU patients is a synergistic response to inflammation and inactivity leading to loss of muscle mass. As these entities are predominantly present in the early phase of ICU stay, interventions employed during this time frame may exhibit the greatest...... potential to counteract loss of muscle mass. Despite the obvious clinical significance of muscle atrophy for the functional impairment observed in ICU survivors, no preventive therapies have been identified as yet. The overall aim of the present dissertation is to characterize aspects of physical function...

  18. Sequential compression biomechanical device versus primary amputation in patients with critical limb ischemia.

    LENUS (Irish Health Repository)

    Tawfick, Wael A

    2013-10-01

    Introduction: Patients with critical limb ischemia (CLI), who are unsuitable for intervention, face the consequence of primary amputation. Sequential compression biomechanical device (SCBD) therapy provides a limb salvage option for these patients. Objectives: To assess the outcome of SCBD in patients with severe CLI who are unsuitable for revascularization. Primary end points were limb salvage and 30-day mortality. Methods: From 2005 to 2012, 189 patients with severe CLI were not suitable for revascularization. In all, 171 joined the SCBD program. We match controlled 75 primary amputations. Results: All patients were Rutherford category 4 or higher. Sustained clinical improvement was 68% at 1 year. Mean toe pressure increased from 19.9 to 35.42 mm Hg, P < .0001. Mean popliteal flow increased from 35.44 to 55.91 cm\\/sec, P < .0001. The 30-day mortality was 0.6%. Limb salvage was 94% at 5 years. Freedom from major adverse clinical events was 62.5%. All-cause survival was 69%. Median cost of managing a primary amputation patient is €29 815 compared to €3985 for SCBD. We treated 171 patients with artassist at a cost of €681 965. However, primary amputation for 75 patients cost €2 236 125. Conclusion: The SCBD therapy is a cost-effective and clinically effective solution in patients with CLI having no option of revascularization. It provides adequate limb salvage while providing relief of rest pain without any intervention.

  19. Evaluation of Spasticity Variations at the Elbow Joint of CVA Patients According to the Biomechanical Indices

    Directory of Open Access Journals (Sweden)

    Nima Soleimanzadeh-Ardabili

    2013-10-01

    Full Text Available Objective: The goal of the present study was to evaluate spasticity variations by increase the velocity of motion and MAS value in the elbow flexor and extensor muscles at extension and flexion of CVA patients elbow joint according to the biomechanical indices. Materials & Methods: Fifteen adult patients with a history of stroke and upper-extremity spasticity volunteered to participate in this study and fifteen healthy subjects were recruited in order to establish the control group. The degree of spasticity was evaluated for each patient using the MAS. CPM tests were imposed in elbow extension and flexion and the biomechanical indices were calculated at each of the following velocities: 15, 45, 75 and 120 º/s. Results: It seemed a regular increment of the viscoelastic and viscose stiffness indices by increasing the velocity of motion and the rate of MAS value in both extension and flexion in all test groups and also there was significant regular increment of elastic stiffness index by increasing the velocity in both extension and flexion between the control group and group 1 and also irregular increment between group1 and group 2 and 3 and also the effect of mentioned index was decreased at higher level of MAS. Conclusion: it seemed the more effect of elastic stiffness in spasticity in CVA patients at lower level of MAS and more effect of viscose stiffness in higher level of MAS and also results showed the increment of viscose stiffness by increment of speed of motion and the rate of MAS.

  20. The effect of contact lens usage on corneal biomechanical parameters in myopic patients.

    Science.gov (United States)

    Cankaya, Ali B; Beyazyildiz, Emrullah; Ileri, Dilek; Ozturk, Faruk

    2012-07-01

    To determine and compare the corneal biomechanical properties in myopic patients who use contact lenses and those who do not use contact lenses. The study consisted of 56 myopic patients who used contact lenses (study group) and 123 myopic patients who did not use contact lenses (control group). Intraocular pressure (IOP) was measured with an ocular response analyzer (ORA) and a Goldmann applanation tonometer. Central corneal thickness was measured with an ultrasonic pachymeter. Axial length and anterior chamber depth measurements were acquired with contact ultrasound A-scan biometry. The differences in ORA parameters between study and control group participants were analyzed. The mean corneal hysteresis in study and control groups was 10.1 ± 1.6 mm Hg (6.5-15.9 mm Hg) and 9.7 ± 1.5 mm Hg (6.3-14.2 mm Hg), respectively (P = 0.16). The mean corneal resistance factor was 10.4 ± 1.9 mm Hg (4.6-15.5 mm Hg) in the study group compared with 9.6 ± 1.9 mm Hg (5.1-15.0 mm Hg) in the control group. The difference for corneal resistance factor was statistically significant (P = 0.014). There was no significant difference in corneal-compensated IOP (P = 0.24). Mean Goldmann-correlated IOP was significantly higher in the study group than in control subjects (15.8 ± 3.2 vs. 14.7 ± 3.7 mm Hg) (P = 0.044). None of the corneal biomechanical parameters was significantly correlated to duration of contact lens usage in the study group. Our results suggest that ORA-generated parameters may be different in subjects with and without contact lens usage. Further longitudinal studies need to be performed to establish the relevance of our results.

  1. TKA patients with unsatisfying knee function show changes in neuromotor synergy pattern but not joint biomechanics.

    Science.gov (United States)

    Ardestani, Marzieh M; Malloy, Philip; Nam, Denis; Rosenberg, Aaron G; Wimmer, Markus A

    2017-12-01

    Nearly 20% of patients who have undergone total knee arthroplasty (TKA) report persistent poor knee function. This study explores the idea that, despite similar knee joint biomechanics, the neuro-motor synergies may be different between high-functional and low-functional TKA patients. We hypothesized that (1) high-functional TKA recruit a more complex neuro-motor synergy pattern compared to low-functional TKA and (2) high-functional TKA patients demonstrate more stride-to-stride variability (flexibility) in their synergies. Gait and electromyography (EMG) data were collected during level walking for three groups of participants: (i) high-functional TKA patients (n=13); (ii) low-functional TKA patients (n=13) and (iii) non-operative controls (n=18). Synergies were extracted from EMG data using non-negative matrix factorization. Analysis of variance and Spearman correlation analyses were used to investigate between-group differences in gait and neuro-motor synergies. Results showed that synergy patterns were different among the three groups. Control subjects used 5-6 independent neural commands to execute a gait cycle. High functional TKA patients used 4-5 independent neural commands while low-functional TKA patients relied on only 2-3 independent neural commands to execute a gait cycle. Furthermore, stride-to-stride variability of muscles' response to the neural commands was reduced up to 15% in low-functional TKAs compared to the other two groups. Copyright © 2017 Elsevier Ltd. All rights reserved.

  2. THE CLINICAL, FUNCTIONAL AND BIOMECHANICAL PRESENTATION OF PATIENTS WITH SYMPTOMATIC HIP ABDUCTOR TENDON TEARS.

    Science.gov (United States)

    Ebert, Jay R; Retheesh, Theertha; Mutreja, Rinky; Janes, Gregory C

    2016-10-01

    Hip abductor tendon (HAT) tearing is commonly implicated in greater trochanteric pain syndrome (GTPS), though limited information exists on the disability associated with this condition and specific presentation of these patients. To describe the clinical, functional and biomechanical presentation of patients with symptomatic HAT tears. Secondary purposes were to investigate the association between these clinical and functional measures, and to compare the pain and disability reported by HAT tear patients to those with end-stage hip osteoarthritis (OA). Prospective case series. One hundred forty-nine consecutive patients with symptomatic HAT tears were evaluated using the Harris (HHS) and Oxford (OHS) Hip Scores, SF-12, an additional series of 10 questions more pertinent to those with lateral hip pain, active hip range of motion (ROM), maximal isometric hip abduction strength, six-minute walk capacity and 30-second single limb stance (SLS) test. The presence of a Trendelenburg sign and pelvis-on-femur (POF) angle were determined via 2D video analysis. An age matched comparative sample of patients with end-stage hip OA was recruited for comparison of all patient-reported outcome scores. Independent t-tests investigated group and limb differences, while analysis of variance evaluated pain changes during the functional tests. Pearson's correlation coefficients investigated the correlation between clinical measures in the HAT tear group. No differences existed in patient demographics and patient-reported outcome scores between HAT tear and hip OA cohorts, apart from significantly worse SF-12 mental subscale scores (p = 0.032) in the HAT tear group. Patients with HAT tears demonstrated significantly lower (p presentation of these patients. Level 3 case-controlled study, with matched comparison.

  3. Biomechanical Evaluation of a Bed Feature to Assist in Turning and Laterally Repositioning Patients.

    Science.gov (United States)

    Wiggermann, Neal

    2016-08-01

    This study investigated the effects of hospital bed features on the biomechanical stresses experienced by nurses when turning and laterally repositioning patients. Turn Assist, a common feature in ICU beds that helps to rotate patients, and side rail orientation were evaluated. Manual patient handling is a risk factor for musculoskeletal injury, and turning patients is one of the most common patient handling activities. No known studies have evaluated bed attributes such as the Turn Assist feature and side rail orientation that may affect the stresses experienced by the nurse. Nine female nurses laterally repositioned and turned a 63-kg and 123-kg subject on an ICU bed while motion capture, ground reaction forces, and hand force data were recorded. Loading of the spine and shoulder was modeled using 3D Static Strength Prediction Program (3DSSPP). Spine compression and shear forces did not exceed recommended limits when turning or laterally repositioning. However, the mean pull forces required to manually laterally reposition even the 63-kg subject was 340 Newtons, more than 50% greater than limits established in psychophysical testing. Turn Assist considerably reduced spine loading and pull forces for both turning and laterally repositioning. Lowering side rails reduced spinal compression by 11% when turning patients. Laterally repositioning patients as part of turning may pose an injury risk to caregivers. Turn Assist reduces physical loading on nurses when turning and repositioning patients. Caregivers should consider using Turn Assist and other aids such as mechanical lifts or sliding sheets especially when turning patients requires lateral repositioning. © 2015, Human Factors and Ergonomics Society.

  4. No effects of functional exercise therapy on walking biomechanics in patients with knee osteoarthritis

    DEFF Research Database (Denmark)

    Henriksen, Marius; Klokker, Louise; Bartholdy, Cecilie

    2016-01-01

    AIM: To assess the effects of a functional and individualised exercise programme on gait biomechanics during walking in people with knee OA. METHODS: Sixty participants were randomised to 12 weeks of facility-based functional and individualised neuromuscular exercise therapy (ET), 3 sessions per...... limited confidence in the findings due to multiple statistical tests and lack of biomechanical logics. Therefore we conclude that a 12-week supervised individualised neuromuscular exercise programme has no effects on gait biomechanics. Future studies should focus on exercise programmes specifically...

  5. Transference in the nurse-patient relationship.

    Science.gov (United States)

    Evans, A M

    2007-04-01

    The therapeutic relationship has been considered foundational to psychiatric nursing practice since at least the mid-20th century. However, this does not, in itself, guarantee either its continuity or relevance to current practice. Concepts such as the therapeutic relationship require sustained attention, both in theory and in practice, to illustrate ongoing relevance to the discipline. This paper addresses the therapeutic relationship in psychiatric nursing via aspects of psychoanalytic theory, particularly the notion of transference, as theorized by both Freud and Lacan. Two case fragments provide practice material, through which transference in the nurse-patient relationship is explored. The nurse, in the context of his/her relationship with the patient, a sick stranger, offers both a listening and the potential development of transference. This transference can be experienced, in part, as a form of attachment to the nurse, one that is not regarded pejoratively as dependency. There is the potential, within the nurse-patient relationship, for a psychical holding to develop, one from within which both the patient can speak and transference might arise. It is argued that listening to the patient has the potential to assist the patient and, with the development of transference, can provide the context for important work.

  6. Understanding how axial loads on the spine influence segmental biomechanics for idiopathic scoliosis patients: A magnetic resonance imaging study.

    Science.gov (United States)

    Little, J P; Pearcy, M J; Izatt, M T; Boom, K; Labrom, R D; Askin, G N; Adam, C J

    2016-02-01

    Segmental biomechanics of the scoliotic spine are important since the overall spinal deformity is comprised of the cumulative coronal and axial rotations of individual joints. This study investigates the coronal plane segmental biomechanics for adolescent idiopathic scoliosis patients in response to physiologically relevant axial compression. Individual spinal joint compliance in the coronal plane was measured for a series of 15 idiopathic scoliosis patients using axially loaded magnetic resonance imaging. Each patient was first imaged in the supine position with no axial load, and then again following application of an axial compressive load. Coronal plane disc wedge angles in the unloaded and loaded configurations were measured. Joint moments exerted by the axial compressive load were used to derive estimates of individual joint compliance. The mean standing major Cobb angle for this patient series was 46°. Mean intra-observer measurement error for endplate inclination was 1.6°. Following loading, initially highly wedged discs demonstrated a smaller change in wedge angle, than less wedged discs for certain spinal levels (+2,+1,-2 relative to the apex, (pbiomechanical data on in vivo spinal biomechanics of the scoliotic spine, for analysis of deformity progression and surgical planning. Copyright © 2015 Elsevier Ltd. All rights reserved.

  7. Patient transfers and risk of back injury

    DEFF Research Database (Denmark)

    Vinstrup, Jonas; Madeleine, Pascal; Jakobsen, Markus Due

    2017-01-01

    in Danish nurses during patient transfers performed with different types of assistive devices, and (2) to combine the exposure profile for each type of assistive device with fortnightly questionnaires to identify the importance of muscle load (intensity and frequency of transfers) and body position (degree...... which type of assistive devices most efficiently prevent LBP, exposure assessments using technological advancements allow for quantification of muscle load and body positions during common work tasks. OBJECTIVE: The main objectives of this study are (1) to quantify low back and neck/shoulder muscle load....... The prospective cohort study will consist of questionnaires at baseline and 1-year follow-up, as well as follow-up via email every other week for one year on questions regarding the frequency of patient transfers, use of assistive devices, intensity of LBP, and back injuries related to patient transfers...

  8. [A complex study of the movement biomechanics in patients with post-stroke hemiparesis].

    Science.gov (United States)

    Skvortsov, D V; Bulatova, M A; Kovrazhkina, E A; Suvorov, A Iu; Ivanova, G E; Skvortsova, V I

    2012-01-01

    The authors present results of a pilot study on biomechanics of non-cyclic movements of the human consequent verticalization in the ontogenesis of patients with post-stroke hemiparesis (10 patients in the acute stage of cerebral stroke) and 10 healthy volunteers without neurologic and orthopedic pathology. Some movements of therapeutic exercises Balance (a model of ontogenetic kinesitherapy) have been selected for the study. Cinematic parameters have been recorded using a system of motion 3D video analysis, a kinematic model was build in accordance to standard protocols. The skin (native and straightened) electromyogram (EMG) was recorded synchronously with kinematic data using 16-channel electromyography from the following pairs of muscles: mm. sternocleido-mastoideus, trapezius (горизонтальная порция), biceps brachii, triceps brachii, rectus femoris, adductor magnus. Major differences in the EMG picture between patients and controls were: 1) the EMG "monotony" with the involvement of multiple additional muscles in locomotions with the prevalence of the peculiar "tonic" muscle activity (low amplitudes without distinct peaks), stretching along the whole cycle of movement. In controls, EMG demonstrated variability and had mostly "phasic" character with distinct 1 or 2 peaks; 2) the asymmetry of EMG profile in symmetric movements. i.e. when performed simultaneously from the right and from the left sides. The latter feature may be considered as predictive because it was never found in healthy people. It allows to identify objectively weak muscles even in the absence of visible parethis during the routine neurological examination.

  9. Evaluation of corneal biomechanics in patients with keratectasia following LASIK using dynamic Scheimpflug analyzer.

    Science.gov (United States)

    Ueki, Ryotaro; Maeda, Naoyuki; Fuchihata, Mutsumi; Asai, Tomoko; Koh, Shizuka; Fujimoto, Hisataka; Uematsu, Masafumi; Nishida, Kohji

    2018-04-26

    To investigate the corneal biomechanics in eyes with keratectasia following LASIK using a dynamic Scheimpflug analyzer. Case-Control study. The subjects in the study included 12 eyes with keratectasia after LASIK (KE), 24 eyes with keratoconus (KC), 17 eyes without keratectasia after LASIK (LASIK), and 34 eyes with normal corneas (Normal). Corneal biomechanics of the four groups were evaluated using a dynamic Scheimpflug analyzer. Compared with Normal (7.06 ± 0.54), the radius at the highest concavity (radius, mm) of LASIK (5.96 ± 0.76), KE (4.93 ± 0.61) and KC (5.39 ± 1.02) were significantly small. The Deflection Amplitude (HCDLA, mm) of Normal (0.94 ± 0.07) was significantly lower than those of KE (1.11 ± 0.10) and KC (1.06 ± 0.16), and was not significantly different from that of LASIK (0.98 ± 0.07). There were significant differences between LASIK and KE in radius and HCDLA (P biomechanical features evaluated using the dynamic Scheimpflug analyzer suggest that biomechanical properties in eyes with keratectasia, keratoconus, and LASIK are different from those of normal eyes. Although the biomechanics in eyes with keratectasia differs from that in eyes with LASIK, it is similar to that in eyes with keratoconus.

  10. Concept Generation Process for Patient Transferring Device

    Science.gov (United States)

    Dandavate, A. L.; Sarje, S. H.

    2012-07-01

    In this paper, an attempt has been made to develop concepts for patient transferring tasks. The concept generation process of patient transferring device (PTD), which includes interviews of the customers, interpretation of the needs, organizing the needs into a hierarchy, establishing relative importance of the needs, establishing target specifications, and conceptualization has been discussed in this paper. The authors conducted the interviews of customers at Mobilink NGO, St. John's Hospital, Bangalore in order to know the needs and wants for the PTD. AHP technique was used for establishing and evaluating relative importance of needs, and based on the importance of the customer needs, concepts were developed through brainstorming.

  11. The transfer of strength and power into the stroke biomechanics of young swimmers over a 34-week period.

    Science.gov (United States)

    Morais, Jorge E; Silva, António J; Garrido, Nuno D; Marinho, Daniel A; Barbosa, Tiago M

    2018-03-24

    The purpose of this study was to learn the interplay between dry-land strength and conditioning, and stroke biomechanics in young swimmers, during a 34-week training programme. Twenty-seven swimmers (overall: 13.33 ± 0.85 years old; 11 boys: 13.5 ± 0.75 years old; 16 girls: 13.2 ± 0.92 years old) competing at regional- and national-level competitions were evaluated. The swimmers were submitted to a specific in-water and dry-land strength training over 34 weeks (and evaluated at three time points: pre-, mid-, and post-test; M1, M2, and M3, respectively). The 100-m freestyle performance was chosen as the main outcome (i.e. dependent variable). The arm span (AS; anthropometrics), throwing velocity (TV; strength), stroke length (SL), and stroke frequency (SF; kinematics) were selected as independent variables. There was a performance enhancement over time (M1 vs. M3: 68.72 ± 5.57 s, 66.23 ± 5.23 s; Δ = -3.77%; 95% CI: -3.98;-3.56) and an overall improvement of the remaining variables. At M1 and M2, all links between variables presented significant effects (p biomechanics parameters (SL and SF) increased. The model predicted 89%, 88%, and 92% of the performance at M1, M2, and M3, respectively, with a reasonable adjustment (i.e. goodness-of-fit M1: χ 2 /df = 3.82; M2: χ 2 /df = 3.08; M3: χ 2 /df = 4.94). These findings show that strength and conditioning parameters have a direct effect on the stroke biomechanics, and the latter one on the swimming performance.

  12. Muscle-skeletal model of the thigh: a tool for understanding the biomechanics of gait in patients with cerebral palsy

    Science.gov (United States)

    Ravera, Emiliano Pablo; Catalfamo Formento, Paola Andrea; José Crespo, Marcos; Andrés Braidot, Ariel

    2011-12-01

    Cerebral Palsy represents the most common cause of physical disability in modern world and within the pediatrics orthopedics units. The gait analysis provides great contributions to the understanding of gait disorders in CP. Giving a more comprehensive treatment plan, including or excluding surgical procedures that can potentially decrease the number of surgical interventions in the life of these patients. Recommendations for orthopedic surgery may be based on a quantitative description of how to alter the properties probably muscle force generation, and how this affects the action of the muscle to determine how these muscles, impaired by disease or surgery, contributing to the movement of the segments of the limb during crouch gait. So the causes and appropriate treatment of gait abnormalities are difficult to determine because the movements generated by the muscular forces of these patients are not clearly understood. A correct determination of the etiology of abnormal patterns of the knee is the key to select the appropriate therapy, presenting a major challenge at present since there is no theoretical basis to determine the biomechanical causes of abnormal gait of these patients. The potential and necessity of using correct biomechanical models that consistently study the abnormalities becomes clear. Reinforcing and correcting a simple gait analysis and eliminating the unknowns when selecting the appropriate treatment is crucial in clinical settings. In this paper a computer muscle-skeletal model is proposed. The model represents a person's thigh simulating the six most representative muscles and joints of the hip and knee. In this way you can have a better understanding of gait abnormalities present in these patients. So the quality of these estimates of individual muscle dynamics facilitate better understanding of the biomechanics of gait pathologies helping to reach better diagnosis prior to surgery and rehabilitation treatments.

  13. Muscle-skeletal model of the thigh: a tool for understanding the biomechanics of gait in patients with cerebral palsy

    International Nuclear Information System (INIS)

    Ravera, Emiliano Pablo; Catalfamo Formento, Paola Andrea; Crespo, Marcos José; Braidot, Ariel Andrés

    2011-01-01

    Cerebral Palsy represents the most common cause of physical disability in modern world and within the pediatrics orthopedics units. The gait analysis provides great contributions to the understanding of gait disorders in CP. Giving a more comprehensive treatment plan, including or excluding surgical procedures that can potentially decrease the number of surgical interventions in the life of these patients. Recommendations for orthopedic surgery may be based on a quantitative description of how to alter the properties probably muscle force generation, and how this affects the action of the muscle to determine how these muscles, impaired by disease or surgery, contributing to the movement of the segments of the limb during crouch gait. So the causes and appropriate treatment of gait abnormalities are difficult to determine because the movements generated by the muscular forces of these patients are not clearly understood. A correct determination of the etiology of abnormal patterns of the knee is the key to select the appropriate therapy, presenting a major challenge at present since there is no theoretical basis to determine the biomechanical causes of abnormal gait of these patients. The potential and necessity of using correct biomechanical models that consistently study the abnormalities becomes clear. Reinforcing and correcting a simple gait analysis and eliminating the unknowns when selecting the appropriate treatment is crucial in clinical settings. In this paper a computer muscle-skeletal model is proposed. The model represents a person's thigh simulating the six most representative muscles and joints of the hip and knee. In this way you can have a better understanding of gait abnormalities present in these patients. So the quality of these estimates of individual muscle dynamics facilitate better understanding of the biomechanics of gait pathologies helping to reach better diagnosis prior to surgery and rehabilitation treatments.

  14. Invertebrate biomechanics.

    Science.gov (United States)

    Patek, S N; Summers, A P

    2017-05-22

    Invertebrate biomechanics focuses on mechanical analyses of non-vertebrate animals, which at root is no different in aim and technique from vertebrate biomechanics, or for that matter the biomechanics of plants and fungi. But invertebrates are special - they are fabulously diverse in form, habitat, and ecology and manage this without the use of hard, internal skeletons. They are also numerous and, in many cases, tractable in an experimental and field setting. In this Primer, we will probe three axes of invertebrate diversity: worms (Phylum Annelida), spiders (Class Arachnida) and insects (Class Insecta); three habitats: subterranean, terrestrial and airborne; and three integrations with other fields: ecology, engineering and evolution. Our goal is to capture the field of invertebrate biomechanics, which has blossomed from having a primary focus on discoveries at the interface of physics and biology to being inextricably linked with integrative challenges that span biology, physics, mathematics and engineering. Copyright © 2017 Elsevier Ltd. All rights reserved.

  15. Computational biomechanics

    International Nuclear Information System (INIS)

    Ethier, C.R.

    2004-01-01

    Computational biomechanics is a fast-growing field that integrates modern biological techniques and computer modelling to solve problems of medical and biological interest. Modelling of blood flow in the large arteries is the best-known application of computational biomechanics, but there are many others. Described here is work being carried out in the laboratory on the modelling of blood flow in the coronary arteries and on the transport of viral particles in the eye. (author)

  16. Brief biomechanical analysis on the walking of spinal cord injury patients with a lower limb exoskeleton robot.

    Science.gov (United States)

    Jung, Jun-Young; Park, Hyunsub; Yang, Hyun-Dae; Chae, Mingi

    2013-06-01

    This paper presents a brief biomechanical analysis on the walking behavior of spinal cord injury (SCI) patients. It is known that SCI patients who have serious injuries to their spines cannot walk, and hence, several walking assistance lower limb exoskeleton robots have been proposed whose assistance abilities are shown to be well customized. However, these robots are not yet fully helpful to all SCI patients for several reasons. To overcome these problems, an exact analysis and evaluation of the restored walking function while the exoskeleton is worn is important. In this work, walking behavior of SCI patients wearing the rehabilitation of brain injuries (ROBIN) lower-limb walking assistant exoskeleton was analyzed in comparison to that of normal unassisted walking. The analysis method and results presented herein can be used by other researchers to improve their robots.

  17. Biomechanically acquired foot types

    International Nuclear Information System (INIS)

    Weissman, S.D.

    1989-01-01

    Over the years, orthopedics of the foot has gone through many stages and phases, each of which has spawned a whole vocabulary of its own. According the author, today we are in the biomechanical age, which represents a step forward in understanding the mechanisms governing the functions of the lower extremity. A great deal of scientific research on the various foot types and pathological entities is now being performed. This paper discusses how, from a radiographic point of view, a knowledge of certain angular relationships must be achieved before one can perform a biomechanical evaluation. In order to validate the gross clinical findings, following an examination of a patient, a biomechanical evaluation can be performed on the radiographs taken. It must be remembered, however, that x-rays are never the sole means of making a diagnosis. They are just one of many findings that must be put together to arrive at a pertinent clinical assessment or diagnosis

  18. Safety analysis of patient transfers and handling tasks.

    Science.gov (United States)

    Vieira, Er; Kumar, S

    2009-10-01

    Low-back disorders are related to biomechanical demands, and nurses are among the professionals with the highest rates. Quantification of risk factors is important for safety assessment and reduction of low-back disorders. This study aimed to quantify physical demands of frequent nursing tasks and provide evidence-based recommendations to increase low-back safety. Thirty-six volunteer female nurses participated in a cross-sectional study of nine nursing tasks. Lumbar range of motion (ROM) and motion during nursing tasks were measured. Compression and shear forces at L5/S1, ligament strain and percentage of population without sufficient torso strength to perform 14 phases of nine nursing tasks were estimated. Peak flexions during trolley-to-bed, bed-to-chair and chair-to-bed transfers reached the maximum flexion ROM of the nurses. Average lumbar flexion during trolley-to-bed transfers was >50% of flexion ROM, being higher than during all other tasks. Mean (SD) compression at L5/S1 (4754 N (437 N)) and population without sufficient torso strength (37% (9%)) were highest during the pushing phase of bed-to-trolley transfers. Shear force (487 N (40 N)) and ligament strain (14% (5%)) were highest during the pulling phase of trolley-to-bed transfers. Nursing tasks impose high biomechanical demands on the lumbar spine. Excessive lumbar flexion and forces are critical aspects of manual transfers requiring most of the nurses' capabilities. Evidence-based recommendations to improve low-back safety in common nursing tasks were provided. Fitness to work, job modifications and training programs can now be designed and assessed based on the results.

  19. Effect of biometric characteristics on biomechanical properties of the cornea in cataract patient.

    Science.gov (United States)

    Song, Xue-Fei; Langenbucher, Achim; Gatzioufas, Zisis; Seitz, Berthold; El-Husseiny, Moatasem

    2016-01-01

    To determine the impact of biometric characteristics on the biomechanical properties of the human cornea using the ocular response analyzer (ORA) and standard comprehensive ophthalmic examinations before and after standard phacoemulsification. This study comprised 54 eyes with cataract with significant lens opacification in stages I or II that underwent phacoemulsification (2.8 mm incision). Corneal hysteresis (CH), corneal resistance factor (CRF), Goldmann-correlated intraocular pressure (IOPg), and corneal-compensated intraocular pressure (IOPcc) were measured by ORA preoperatively and at 1mo postoperatively. Biometric characteristics were derived from corneal topography [TMS-5, anterior equivalent (EQTMS) and cylindric (CYLTMS) power], corneal tomography [Casia, anterior and posterior equivalent (EQaCASIC, EQpCASIA) and cylindric (CYLaCASIA, CYLpCASIA) power], keratometry [IOLMaster, anterior equivalent (EQIOL) and cylindric (CYLIOL) power] and autorefractor [anterior equivalent (EQAR)]. Results from ORA were analyzed and correlated with those from all other examinations taken at the same time point. Preoperatively, CH correlated with EQpCASIA and CYLpCASIA only (P=0.001, P=0.002). Postoperatively, IOPg and IOPcc correlated with all equivalent powers (EQTMS, EQIOL, EQAR, EQaCASIA and EQpCASIA) (P=0.001, P=0.007, P=0.001, P=0.015, P=0.03 for IOPg and PBiometric characteristics may significantly affect biomechanical properties of the cornea in terms of CH, IOPcc and IOPg before, but even more after cataract surgery.

  20. Electronic transfer of sensitive patient data.

    Science.gov (United States)

    Detterbeck, A M W; Kaiser, J; Hirschfelder, U

    2015-01-01

    The purpose of this study was to develop decision-making aids and recommendations for dental practitioners regarding the utilization and sharing of sensitive digital patient data. In the current environment of growing digitization, healthcare professionals need detailed knowledge of secure data management to maximize confidentiality and minimize the risks involved in both archiving patient data and sharing it through electronic channels. Despite well-defined legal requirements, an all-inclusive technological solution does not currently exist. The need for a preliminary review and critical appraisal of common practices of data transfer prompted a search of the literature and the Web to identify viable methods of secure data exchange and to develop a flowchart. A strong focus was placed on the transmission of datasets both smaller than and larger than 10 MB, and on secure communication by smartphone. Although encryption of patient-related data should be routine, it is often difficult to implement. Pretty Good Privacy (PGP) and Secure/Multipurpose Internet Mail Extensions (S/MIME) are viable standards for secure e-mail encryption. Sharing of high-volume data should be accomplished with the help of file encryption. Careful handling of sensitive patient data is mandatory, and it is the end-user's responsibility to meet any requirements for encryption, preferably by using free, open-source (and hence transparent) software.

  1. Effect of biometric characteristics on biomechanical properties of the cornea in cataract patient

    Directory of Open Access Journals (Sweden)

    Xue-Fei Song

    2016-06-01

    Full Text Available AIM: To determine the impact of biometric characteristics on the biomechanical properties of the human cornea using the ocular response analyzer (ORA and standard comprehensive ophthalmic examinations before and after standard phacoemulsification. METHODS: This study comprised 54 eyes with cataract with significant lens opacification in stages I or II that underwent phacoemulsification (2.8 mm incision. Corneal hysteresis (CH, corneal resistance factor (CRF, Goldmann-correlated intraocular pressure (IOPg, and corneal-compensated intraocular pressure (IOPcc were measured by ORA preoperatively and at 1mo postoperatively. Biometric characteristics were derived from corneal topography [TMS-5, anterior equivalent (EQTMS and cylindric (CYLTMS power], corneal tomography [Casia, anterior and posterior equivalent (EQaCASIC, EQpCASIA and cylindric (CYLaCASIA, CYLpCASIA power], keratometry [IOLMaster, anterior equivalent (EQIOL and cylindric (CYLIOL power] and autorefractor [anterior equivalent (EQAR]. Results from ORA were analyzed and correlated with those from all other examinations taken at the same time point. RESULTS: Preoperatively, CH correlated with EQpCASIA and CYLpCASIA only (P=0.001, P=0.002. Postoperatively, IOPg and IOPcc correlated with all equivalent powers (EQTMS, EQIOL, EQAR, EQaCASIA and EQpCASIA (P=0.001, P=0.007, P=0.001, P=0.015, P=0.03 for IOPg and P<0.001, P=0.003, P<0.001, P=0.009, P=0.014 for IOPcc. CH correlated postoperatively with EQaCASIA and EQpCASIC only (P=0.021, P=0.022. CONCLUSION: Biometric characteristics may significantly affect biomechanical properties of the cornea in terms of CH, IOPcc and IOPg before, but even more after cataract surgery.

  2. The attitudes of Australian radiography students towards the use of assistive transfer devices to reduce biomechanical stress in the clinical setting

    International Nuclear Information System (INIS)

    Ngo, Mark; Schneider-Kolsky, Michal; Baird, Marilyn

    2013-01-01

    The duties performed by radiographers, which includes transferring patients onto and off the examination table, can increase their risk of developing back and neck pain. This study used a survey to identify the assistive transfer devices Australian radiography undergraduate students are familiar with and have had practise using in the clinical setting. It also sought to determine whether students are being encouraged by other radiographers to use these devices during clinical training and if they would conform to practicing unsafe transfers if instructed to by senior staff. Results indicated that radiography students were familiar with the majority of the surveyed assistive devices such as the Patslide and X-ray cassette slider. Many of the students were unlikely to participate in unsafe work practices and were able to provide alternative methods of transferring patients. However, some of the respondents could be coerced into participating in unsafe patient transfers. Radiographers should therefore be vigilant in refraining from practicing unsafe transfer techniques as it could lead to students believing it is acceptable and emulating these practices in the work place

  3. Transfer of patients--from the spoke to the hub.

    LENUS (Irish Health Repository)

    Deasy, C

    2012-02-03

    We describe the nature, frequency, and characteristics of transfers to a regional centre. This was a three month prospective descriptive study of all transfers into the hospital through the ED and a further sample survey of 100 patients received into the resuscitation room over a 2 year period. 105 patient transfers were surveyed over the three month period. A significant number (43 patients) arrived at the ED without prior notification being received by ED staff, a proportion (7 patients) warranting resuscitation room assessment. The rate of Doctor Transfer was 22%. Of the 23 patients that warranted assessment in the resuscitation room 10 were unaccompanied by a Doctor and 5 were unaccompanied by either a Doctor or a Nurse. 11% of transfers had no transfer letter or radiographs. Only 51% of transferred patients had an IV line in situ. 4 out of the 8 transfers into the resuscitation room performed by interns were associated with adverse events. There continues to be problems with the quality of care that these patients receive. Clinicians must be actively involved in the development of regional transfer protocols and interfacility agreements to ensure the safe transfer of patients to definitive care.

  4. A dynamic 3D biomechanical evaluation of the load on the low back during different patient-handling tasks.

    Science.gov (United States)

    Skotte, J H; Essendrop, M; Hansen, A F; Schibye, B

    2002-10-01

    The objective of this study was to investigate the low-back loading during common patient-handling tasks. Ten female health care workers without formal training in patient handling performed nine patient-handling tasks including turning, lifting and repositioning a male stroke patient. The low-back loading was quantified by net moment, compression, and shear forces at the L4/L5 joint, measured muscle activity (EMG) in erector spinae muscles and rate of perceived exertion (RPE; Borg scale). The experiments were videotaped with a 50Hz video system using five cameras, and the ground and bedside reaction forces of the health care worker were recorded by means of force platforms and force transducers on the bed. The biomechanical load was calculated using a dynamic 3D seven-segment model of the lower part of the body, and the forces at the L4/L5 joint were estimated by a 14 muscles cross-sectional model of the low back (optimisation procedure). Compression force and torque showed high task dependency whereas the EMG data and the RPE values were more dependent on the subject. The peak compression during two tasks involving lifting the patient (4132/4433N) was significantly higher than all other tasks. Four tasks involving repositioning the patient in the bed (3179/3091/2932/3094N) did not differ, but showed higher peak compression than two tasks turning the patient in the bed (1618/2197N). Thus, in this study the patient-handling tasks could be classified into three groups-characterised by lifting, repositioning or turning-with different levels of peak net torque and compression at the L4/L5 joint.

  5. Shoulder biomechanics

    Energy Technology Data Exchange (ETDEWEB)

    Lugo, Roberto; Kung, Peter; Ma, C. Benjamin [Sports Medicine and Shoulder Service, University of California, San Francisco, 500 Parnassus Avenue, MU 320W-0728 San Francisco, CA 914143 (United States)], E-mail: maben@orthosurg.ucsf.edu

    2008-10-15

    The biomechanics of the glenohumeral joint depend on the interaction of both static and dynamic-stabilizing structures. Static stabilizers include the bony anatomy, negative intra-articular pressure, the glenoid labrum, and the glenohumeral ligaments along with the joint capsule. The dynamic-stabilizing structures include the rotator cuff muscles and the other muscular structures surrounding the shoulder joint. The combined effect of these stabilizers is to support the multiple degrees of motion within the glenohumeral joint. The goal of this article is to review how these structures interact to provide optimal stability and how failure of some of these mechanisms can lead to shoulder joint pathology.

  6. Biomechanics and muscle coordination of human walking. Part I: introduction to concepts, power transfer, dynamics and simulations.

    Science.gov (United States)

    Zajac, Felix E; Neptune, Richard R; Kautz, Steven A

    2002-12-01

    Current understanding of how muscles coordinate walking in humans is derived from analyses of body motion, ground reaction force and EMG measurements. This is Part I of a two-part review that emphasizes how muscle-driven dynamics-based simulations assist in the understanding of individual muscle function in walking, especially the causal relationships between muscle force generation and walking kinematics and kinetics. Part I reviews the strengths and limitations of Newton-Euler inverse dynamics and dynamical simulations, including the ability of each to find the contributions of individual muscles to the acceleration/deceleration of the body segments. We caution against using the concept of biarticular muscles transferring power from one joint to another to infer muscle coordination principles because energy flow among segments, even the adjacent segments associated with the joints, cannot be inferred from computation of joint powers and segmental angular velocities alone. Rather, we encourage the use of dynamical simulations to perform muscle-induced segmental acceleration and power analyses. Such analyses have shown that the exchange of segmental energy caused by the forces or accelerations induced by a muscle can be fundamentally invariant to whether the muscle is shortening, lengthening, or neither. How simulation analyses lead to understanding the coordination of seated pedaling, rather than walking, is discussed in this first part because the dynamics of pedaling are much simpler, allowing important concepts to be revealed. We elucidate how energy produced by muscles is delivered to the crank through the synergistic action of other non-energy producing muscles; specifically, that a major function performed by a muscle arises from the instantaneous segmental accelerations and redistribution of segmental energy throughout the body caused by its force generation. Part II reviews how dynamical simulations provide insight into muscle coordination of walking.

  7. Computational biomechanics for medicine from algorithms to models and applications

    CERN Document Server

    Joldes, Grand; Nielsen, Poul; Doyle, Barry; Miller, Karol

    2017-01-01

    This volume comprises the latest developments in both fundamental science and patient-specific applications, discussing topics such as: cellular mechanics; injury biomechanics; biomechanics of heart and vascular system; medical image analysis; and both patient-specific fluid dynamics and solid mechanics simulations. With contributions from researchers world-wide, the Computational Biomechanics for Medicine series of titles provides an opportunity for specialists in computational biomechanics to present their latest methodologies and advancements.

  8. [Biomechanical study of internal midface distraction after different types of maxillary osteotomy in patients with cleft lip and palate].

    Science.gov (United States)

    Hou, Min; Shi, Guang-Yu; Pu, Li-Chen; Song, Da-Li; Zhang, Xi-Zhong; Liu, Chun-Ming

    2009-09-01

    To investigate the biomechanical changes of internal midface distraction after different types of maxillary osteotomy in patients with cleft lip and palate (CLP). 3-D finite element (FEM) analysis was used. 3-D models of Le Fort I, II, III osteotomy and soft tissue were established. Based on the new pattern of internal midface distractor, the distraction of maxillary complex was simulated to advance 10 mm anteriorly. The mechanical change was studied. The maxillary complex in CLP were advanced after distraction. Constriction of alveolar crest and palate occurred in Le Fort I osteotomy, but not in Le Fort II and III osteotomy. The maxillary complex was moved anteriorly en bloc after Le Fort III osteotomy, but some degree of rotation of maxillary complex was observed during the distraction after Le Fort I and II osteotomy. In vertical direction, the maxillary complex had more counterclockwise rotation after Le Fort II osteotomy. 3-D FEM analysis can be used for the study of internal distraction. It can reflect the maxillary movement and provide the theory basis for preoperative design.

  9. SU-F-BRF-01: A GPU Framework for Developing Interactive High-Resolution Patient-Specific Biomechanical Models

    International Nuclear Information System (INIS)

    Neylon, J; Qi, S; Sheng, K; Kupelian, P; Santhanam, A

    2014-01-01

    Purpose: To develop a GPU-based framework that can generate highresolution and patient-specific biomechanical models from a given simulation CT and contoured structures, optimized to run at interactive speeds, for addressing adaptive radiotherapy objectives. Method: A Massspring-damping (MSD) model was generated from a given simulation CT. The model's mass elements were generated for every voxel of anatomy, and positioned in a deformation space in the GPU memory. MSD connections were established between neighboring mass elements in a dense distribution. Contoured internal structures allowed control over elastic material properties of different tissues. Once the model was initialized in GPU memory, skeletal anatomy was actuated using rigid-body transformations, while soft tissues were governed by elastic corrective forces and constraints, which included tensile forces, shear forces, and spring damping forces. The model was validated by applying a known load to a soft tissue block and comparing the observed deformation to ground truth calculations from established elastic mechanics. Results: Our analyses showed that both local and global load experiments yielded results with a correlation coefficient R 2 > 0.98 compared to ground truth. Models were generated for several anatomical regions. Head and neck models accurately simulated posture changes by rotating the skeletal anatomy in three dimensions. Pelvic models were developed for realistic deformations for changes in bladder volume. Thoracic models demonstrated breast deformation due to gravity when changing treatment position from supine to prone. The GPU framework performed at greater than 30 iterations per second for over 1 million mass elements with up to 26 MSD connections each. Conclusions: Realistic simulations of site-specific, complex posture and physiological changes were simulated at interactive speeds using patient data. Incorporating such a model with live patient tracking would facilitate real

  10. The history of biomechanics in total hip arthroplasty

    Directory of Open Access Journals (Sweden)

    Jan Van Houcke

    2017-01-01

    Full Text Available Biomechanics of the hip joint describes how the complex combination of osseous, ligamentous, and muscular structures transfers the weight of the body from the axial skeleton into the appendicular skeleton of the lower limbs. Throughout history, several biomechanical studies based on theoretical mathematics, in vitro, in vivo as well as in silico models have been successfully performed. The insights gained from these studies have improved our understanding of the development of mechanical hip pathologies such as osteoarthritis, hip fractures, and developmental dysplasia of the hip. The main treatment of end-stage degeneration of the hip is total hip arthroplasty (THA. The increasing number of patients undergoing this surgical procedure, as well as their demand for more than just pain relief and leading an active lifestyle, has challenged surgeons and implant manufacturers to deliver higher function as well as longevity with the prosthesis. The science of biomechanics has played and will continue to play a crucial and integral role in achieving these goals. The aim of this article, therefore, is to present to the readers the key concepts in biomechanics of the hip and their application to THA.

  11. Relationship between the Modified Modified Ashworth Scale and the Biomechanical Measure in Assessing Knee Extensor Muscle Spasticity in Patients with Post-Stroke Hemiparesia:A Pilot Study

    Directory of Open Access Journals (Sweden)

    N. Nakhostin Ansari

    2014-07-01

    Full Text Available Introduction & Objective: The Modified Modified Ashworth Scale (MMAS is a clinical meas-ure that has been recently developed for the assessment of muscle spasticity. There is a dearth of research on the validity of the MMAS. The aim of the present study was to investi-gate the relationship between the MMAS and the biomechanical measure of work-velocity slope in assessing knee extensor muscle spasticity in patients with hemiparesia. Materials & Methods: Fourteen patients with post-stroke hemiparesia were included in this cross sectional study. Knee extensor spasticity was assessed with MMAS. An isokinetic dy-namometer was used to impose knee passive flexion with the angular velocity of 10, 30, 60, and 90 °/Sec to measure Torque-angle data. Work (Joule was calculated at each velocity to determine the slope of the work-velocity curves as the biomechanical measure of muscle spasticity. Results: The mean work decreased as the velocity increased but was not statistically signifi-cant (P = 0.07. The mean slope was – 0.35 [J /(°/Sec]. There was no significant correlation between the MMAS and the work-velocity slope (r =0.31, P = 0.28. Conclusion: There was no significant relationship between the MMAS and the biomechanical measure of work-velocity slope. Further studies with larger sample size are suggested. (Sci J Hamadan Univ Med Sci 2014; 21 (2: 131-136

  12. Dinosaur biomechanics

    Science.gov (United States)

    Alexander, R. McNeill

    2006-01-01

    Biomechanics has made large contributions to dinosaur biology. It has enabled us to estimate both the speeds at which dinosaurs generally moved and the maximum speeds of which they may have been capable. It has told us about the range of postures they could have adopted, for locomotion and for feeding, and about the problems of blood circulation in sauropods with very long necks. It has made it possible to calculate the bite forces of predators such as Tyrannosaurus, and the stresses they imposed on its skull; and to work out the remarkable chewing mechanism of hadrosaurs. It has shown us how some dinosaurs may have produced sounds. It has enabled us to estimate the effectiveness of weapons such as the tail spines of Stegosaurus. In recent years, techniques such as computational tomography and finite element analysis, and advances in computer modelling, have brought new opportunities. Biomechanists should, however, be especially cautious in their work on animals known only as fossils. The lack of living specimens and even soft tissues oblige us to make many assumptions. It is important to be aware of the often wide ranges of uncertainty that result. PMID:16822743

  13. Biomechanics in Schools.

    Science.gov (United States)

    Vincent, J. F. V.

    1980-01-01

    Examines current usage of the term "biomechanics" and emphasizes the importance of differentiating between structure and material. Describes current prolects in biomechanics and lists four points about the educational significance of the field. (GS)

  14. Why National Biomechanics Day?

    Science.gov (United States)

    DeVita, Paul

    2018-04-11

    National Biomechanics Day (NBD) seeks to expand the influence and impact of Biomechanics on our society by expanding the awareness of Biomechanics among young people. NBD will manifest this goal through worldwide, synchronized and coordinated celebrations and demonstrations of all things Biomechanics with high school students. NBD invites all Biomechanists to participate in NBD 2018, http://nationalbiomechanicsday.asbweb.org/. Copyright © 2018 Elsevier Ltd. All rights reserved.

  15. Directing clinical care using lower extremity biomechanics in patients with ankle osteoarthritis and ankle arthroplasty.

    Science.gov (United States)

    Queen, Robin

    2017-11-01

    Ankle osteoarthritis is a debilitating disease with approximately 50,000 new cases per year leading to skeletal deformity, severe and recurrent pain, cartilage breakdown, and gait dysfunction limiting patient mobility and well-being. Although many treatments (total ankle arthroplasty [TAA], ankle fusion [arthrodesis], and ankle distraction arthroplasty) relieve pain, it is not clear that these procedures significantly improve patient mobility. The goal of the research presented here is to summarize what is presently known about lower extremity gait mechanics and outcomes and to quantify the impact of ankle osteoarthritis and TAA have on these measures using an explicitly holistic and mechanistic approach. Our recent studies have explored physical performance and energy recovery and revealed unexpected patterns and sequelae to treatment including incomplete restoration of gait function. These studies demonstrated for the first time the extreme levels and range of gait and balance dysfunction present in ankle osteoarthritis patients as well as quantifying the ways in which the affected joint alters movement and loading patterns not just in the painful joint, but throughout both the ipsilateral and contralateral lower extremity. Through this work, we determined that relieving pain alone through TAA is not enough to restore normal walking mechanics and balance due to underlying causes including limited ankle range of motion and balance deficits leading to long-term disability despite treatment. The results indicate the need to consider additional therapeutic interventions aimed at restoring balance, ankle range of motion, and movement symmetry in order to improve long-term health and function. © 2017 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 35:2345-2355, 2017. © 2017 Orthopaedic Research Society. Published by Wiley Periodicals, Inc.

  16. Research Techniques in Biomechanics.

    Science.gov (United States)

    Ward, Terry

    Biomechanics involves the biological human beings interacting with his/her mechanical environment. Biomechanics research is being done in connection with sport, physical education, and general motor behavior, and concerns mechanics independent of implements. Biomechanics research falls in the following two general categories: (1) that specific…

  17. Volumetry and biomechanical parameters detected by 3D and 2D ultrasound in patients with and without an abdominal aortic aneurysm.

    Science.gov (United States)

    Batagini, Nayara Cioffi; Ventura, Carlos Augusto Pinto; Raghavan, Madhavan L; Chammas, Maria Cristina; Tachibana, Adriano; da Silva, Erasmo Simão

    2016-06-01

    The objective was to demonstrate the ability of ultrasound (US) with 3D properties to evaluate volumetry and biomechanical parameters of the aorta in patients with and without abdominal aortic aneurysm (AAA). Thirty-one patients with normal aortas (group 1), 46 patients with AAA measuring 3.0-5.5 cm (group 2) and 31 patients with AAA ⩾ 5.5 cm (group 3) underwent a 2D/3D-US examination of the infra-renal aorta, and the images were post-processed prior to being analyzed. In the maximum diameter, the global circumferential strain and the global maximum rotation assessed by 2D speckle-tracking algorithms were compared among the three groups. The volumetry data obtained using 3D-US from 40 AAA patients were compared with the volumetry data obtained by a contemporary computed tomography (CT) scan. The median global circumferential strain was 2.0% (interquartile range (IR): 1.0-3.0), 1.0% (IR: 1.0-2.0) and 1.0% (IR: 1.0-1.75) in groups 1, 2 and 3, respectively (p volumetry and biomechanical characteristics of AAA. © The Author(s) 2016.

  18. The elderly patient with spinal injury: treat or transfer?

    Science.gov (United States)

    Barmparas, Galinos; Cooper, Zara; Haider, Adil H; Havens, Joaquim M; Askari, Reza; Salim, Ali

    2016-05-01

    The purpose of this investigation was to delineate whether elderly patients with spinal injuries benefit from transfers to higher level trauma centers. Retrospective review of the National Trauma Data Bank 2007 to 2011, including patients > 65 (y) with any spinal fracture and/or spinal cord injury from a blunt mechanism. Patients who were transferred to level I and II centers from other facilities were compared to those admitted and received their definitive treatment at level III or other centers. Of 3,313,117 eligible patients, 43,637 (1.3%) met inclusion criteria: 19,588 (44.9%) were transferred to level I-II centers, and 24,049 (55.1%) received definitive treatment at level III or other centers. Most of the patients (95.8%) had a spinal fracture without a spinal cord injury. Transferred patients were more likely to require an intensive care unit admission (48.5% versus 36.0%, P spinal cord injury (22.3% versus 21.0%, P elderly patients with spinal injuries to higher level trauma centers is not associated with improved survival. Future studies should explore the justifications used for these transfers and focus on other outcome measures such as functional status to determine the potential benefit from such practices. Copyright © 2016 Elsevier Inc. All rights reserved.

  19. INTERFACILITY TRANSFER OF PATIENTS IN SOUTH AFRICA ...

    African Journals Online (AJOL)

    Enrique

    Many people have medical aids to cover ... ment by appropriate transport teams so that the patient's level of care constantly increases. Central to ... that one must keep in mind and when there is ..... who had low concentrations of the hormone.

  20. Improving the transition of care in patients transferred through the ochsner medical center transfer center.

    Science.gov (United States)

    Amedee, Ronald G; Maronge, Genevieve F; Pinsky, William W

    2012-01-01

    Patient transfers from other hospitals within the Ochsner Health System to the main campus are coordinated through a Transfer Center that was established in fall 2008. We analyzed the transfer process to assess distinct opportunities to enhance the overall transition of patient care. We surveyed internal medicine residents and nocturnists to determine their satisfaction with transfers in terms of safety, efficiency, and usefulness of information provided at the time of transfer. After a kaizen event at which complementary goals for the institution and members of the study team were recognized and implemented, we resurveyed the group to evaluate improvement in the transfer process. The preintervention average satisfaction score was 1.18 (SD=0.46), while the postintervention score was 3.7 (SD=1.01). A t test showed a significant difference in the average scores between the preintervention and postintervention surveys (Pkaizen event), data were collected that facilitated fewer and higher quality handoffs that were performed in less time. In addition, the process resulted in increased awareness of the value of resident participation in institutional quality improvement projects.

  1. Doctor-Patient Knowledge Transfer: Innovative Technologies and Policy Implications

    OpenAIRE

    Sára, Zoltán; Csedő, Zoltán; Tóth, Tamás; Fejes, József; Pörzse, Gábor

    2013-01-01

    The aim of this study was to empirically investigate the barriers in doctor-patient communication and knowledge transfer and the role of innovative technologies in overcoming these barriers. We applied qualitative research methods. Our results show that patients extensively use information sources, primarily the Internet before the visits. Patients regularly apply a self-diagnosis regarding their diseases. This implies several risks as many of them are not able to properly inte...

  2. FUNDAMENTALS OF BIOMECHANICS

    Directory of Open Access Journals (Sweden)

    Duane Knudson

    2007-09-01

    Full Text Available DESCRIPTION This book provides a broad and in-depth theoretical and practical description of the fundamental concepts in understanding biomechanics in the qualitative analysis of human movement. PURPOSE The aim is to bring together up-to-date biomechanical knowledge with expert application knowledge. Extensive referencing for students is also provided. FEATURES This textbook is divided into 12 chapters within four parts, including a lab activities section at the end. The division is as follows: Part 1 Introduction: 1.Introduction to biomechanics of human movement; 2.Fundamentals of biomechanics and qualitative analysis; Part 2 Biological/Structural Bases: 3.Anatomical description and its limitations; 4.Mechanics of the musculoskeletal system; Part 3 Mechanical Bases: 5.Linear and angular kinematics; 6.Linear kinetics; 7.Angular kinetics; 8.Fluid mechanics; Part 4 Application of Biomechanics in Qualitative Analysis :9.Applying biomechanics in physical education; 10.Applying biomechanics in coaching; 11.Applying biomechanics in strength and conditioning; 12.Applying biomechanics in sports medicine and rehabilitation. AUDIENCE This is an important reading for both student and educators in the medicine, sport and exercise-related fields. For the researcher and lecturer it would be a helpful guide to plan and prepare more detailed experimental designs or lecture and/or laboratory classes in exercise and sport biomechanics. ASSESSMENT The text provides a constructive fundamental resource for biomechanics, exercise and sport-related students, teachers and researchers as well as anyone interested in understanding motion. It is also very useful since being clearly written and presenting several ways of examples of the application of biomechanics to help teach and apply biomechanical variables and concepts, including sport-related ones

  3. A proactive transfer policy for critical patient flow management.

    Science.gov (United States)

    González, Jaime; Ferrer, Juan-Carlos; Cataldo, Alejandro; Rojas, Luis

    2018-02-17

    Hospital emergency departments are often overcrowded, resulting in long wait times and a public perception of poor attention. Delays in transferring patients needing further treatment increases emergency department congestion, has negative impacts on their health and may increase their mortality rates. A model built around a Markov decision process is proposed to improve the efficiency of patient flows between the emergency department and other hospital units. With each day divided into time periods, the formulation estimates bed demand for the next period as the basis for determining a proactive rather than reactive transfer decision policy. Due to the high dimensionality of the optimization problem involved, an approximate dynamic programming approach is used to derive an approximation of the optimal decision policy, which indicates that a certain number of beds should be kept free in the different units as a function of the next period demand estimate. Testing the model on two instances of different sizes demonstrates that the optimal number of patient transfers between units changes when the emergency patient arrival rate for transfer to other units changes at a single unit, but remains stable if the change is proportionally the same for all units. In a simulation using real data for a hospital in Chile, significant improvements are achieved by the model in key emergency department performance indicators such as patient wait times (reduction higher than 50%), patient capacity (21% increase) and queue abandonment (from 7% down to less than 1%).

  4. Coupling biomechanics to a cellular level model: an approach to patient-specific image driven multi-scale and multi-physics tumor simulation.

    Science.gov (United States)

    May, Christian P; Kolokotroni, Eleni; Stamatakos, Georgios S; Büchler, Philippe

    2011-10-01

    Modeling of tumor growth has been performed according to various approaches addressing different biocomplexity levels and spatiotemporal scales. Mathematical treatments range from partial differential equation based diffusion models to rule-based cellular level simulators, aiming at both improving our quantitative understanding of the underlying biological processes and, in the mid- and long term, constructing reliable multi-scale predictive platforms to support patient-individualized treatment planning and optimization. The aim of this paper is to establish a multi-scale and multi-physics approach to tumor modeling taking into account both the cellular and the macroscopic mechanical level. Therefore, an already developed biomodel of clinical tumor growth and response to treatment is self-consistently coupled with a biomechanical model. Results are presented for the free growth case of the imageable component of an initially point-like glioblastoma multiforme tumor. The composite model leads to significant tumor shape corrections that are achieved through the utilization of environmental pressure information and the application of biomechanical principles. Using the ratio of smallest to largest moment of inertia of the tumor material to quantify the effect of our coupled approach, we have found a tumor shape correction of 20% by coupling biomechanics to the cellular simulator as compared to a cellular simulation without preferred growth directions. We conclude that the integration of the two models provides additional morphological insight into realistic tumor growth behavior. Therefore, it might be used for the development of an advanced oncosimulator focusing on tumor types for which morphology plays an important role in surgical and/or radio-therapeutic treatment planning. Copyright © 2011 Elsevier Ltd. All rights reserved.

  5. Measurement of action forces and posture to determine the lumbar load of healthcare workers during care activities with patient transfers.

    Science.gov (United States)

    Theilmeier, Andreas; Jordan, Claus; Luttmann, Alwin; Jäger, Matthias

    2010-11-01

    Moving patients or other care activities with manual patient handling is characterized by high mechanical load on the lumbar spine of healthcare workers (HCWs). During the patient transfer activity, the caregivers exert lifting, pulling, and pushing forces varying over time with respect to amplitude and direction. Furthermore, the caregivers distinctly change their posture and frequently obtain postures asymmetrical to the median sagittal plane, including lateral bending and turning the trunk. This paper describes a procedure to determine lumbar load during patient transfer supported by measurement techniques and an exemplary application; this methodology represents the basis of a complex research project, the third 'Dortmund Lumbar Load Study (DOLLY 3)'. Lumbar load was determined by simulation calculations using a comprehensive biomechanical model ('The Dortmunder'). As the main influencing factors, the hand forces of the caregiver exerted during typical patient transfers and the posture and movements of the HCW were recorded in laboratory studies. The action forces were determined three-dimensionally with the help of a newly developed 'measuring bed', two different 'measuring chairs', a 'measuring bathtub', and a 'measuring floor'. To capture the forces during transfers in or at the bed, a common hospital bed was equipped with an additional framework, which is attached to the bedstead and connected to the bedspring frame via three-axial force sensors at the four corners. The other measuring systems were constructed similarly. Body movements were recorded using three-dimensional optoelectronic recording tools and video recordings. The posture and force data served as input data for the quantification of various lumbar-load indicators.

  6. Biomechanics of coupled motion in the cervical spine during simulated whiplash in patients with pre-existing cervical or lumbar spinal fusion

    Science.gov (United States)

    Huang, H.; Nightingale, R. W.

    2018-01-01

    Objectives Loss of motion following spine segment fusion results in increased strain in the adjacent motion segments. However, to date, studies on the biomechanics of the cervical spine have not assessed the role of coupled motions in the lumbar spine. Accordingly, we investigated the biomechanics of the cervical spine following cervical fusion and lumbar fusion during simulated whiplash using a whole-human finite element (FE) model to simulate coupled motions of the spine. Methods A previously validated FE model of the human body in the driver-occupant position was used to investigate cervical hyperextension injury. The cervical spine was subjected to simulated whiplash exposure in accordance with Euro NCAP (the European New Car Assessment Programme) testing using the whole human FE model. The coupled motions between the cervical spine and lumbar spine were assessed by evaluating the biomechanical effects of simulated cervical fusion and lumbar fusion. Results Peak anterior longitudinal ligament (ALL) strain ranged from 0.106 to 0.382 in a normal spine, and from 0.116 to 0.399 in a fused cervical spine. Strain increased from cranial to caudal levels. The mean strain increase in the motion segment immediately adjacent to the site of fusion from C2-C3 through C5-C6 was 26.1% and 50.8% following single- and two-level cervical fusion, respectively (p = 0.03, unpaired two-way t-test). Peak cervical strains following various lumbar-fusion procedures were 1.0% less than those seen in a healthy spine (p = 0.61, two-way ANOVA). Conclusion Cervical arthrodesis increases peak ALL strain in the adjacent motion segments. C3-4 experiences greater changes in strain than C6-7. Lumbar fusion did not have a significant effect on cervical spine strain. Cite this article: H. Huang, R. W. Nightingale, A. B. C. Dang. Biomechanics of coupled motion in the cervical spine during simulated whiplash in patients with pre-existing cervical or lumbar spinal fusion: A Finite Element Study. Bone

  7. Biomechanics of coupled motion in the cervical spine during simulated whiplash in patients with pre-existing cervical or lumbar spinal fusion: A Finite Element Study.

    Science.gov (United States)

    Huang, H; Nightingale, R W; Dang, A B C

    2018-01-01

    Loss of motion following spine segment fusion results in increased strain in the adjacent motion segments. However, to date, studies on the biomechanics of the cervical spine have not assessed the role of coupled motions in the lumbar spine. Accordingly, we investigated the biomechanics of the cervical spine following cervical fusion and lumbar fusion during simulated whiplash using a whole-human finite element (FE) model to simulate coupled motions of the spine. A previously validated FE model of the human body in the driver-occupant position was used to investigate cervical hyperextension injury. The cervical spine was subjected to simulated whiplash exposure in accordance with Euro NCAP (the European New Car Assessment Programme) testing using the whole human FE model. The coupled motions between the cervical spine and lumbar spine were assessed by evaluating the biomechanical effects of simulated cervical fusion and lumbar fusion. Peak anterior longitudinal ligament (ALL) strain ranged from 0.106 to 0.382 in a normal spine, and from 0.116 to 0.399 in a fused cervical spine. Strain increased from cranial to caudal levels. The mean strain increase in the motion segment immediately adjacent to the site of fusion from C2-C3 through C5-C6 was 26.1% and 50.8% following single- and two-level cervical fusion, respectively (p = 0.03, unpaired two-way t -test). Peak cervical strains following various lumbar-fusion procedures were 1.0% less than those seen in a healthy spine (p = 0.61, two-way ANOVA). Cervical arthrodesis increases peak ALL strain in the adjacent motion segments. C3-4 experiences greater changes in strain than C6-7. Lumbar fusion did not have a significant effect on cervical spine strain. Cite this article : H. Huang, R. W. Nightingale, A. B. C. Dang. Biomechanics of coupled motion in the cervical spine during simulated whiplash in patients with pre-existing cervical or lumbar spinal fusion: A Finite Element Study. Bone Joint Res 2018;7:28-35. DOI: 10

  8. Biomechanics principles and practices

    CERN Document Server

    Peterson, Donald R

    2014-01-01

    Presents Current Principles and ApplicationsBiomedical engineering is considered to be the most expansive of all the engineering sciences. Its function involves the direct combination of core engineering sciences as well as knowledge of nonengineering disciplines such as biology and medicine. Drawing on material from the biomechanics section of The Biomedical Engineering Handbook, Fourth Edition and utilizing the expert knowledge of respected published scientists in the application and research of biomechanics, Biomechanics: Principles and Practices discusses the latest principles and applicat

  9. Impact of Using a Robot Patient for Nursing Skill Training in Patient Transfer

    Science.gov (United States)

    Huang, Zhifeng; Lin, Chingszu; Kanai-Pak, Masako; Maeda, Jukai; Kitajima, Yasuko; Nakamura, Mitsuhiro; Kuwahara, Noriaki; Ogata, Taiki; Ota, Jun

    2017-01-01

    In the past few decades, simulation training has been used to help nurses improve their patient-transfer skills. However, the effectiveness of such training remains limited because it lacks effective ways of simulating patients' actions realistically. It is difficult for nurses to use the skills learned from simulation training to transfer an…

  10. Gingival Recessions and Biomechanics

    DEFF Research Database (Denmark)

    Laursen, Morten Godtfredsen

    Gingival recessions and biomechanics “Tissue is the issue, but bone sets the tone.“ A tooth outside the cortical plate can result in loss of bone and development of a gingival recession. The presentation aims to show biomechanical considerations in relation to movement of teeth with gingival...... by moving the root back in the alveolus. The tooth movement is accompanied by bone gain and thus increase the success rate for soft tissue augmentation. The choice of biomechanical system influences the treatment outcome. If a standard straight wire appliance is used, a biomechanical dilemma can arise...

  11. Methodology based on genetic heuristics for in-vivo characterizing the patient-specific biomechanical behavior of the breast tissues.

    Science.gov (United States)

    Lago, M A; Rúperez, M J; Martínez-Martínez, F; Martínez-Sanchis, S; Bakic, P R; Monserrat, C

    2015-11-30

    This paper presents a novel methodology to in-vivo estimate the elastic constants of a constitutive model proposed to characterize the mechanical behavior of the breast tissues. An iterative search algorithm based on genetic heuristics was constructed to in-vivo estimate these parameters using only medical images, thus avoiding invasive measurements of the mechanical response of the breast tissues. For the first time, a combination of overlap and distance coefficients were used for the evaluation of the similarity between a deformed MRI of the breast and a simulation of that deformation. The methodology was validated using breast software phantoms for virtual clinical trials, compressed to mimic MRI-guided biopsies. The biomechanical model chosen to characterize the breast tissues was an anisotropic neo-Hookean hyperelastic model. Results from this analysis showed that the algorithm is able to find the elastic constants of the constitutive equations of the proposed model with a mean relative error of about 10%. Furthermore, the overlap between the reference deformation and the simulated deformation was of around 95% showing the good performance of the proposed methodology. This methodology can be easily extended to characterize the real biomechanical behavior of the breast tissues, which means a great novelty in the field of the simulation of the breast behavior for applications such as surgical planing, surgical guidance or cancer diagnosis. This reveals the impact and relevance of the presented work.

  12. Online Learning of Safe Patient Transfers in Occupational Therapy Education

    Directory of Open Access Journals (Sweden)

    Cynthia L. Hayden D. H. Ed., OTR/L, CHT

    2013-02-01

    Full Text Available Online higher education is steadily increasing. For programs in allied health to be offered effectively in an elearning format, clinical psychomotor skills need to be addressed. The aim of this research was to design, implement, and evaluate an online safe patient transfers module for occupational therapy assistant (OTAstudents. The efficacy of teaching safe patient transfers in an e-learning environment was appraised using both quantitative and qualitative analysis. The applied research project was completed at a Tennessee community college. A convenience sample of eighteen students participated in the pilot study. Twenty-five studentsparticipated in the subsequent study. The instructional design of the course was based on Mager’s CriterionReferenced Instruction model. Streaming video was used as the delivery method for course material. A pretest/posttest evaluated the students’ cognitive knowledge of safe patient transfers. A behavioral transferscompetency checklist was used to rate videotapes of students’ performance of assisted stand pivot and dependent sliding board transfers. Research findings indicated students were able to learn this psychomotor clinical skill online with beginning proficiency. A paired t-test showed marked improvement of cognitive knowledge. A student learning survey revealed the majority of students preferred at least one hands-on classroom session where instructor feedback and interaction with classmates confirmed safe and effectiveclinical technique.

  13. Brillouin microscopy: assessing ocular tissue biomechanics.

    Science.gov (United States)

    Yun, Seok Hyun; Chernyak, Dimitri

    2018-07-01

    Assessment of corneal biomechanics has been an unmet clinical need in ophthalmology for many years. Many researchers and clinicians have identified corneal biomechanics as source of variability in refractive procedures and one of the main factors in keratoconus. However, it has been difficult to accurately characterize corneal biomechanics in patients. The recent development of Brillouin light scattering microscopy heightens the promise of bringing biomechanics into the clinic. The aim of this review is to overview the progress and discuss prospective applications of this new technology. Brillouin microscopy uses a low-power near-infrared laser beam to determine longitudinal modulus or mechanical compressibility of tissue by analyzing the return signal spectrum. Human clinical studies have demonstrated significant difference in the elastic properties of normal corneas versus corneas diagnosed with mild and severe keratoconus. Clinical data have also shown biomechanical changes after corneal cross-linking treatment of keratoconus patients. Brillouin measurements of the crystalline lens and sclera have also been demonstrated. Brillouin microscopy is a promising technology under commercial development at present. The technique enables physicians to characterize the biomechanical properties of ocular tissues.

  14. WE-AB-BRA-02: Development of Biomechanical Models to Describe Dose-Volume Response to Liver Stereotactic Body Radiation Therapy (SBRT) Patients

    International Nuclear Information System (INIS)

    McCulloch, M; Polan, D; Feng, M; Lawrence, T; Haken, R Ten; Brock, K

    2015-01-01

    Purpose: Previous studies have shown that radiotherapy treatment for liver metastases causes marked liver hypertrophy in areas receiving low dose and atrophy/fibrosis in areas receiving high dose. The purpose of this work is to develop and evaluate a biomechanical model-based dose-response model to describe these liver responses to SBRT. Methods: In this retrospective study, a biomechanical model-based deformable registration algorithm, Morfeus, was expanded to include dose-based boundary conditions. Liver and tumor volumes were contoured on the planning images and CT/MR images three months post-RT and converted to finite element models. A thermal expansion-based relationship correlating the delivered dose and volume response was generated from 22 patients previously treated. This coefficient, combined with the planned dose, was applied as an additional boundary condition to describe the volumetric response of the liver of an additional cohort of metastatic liver patients treated with SBRT. The accuracy of the model was evaluated based on overall volumetric liver comparisons and the target registration error (TRE) using the average deviations in positions of identified vascular bifurcations on each set of registered images, with a target accuracy of the 2.5mm isotropic dose grid (vector dimension 4.3mm). Results: The thermal expansion coefficient models the volumetric change of the liver to within 3%. The accuracy of Morfeus with dose-expansion boundary conditions a TRE of 5.7±2.8mm compared to 11.2±3.7mm using rigid registration and 8.9±0.28mm using Morfeus with only spatial boundary conditions. Conclusion: A biomechanical model has been developed to describe the volumetric and spatial response of the liver to SBRT. This work will enable the improvement of correlating functional imaging with delivered dose, the mapping of the delivered dose from one treatment onto the planning images for a subsequent treatment, and will further provide information to assist

  15. Using business intelligence for efficient inter-facility patient transfer.

    Science.gov (United States)

    Haque, Waqar; Derksen, Beth Ann; Calado, Devin; Foster, Lee

    2015-01-01

    In the context of inter-facility patient transfer, a transfer operator must be able to objectively identify a destination which meets the needs of a patient, while keeping in mind each facility's limitations. We propose a solution which uses Business Intelligence (BI) techniques to analyze data related to healthcare infrastructure and services, and provides a web based system to identify optimal destination(s). The proposed inter-facility transfer system uses a single data warehouse with an Online Analytical Processing (OLAP) cube built on top that supplies analytical data to multiple reports embedded in web pages. The data visualization tool includes map based navigation of the health authority as well as an interactive filtering mechanism which finds facilities meeting the selected criteria. The data visualization is backed by an intuitive data entry web form which safely constrains the data, ensuring consistency and a single version of truth. The overall time required to identify the destination for inter-facility transfers is reduced from hours to a few minutes with this interactive solution.

  16. Biomechanical and neuromuscular adaptations during the landing phase of a stepping-down task in patients with early or established knee osteoarthritis.

    Science.gov (United States)

    Sanchez-Ramirez, Diana C; Malfait, Bart; Baert, Isabel; van der Leeden, Marike; van Dieën, Jaap; Lems, Willem F; Dekker, Joost; Luyten, Frank P; Verschueren, Sabine

    2016-06-01

    To compare the knee joint kinematics, kinetics and EMG activity patterns during a stepping-down task in patients with knee osteoarthritis (OA) with control subjects. 33 women with knee OA (early OA, n=14; established OA n=19) and 14 female control subjects performed a stepping-down task from a 20cm step. Knee joint kinematics, kinetics and EMG activity were recorded on the stepping-down leg during the loading phase. During the stepping-down task patients with established knee OA showed greater normalized medial hamstrings activity (p=0.034) and greater vastus lateralis-medial hamstrings co-contraction (p=0.012) than controls. Greater vastus medialis-medial hamstrings co-contraction was found in patients with established OA compared to control subjects (p=0.040) and to patients with early OA (p=0.023). Self-reported knee instability was reported in 7% and 32% of the patients with early and established OA, respectively. The greater EMG co-activity found in established OA might suggest a less efficient use of knee muscles or an attempt to compensate for greater knee laxity usually present in patients with established OA. In the early stage of the disease, the biomechanical and neuromuscular control of stepping-down is not altered compared to healthy controls. Copyright © 2016 Elsevier B.V. All rights reserved.

  17. Effects of bilateral swing-away grab bars on the biomechanics of stand-to-sit and sit-to-stand toilet transfers.

    Science.gov (United States)

    Lee, Su Jin; Mehta-Desai, Ricky; Oh, Kyunggeune; Sanford, Jon; Prilutsky, Boris I

    2018-03-09

    Kinetic characteristics of transfers to and from a toilet performed using bilateral grab bars are not fully quantified to inform grab bar design and configuration. The purpose of this study was to (1) determine effects of bilateral swing-away grab bars on peaks of ankle, knee and hip joint moments during grab bar assisted stand-to-sit and sit-to-stand transfers; and (2) determine effects of three different heights and widths of swing-away grab bars on the same kinetic characteristics. Healthy subjects (N = 11, age 25-58 years) performed stand-to-sit and sit-to-stand transfers with and without grab bars. In transfers with grab bars, 9 grab bar configurations were tested by varying their height from the floor (0.787 m, 0.813 m, 0.838 m; 31″-33″) and width, the distance of each grab bar from the toilet's centerline (0.330 m, 0.356 m, 0.381 m; 13″-15″). Motion capture, force plate and inverse dynamics analysis were used to determine lower limb joint moments. The use of bilateral grab bars generally reduced the peak magnitude of extension moments at lower limb joints during stand-to-sit and sit-to-stand transfers (p away grab bars is useful for informing grab bar design and configuration recommendations for assisted living and skilled nursing facilities. Our findings suggest that the swing-away grab bars located at certain ranges are a reasonable alternative to the grab bars mandated by the current Americans with Disabilities Act (ADA) Accessibility Guidelines. Future research investigating the effects of grab bars on transfer performance should consider additional factors, such as a wider range of abilities and transfer methods of the users.

  18. Development and testing of emergency department patient transfer communication measures.

    Science.gov (United States)

    Klingner, Jill; Moscovice, Ira

    2012-01-01

    Communication problems are a major contributing factor to adverse events in hospitals.(1) The contextual environment in small rural hospitals increases the importance of emergency department (ED) patient transfer communication quality. This study addresses the communication problems through the development and testing of ED quality measurement of interfacility patient transfer communication. Input from existing measures, measurement and health care delivery experts, as well as hospital frontline staff was used to design and modify ED quality measures. Three field tests were conducted to determine the feasibility of data collection and the effectiveness of different training methods and types of partnerships. Measures were evaluated based on their prevalence, ease of data collection, and usefulness for internal and external improvement. It is feasible to collect ED quality measure data. Different data sources, data collection, and data entry methods, training and partners can be used to examine hospital ED quality. There is significant room for improvement in the communication of patient information between health care facilities. Current health care reform efforts highlight the importance of clear communication between organizations held accountable for patient safety and outcomes. The patient transfer communication measures have been tested in a wide range of rural settings and have been vetted nationally. They have been endorsed by the National Quality Forum, are included in the National Quality Measurement Clearinghouse supported by the Agency for Health Care Research and Quality (AHRQ), and are under consideration by the Centers for Medicare and Medicaid Services for future payment determinations beginning in calendar year 2013. © 2011 National Rural Health Association.

  19. Biomechanics of the brain

    CERN Document Server

    Miller, Karol

    2011-01-01

    With contributions from scientists at major institutions, this book presents an introduction to brain anatomy for engineers and scientists. It provides, for the first time, a comprehensive resource in the field of brain biomechanics.

  20. Computational modeling in biomechanics

    CERN Document Server

    Mofrad, Mohammad

    2010-01-01

    This book provides a glimpse of the diverse and important roles that modern computational technology is playing in various areas of biomechanics. It includes unique chapters on ab initio quantum mechanical, molecular dynamic and scale coupling methods..

  1. Biomechanics of Spider Silks

    Science.gov (United States)

    2006-03-02

    water and deformation conditions. Such fibres [Nexia ’ biosteel ’ silk ] were spun from recombinant silk ’cloned’ from Spidroin II and indeed show 67...SUBTITLE 5. FUNDING NUMBERS Biomechanics of Spider Silks F49620-03-1-0111 6. AUTHOR(S) Fritz Vollrath 7. PERFORMING ORGANIZATION NAME(S) AND ADDRESS(ES...Perform Pro, WHSIDIOR, Oct 94 COVER SHEET FINAL (3rd Year) Report to AFOSR on: BIOMECHANICS OF SPIDER SILKS Fritz Vollrath, Oxford University, England

  2. Biomechanics and tennis.

    Science.gov (United States)

    Elliott, B

    2006-05-01

    Success in tennis requires a mix of player talent, good coaching, appropriate equipment, and an understanding of those aspects of sport science pertinent to the game. This paper outlines the role that biomechanics plays in player development from sport science and sport medicine perspectives. Biomechanics is a key area in player development because all strokes have a fundamental mechanical structure and sports injuries primarily have a mechanical cause.

  3. Transfer of Patients in a Telestroke Network: What Are the Relevant Factors for Making This Decision?

    Science.gov (United States)

    Klingner, Carsten M; Brodoehl, Stefan; Funck, Laura; Klingner, Caroline C; Berrouschot, Jörg; Witte, Otto W; Günther, Albrecht

    2018-02-01

    Background/Introduction: Current telestroke network consultations are focused on decision-making in the hyperacute stage of stroke management. The two main questions in telestroke consultations are whether thrombolysis should be initiated and whether the patient should be transferred to a hub hospital. Although guidelines exist for initiating intravenous thrombolytic therapy, the question of whether patients should be transferred is far more elusive. In this study, we investigated the factors involved in the decision to transfer stroke patients to a hub hospital. We were particularly interested in identifying factors that promote or impede the transfer of patients. We enrolled 1,615 cases of telestroke consultation of the University Hospital Jena. The two main factors that independently influenced the probability of transferring a patient were the patient's age and the identification of a proximal vessel occlusion. Interestingly, factors such as the severity of symptoms and the time elapsed from symptom onset were not found to have an independent influence on the decision to transfer a patient. The transfer of most patients was justified by the possibility of performing interventional reperfusion therapy. We discuss the effectiveness of the current decision-making process and possible ways to improve decision-making for a more effective selection of patients who would benefit from transfer. The decision-making process to a transfer patient is not standardized and constitutes a trade-off between the intention to treat all possible patients while avoiding the transfer of patients without treatment options.

  4. What happens to patients on antiretroviral therapy who transfer out to another facility?

    Directory of Open Access Journals (Sweden)

    Joseph Kwong-Leung Yu

    Full Text Available BACKGROUND: Long term retention of patients on antiretroviral therapy (ART in Africa's rapidly expanding programmes is said to be 60% at 2 years. Many reports from African ART programmes make little mention of patients who are transferred out to another facility, yet Malawi's national figures show a transfer out of 9%. There is no published information about what happens to patients who transfer-out, but this is important because if they transfer-in and stay alive in these other facilities then national retention figures will be better than previously reported. METHODOLOGY/PRINCIPAL FINDINGS: Of all patients started on ART over a three year period in Mzuzu Central Hospital, North Region, Malawi, those who transferred out were identified from the ART register and master cards. Clinic staff attempted to trace these patients to determine whether they had transferred in to a new ART facility and their outcome status. There were 805 patients (19% of the total cohort who transferred out, of whom 737 (92% were traced as having transferred in to a new ART facility, with a median time of 1.3 months between transferring-out and transferring-in. Survival probability was superior and deaths were lower in the transfer-out patients compared with those who did not transfer. CONCLUSION/SIGNIFICANCE: In Mzuzu Central Hospital, patients who transfer-out constitute a large proportion of patients not retained on ART at their original clinic of registration. Good documentation of transfer-outs and transfer-ins are needed to keep track of national outcomes. Furthermore, the current practice of regarding transfer-outs as being double counted in national cohorts and subtracting this number from the total national registrations to get the number of new patients started on ART is correct.

  5. Tennis elbow: a biomechanical and therapeutic approach.

    Science.gov (United States)

    Schnatz, P; Steiner, C

    1993-07-01

    Lateral epicondylitis, one of the most common lesions of the arm, affects some 50% of tennis players. This condition poses a problem in clinical management because treatment is dependent not only on proper medical therapy but also on correction of the improper on-court biomechanics. The most common flaw is a late contact on the backhand groundstroke, forcing the player to extend the wrist with the extensor muscles. This action predisposes to trauma of the tendon fibers at the lateral epicondyle. Understanding the biomechanics will better prepare the physician to advise the patient and to communicate with a tennis teaching professional to facilitate long-term relief.

  6. Dr Dapertutto's biomechanics

    Directory of Open Access Journals (Sweden)

    Stojmenović Dragan

    2015-01-01

    Full Text Available The subject matter of the research is the basic models of Meyerhold's biomechanics, which were used to define its theoretical principles. Professor Meyerhold, the theatrical leader of an eccentric stream, with which he changed the modern understanding of the theatre, established the technique of biomechanics by analysing the calculated type of movement. The analysis determines the answers to the questions: What kind of influence does Taylor's 'scientific management of work' have on defining the principles of Meyerhold's techniques of biomechanics? Which aesthetic models of stage movement were some of the basic subjects of Meyerhold's research? Meyerhold's theatrical work has been researched by a number of theatre theorists. However, how much does his work influence the film medium?.

  7. Trainees' perceptions of practitioner competence during patient transfer.

    Science.gov (United States)

    Grierson, Lawrence; Dubrowski, Adam; So, Steph; Kistner, Nicole; Carnahan, Heather

    2012-01-01

    Technical and communicative skills are both important features for one's perception of practitioner competence. This research examines how trainees' perceptions of practitioner competence change as they view health care practitioners who vary in their technical and communicative skill proficiencies. Occupational therapy students watched standardized encounters of a practitioner performing a patient transfer in combinations of low and high technical and communicative proficiency and then reported their perceptions of practitioner competence. The reports indicate that technical and communicative skills have independently identifiable impacts on the perceptions of practitioner competency, but technical proficiency has a special impact on the students' perceptions of practitioner communicative competence. The results are discussed with respect to the way in which students may evaluate their own competence on the basis of either technical or communicative skill. The issue of how this may lead trainees to dedicate their independent learning efforts to an incomplete set of features needed for the development of practitioner competency is raised.

  8. Transfer

    DEFF Research Database (Denmark)

    Wahlgren, Bjarne; Aarkrog, Vibe

    Bogen er den første samlede indføring i transfer på dansk. Transfer kan anvendes som praksis-filosofikum. Den giver en systematisk indsigt til den studerende, der spørger: Hvordan kan teoretisk viden bruges til at reflektere over handlinger i situationer, der passer til min fremtidige arbejdsplads?...

  9. Mathematical foundations of biomechanics.

    Science.gov (United States)

    Niederer, Peter F

    2010-01-01

    The aim of biomechanics is the analysis of the structure and function of humans, animals, and plants by means of the methods of mechanics. Its foundations are in particular embedded in mathematics, physics, and informatics. Due to the inherent multidisciplinary character deriving from its aim, biomechanics has numerous connections and overlapping areas with biology, biochemistry, physiology, and pathophysiology, along with clinical medicine, so its range is enormously wide. This treatise is mainly meant to serve as an introduction and overview for readers and students who intend to acquire a basic understanding of the mathematical principles and mechanics that constitute the foundation of biomechanics; accordingly, its contents are limited to basic theoretical principles of general validity and long-range significance. Selected examples are included that are representative for the problems treated in biomechanics. Although ultimate mathematical generality is not in the foreground, an attempt is made to derive the theory from basic principles. A concise and systematic formulation is thereby intended with the aim that the reader is provided with a working knowledge. It is assumed that he or she is familiar with the principles of calculus, vector analysis, and linear algebra.

  10. Biomechanical pulping of kenaf

    Science.gov (United States)

    Aziz Ahmed; Masood Akhtar; Gary C. Myers; Gary M. Scott

    1999-01-01

    The objective of this study was to investigate the effect of fungal pretreatment of whole kenaf prior to refining on refiner electrical energy consumption, paper strength, and optical properties. We also explored the suitability of whole kenaf biomechanical pulp for making newsprint in terms of ISO brightness and strength properties. Kenaf was sterilized by autoclaving...

  11. Biomechanics of footwear.

    Science.gov (United States)

    Snijders, C J

    1987-07-01

    This article discusses biomechanical principles that indicate a number of basic design criteria for shoes and the properties of good footwear in terms of normal daily activities at home, at school, and at work. These properties also apply to normal occupational footwear and safety footwear.

  12. Patient Perspectives on Gene Transfer Therapy for Sickle Cell Disease.

    Science.gov (United States)

    Strong, Heather; Mitchell, Monica J; Goldstein-Leever, Alana; Shook, Lisa; Malik, Punam; Crosby, Lori E

    2017-08-01

    Sickle cell disease (SCD) is a chronic genetic disease with high morbidity and early mortality; it affects nearly 100,000 individuals in the USA. Bone marrow transplantation, the only curative treatment, is available to less than 20% of patients because of a number of access barriers. Gene transfer therapy (GTT) has been shown to be curative in animal models and is approved for use in humans for early-phase studies at a few centers. GTT would offer a more accessible treatment option available to all patients. It is important to understand patient perspectives on GTT to help ensure human clinical trial success. Two focus groups were conducted with younger (18-30 years) and older (31 years and older) adults with SCD to obtain data on patient knowledge and beliefs about GTT. Data from these two focus groups was used to develop a GTT educational brochure. A third focus group was conducted to obtain participant feedback on acceptability and feasibility of education and the brochure. Most adults, especially young adults, had little knowledge about GTT and expressed fear and uncertainty about the side effects of chemotherapy (e.g., hair loss, infertility), use of a human immunodeficiency virus (HIV)-derived viral vector, and potential for cancer risk. Participants wanted full transparency in educational materials, but advised researchers not to share the vector's relation to HIV because of cultural stigma and no HIV virus is used for the GTT vector. Older adults had more desire to participate in human clinical GTT trials than younger participants. When recruiting for trials, researchers should develop GTT educational materials that address participant lack of trust in the healthcare system, cultural beliefs, fears related to side effects, and include visual illustrations. Use of such materials will provide adults with SCD the information they need to fully evaluate GTT.

  13. Evaluation of ceiling lifts: transfer time, patient comfort and staff perceptions.

    Science.gov (United States)

    Alamgir, Hasanat; Li, Olivia Wei; Yu, Shicheng; Gorman, Erin; Fast, Catherine; Kidd, Catherine

    2009-09-01

    Mechanical lifting devices have been developed to reduce healthcare worker injuries related to patient handling. The purpose of this study was to evaluate ceiling lifts in comparison to floor lifts based on transfer time, patient comfort and staff perceptions in three long-term care facilities with varying ceiling lift coverage. The time required to transfer or reposition patients along with patient comfort levels were recorded for 119 transfers. Transfers performed with ceiling lifts required on average less time (bed to chair transfers: 156.9 seconds for ceiling lift, 273.6 seconds for floor lift) and were found to be more comfortable for patients. In the three facilities, 143 healthcare workers were surveyed on their perceptions of patient handling tasks and equipment. For both transferring and repositioning tasks, staff preferred to use ceiling lifts and also found them to be less physically demanding. Further investigation is needed on repositioning tasks to ensure safe practice.

  14. COBRA 9121: Federal liability for patient screening and transfer.

    Science.gov (United States)

    Frew, S A

    1988-01-01

    Health care is no longer a simple cottage industry of individual providers. Increases in competition and government regulation have transformed the old structure of health care into a fend-for-yourself marketplace dominated by multi-institutional corporations. In order to accomplish this change, health care providers have had to alter their locus of attention from the patient to the bottom line. As a result, it is not surprising to find corporate business practices interspersed among the traditional health care practices. On March 1, 1987, the federal government began an assault on a casualty of this new market oriental philosophy, patient transfers or "dumping". COBRA 9121 is an "anti-dumping" law designed to prevent hospitals from continuing this practice. The vehicle for ensuring that the statute's broad provisions are followed is a set of "sudden death" probations. For example, under COBRA, hospitals found guilty of knowing or negligent violations may be suspended or terminated from receiving all Medicare reimbursement. One way to avoid these "sudden death" probations is to understand the implications of this law.

  15. Transferring skills in quality collaboratives focused on improving patient logistics.

    Science.gov (United States)

    Weggelaar-Jansen, Anne Marie; van Wijngaarden, Jeroen

    2018-04-02

    A quality improvement collaborative, often used by the Institute for Healthcare Improvement, is used to educate healthcare professionals and improve healthcare at the same time. However, no prior research has been done on the knowledge and skills healthcare professionals need to achieve improvements or the extent to which quality improvement collaboratives help enhance both knowledge and skills. Our research focused on quality improvement collaboratives aiming to improve patient logistics and tried to identify which knowledge and skills are required and to what extent these were enhanced during the QIC. We defined skills important for logistic improvements in a three-phase Delphi study. Based on the Delphi results we made a questionnaire. We surveyed participants in a national quality improvement collaborative to assess the skills rated as 1) important, 2) available and 3) improved during the collaborative. At two sense-making meetings, experts reflected on our findings and hypothesized on how to improve (logistics) collaboratives. The Delphi study found 18 skills relevant for reducing patient access time and 21 for reducing throughput time. All skills retrieved from the Delphi study were scored as 'important' in the survey. Teams especially lacked soft skills connected to project and change management. Analytical skills increased the most, while more reflexive skills needed for the primary goal of the collaborative (reduce access and throughput times) increased modestly. At two sense-making meetings, attendees suggested four improvements for a quality improvement collaborative: 1) shift the focus to project- and change management skills; 2) focus more on knowledge transfer to colleagues; 3) teach participants to adapt the taught principles to their own situations; and 4) foster intra-project reflexive learning to translate gained insights to other projects (inter-project learning). Our findings seem to suggest that Quality collaboratives could benefit if more

  16. Biomechanical implications of lumbar spinal ligament transection.

    Science.gov (United States)

    Von Forell, Gregory A; Bowden, Anton E

    2014-11-01

    Many lumbar spine surgeries either intentionally or inadvertently damage or transect spinal ligaments. The purpose of this work was to quantify the previously unknown biomechanical consequences of isolated spinal ligament transection on the remaining spinal ligaments (stress transfer), vertebrae (bone remodelling stimulus) and intervertebral discs (disc pressure) of the lumbar spine. A finite element model of the full lumbar spine was developed and validated against experimental data and tested in the primary modes of spinal motion in the intact condition. Once a ligament was removed, stress increased in the remaining spinal ligaments and changes occurred in vertebral strain energy, but disc pressure remained similar. All major biomechanical changes occurred at the same spinal level as the transected ligament, with minor changes at adjacent levels. This work demonstrates that iatrogenic damage to spinal ligaments disturbs the load sharing within the spinal ligament network and may induce significant clinically relevant changes in the spinal motion segment.

  17. The effect of a combined glenoid and Hill-Sachs defect on glenohumeral stability: a biomechanical cadaveric study using 3-dimensional modeling of 142 patients.

    Science.gov (United States)

    Arciero, Robert A; Parrino, Anthony; Bernhardson, Andrew S; Diaz-Doran, Vilmaris; Obopilwe, Elifho; Cote, Mark P; Golijanin, Petr; Mazzocca, Augustus D; Provencher, Matthew T

    2015-06-01

    Bone loss in anterior glenohumeral instability occurs on both the glenoid and the humerus; however, existing biomechanical studies have evaluated glenoid and humeral head defects in isolation. Thus, little is known about the combined effect of these bony lesions in a clinically relevant model on glenohumeral stability. The purpose of this study was to determine the biomechanical efficacy of a Bankart repair in the setting of bipolar (glenoid and humeral head) bone defects determined via computer-generated 3-dimensional (3D) modeling of 142 patients with recurrent anterior shoulder instability. The null hypothesis was that adding a bipolar bone defect will have no effect on glenohumeral stability after soft tissue Bankart repair. Controlled laboratory study. A total of 142 consecutive patients with recurrent anterior instability were analyzed with 3D computed tomography scans. Two Hill-Sachs lesions were selected on the basis of volumetric size representing the 25th percentile (0.87 cm(3); small) and 50th percentile (1.47 cm(3); medium) and printed in plastic resin with a 3D printer. A total of 21 cadaveric shoulders were evaluated on a custom shoulder-testing device permitting 6 degrees of freedom, and the force required to translate the humeral head anteriorly 10 mm at a rate of 2.0 mm/s with a compressive load of 50 N was determined at 60° of glenohumeral abduction and 60° of external rotation. All Bankart lesions were made sharply from the 2- to 6-o'clock positions for a right shoulder. Subsequent Bankart repair with transosseous tunnels using high-strength suture was performed. Hill-Sachs lesions were made in the cadaver utilizing a plastic mold from the exact replica off the 3D printer. Testing was conducted in the following sequence for each specimen: (1) intact, (2) posterior capsulotomy, (3) Bankart lesion, (4) Bankart repair, (5) Bankart lesion with 2-mm glenoid defect, (6) Bankart repair, (7) Bankart lesion with 2-mm glenoid defect and Hill-Sachs lesion

  18. INTER-HOSPITAL TRANSFER OF TRAUMA PATIENTS IN A DEVELOPING COUNTRY: A PROSPECTIVE DESCRIPTIVE STUDY

    Directory of Open Access Journals (Sweden)

    Vikas Verma

    2013-12-01

    Full Text Available Introduction: During interhospital transfer patients are at risk due to possibility of serious complications. There are no guidelines governing the transfer of injured patients in India. It is important to identify the extent of the problem in the transfer process of the injured transferred to the trauma centre.Methods: On arrival in the Emergency Department patients were assessed for clinical status and the Glasgow Coma Score (GCS. The transfer vehicle was evaluated and the accompanying transfer personnel was interviewed to record details of the transfer process, training of the transfer personnel, adequacy of the transfer vehicle and its outfitted monitoring equipment. Data communicated to the trauma centre from the referring hospitals were also collected from the transfer records. The transferred group was compared to the non-transferred group.Results: Of the 592 patients admitted, 572 consented to the study. 327 were referred patients and 245 were directly admitted patients. Patients referred from peripheral hospitals had significantly lower GCS, higher ISS, higher admission gap and longer duration of hospital stay. The date and time of injury was documented in none of the referred patients, referral time in 44 (13.71% cases, pulse rate in 110(34.38% patients, blood pressure in 112 (34.25% cases. The request for transfer was made in only 3 (0.93% cases. Twelve cases (3.66% were accompanied by a paramedic or a nurse. Intravenous access and infusions in progress were present in 192/327 (58.71% transferred patients. Urethral catheters were present in 49 (15.17% patients. Only 9/327 (2.79% transferred patients had hard cervical immobilization. Hypotension at admission defined as a systolic BP < 120mm of Hg was present in 106 referred admitted cases. Conclusion: This study suggests that the injured patients are not being transferred in a manner that is consistent with evidence based guidelines which are known to minimize the known hazards of

  19. A Patient Specific Biomechanical Analysis of Custom Root Analogue Implant Designs on Alveolar Bone Stress: A Finite Element Study

    Directory of Open Access Journals (Sweden)

    David Anssari Moin

    2016-01-01

    Full Text Available Objectives. The aim of this study was to analyse by means of FEA the influence of 5 custom RAI designs on stress distribution of peri-implant bone and to evaluate the impact on microdisplacement for a specific patient case. Materials and Methods. A 3D surface model of a RAI for the upper right canine was constructed from the cone beam computed tomography data of one patient. Subsequently, five (targeted press-fit design modification FE models with five congruent bone models were designed: “Standard,” “Prism,” “Fins,” “Plug,” and “Bulbs,” respectively. Preprocessor software was applied to mesh the models. Two loads were applied: an oblique force (300 N and a vertical force (150 N. Analysis was performed to evaluate stress distributions and deformed contact separation at the peri-implant region. Results. The lowest von Mises stress levels were numerically observed for the Plug design. The lowest levels of contact separation were measured in the Fins model followed by the Bulbs design. Conclusions. Within the limitations of the applied methodology, adding targeted press-fit geometry to the RAI standard design will have a positive effect on stress distribution, lower concentration of bone stress, and will provide a better primary stability for this patient specific case.

  20. TRANSFER

    African Journals Online (AJOL)

    This paper reports on further studies on long range energy transfer between curcumine as donor and another thiazine dye, thionine, which is closely related to methylene blue as energy harvester (Figure 1). Since thionine is known to have a higher quantum yield of singlet oxygen sensitization than methylene blue [8], it is ...

  1. Interhospital Transfer of Neurosurgical Patients: Implications of Timing on Hospital Course and Clinical Outcomes.

    Science.gov (United States)

    Holland, Christopher M; Lovasik, Brendan P; Howard, Brian M; McClure, Evan W; Samuels, Owen B; Barrow, Daniel L

    2017-09-01

    Interhospital transfer of neurosurgical patients is common; however, little is known about the impact of transfer parameters on clinical outcomes. Lower survival rates have been reported for patients admitted at night and on weekends in other specialties. Whether time or day of admission affects neurosurgical patient outcomes, specifically those transferred from other facilities, is unknown. To examine the impact of the timing of interhospital transfer on the hospital course and clinical outcomes of neurosurgical patients. All consecutive admissions of patients transferred to our adult neurosurgical service were retrospectively analyzed for a 1-year study period using data from a central transfer database and the electronic health record. Patients arrived more often at night (70.8%) despite an even distribution of transfer requests. The lack of transfer imaging did not affect length of stay, intervention times, or patient outcomes. Daytime arrivals had shorter total transfer time, but longer intenstive care unit and overall length of stay (8.7 and 11.6 days, respectively), worse modified Rankin Scale scores, lower rates of functional independence, and almost twice the mortality rate. Weekend admissions had significantly worse modified Rankin Scale scores and lower rates of functional independence. The timing of transfer arrivals, both by hour or day of the week, is correlated with the time to intervention, hospital course, and overall patient outcomes. Patients admitted during the weekend suffered worse functional outcomes and a trend towards increased mortality. While transfer logistics clearly impact patient outcomes, further work is needed to understand these complex relationships. Copyright © 2017 by the Congress of Neurological Surgeons.

  2. Decreased plasma cholesterol esterification and cholesteryl ester transfer in hypopituitary patients on glucocorticoid replacement therapy

    NARCIS (Netherlands)

    Beentjes, JAM; Van Tol, A; Sluiter, WJ; Dullaart, RPF

    Cardiovascular risk is increased in hypopituitary patients. No data are available with respect to the effect of glucocorticoid replacement therapy on high density lipoproteins (HDL) metabolism in such patients. Plasma lecithin:choresterol acyl transferase (LCAT), cholesteryl ester transfer protein

  3. Biomechanical interpretation of a free-breathing lung motion model

    International Nuclear Information System (INIS)

    Zhao Tianyu; White, Benjamin; Lamb, James; Low, Daniel A; Moore, Kevin L; Yang Deshan; Mutic, Sasa; Lu Wei

    2011-01-01

    The purpose of this paper is to develop a biomechanical model for free-breathing motion and compare it to a published heuristic five-dimensional (5D) free-breathing lung motion model. An ab initio biomechanical model was developed to describe the motion of lung tissue during free breathing by analyzing the stress–strain relationship inside lung tissue. The first-order approximation of the biomechanical model was equivalent to a heuristic 5D free-breathing lung motion model proposed by Low et al in 2005 (Int. J. Radiat. Oncol. Biol. Phys. 63 921–9), in which the motion was broken down to a linear expansion component and a hysteresis component. To test the biomechanical model, parameters that characterize expansion, hysteresis and angles between the two motion components were reported independently and compared between two models. The biomechanical model agreed well with the heuristic model within 5.5% in the left lungs and 1.5% in the right lungs for patients without lung cancer. The biomechanical model predicted that a histogram of angles between the two motion components should have two peaks at 39.8° and 140.2° in the left lungs and 37.1° and 142.9° in the right lungs. The data from the 5D model verified the existence of those peaks at 41.2° and 148.2° in the left lungs and 40.1° and 140° in the right lungs for patients without lung cancer. Similar results were also observed for the patients with lung cancer, but with greater discrepancies. The maximum-likelihood estimation of hysteresis magnitude was reported to be 2.6 mm for the lung cancer patients. The first-order approximation of the biomechanical model fit the heuristic 5D model very well. The biomechanical model provided new insights into breathing motion with specific focus on motion trajectory hysteresis.

  4. Pediatric patients transferred for operative management of appendicitis: are they at a disadvantage?

    Science.gov (United States)

    Farach, Sandra M; Danielson, Paul D; Walford, N Elizabeth; Harmel, Richard P; Chandler, Nicole M

    2015-09-01

    Many pediatric patients are initially diagnosed with appendicitis at referring hospitals and are subsequently transferred to pediatric facilities. We aimed to compare outcomes of patients transferred to a pediatric referral center to those who present primarily for operative management of appendicitis. A retrospective review of 326 patients with operative appendicitis from July 2012 to July 2013 was performed. Demographic data, clinical parameters, and outcomes were analyzed. Transferred (n=222, 68%) and primary patients (n=104, 32%) were similar except for mean age (primary 12.4 vs. transferred 11.2 years, pprimary patients. Primary patients were more likely to present between the hours of 09:00 and 17:59 (52%), while transferred arrived equally across all hours. Both groups were more likely to present with acute appendicitis (primary 56% vs. transfer 61%, p=NS). There was no difference in time of diagnosis to time of appendectomy, length of hospital stay, or 30 day complications (primary 8.6% vs. transfer 5.8%, p=NS). Patients transferred for definitive care of appendicitis are not found to have more advanced disease or have increased complications; however, they are exposed to significantly more ionizing radiation during evaluation for appendicitis. Copyright © 2015 Elsevier Inc. All rights reserved.

  5. Using Six Sigma methodology to reduce patient transfer times from floor to critical-care beds.

    Science.gov (United States)

    Silich, Stephan J; Wetz, Robert V; Riebling, Nancy; Coleman, Christine; Khoueiry, Georges; Abi Rafeh, Nidal; Bagon, Emma; Szerszen, Anita

    2012-01-01

    In response to concerns regarding delays in transferring critically ill patients to intensive care units (ICU), a quality improvement project, using the Six Sigma process, was undertaken to correct issues leading to transfer delay. To test the efficacy of a Six Sigma intervention to reduce transfer time and establish a patient transfer process that would effectively enhance communication between hospital caregivers and improve the continuum of care for patients. The project was conducted at a 714-bed tertiary care hospital in Staten Island, New York. A Six Sigma multidisciplinary team was assembled to assess areas that needed improvement, manage the intervention, and analyze the results. The Six Sigma process identified eight key steps in the transfer of patients from general medical floors to critical care areas. Preintervention data and a root-cause analysis helped to establish the goal transfer-time limits of 3 h for any individual transfer and 90 min for the average of all transfers. The Six Sigma approach is a problem-solving methodology that resulted in almost a 60% reduction in patient transfer time from a general medical floor to a critical care area. The Six Sigma process is a feasible method for implementing healthcare related quality of care projects, especially those that are complex. © 2011 National Association for Healthcare Quality.

  6. Cost Savings Associated with the Adoption of a Cloud Computing Data Transfer System for Trauma Patients.

    Science.gov (United States)

    Feeney, James M; Montgomery, Stephanie C; Wolf, Laura; Jayaraman, Vijay; Twohig, Michael

    2016-09-01

    Among transferred trauma patients, challenges with the transfer of radiographic studies include problems loading or viewing the studies at the receiving hospitals, and problems manipulating, reconstructing, or evalu- ating the transferred images. Cloud-based image transfer systems may address some ofthese problems. We reviewed the charts of patients trans- ferred during one year surrounding the adoption of a cloud computing data transfer system. We compared the rates of repeat imaging before (precloud) and af- ter (postcloud) the adoption of the cloud-based data transfer system. During the precloud period, 28 out of 100 patients required 90 repeat studies. With the cloud computing transfer system in place, three out of 134 patients required seven repeat films. There was a statistically significant decrease in the proportion of patients requiring repeat films (28% to 2.2%, P < .0001). Based on an annualized volume of 200 trauma patient transfers, the cost savings estimated using three methods of cost analysis, is between $30,272 and $192,453.

  7. No effects of functional exercise therapy on walking biomechanics in patients with knee osteoarthritis: exploratory outcome analyses from a randomised trial

    OpenAIRE

    Henriksen, Marius; Klokker, Louise; Bartholdy, Cecilie; Schjoedt-Jorgensen, Tanja; Bandak, Elisabeth; Bliddal, Henning

    2017-01-01

    Aim To assess the effects of a functional and individualised exercise programme on gait biomechanics during walking in people with knee OA. Methods Sixty participants were randomised to 12 weeks of facility-based functional and individualised neuromuscular exercise therapy (ET), 3 sessions per week supervised by trained physical therapists, or a no attention control group (CG). Three-dimensional gait analyses were used, from which a comprehensive list of conventional gait variables were extra...

  8. Nursing staff's communication modes in patient transfer before and after an educational intervention.

    Science.gov (United States)

    Kindblom-Rising, Kristina; Wahlstrom, Rolf; Ekman, Sirkka-Liisa; Buer, Nina; Nilsson-Wikmar, Lena

    2010-10-01

    The objective was to explore and describe nursing staff's body awareness and communication in patient transfers and evaluate any changes made after an educational intervention to promote staff competence in guiding patients to move independently. In total, 63 nursing staff from two hospitals wrote weekly notes before and after the intervention. The topics were: A) reflect on a transfer during the last week that you consider was good and one that was poor; B) reflect on how your body felt during a good and a poor transfer. The notes were analysed with content analysis. The results showed five different communication modes connected with nursing staff's physical and verbal communication. These communication modes changed after 1 year to a more verbal communication, focusing on the patient's mobility. The use of instructions indicated a new or different understanding of patient transfer, which may contribute to a development of nursing staff's competence. STATEMENT OF RELEVANCE: The present findings indicate that patient transfer consists of communication. Therefore, verbal and bodily communication can have an integral part of training in patient transfer; furthermore, the educational design of such programmes is important to reach the goal of developing new understanding and enhancing nursing staff's competence in patient transfer.

  9. No effects of functional exercise therapy on walking biomechanics in patients with knee osteoarthritis: exploratory outcome analyses from a randomised trial.

    Science.gov (United States)

    Henriksen, Marius; Klokker, Louise; Bartholdy, Cecilie; Schjoedt-Jorgensen, Tanja; Bandak, Elisabeth; Bliddal, Henning

    2016-01-01

    To assess the effects of a functional and individualised exercise programme on gait biomechanics during walking in people with knee OA. Sixty participants were randomised to 12 weeks of facility-based functional and individualised neuromuscular exercise therapy (ET), 3 sessions per week supervised by trained physical therapists, or a no attention control group (CG). Three-dimensional gait analyses were used, from which a comprehensive list of conventional gait variables were extracted (totally 52 kinematic, kinetic and spatiotemporal variables). According to the protocol, the analyses were based on the 'Per-Protocol' population (defined as participants following the protocol with complete and valid gait analyses). Analysis of covariance adjusting for the level at baseline was used to determine differences between groups (95% CIs) in the changes from baseline at follow-up. The per-protocol population included 46 participants (24 ET/22 CG). There were no group differences in the analysed gait variables, except for a significant group difference in the second peak knee flexor moment and second peak vertical ground reaction force. While plausible we have limited confidence in the findings due to multiple statistical tests and lack of biomechanical logics. Therefore we conclude that a 12-week supervised individualised neuromuscular exercise programme has no effects on gait biomechanics. Future studies should focus on exercise programmes specifically designed to alter gait patterns, or include other measures of mobility, such as walking on stairs or inclined surfaces. ClinicalTrials.gov: NCT01545258.

  10. Patients' Preference for Number of Embryos Transferred During IVF ...

    African Journals Online (AJOL)

    Background: The Human Fertilization and Embryology Authority is considering limiting the number of embryos that can be transferred to single embryo per cycle as has been done in several European countries, with the aim of reducing the rate of multiple pregnancies and its attendant complications following in vitro ...

  11. Biomedical Imaging and Computational Modeling in Biomechanics

    CERN Document Server

    Iacoviello, Daniela

    2013-01-01

    This book collects the state-of-art and new trends in image analysis and biomechanics. It covers a wide field of scientific and cultural topics, ranging from remodeling of bone tissue under the mechanical stimulus up to optimizing the performance of sports equipment, through the patient-specific modeling in orthopedics, microtomography and its application in oral and implant research, computational modeling in the field of hip prostheses, image based model development and analysis of the human knee joint, kinematics of the hip joint, micro-scale analysis of compositional and mechanical properties of dentin, automated techniques for cervical cell image analysis, and iomedical imaging and computational modeling in cardiovascular disease.   The book will be of interest to researchers, Ph.D students, and graduate students with multidisciplinary interests related to image analysis and understanding, medical imaging, biomechanics, simulation and modeling, experimental analysis.

  12. Cervical spondylosis anatomy: pathophysiology and biomechanics.

    Science.gov (United States)

    Shedid, Daniel; Benzel, Edward C

    2007-01-01

    Cervical spondylosis is the most common progressive disorder in the aging cervical spine. It results from the process of degeneration of the intervertebral discs and facet joints of the cervical spine. Biomechanically, the disc and the facets are the connecting structures between the vertebrae for the transmission of external forces. They also facilitate cervical spine mobility. Symptoms related to myelopathy and radiculopathy are caused by the formation of osteophytes, which compromise the diameter of the spinal canal. This compromise may also be partially developmental. The developmental process, together with the degenerative process, may cause mechanical pressure on the spinal cord at one or multiple levels. This pressure may produce direct neurological damage or ischemic changes and, thus, lead to spinal cord disturbances. A thorough understanding of the biomechanics, the pathology, the clinical presentation, the radiological evaluation, as well as the surgical indications of cervical spondylosis, is essential for the management of patients with cervical spondylosis.

  13. Biomechanics/risk management (Working Group 2)

    DEFF Research Database (Denmark)

    Sanz, Mariano; Naert, Ignace; Gotfredsen, Klaus

    2009-01-01

    INTRODUCTION: The remit of this workgroup was to update the existing knowledge base in biomechanical factors, navigation systems and medications that may affect the outcome of implant therapy. MATERIAL AND METHODS: The literature was systematically searched and critically reviewed. Five manuscripts...... were produced in five specific topics identified as areas where innovative approaches have been developed in biomechanical factors, navigation systems and medications that may affect the outcome of implant therapy. RESULTS: The results and conclusions of the review process are presented...... survival and complications of implant supported restorations? * A systematic review on the accuracy and the clinical outcome of computer-guided template based implant dentistry. * What is the impact of systemic bisphosphonates on patients undergoing oral implant therapy? * What is the impact...

  14. Biomechanics of occlusion--implications for oral rehabilitation.

    Science.gov (United States)

    Peck, C C

    2016-03-01

    The dental occlusion is an important aspect of clinical dentistry; there are diverse functional demands ranging from highly precise tooth contacts to large crushing forces. Further, there are dogmatic, passionate and often diverging views on the relationship between the dental occlusion and various diseases and disorders including temporomandibular disorders, non-carious cervical lesions and tooth movement. This study provides an overview of the biomechanics of the masticatory system in the context of the dental occlusion's role in function. It explores the adaptation and precision of dental occlusion, its role in bite force, jaw movement, masticatory performance and its influence on the oro-facial musculoskeletal system. Biomechanics helps us better understand the structure and function of biological systems and consequently an understanding of the forces on, and displacements of, the dental occlusion. Biomechanics provides insight into the relationships between the dentition, jaws, temporomandibular joints, and muscles. Direct measurements of tooth contacts and forces are difficult, and biomechanical models have been developed to better understand the relationship between the occlusion and function. Importantly, biomechanical research will provide knowledge to help correct clinical misperceptions and inform better patient care. The masticatory system demonstrates a remarkable ability to adapt to a changing biomechanical environment and changes to the dental occlusion or other components of the musculoskeletal system tend to be well tolerated. © 2015 John Wiley & Sons Ltd.

  15. Autologous Fat Transfer in a Patient with Lupus Erythematosus Profundus

    Directory of Open Access Journals (Sweden)

    Jimi Yoon

    2012-10-01

    Full Text Available Lupus erythematosus profundus, a form of chronic cutaneous lupus erythematosus, is a rare inflammatory disease involving in the lower dermis and subcutaneous tissues. It primarily affects the head, proximal upper arms, trunk, thighs, and presents as firm nodules, 1 to 3 cm in diameter. The overlying skin often becomes attached to the subcutaneous nodules and is drawn inward to produce deep, saucerized depressions. We present a rare case of lupus erythematosus profundus treated with autologous fat transfer.

  16. Successful twin delivery following transmyometrial embryo transfer in a patient with a false uterine cavity.

    Science.gov (United States)

    Muñoz, Manuel; Galindo, Noemí; Pérez-Cano, Inmaculada; Cruz, María; García-Velasco, Juan Antonio

    2014-02-01

    A successful pregnancy is the greatest goal for reproductive medicine. The probability that pregnancy occurs during a cycle of assisted reproduction is a function of multiple factors, of which embryo transfer is one of the most critical steps in these treatments. This article reports a case of successful pregnancy and twin delivery by transmyometrial embryo transfer after IVF in a woman with a neocavity parallel to the uterine cavity, which prevented the transfer of embryos to the correct place. The patient first went to another fertility centre where embryo transfer was impossible to perform because the cervix could not be canalized. Subsequently in this study clinic, after considering the difficulty of inserting a catheter into the endometrial cavity, a trial transfer was performed, which discovered a false route parallel to endometrial cavity. Following a first cycle in which conventional transcervical embryo transfer was performed, a transmyometrial embryo transfer was carried out and the patient became pregnant with twins. In cases where transcervical embryo transfer is very difficult or impossible to perform, the value of transmyometrial transfer is self-evident. Copyright © 2013 Reproductive Healthcare Ltd. Published by Elsevier Ltd. All rights reserved.

  17. Evaluation of Biomechanical Changes in Myopia Patients with Unsatisfactory Corneas After Femto Second-Laser In Situ Keratomileusis (FS-LASIK) Concurrent with Accelerated Corneal Collagen Cross-Linking Using Corvis-ST: Two-Year Follow-Up Results.

    Science.gov (United States)

    Xu, Weiwei; Tao, Ye; Wang, Liqiang; Huang, Yifei

    2017-07-27

    BACKGROUND Some myopia patients with unsatisfactory corneas consider corneal refractive surgery for different reasons. Accelerated corneal collagen crosslinking (ACXL) is an effective method to enhance the resistance of the cornea. The present investigation was designed to evaluate the changes of biomechanical properties in patients with myopia and thin corneas after femtosecond-laser in situ keratomileusis (FS-LASIK) concurrent with ACXL. MATERIAL AND METHODS A prospective study was designed. A total of 22 eyes of 11 myopia astigmatism patients with unsatisfactory corneas were enrolled. The patients were assigned to femtosecond-laser in situ keratomileusis concurrent with accelerated corneal collagen crosslinking (FS-LASIK-ACXL). The follow-up duration was 24 months. Manifest refraction, uncorrected (UDVA), and corrected distance visual acuity (CDVA), ultra-high-speed camera (Corvis-ST), corneal topography, anterior segment OCT (AS-OCT), Pentacam, and endothelial cell density (ECD) were examined before and after the operation. The corneal biomechanical and refractive data was analyzed using SAS9.3. Data were analyzed through normal distribution test and variance of analysis. The difference was considered as statistically significant when pLASIK-ACXL operation. The values of first applanation length (A1L), the second applanation length (A2L), the first applanation velocity (A1V), the second applanation velocity (A2V), deformation amplitude (DA), highest concavity peak distance (PD), and radius of curvature at the time of highest concavity (HCR) did not show significant difference after the operation. CONCLUSIONS FS-LASIK-ACXL is an effective and safe surgery for improving visual acuity for myopic patients with thin corneas, and it does not increase the risk of iatrogenic keratectasia.

  18. Improving the safety of patient transfer from AMU using a written checklist.

    Science.gov (United States)

    Hindmarsh, D; Lees, L

    2012-01-01

    Unsafe patient transfers are one of the top reasons for incident reporting in hospitals. Criteria guiding safe transfer have been issued by the NHS Litigation Authority. To meet this standard, a "transfer check list" was redesigned for all patients leaving the Acute Medical Unit (AMU) in the Heartlands Hospital. Following the introduction of the checklist two full audit cycles were conducted. The first cycle highlighted an extremely poor uptake of the checklist. After interventions to educate nursing staff and raise awareness of the issues at the regular staff meetings, re-audit demonstrated significant improvement in completion rate. Subsequent monitoring indicates continued improvement, with compliance up to 95% for completion of the transfer checklist on AMU. Incident reporting relating to transfer has also decreased significantly.

  19. Systems biomechanics of the cell

    CERN Document Server

    Maly, Ivan V

    2013-01-01

    Systems Biomechanics of the Cell attempts to outline systems biomechanics of the cell as an emergent and promising discipline. The new field owes conceptually to cell mechanics, organism-level systems biomechanics, and biology of biochemical systems. Its distinct methodology is to elucidate the structure and behavior of the cell by analyzing the unintuitive collective effects of elementary physical forces that interact within the heritable cellular framework. The problematics amenable to this approach includes the variety of cellular activities that involve the form and movement of the cell body and boundary (nucleus, centrosome, microtubules, cortex, and membrane). Among the elementary system effects in the biomechanics of the cell, instability of symmetry, emergent irreversibility, and multiperiodic dissipative motion can be noted. Research results from recent journal articles are placed in this unifying framework. It is suggested that the emergent discipline has the potential to expand the spectrum of ques...

  20. Scale-Independent Biomechanical Optimization

    National Research Council Canada - National Science Library

    Schutte, J. F; Koh, B; Reinbolt, J. A; Haftka, R. T; George, A; Fregly, B. J

    2003-01-01

    ...: the Particle Swarm Optimizer (PSO). They apply this method to the biomechanical system identification problem of finding positions and orientations of joint axes in body segments through the processing of experimental movement data...

  1. Biomechanics: basic and applied research

    International Nuclear Information System (INIS)

    Bergmann, G.; Rohlmann, A.; Koelbel, R.

    1987-01-01

    This volume presents the state of the art in biomechanics. The most recent achievements of biomechanical research in the fields of orthopaedics, dynamics of the musculoskeletal system, hard and soft tissues, rehabilitation, sports, cardiovascular problems and research methodology have been selected and edited by a distinguished panel of reviewers. The material is such that the volume will serve as a reference for many years for bioengineers, sports scientists, clinicians and clinical researchers in rehabilitation, orthopaedics and cardiovascular surgery

  2. Forward lunge knee biomechanics before and after partial meniscectomy

    DEFF Research Database (Denmark)

    Hall, Michelle; Nielsen, Jonas Høberg; Holsgaard-Larsen, Anders

    2015-01-01

    partial meniscectomy (APM) on knee joint mechanics. The purpose of this study was to evaluate changes in knee joint biomechanics during a forward lunge in patients with a suspected degenerative meniscal tear from before to three months after APM. METHODS: Twenty-two patients (35-55years old......) with a suspected degenerative medial meniscal tear participated in this study. Three dimensional knee biomechanics were assessed on the injured and contralateral leg before and three months after APM. The visual analogue scale was used to assess knee pain and the Knee Injury Osteoarthritis Outcome Score was used...

  3. A taxonomy and cultural analysis of intra-hospital patient transfers.

    Science.gov (United States)

    Rosenberg, Alana; Campbell Britton, Meredith; Feder, Shelli; Minges, Karl; Hodshon, Beth; Chaudhry, Sarwat I; Jenq, Grace Y; Emerson, Beth L

    2018-05-02

    Existing research on intra-hospital patient transitions focuses chiefly on handoffs, or exchanges of information, between clinicians. Less is known about patient transfers within hospitals, which include but extend beyond the exchange of information. Using participant observations and interviews at a 1,541-bed, academic, tertiary medical center, we explored the ways in which staff define and understand patient transfers between units. We conducted observations of staff (n = 16) working in four hospital departments and interviewed staff (n = 29) involved in transfers to general medicine floors from either the Emergency Department or the Medical Intensive Care Unit between February and September 2015. The collected data allowed us to understand transfers in the context of several hospital cultural microsystems. Decisions were made through the lens of the specific unit identity to which staff felt they belonged; staff actively strategized to manage workload; and empty beds were treated as a scarce commodity. Staff concepts informed the development of a taxonomy of intra-hospital transfers that includes five categories of activity: disposition, or determining the right floor and bed for the patient; notification to sending and receiving staff of patient assignment, departure and arrival; preparation to send and receive the patient; communication between sending and receiving units; and coordination to ensure that transfer components occur in a timely and seamless manner. This taxonomy widens the study of intra-hospital patient transfers from a communication activity to a complex cultural phenomenon with several categories of activity and views them as part of multidimensional hospital culture, as constructed and understood by staff. © 2018 Wiley Periodicals, Inc.

  4. Pregnancy derived from human zygote pronuclear transfer in a patient who had arrested embryos after IVF.

    Science.gov (United States)

    Zhang, John; Zhuang, Guanglun; Zeng, Yong; Grifo, Jamie; Acosta, Carlo; Shu, Yimin; Liu, Hui

    2016-10-01

    Nuclear transfer of an oocyte into the cytoplasm of another enucleated oocyte has shown that embryogenesis and implantation are influenced by cytoplasmic factors. We report a case of a 30-year-old nulligravida woman who had two failed IVF cycles characterized by all her embryos arresting at the two-cell stage and ultimately had pronuclear transfer using donor oocytes. After her third IVF cycle, eight out of 12 patient oocytes and 12 out of 15 donor oocytes were fertilized. The patient's pronuclei were transferred subzonally into an enucleated donor cytoplasm resulting in seven reconstructed zygotes. Five viable reconstructed embryos were transferred into the patient's uterus resulting in a triplet pregnancy with fetal heartbeats, normal karyotypes and nuclear genetic fingerprinting matching the mother's genetic fingerprinting. Fetal mitochondrial DNA profiles were identical to those from donor cytoplasm with no detection of patient's mitochondrial DNA. This report suggests that a potentially viable pregnancy with normal karyotype can be achieved through pronuclear transfer. Ongoing work to establish the efficacy and safety of pronuclear transfer will result in its use as an aid for human reproduction. Copyright © 2016 Reproductive Healthcare Ltd. Published by Elsevier Ltd. All rights reserved.

  5. Biomechanics of the thorax - research evidence and clinical expertise.

    Science.gov (United States)

    Lee, Diane Gail

    2015-07-01

    Understanding the biomechanics of the thorax is critical for understanding its role in multiple conditions since the thorax is part of many integrated systems including the musculoskeletal, respiratory, cardiac, digestive and urogynecological. The thorax is also an integrated system within itself and an element of the whole body/person. Therefore, understanding the biomechanics of the thorax is fundamental to all forms of treatment for multiple conditions. The interpretation of movement examination findings depends on one's view of optimal biomechanics and the influential factors. This article will provide a synopsis of the current state of research evidence as well as observations from clinical experience pertaining to the biomechanics of the thorax in order to help clinicians organise this knowledge and facilitate evidence-based and informed management of the, often complex, patient with or without thoracic pain and impairment. The integrated systems model (ISM) will be introduced as a way to determine when the noted biomechanical findings are relevant to a patient's clinical presentation.

  6. Biomechanics of the thorax – research evidence and clinical expertise

    Science.gov (United States)

    Lee, Diane Gail

    2015-01-01

    Understanding the biomechanics of the thorax is critical for understanding its role in multiple conditions since the thorax is part of many integrated systems including the musculoskeletal, respiratory, cardiac, digestive and urogynecological. The thorax is also an integrated system within itself and an element of the whole body/person. Therefore, understanding the biomechanics of the thorax is fundamental to all forms of treatment for multiple conditions. The interpretation of movement examination findings depends on one's view of optimal biomechanics and the influential factors. This article will provide a synopsis of the current state of research evidence as well as observations from clinical experience pertaining to the biomechanics of the thorax in order to help clinicians organise this knowledge and facilitate evidence-based and informed management of the, often complex, patient with or without thoracic pain and impairment. The integrated systems model (ISM) will be introduced as a way to determine when the noted biomechanical findings are relevant to a patient's clinical presentation. PMID:26309383

  7. Biomechanics Strategies for Space Closure in Deep Overbite

    Directory of Open Access Journals (Sweden)

    Harryanto Wijaya

    2013-07-01

    Full Text Available Space closure is an interesting aspect of orthodontic treatment related to principles of biomechanics. It should be tailored individually based on patient’s diagnosis and treatment plan. Understanding the space closure biomechanics basis leads to achieve the desired treatment objective. Overbite deepening and losing posterior anchorage are the two most common unwanted side effects in space closure. Conventionally, correction of overbite must be done before space closure resulted in longer treatment. Application of proper space closure biomechanics strategies is necessary to achieve the desired treatment outcome. This cases report aimed to show the space closure biomechanics strategies that effectively control the overbite as well as posterior anchorage in deep overbite patients without increasing treatment time. Two patients who presented with class II division 1 malocclusion were treated with fixed orthodontic appliance. The primary strategies included extraction space closure on segmented arch that employed two-step space closure, namely single canine retraction simultaneously with incisors intrusion followed by enmasse retraction of four incisors by using differential moment concept. These strategies successfully closed the space, corrected deep overbite and controlled posterior anchorage simultaneously so that the treatment time was shortened. Biomechanics strategies that utilized were effective to achieve the desired treatment outcome.

  8. Is gender influencing the biomechanical results after autologous chondrocyte implantation?

    Science.gov (United States)

    Kreuz, Peter C; Müller, Sebastian; Erggelet, Christoph; von Keudell, Arvind; Tischer, Thomas; Kaps, Christian; Niemeyer, Philipp; Hirschmüller, Anja

    2014-01-01

    The influence of gender on the biomechanical outcome after autologous chondrocyte implantation (ACI) including isokinetic muscle strength measurements has not been investigated. The present prospective study was performed to evaluate gender-specific differences in the biomechanical function 48 months after ACI. Fifty-two patients (mean age 35.6 ± 8.5 years) that met our inclusion criteria, underwent ACI with Bioseed C(®) and were evaluated with the KOOS score preoperatively, 6, 12 and 48 months after surgery. At final follow-up, 44 out of the 52 patients underwent biomechanical evaluation with isokinetic strength measurements of both knees. All data were evaluated separately for men and women and compared for each time interval using the Mann-Whitney U test. Clinical scores improved significantly over the whole study period (p genders. Isokinetic muscle strength measures are significantly worse in women (p role for the explanation of gender-specific results after ACI.

  9. Transfer effects of a cognitive strategy training for stroke patients with apraxia

    NARCIS (Netherlands)

    Geusgens, C. A. V.; van Heugten, C. M.; Cooijmans, J. P. J.; Jolles, J.; van den Heuvel, W. J. A.

    2007-01-01

    The objective of this study was to evaluate transfer effects of cognitive strategy training for stroke patients with apraxia. During 8 weeks, 29 apraxic patients received cognitive strategy training to teach them how to perform activities of daily living (ADL) as independently as possible. ADL

  10. The effect of constructing versus solving virtual patient cases on transfer of learning

    DEFF Research Database (Denmark)

    Tolsgaard, Martin G; Jepsen, Rikke M H G; Rasmussen, Maria B

    2016-01-01

    standardized patients representing cardiopulmonary cases. Performances on the transfer test were video-recorded and assessed by two blinded raters using the Reporter, Interpreter, Manager, Educator (RIME) framework. Thirty-nine participants completed the transfer test. The VP-construction group spent......The purpose of this study was to explore the effect of actively constructing virtual patient (VP) cases compared with solving VP cases on knowledge gains, skills transfer and time spent on cases. Forty-five fourth-year medical students were randomized to constructing (VP-construction, n = 23......) or solving (VP-solving, n = 22) four cardiopulmonary VP cases. Whereas the VP-solving group solved the cases, the VP-construction group only received the final diagnosis and had to complete the history, physical findings, and lab results. After a week, participants completed a transfer test involving two...

  11. Transferring skills in quality collaboratives focused on improving patient logistics

    NARCIS (Netherlands)

    J.W.M. Weggelaar-Jansen (Anne Marie); J.D.H. van Wijngaarden (Jeroen)

    2018-01-01

    textabstractA quality improvement collaborative, often used by the Institute for Healthcare Improvement, is used to educate healthcare professionals and improve healthcare at the same time. Our research focused on quality improvement collaboratives aiming to improve patient logistics and tried to

  12. Biomechanical evaluation of sagittal maxillary internal distraction osteogenesis in unilateral cleft lip and palate patient and noncleft patients: a three-dimensional finite element analysis.

    Science.gov (United States)

    Olmez, Sultan; Dogan, Servet; Pekedis, Mahmut; Yildiz, Hasan

    2014-09-01

    To compare the pattern and amount of stress and displacement during maxillary sagittal distraction osteogenesis (DO) between a patient with unilateral cleft lip and palate (UCLP) and a noncleft patient. Three-dimensional finite element models for both skulls were constructed. Displacements of the surface landmarks and stress distributions in the circummaxillary sutures were analyzed after an anterior displacement of 6 mm was loaded to the elements where the inferior plates of the distractor were assumed to be fixed and were below the Le Fort I osteotomy line. In sagittal plane, more forward movement was found on the noncleft side in the UCLP model (-6.401 mm on cleft side and -6.651 mm on noncleft side for the central incisor region). However, similar amounts of forward movement were seen in the control model. In the vertical plane, a clockwise rotation occurred in the UCLP model, whereas a counterclockwise rotation was seen in the control model. The mathematical UCLP model also showed higher stress values on the sutura nasomaxillaris, frontonasalis, and zygomatiomaxillaris on the cleft side than on the normal side. Not only did the sagittal distraction forces produce advancement forces at the intermaxillary sutures, but more stress was also present on the sutura nasomaxillaris, sutura frontonasalis, and sutura zygomaticomaxillaris on the cleft side than on the noncleft side.

  13. CURRENT CONCEPTS IN BIOMECHANICAL INTERVENTIONS FOR PATELLOFEMORAL PAIN

    Science.gov (United States)

    Meira, Erik P.

    2016-01-01

    Patellofemoral pain (PFP) has historically been a complex and enigmatic issue. Many of the factors thought to relate to PFP remain after patients' symptoms have resolved making their clinical importance difficult to determine. The tissue homeostasis model proposed by Dye in 2005 can assist with understanding and implementing biomechanical interventions for PFP. Under this model, the goal of interventions for PFP should be to re-establish patellofemoral joint (PFJ) homeostasis through a temporary alteration of load to the offended tissue, followed by incrementally restoring the envelope of function to the baseline level or higher. High levels of PFJ loads, particularly in the presence of an altered PFJ environment, are thought to be a factor in the development of PFP. Clinical interventions often aim to alter the biomechanical patterns that are thought to result in elevated PFJ loads while concurrently increasing the load tolerance capabilities of the tissue through therapeutic exercise. Biomechanics may play a role in PFJ load modification not only when addressing proximal and distal components, but also when considering the involvement of more local factors such as the quadriceps musculature. Biomechanical considerations should consider the entire kinetic chain including the hip and the foot/ankle complex, however the beneficial effects of these interventions may not be the result of long-term biomechanical changes. Biomechanical alterations may be achieved through movement retraining, but the interventions likely need to be task-specific to alter movement patterns. The purpose of this commentary is to describe biomechanical interventions for the athlete with PFP to encourage a safe and complete return to sport. Level of Evidence 5 PMID:27904791

  14. Hours and Miles: Patient and Health System Implications of Transfer for Psychiatric Bed Capacity.

    Science.gov (United States)

    O'Neil, Amy M; Sadosty, Annie T; Pasupathy, Kalyan S; Russi, Christopher; Lohse, Christine M; Campbell, Ronna L

    2016-11-01

    An increasing number of behavioral health (BH) patients are presenting to the emergency department (ED) while BH resources continue to decline. This situation-may lead to more external transfers to find care. This is a retrospective cohort study of consecutive patients presenting to a tertiary care academic ED from February 1, 2013, through January 31, 2014. Patients were identified through electronic health record documentation of psychiatric consultation during ED evaluation. We reviewed electronic health records for demographic characteristics, diagnoses, payer source, ED length of stay, ED disposition, arrival method, and distance traveled to an external facility for inpatient admission. Univariable and multivariable associations with transfer to an external facility in comparison with patients admitted internally were evaluated with logistic regression models and summarized with odds ratios (OR). We identified 2,585 BH visits, of which 1,083 (41.9%) resulted in discharge. A total of 1,502 patient visits required inpatient psychiatric admission, and of these cases, 177 patients (11.8%; 95% CI = [10.2-13.5]) required transfer to an external facility. The median ED length of stay for transferred patients was 13.9 hours (interquartile range [IQR], 9.3-20.2 hours; range, 3.0-243.0 hours). The median distance for transport was 83 miles (IQR, 42-111 miles; range, 42-237 miles). In multivariable analysis, patients with suicidal or homicidal ideation had increased risk of transfer (odds ratio [OR] [95% CI], 1.93 [1.22-3.06]; P =0.005). Children younger than 18 years (OR [95% CI], 2.34 [1.60-3.40]; P< 0.001) and adults older than 65 years (OR [95% CI], 3.46 [1.93-6.19]; P <0.001) were more likely to require transfer and travel farther to access care. Patients requiring external transfer for inpatient psychiatric care were found to have prolonged ED lengths of stay. Patients with suicidal and homicidal ideation as well as children and adults older than 65 years are more

  15. Hours and Miles: Patient and Health System Implications of Transfer for Psychiatric Bed Capacity

    Directory of Open Access Journals (Sweden)

    Amy M. O’Neil

    2016-11-01

    Full Text Available Introduction: An increasing number of behavioral health (BH patients are presenting to the emergency department (ED while BH resources continue to decline. This situation may lead to more external transfers to find care. Methods: This is a retrospective cohort study of consecutive patients presenting to a tertiary care academic ED from February 1, 2013, through January 31, 2014. Patients were identified through electronic health record documentation of psychiatric consultation during ED evaluation. We reviewed electronic health records for demographic characteristics, diagnoses, payer source, ED length of stay, ED disposition, arrival method, and distance traveled to an external facility for inpatient admission. Univariable and multivariable associations with transfer to an external facility in comparison with patients admitted internally were evaluated with logistic regression models and summarized with odds ratios (OR. Results: We identified 2,585 BH visits, of which 1,083 (41.9% resulted in discharge. A total of 1,502 patient visits required inpatient psychiatric admission, and of these cases, 177 patients (11.8%; 95% CI = [10.2-13.5] required transfer to an external facility. The median ED length of stay for transferred patients was 13.9 hours (interquartile range [IQR], 9.3-20.2 hours; range, 3.0-243.0 hours. The median distance for transport was 83 miles (IQR, 42-111 miles; range, 42-237 miles. In multivariable analysis, patients with suicidal or homicidal ideation had increased risk of transfer (odds ratio [OR] [95% CI], 1.93 [1.22-3.06]; P=0.005. Children younger than 18 years (OR [95% CI], 2.34 [1.60- 3.40]; P<0.001 and adults older than 65 years (OR [95% CI], 3.46 [1.93-6.19]; P<0.001 were more likely to require transfer and travel farther to access care. Conclusion: Patients requiring external transfer for inpatient psychiatric care were found to have prolonged ED lengths of stay. Patients with suicidal and homicidal ideation as well

  16. Assessing written communication during interhospital transfers of emergency general surgery patients.

    Science.gov (United States)

    Harl, Felicity N R; Saucke, Megan C; Greenberg, Caprice C; Ingraham, Angela M

    2017-06-15

    Poor communication causes fragmented care. Studies of transitions of care within a hospital and on discharge suggest significant communication deficits. Communication during transfers between hospitals has not been well studied. We assessed the written communication provided during interhospital transfers of emergency general surgery patients. We hypothesized that patients are transferred with incomplete documentation from referring facilities. We performed a retrospective review of written communication provided during interhospital transfers to our emergency department (ED) from referring EDs for emergency general surgical evaluation between January 1, 2014 and January 1, 2016. Elements of written communication were abstracted from referring facility documents scanned into the medical record using a standardized abstraction protocol. Descriptive statistics summarized the information communicated. A total of 129 patients met inclusion criteria. 87.6% (n = 113) of charts contained referring hospital documents. 42.5% (n = 48) were missing history and physicals. Diagnoses were missing in 9.7% (n = 11). Ninety-one computed tomography scans were performed; among 70 with reads, final reads were absent for 70.0% (n = 49). 45 ultrasounds and x-rays were performed; among 27 with reads, final reads were missing for 80.0% (n = 36). Reasons for transfer were missing in 18.6% (n = 21). Referring hospital physicians outside the ED were consulted in 32.7% (n = 37); consultants' notes were absent in 89.2% (n = 33). In 12.4% (n = 14), referring documents arrived after the patient's ED arrival and were not part of the original documentation provided. This study documents that information important to patient care is often missing in the written communication provided during interhospital transfers. This gap affords a foundation for standardizing provider communication during interhospital transfers. Copyright © 2017 Elsevier Inc. All rights reserved.

  17. Benefits of a transfer clinic in adolescent and young adult kidney transplant patients.

    Science.gov (United States)

    McQuillan, Rory F; Toulany, Alene; Kaufman, Miriam; Schiff, Jeffrey R

    2015-01-01

    Adolescent and young adult kidney transplant recipients have worse graft outcomes than older and younger age groups. Difficulties in the process of transition, defined as the purposeful, planned movement of adolescents with chronic health conditions from child to adult-centered health care systems, may contribute to this. Improving the process of transition may improve adherence post-transfer to adult care services. The purpose of this study is to investigate whether a kidney transplant transfer clinic for adolescent and young adult kidney transplant recipients transitioning from pediatric to adult care improves adherence post-transfer. We developed a joint kidney transplant transfer clinic between a pediatric kidney transplant program, adult kidney transplant program, and adolescent medicine at two academic health centers. The transfer clinic facilitated communication between the adult and pediatric transplant teams, a face-to-face meeting of the patient with the adult team, and a meeting with the adolescent medicine physician. We compared the outcomes of 16 kidney transplant recipients transferred before the clinic was established with 16 patients who attended the clinic. The primary outcome was a composite measure of non-adherence. Non-adherence was defined as either self-reported medication non-adherence or displaying two of the following three characteristics: non-attendance at clinic, non-attendance for blood work appointments, or undetectable calcineurin inhibitor levels within 1 year post-transfer. The two groups were similar at baseline, with non-adherence identified in 43.75 % of patients. Non-adherent behavior in the year post-transfer, which included missing clinic visits, missing regular blood tests, and undetectable calcineurin inhibitor levels, was significantly lower in the cohort which attended the transfer clinic (18.8 versus 62.5 %, p = 0.03). The median change in estimated glomerular filtration rate (eGFR) in the year following transfer

  18. Benefits of a Transfer Clinic in Adolescent and Young Adult Kidney Transplant Patients

    Directory of Open Access Journals (Sweden)

    Rory F. McQuillan

    2015-12-01

    Full Text Available Background: Adolescent and young adult kidney transplant recipients have worse graft outcomes than older and younger age groups. Difficulties in the process of transition, defined as the purposeful, planned movement of adolescents with chronic health conditions from child to adult-centered health care systems, may contribute to this. Improving the process of transition may improve adherence post-transfer to adult care services. Objective: The purpose of this study is to investigate whether a kidney transplant transfer clinic for adolescent and young adult kidney transplant recipients transitioning from pediatric to adult care improves adherence post-transfer. Methods: We developed a joint kidney transplant transfer clinic between a pediatric kidney transplant program, adult kidney transplant program, and adolescent medicine at two academic health centers. The transfer clinic facilitated communication between the adult and pediatric transplant teams, a face-to-face meeting of the patient with the adult team, and a meeting with the adolescent medicine physician. We compared the outcomes of 16 kidney transplant recipients transferred before the clinic was established with 16 patients who attended the clinic. The primary outcome was a composite measure of non-adherence. Non-adherence was defined as either self-reported medication non-adherence or displaying two of the following three characteristics: non-attendance at clinic, non-attendance for blood work appointments, or undetectable calcineurin inhibitor levels within 1 year post-transfer. Results: The two groups were similar at baseline, with non-adherence identified in 43.75 % of patients. Non-adherent behavior in the year post-transfer, which included missing clinic visits, missing regular blood tests, and undetectable calcineurin inhibitor levels, was significantly lower in the cohort which attended the transfer clinic (18.8 versus 62.5 %, p = 0.03. The median change in estimated glomerular

  19. Telemedicine Use Decreases Rural Emergency Department Length of Stay for Transferred North Dakota Trauma Patients.

    Science.gov (United States)

    Mohr, Nicholas M; Vakkalanka, J Priyanka; Harland, Karisa K; Bell, Amanda; Skow, Brian; Shane, Dan M; Ward, Marcia M

    2018-03-01

    Telemedicine has been proposed as one strategy to improve local trauma care and decrease disparities between rural and urban trauma outcomes. This study was conducted to describe the effect of telemedicine on management and clinical outcomes for trauma patients in North Dakota. Cohort study of adult (age ≥18 years) trauma patients treated in North Dakota Critical Access Hospital (CAH) Emergency Departments (EDs) from 2008 to 2014. Records were linked to a telemedicine network's call records, indicating whether telemedicine was available and/or used at the institution at the time of the care. Multivariable generalized estimating equations were developed to identify associations between telemedicine consultation and availability and outcomes such as transfer, timeliness of care, trauma imaging, and mortality. Of the 7,500 North Dakota trauma patients seen in CAH, telemedicine was consulted for 11% of patients in telemedicine-capable EDs and 4% of total trauma patients. Telemedicine utilization was independently associated with decreased initial ED length of stay (LOS) (30 min, 95% confidence interval [CI] 14-45 min) for transferred patients. Telemedicine availability was associated with an increase in the probability of interhospital transfer (adjusted odds ratio [aOR] 1.2, 95% CI 1.1-1.4). Telemedicine availability was associated with increased total ED LOS (15 min, 95% CI 10-21 min), and computed tomography scans (aOR 1.6, 95% CI 1.3-1.9). ED-based telemedicine consultation is requested for the most severely injured rural trauma patients. Telemedicine consultation was associated with more rapid interhospital transfer, and telemedicine availability is associated with increased radiography use and transfer. Future work should evaluate how telemedicine could target patients likely to benefit from telemedicine consultation.

  20. Computational biomechanics for medicine new approaches and new applications

    CERN Document Server

    Miller, Karol; Wittek, Adam; Nielsen, Poul

    2015-01-01

    The Computational Biomechanics for Medicine titles provide an opportunity for specialists in computational biomechanics to present their latest methodologiesand advancements. Thisvolumecomprises twelve of the newest approaches and applications of computational biomechanics, from researchers in Australia, New Zealand, USA, France, Spain and Switzerland. Some of the interesting topics discussed are:real-time simulations; growth and remodelling of soft tissues; inverse and meshless solutions; medical image analysis; and patient-specific solid mechanics simulations. One of the greatest challenges facing the computational engineering community is to extend the success of computational mechanics to fields outside traditional engineering, in particular to biology, the biomedical sciences, and medicine. We hope the research presented within this book series will contribute to overcoming this grand challenge.

  1. Knowledge management strategies: Enhancing knowledge transfer to clinicians and patients.

    Science.gov (United States)

    Roemer, Lorrie K; Rocha, Roberto A; Del Fiol, Guilherme; Bradshaw, Richard L; Hanna, Timothy P; Hulse, Nathan C

    2006-01-01

    At Intermountain Healthcare (Intermountain), executive clinical content experts are responsible for disseminating consistent evidence-based clinical content throughout the enterprise at the point-of-care. With a paper-based system it was difficult to ensure that current information was received and was being used in practice. With electronic information systems multiple applications were supplying similar, but different, vendor-licensed and locally-developed content. These issues influenced the consistency of clinical practice within the enterprise, jeopardized patient and clinician safety, and exposed the enterprise and its employees to potential financial penalties. In response to these issues Intermountain is developing a knowledge management infrastructure providing tools and services to support clinical content development, deployment, maintenance, and communication. The Intermountain knowledge management philosophy includes strategies guiding clinicians and consumers of health information to relevant best practice information with the intention of changing behaviors. This paper presents three case studies describing different information management problems identified within Intermountain, methods used to solve the problems, implementation challenges, and the current status of each project.

  2. A statewide teleradiology system reduces radiation exposure and charges in transferred trauma patients.

    Science.gov (United States)

    Watson, Justin J J; Moren, Alexis; Diggs, Brian; Houser, Ben; Eastes, Lynn; Brand, Dawn; Bilyeu, Pamela; Schreiber, Martin; Kiraly, Laszlo

    2016-05-01

    Trauma transfer patients routinely undergo repeat imaging because of inefficiencies within the radiology system. In 2009, the virtual private network (VPN) telemedicine system was adopted throughout Oregon allowing virtual image transfer between hospitals. The startup cost was a nominal $3,000 per hospital. A retrospective review from 2007 to 2012 included 400 randomly selected adult trauma transfer patients based on a power analysis (200 pre/200 post). The primary outcome evaluated was reduction in repeat computed tomography (CT) scans. Secondary outcomes included cost savings, emergency department (ED) length of stay (LOS), and spared radiation. All data were analyzed using Mann-Whitney U and chi-square tests. P less than .05 indicated significance. Spared radiation was calculated as a weighted average per body region, and savings was calculated using charges obtained from Oregon Health and Science University radiology current procedural terminology codes. Four-hundred patients were included. Injury Severity Score, age, ED and overall LOS, mortality, trauma type, and gender were not statistically different between groups. The percentage of patients with repeat CT scans decreased after VPN implementation: CT abdomen (13.2% vs 2.8%, P < .01) and cervical spine (34.4% vs 18.2%, P < .01). Post-VPN, the total charges saved in 2012 for trauma transfer patients was $333,500, whereas the average radiation dose spared per person was 1.8 mSV. Length of stay in the ED for patients with Injury Severity Score less than 15 transferring to the ICU was decreased (P < .05). Implementation of a statewide teleradiology network resulted in fewer total repeat CT scans, significant savings, decrease in radiation exposure, and decreased LOS in the ED for patients with less complex injuries. The potential for health care savings by widespread adoption of a VPN is significant. Copyright © 2016 Elsevier Inc. All rights reserved.

  3. Validation of the Provincial Transfer Authorization Centre database: a comprehensive database containing records of all inter-facility patient transfers in the province of Ontario

    Directory of Open Access Journals (Sweden)

    MacDonald Russell D

    2006-10-01

    Full Text Available Abstract Background The Provincial Transfer Authorization Centre (PTAC was established as a part of the emergency response in Ontario, Canada to the Severe Acute Respiratory Syndrome (SARS outbreak in 2003. Prior to 2003, data relating to inter-facility patient transfers were not collected in a systematic manner. Then, in an emergency setting, a comprehensive database with a complex data collection process was established. For the first time in Ontario, population-based data for patient movement between healthcare facilities for a population of twelve million are available. The PTAC database stores all patient transfer data in a large database. There are few population-based patient transfer databases and the PTAC database is believed to be the largest example to house this novel dataset. A patient transfer database has also never been validated. This paper presents the validation of the PTAC database. Methods A random sample of 100 patient inter-facility transfer records was compared to the corresponding institutional patient records from the sending healthcare facilities. Measures of agreement, including sensitivity, were calculated for the 12 common data variables. Results Of the 100 randomly selected patient transfer records, 95 (95% of the corresponding institutional patient records were located. Data variables in the categories patient demographics, facility identification and timing of transfer and reason and urgency of transfer had strong agreement levels. The 10 most commonly used data variables had accuracy rates that ranged from 85.3% to 100% and error rates ranging from 0 to 12.6%. These same variables had sensitivity values ranging from 0.87 to 1.0. Conclusion The very high level of agreement between institutional patient records and the PTAC data for fields compared in this study supports the validity of the PTAC database. For the first time, a population-based patient transfer database has been established. Although it was created

  4. Biomechanical analysis of rollator walking

    DEFF Research Database (Denmark)

    Alkjaer, T; Larsen, Peter K; Pedersen, Gitte

    2006-01-01

    The rollator is a very popular walking aid. However, knowledge about how a rollator affects the walking patterns is limited. Thus, the purpose of the study was to investigate the biomechanical effects of walking with and without a rollator on the walking pattern in healthy subjects.......The rollator is a very popular walking aid. However, knowledge about how a rollator affects the walking patterns is limited. Thus, the purpose of the study was to investigate the biomechanical effects of walking with and without a rollator on the walking pattern in healthy subjects....

  5. Accuracy of burn size estimation in patients transferred to adult Burn Units in Sydney, Australia: an audit of 698 patients.

    Science.gov (United States)

    Harish, Varun; Raymond, Andrew P; Issler, Andrea C; Lajevardi, Sepehr S; Chang, Ling-Yun; Maitz, Peter K M; Kennedy, Peter

    2015-02-01

    The purpose of this study was to compare burn size estimation between referring centres and Burn Units in adult patients transferred to Burn Units in Sydney, Australia. A review of all adults transferred to Burn Units in Sydney, Australia between January 2009 and August 2013 was performed. The TBSA estimated by the referring institution was compared with the TBSA measured at the Burns Unit. There were 698 adults transferred to a Burns Unit. Equivalent TBSA estimation between the referring hospital and Burns Unit occurred in 30% of patients. Overestimation occurred at a ratio exceeding 3:1 with respect to underestimation, with the difference between the referring institutions and Burns Unit estimation being statistically significant (Pburn-injured patients as well as in patients transferred more than 48h after the burn (Pburn (Pburns (≥20% TBSA) were found to have more satisfactory burn size estimations compared with less severe injuries (burn size assessment by referring centres. The systemic tendency for overestimation occurs throughout the entire TBSA spectrum, and persists with increasing time after the burn. Underestimation occurs less frequently but rises with increasing time after the burn and with increasing TBSA. Severe burns (≥20% TBSA) are more accurately estimated by the referring hospital. The inaccuracies in burn size assessment have the potential to result in suboptimal treatment and inappropriate referral to specialised Burn Units. Copyright © 2014 Elsevier Ltd and ISBI. All rights reserved.

  6. Simulations of Biomechanical Phenomena

    Science.gov (United States)

    Gonzalez, Jose Cruz

    Recent studies have published breakthroughs in the application of finite element (FEA) studies in the design and analysis of advanced orthodontics. However, FEA has not captured bone remodeling responses to advanced orthodontics. The results of these simulations report unrealistic displacement around the nasal bridge, which impeded correlation with clinical data. Bone remodeling has been previously documented in FEA and has shown bone response to mechanical stimulus in femur bone models. However, the relationship between mechanical stimulus and bone remodeling has not been reported in orthodontic studies due to the complexity of the skull. In the current study, strain energy is used as the mechanical stimulus to control remodeling, from which density and modulus evolve. Due to the localization of forces in orthodontics, current remodeling algorithms have limited application. In turn, we developed an algorithm that dynamically collects, sorts, and bins stresses in all elements for regional remodeling based on the proximity of the element to the load. The results demonstrate that bone response to orthodontic appliances is different than that of an FEA without bone remodeling, due to load path changes based upon evolution of the bone properties. It was also found that density and moduli proximal to the load application site exhibit faster remodeling than those located remotely. Modeling another biomechanical phenomena, a 3D simulation was created to simulate recent experimental results that discovered a difference in impact mitigation properties of dense-polymer/foam bilayer structure based on the orientation of the dense-polymer with respect to the impact site. The impact energy transmitted varied in time of arrival and amplitude depending on the orientation of the structure (thin layer up or down). By creating a 3D explicit dynamic FEA simulation, it is expected to reduce costly experiments and time consumed in set up, and offer opportunities for optimization for

  7. Transfer of training effects in stroke patients with apraxia: an exploratory study.

    Science.gov (United States)

    Geusgens, Chantal; van Heugten, Caroline; Donkervoort, Mireille; van den Ende, Els; Jolles, Jelle; van den Heuvel, Wim

    2006-04-01

    The goal of the present study was to examine the transfer of the effects of cognitive strategy training for stroke patients with apraxia from trained to non-trained tasks. In strategy training, the occurrence of transfer is expected as the training programme is aimed, not at relearning specific tasks, but at teaching patients new ways to handle the problems resulting from the impairment. Exploratory analyses were conducted on data previously collected in a randomised controlled trial on the efficacy of the strategy training. A total of 113 left hemisphere stroke patients were randomly assigned to a strategy training group and a group receiving occupational therapy as usual. Assessment of apraxia, motor functioning and activities of daily living (ADL) took place at baseline, after an eight-week treatment period, and five months after baseline. The primary outcome measure consisted of standardised ADL observations of trained and non-trained tasks. The analyses showed that in both treatment groups, the scores on the ADL observations for non-trained tasks improved significantly after eight weeks of training as compared with the baseline score. Change scores of non-trained activities were larger in the strategy training group as compared with the usual treatment group. By using previously collected data we are able to illustrate the potential transfer of treatment effects in a large sample of stroke patients. We found indications for the occurrence of transfer, although the study was not originally designed for the purpose of evaluating transfer. Therefore these results are worth exploring more profoundly. We will further investigate our preliminary conclusions in a new prospective study which is specifically designed to examine the transfer of training effects.

  8. Biomechanical and Hemodynamic Measures of Right Ventricular Diastolic Function: Translating Tissue Biomechanics to Clinical Relevance.

    Science.gov (United States)

    Jang, Sae; Vanderpool, Rebecca R; Avazmohammadi, Reza; Lapshin, Eugene; Bachman, Timothy N; Sacks, Michael; Simon, Marc A

    2017-09-12

    Right ventricular (RV) diastolic function has been associated with outcomes for patients with pulmonary hypertension; however, the relationship between biomechanics and hemodynamics in the right ventricle has not been studied. Rat models of RV pressure overload were obtained via pulmonary artery banding (PAB; control, n=7; PAB, n=5). At 3 weeks after banding, RV hemodynamics were measured using a conductance catheter. Biaxial mechanical properties of the RV free wall myocardium were obtained to extrapolate longitudinal and circumferential elastic modulus in low and high strain regions (E 1 and E 2 , respectively). Hemodynamic analysis revealed significantly increased end-diastolic elastance (E ed ) in PAB (control: 55.1 mm Hg/mL [interquartile range: 44.7-85.4 mm Hg/mL]; PAB: 146.6 mm Hg/mL [interquartile range: 105.8-155.0 mm Hg/mL]; P =0.010). Longitudinal E 1 was increased in PAB (control: 7.2 kPa [interquartile range: 6.7-18.1 kPa]; PAB: 34.2 kPa [interquartile range: 18.1-44.6 kPa]; P =0.018), whereas there were no significant changes in longitudinal E 2 or circumferential E 1 and E 2 . Last, wall stress was calculated from hemodynamic data by modeling the right ventricle as a sphere: stress=Pressure×radius2×thickness. RV pressure overload in PAB rats resulted in an increase in diastolic myocardial stiffness reflected both hemodynamically, by an increase in E ed , and biomechanically, by an increase in longitudinal E 1 . Modest increases in tissue biomechanical stiffness are associated with large increases in E ed . Hemodynamic measurements of RV diastolic function can be used to predict biomechanical changes in the myocardium. © 2017 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley.

  9. Transfer effects of a cognitive strategy training for stroke patients with apraxia.

    Science.gov (United States)

    Geusgens, C A V; van Heugten, C M; Cooijmans, J P J; Jolles, J; van den Heuvel, W J A

    2007-11-01

    The objective of this study was to evaluate transfer effects of cognitive strategy training for stroke patients with apraxia. During 8 weeks, 29 apraxic patients received cognitive strategy training to teach them how to perform activities of daily living (ADL) as independently as possible. ADL functioning was assessed at the rehabilitation centre at baseline and after 8 weeks of training. In addition, assessment took place at the patients' own homes after 8 weeks of training and 5 months after the start of the training. The performance of both trained and nontrained tasks was observed. Patients performed trained tasks and nontrained tasks at the same level of independency at the rehabilitation centre as well as at home, indicating transfer of training effects. These effects turned out to be stable over time.

  10. Self-Help Training System for Nursing Students to Learn Patient Transfer Skills

    Science.gov (United States)

    Huang, Zhifeng; Nagata, Ayanori; Kanai-Pak, Masako; Maeda, Jukai; Kitajima, Yasuko; Nakamura, Mitsuhiro; Aida, Kyoko; Kuwahara, Noriaki; Ogata, Taiki; Ota, Jun

    2014-01-01

    This paper describes the construction and evaluation of a self-help skill training system for assisting student nurses in learning skills involving the transfer of patients from beds to wheelchairs. We have proposed a feedback method that is based on a checklist and video demonstrations. To help trainees efficiently check their performance and…

  11. [Analysis of pregnancy outcomes of polycystic ovary syndrome patients after frozen embryo transfer].

    Science.gov (United States)

    Lyu, X D; Qiao, J

    2018-01-25

    Objective: To investigate pregnancy outcomes of the patients with polycystic ovary syndrome (PCOS) after frozen embryo transfer (FET) . Methods: Data of 2 367 PCOS patients received in vitro fertilization-embryo transfer [including fresh embryo transfer (fET) and FET] from January 2009 to December 2015 in Peking University Third Hospital were evaluated retrospectively. The basal characteristics, pregnancy complications and outcomes were analyzed, then identified the relative factors followed. Results: Totally 2 367 patients received in vitro fertilization-embryo transfer: 1 106 were treated with fET, and the rest 1 261 cases were treated with FET. The incidence of gestational diabetes mellitus (GDM) was lower in FET group [4.04%(51/1 261) versus 6.15%(68/1 106)], the difference was statistically significant ( Ppregnancy complications between the two groups (all P> 0.05). fET was an independent risk factor for GDM (adjusted OR= 1.570, 95% CI: 1.075-2.294). Conclusion: Compared with fET, FET could decrease the risk of GDM and receive better neonatal outcomes in patients with PCOS.

  12. Applications of aerospace technology in biomedicine. A technology transfer profile: Patient monitoring

    Science.gov (United States)

    Murray, D. M.

    1971-01-01

    NASA contributions to cardiovascular monitoring are described along with innovations in intracardiac blood pressure monitoring. A brief overview of the process of NASA technology transfer in patient monitoring is presented and a list of bioinstrumentation tech briefs and the number of requests for technical support is included.

  13. Cycling biomechanics: a literature review.

    Science.gov (United States)

    Wozniak Timmer, C A

    1991-01-01

    Submitted in partial fulfillment for a Master of Science degree at the University of Pittsburgh, School of Health Related Professions, Pittsburgh, PA 1.5213 This review of current literature on cycling biomechanics emphasizes lower extremity muscle actions and joint excursions, seat height, pedal position, pedaling rate, force application, and pedaling symmetry. Guidelines are discussed for optimal seat height, pedal position, and pedaling rate. Force application in the power and recovery phases of cycling and the relationship of force application to pedaling symmetry are discussed. The need for a biomechanical approach to cycling exists since a great deal of the literature is primarily physiologic in nature. The purpose of this review is to make cyclists and their advisors aware of the biomechanics of cycling and guidelines to follow. This approach is also important because cycling is a very common form of exercise prescribed by physical therapists for clinic or home programs. Biomechanical aspects of cycling should be considered by cyclists at any level of participation and by physical therapists in order for goal-oriented, efficient cycling to occur. J Orthop Sports Phys Ther 1991;14(3):106-113.

  14. Clinical applications of biomechanics cinematography.

    Science.gov (United States)

    Woodle, A S

    1986-10-01

    Biomechanics cinematography is the analysis of movement of living organisms through the use of cameras, image projection systems, electronic digitizers, and computers. This article is a comparison of cinematographic systems and details practical uses of the modality in research and education.

  15. The biomechanics of seed germination.

    Science.gov (United States)

    Steinbrecher, Tina; Leubner-Metzger, Gerhard

    2017-02-01

    From a biomechanical perspective, the completion of seed (and fruit) germination depends on the balance of two opposing forces: the growth potential of the embryonic axis (radicle-hypocotyl growth zone) and the restraint of the seed-covering layers (endosperm, testa, and pericarp). The diverse seed tissues are composite materials which differ in their dynamic properties based on their distinct cell wall composition and water uptake capacities. The biomechanics of embryo cell growth during seed germination depend on irreversible cell wall loosening followed by water uptake due to the decreasing turgor, and this leads to embryo elongation and eventually radicle emergence. Endosperm weakening as a prerequisite for radicle emergence is a widespread phenomenon among angiosperms. Research into the biochemistry and biomechanics of endosperm weakening has demonstrated that the reduction in puncture force of a seed's micropylar endosperm is environmentally and hormonally regulated and involves tissue-specific expression of cell wall remodelling proteins such as expansins, diverse hydrolases, and the production of directly acting apoplastic reactive oxygen. The endosperm-weakening biomechanics and its underlying cell wall biochemistry differ between the micropylar (ME) and chalazal (CE) endosperm domains. In the ME, they involve cell wall loosening, cell separation, and programmed cell death to provide decreased and localized ME tissue resistance, autolysis, and finally the formation of an ME hole required for radicle emergence. Future work will further unravel the molecular mechanisms, environmental regulation, and evolution of the diverse biomechanical cell wall changes underpinning the control of germination by endosperm weakening. © The Author 2016. Published by Oxford University Press on behalf of the Society for Experimental Biology. All rights reserved. For permissions, please email: journals.permissions@oup.com.

  16. TRANSFERENCE BEFORE TRANSFERENCE.

    Science.gov (United States)

    Bonaminio, Vincenzo

    2017-10-01

    This paper is predominantly a clinical presentation that describes the transmigration of one patient's transference to another, with the analyst functioning as a sort of transponder. It involves an apparently accidental episode in which there was an unconscious intersection between two patients. The author's aim is to show how transference from one case may affect transference in another, a phenomenon the author calls transference before transference. The author believes that this idea may serve as a tool for understanding the unconscious work that takes place in the clinical situation. In a clinical example, the analyst finds himself caught up in an enactment involving two patients in which he becomes the medium of what happens in session. © 2017 The Psychoanalytic Quarterly, Inc.

  17. Biomechanical characteristics, patient preference and activity level with different prosthetic feet: a randomized double blind trial with laboratory and community testing.

    Science.gov (United States)

    Raschke, Silvia U; Orendurff, Michael S; Mattie, Johanne L; Kenyon, David E A; Jones, O Yvette; Moe, David; Winder, Lorne; Wong, Angie S; Moreno-Hernández, Ana; Highsmith, M Jason; J Sanderson, David; Kobayashi, Toshiki

    2015-01-02

    Providing appropriate prosthetic feet to those with limb loss is a complex and subjective process influenced by professional judgment and payer guidelines. This study used a small load cell (Europa™) at the base of the socket to measure the sagittal moments during walking with three objective categories of prosthetic feet in eleven individuals with transtibial limb loss with MFCL K2, K3 and K4 functional levels. Forefoot stiffness and hysteresis characteristics defined the three foot categories: Stiff, Intermediate, and Compliant. Prosthetic feet were randomly assigned and blinded from participants and investigators. After laboratory testing, participants completed one week community wear tests followed by a modified prosthetics evaluation questionnaire to determine if a specific category of prosthetic feet was preferred. The Compliant category of prosthetic feet was preferred by the participants (P=0.025) over the Stiff and Intermediate prosthetic feet, and the Compliant and Intermediate feet had 15% lower maximum sagittal moments during walking in the laboratory (P=0.0011) compared to the Stiff feet. The activity level of the participants did not change significantly with any of the wear tests in the community, suggesting that each foot was evaluated over a similar number of steps, but did not inherently increase activity. This is the first randomized double blind study in which prosthetic users have expressed a preference for a specific biomechanical characteristic of prosthetic feet: those with lower peak sagittal moments were preferred, and specifically preferred on slopes, stairs, uneven terrain, and during turns and maneuvering during real world use. Copyright © 2014 The Authors. Published by Elsevier Ltd.. All rights reserved.

  18. Acupuncture on the day of embryo transfer: a randomized controlled trial of 635 patients

    DEFF Research Database (Denmark)

    Andersen, Dorthe; Løssl, Kristine; Nyboe Andersen, Anders

    2010-01-01

    This prospective, randomized, controlled and double-blinded trial studied whether acupuncture in relation to embryo transfer could increase the ongoing pregnancy rates and live birth rates in women undergoing assisted reproductive therapy. A total of 635 patients undergoing IVF or intracytoplasmic...... sperm injection (ICSI) were included. In 314 patients, embryo transfer was accompanied by acupuncture according to the principles of traditional Chinese medicine. In the control group, 321 patients received placebo acupuncture using a validated placebo needle. In the acupuncture group and the placebo...... group, the ongoing pregnancy rates were 27% (95% CI 22-32) and 32% (95% CI 27-37), respectively. Live birth rates were 25% (95% CI 20-30) in the acupuncture group and 30% (95% CI 25-30) in the placebo group. The differences were not statistically significant. These results suggest that acupuncture...

  19. Assessment and characterization of in situ rotator cuff biomechanics

    Science.gov (United States)

    Trent, Erika A.; Bailey, Lane; Mefleh, Fuad N.; Raikar, Vipul P.; Shanley, Ellen; Thigpen, Charles A.; Dean, Delphine; Kwartowitz, David M.

    2013-03-01

    Rotator cuff disease is a degenerative disorder that is a common, costly, and often debilitating, ranging in severity from partial thickness tear, which may cause pain, to total rupture, leading to loss in function. Currently, clinical diagnosis and determination of disease extent relies primarily on subjective assessment of pain, range of motion, and possibly X-ray or ultrasound images. The final treatment plan however is at the discretion of the clinician, who often bases their decision on personal experiences, and not quantitative standards. The use of ultrasound for the assessment of tissue biomechanics is established, such as in ultrasound elastography, where soft tissue biomechanics are measured. Few studies have investigated the use of ultrasound elastography in the characterization of musculoskeletal biomechanics. To assess tissue biomechanics we have developed a device, which measures the force applied to the underlying musculotendentious tissue while simultaneously obtaining the related ultrasound images. In this work, the musculotendinous region of the infraspinatus of twenty asymptomatic male organized baseball players was examined to access the variability in tissue properties within a single patient and across a normal population. Elastic moduli at percent strains less than 15 were significantly different than those above 15 percent strain within the normal population. No significant difference in tissue properties was demonstrated within a single patient. This analysis demonstrated elastic moduli are variable across individuals and incidence. Therefore threshold elastic moduli will likely be a function of variation in local-tissue moduli as opposed to a specific global value.

  20. In-Hospital Mortality among Rural Medicare Patients with Acute Myocardial Infarction: The Influence of Demographics, Transfer, and Health Factors

    Science.gov (United States)

    Muus, Kyle J.; Knudson, Alana D.; Klug, Marilyn G.; Wynne, Joshua

    2011-01-01

    Context/Purpose: Most rural hospitals can provide medical care to acute myocardial infarction (AMI) patients, but a need for advanced cardiac care requires timely transfer to a tertiary hospital. There is little information on AMI in-hospital mortality predictors among rural transfer patients. Methods: Cross-sectional retrospective analyses on…

  1. Clinical outcome of fresh and vitrified-warmed blastocyst and cleavage-stage embryo transfers in ethnic Chinese ART patients

    Directory of Open Access Journals (Sweden)

    Tong Guo

    2012-10-01

    Full Text Available Abstract Objectives This study sought to evaluate the outcome of fresh and vitrified-warmed cleavage-stage and blastocyst-stage embryo transfers in patients undergoing ART treatment within an ethnic Chinese population. Study design We compared the clinical results of embryo transfer on the 3rd (cleavage stage or 5th (blastocyst stage day after oocyte retrieval, including clinical pregnancy rates, implantation rates and multiple pregnancy rates. Results Our data showed that blastocyst transfer on day 5 did not significantly increase clinical pregnancy rate (41.07% vs 47.08%, p>0.05 and implantation rate (31.8% vs 31.2%, p>0.05 in patients under 35 years of age, in comparison with day 3 cleavage stage embryo transfer. In patients older than 35 years of age, the clinical pregnancy rate after blastocyst transfer was slightly decreased compared with cleavage stage embryo transfer (33.33% vs 42.31%, p>0.05. Unexpectedly, It was found that vitrified-warmed blastocyst transfer resulted in significantly higher clinical pregnancy rate (56.8% and implantation rate (47% compared with fresh blastocyst transfer in controlled stimulation cycles (41.07% and 31.8%, respectively. For patients under 35 years of age, the cumulative clinical pregnancy rate combining fresh and vitrified-warmed blastocyst transfer cycles were significantly higher compared to just cleavage-stage embryo transfer (70.1% versus 51.8%, p Conclusions In an ethnic Chinese patient population, fresh blastocyst transfer does not significantly increase clinical pregnancy rate. However, subsequent vitrified-warmed blastocyst transfer in a non-controlled ovarian hyperstimulation cycle dramatically improves clinical outcomes. Therefore, blastocyst culture in tandem with vitrified-warmed blastocyst transfer is recommended as a favourable and promising protocol in human ART treatment, particularly for ethnic Chinese patients.

  2. Clinical outcome of fresh and vitrified-warmed blastocyst and cleavage-stage embryo transfers in ethnic Chinese ART patients.

    Science.gov (United States)

    Tong, Guo Qing; Cao, Shan Ren; Wu, Xun; Zhang, Jun Qiang; Cui, Ji; Heng, Boon Chin; Ling, Xiu Feng

    2012-10-05

    This study sought to evaluate the outcome of fresh and vitrified-warmed cleavage-stage and blastocyst-stage embryo transfers in patients undergoing ART treatment within an ethnic Chinese population. We compared the clinical results of embryo transfer on the 3rd (cleavage stage) or 5th (blastocyst stage) day after oocyte retrieval, including clinical pregnancy rates, implantation rates and multiple pregnancy rates. Our data showed that blastocyst transfer on day 5 did not significantly increase clinical pregnancy rate (41.07% vs 47.08%, p>0.05) and implantation rate (31.8% vs 31.2%, p>0.05) in patients under 35 years of age, in comparison with day 3 cleavage stage embryo transfer. In patients older than 35 years of age, the clinical pregnancy rate after blastocyst transfer was slightly decreased compared with cleavage stage embryo transfer (33.33% vs 42.31%, p>0.05). Unexpectedly, It was found that vitrified-warmed blastocyst transfer resulted in significantly higher clinical pregnancy rate (56.8%) and implantation rate (47%) compared with fresh blastocyst transfer in controlled stimulation cycles (41.07% and 31.8%, respectively). For patients under 35 years of age, the cumulative clinical pregnancy rate combining fresh and vitrified-warmed blastocyst transfer cycles were significantly higher compared to just cleavage-stage embryo transfer (70.1% versus 51.8%, p<0.05). However, the cumulative multiple pregnancy rates showed no significant difference between the two groups. In an ethnic Chinese patient population, fresh blastocyst transfer does not significantly increase clinical pregnancy rate. However, subsequent vitrified-warmed blastocyst transfer in a non-controlled ovarian hyperstimulation cycle dramatically improves clinical outcomes. Therefore, blastocyst culture in tandem with vitrified-warmed blastocyst transfer is recommended as a favourable and promising protocol in human ART treatment, particularly for ethnic Chinese patients.

  3. Epidemiology of distal radius fractures in polytrauma patients and the influence of high traumatic energy transfer.

    Science.gov (United States)

    Ferree, Steven; van der Vliet, Quirine M J; Nawijn, Femke; Bhashyam, Abhiram R; Houwert, Roderick M; Leenen, Luke P H; Hietbrink, Falco

    2018-03-01

    For several extremity fractures differences in morphology, incidence rate and functional outcome were found when polytrauma patients were compared to patients with an isolated injury. This is not proven for distal radius fractures (DRF). Therefore, this study aimed to analyse fracture morphology in relation to energy transfer in both poly- and mono-trauma patients with a DRF. This was a retrospective cohort study. All patients aged 16 years and older with a DRF were included. Patients with an Injury Severity Score of 16 or higher were classified as polytrauma patients. Injuries were defined as high or low energy. All DRFs were classified using the AO/OTA fracture classification system. A total of 830 patients with a DRF were included, 12% were polytrauma. The incidence rate of DRF in polytrauma patients was 3.5%. Ipsilateral upper extremity injury was found in >30% of polytrauma and high-energy monotrauma patients, compared to 5% in low-energy monotrauma patients. More type C DRF were found in polytrauma and high-energy monotrauma patients versus low-energy monotrauma patients. Operative intervention rates for all types of DRF were similar for polytrauma and high-energy monotrauma patients. Non-union rates were higher in polytrauma patients. Higher energy mechanisms of injury, in polytrauma and high-energy monotrauma patients, were associated with more severe complex articular distal radius fractures and more ipsilateral upper extremity injuries. Polytrauma and high-energy monotrauma patient have a similar fracture morphology. However, polytrauma patients have in addition to more injured body regions also more non-union related interventions than high-energy monotrauma patients. Copyright © 2018 Elsevier Ltd. All rights reserved.

  4. Uncovering the decision-making work of transferring dying patients home from critical care units: An integrative review.

    Science.gov (United States)

    Lin, Yanxia; Myall, Michelle; Jarrett, Nikki

    2017-12-01

    To understand how decisions are made to transfer dying patients home from critical care units. Many people prefer a home death, but a high proportion die in critical care units. Transferring dying patients home is recognized to be complex but transfer decision-making itself remains unclear. Integrative review. Seven bibliographic databases (origin-2015), grey literature and reference lists were searched. An integrative review method was used to synthesize data from diverse sources. Papers were selected through title and abstract screening and full-text reviewing, using inclusion and exclusion criteria derived from review questions. Following quality appraisal, data were extracted and synthesized using normalization process theory as a framework. The number of patients transferred home ranged from 1-346, with most papers reporting on the transfer of one or two patients. Four themes regarding transfer decision-making work were generated: divergent views and practice, multiple stakeholders' involvement in decision-making, collective work and limited understanding of individuals' experiences. The practice of transferring patients home to die and its decision-making varies internationally and is usually influenced by the care system, culture or religion. It is less common to transfer patients home to die from critical care units in western societies. A better understanding of the decision-making work was obtained but mainly from the perspective of hospital-based healthcare professionals. Further research is needed to develop decision-making practice guidance to facilitate patients' wishes to die at home. © 2017 John Wiley & Sons Ltd.

  5. Predictors of complications when transferring postoperative cardiac patients from the intensive care unit

    Directory of Open Access Journals (Sweden)

    K. V. Paromov

    2017-11-01

    Full Text Available Aim. Emphasis in the study was placed on the evaluation of predictors of complications when transferring postoperative cardiac patients from the intensive care unit (ICU.Methods. 60 patients after cardiac surgery were included into this prospective observational study, with 41 of them undergoing off-pump coronary artery bypass grafting (CABG. Before the transfer from ICU, echocardiographical criteria of their systolic and diastolic dysfunction, parameters of oxygenation, hemodynamic and metabolism status, as well as postoperative complications and duration of hospitalization were evaluated. Results. Preoperatively, the patients had a moderate degree of heart failure and preserved ejection fraction. Those patients who had undergone valvular and combined procedures using cardiopulmonary bypass had higher Euroscore II values, more severe heart failure, prolonged duration of surgery, respiratory support and hospitalization in ICU and in hospital. The echocardiographical criteria of diastolic dysfunction before transfer from ICU were recorded in 14-77% patients. Despite a normal range of blood pressure, the systolic function of the left ventricle and preload (left atrial pressure, oxygenation and metabolic status, venous to arterial carbon dioxide difference (Pv-aCO2 and left ventricle performance index (Tei exceeded the normal values before transfer from ICU. The correlation analysis revealed a relationship between duration of ICU and hospital stay and the criteria of heart failure severity (left atrial pressure [rho = 0.27, 95% CI 0.02–0.48, p = 0.04] and left ventricle dysfunction (e’ [rho = 0.41, 95% CI 0.17–0.59, p<0.01] before the transfer. The increase in fluid balance during ICU stay after off-pump coronary artery bypass surgery tended to result in a complicated postoperative period (AUC = 0.73, p = 0.02 and a higher risk of atrial fibrillation.Conclusion. The impairment of the left ventricle diastolic function before transferring from

  6. Outcomes of microvascular free tissue transfer in twice-irradiated patients.

    Science.gov (United States)

    Clancy, Kate; Melki, Sami; Awan, Musaddiq; Li, Shawn; Lavertu, Pierre; Fowler, Nicole; Yao, Min; Rezaee, Rod; Zender, Chad A

    2017-09-01

    Patients may require microvascular free tissue transfer (MFTT) following re-irradiation for recurrent cancer or radiation complications. The objective of this study was to describe the indications for and outcomes of free flaps performed in twice-radiated patients. A retrospective chart review identified the indications for and outcomes of 36 free flaps performed on 29 twice-irradiated patients. The free flap success rate was 92%. The most common indications requiring MFTT were cancer recurrence and osteoradionecrosis. Sixty-one percent experienced postoperative complications, most commonly wound infection (33%). Twenty-five percent of the procedures required return to the operating room due to postoperative complication. MFTT can be successfully performed in the twice-irradiated patient population with a success rate comparable to singly-radiated patients. Despite a high success rate, there is also a high rate of surgical site complications, especially infection. © 2017 Wiley Periodicals, Inc.

  7. The Biomechanics of Cervical Spondylosis

    Directory of Open Access Journals (Sweden)

    Lisa A. Ferrara

    2012-01-01

    Full Text Available Aging is the major risk factor that contributes to the onset of cervical spondylosis. Several acute and chronic symptoms can occur that start with neck pain and may progress into cervical radiculopathy. Eventually, the degenerative cascade causes desiccation of the intervertebral disc resulting in height loss along the ventral margin of the cervical spine. This causes ventral angulation and eventual loss of lordosis, with compression of the neural and vascular structures. The altered posture of the cervical spine will progress into kyphosis and continue if the load balance and lordosis is not restored. The content of this paper will address the physiological and biomechanical pathways leading to cervical spondylosis and the biomechanical principles related to the surgical correction and treatment of kyphotic progression.

  8. The Effect of Pterygium and Pterygium Surgery on Corneal Biomechanics.

    Science.gov (United States)

    Koç, Mustafa; Yavrum, Fuat; Uzel, Mehmet Murat; Aydemir, Emre; Özülken, Kemal; Yılmazbaş, Pelin

    2018-01-01

    To evaluate the effect of pterygium and pterygium surgery on corneal biomechanics by ocular response analyzer (ORA, Reichert, USA). This study considered 68 eyes (from 34 patients with a mean age of 21.2±7.1 years) with unilateral nasal, primary pterygium (horizontal length biomechanics. The correlation of the ORA measurements with the pterygium area was evaluated. Mean pterygium horizontal length and area were 3.31±1.43 mm and 6.82±2.17 mm 2 , respectively. There was no statistically significant difference between the eyes with and without pterygium in corneal hysteresis (CH, p=0.442), corneal resistance factor (CRF, p=0.554), corneal-compensated intraocular pressure (IOP cc , p=0.906), and Goldmann-correlated IOP (IOP g , p=0.836). All preoperative parameters decreased after surgery; however, none of them were statistically significant (CH, p=0.688; CRF, p=0.197; IOP cc , p=0.503; IOP g , p=0.231). There were no correlations between pterygium area and ORA measurements (p>0.05). Pterygium biomechanics. These results may be taken into account when cornea biomechanics, mainly intraocular pressure measurements, are important.

  9. Surface-based prostate registration with biomechanical regularization

    Science.gov (United States)

    van de Ven, Wendy J. M.; Hu, Yipeng; Barentsz, Jelle O.; Karssemeijer, Nico; Barratt, Dean; Huisman, Henkjan J.

    2013-03-01

    Adding MR-derived information to standard transrectal ultrasound (TRUS) images for guiding prostate biopsy is of substantial clinical interest. A tumor visible on MR images can be projected on ultrasound by using MRUS registration. A common approach is to use surface-based registration. We hypothesize that biomechanical modeling will better control deformation inside the prostate than a regular surface-based registration method. We developed a novel method by extending a surface-based registration with finite element (FE) simulation to better predict internal deformation of the prostate. For each of six patients, a tetrahedral mesh was constructed from the manual prostate segmentation. Next, the internal prostate deformation was simulated using the derived radial surface displacement as boundary condition. The deformation field within the gland was calculated using the predicted FE node displacements and thin-plate spline interpolation. We tested our method on MR guided MR biopsy imaging data, as landmarks can easily be identified on MR images. For evaluation of the registration accuracy we used 45 anatomical landmarks located in all regions of the prostate. Our results show that the median target registration error of a surface-based registration with biomechanical regularization is 1.88 mm, which is significantly different from 2.61 mm without biomechanical regularization. We can conclude that biomechanical FE modeling has the potential to improve the accuracy of multimodal prostate registration when comparing it to regular surface-based registration.

  10. The medical simulation markup language - simplifying the biomechanical modeling workflow.

    Science.gov (United States)

    Suwelack, Stefan; Stoll, Markus; Schalck, Sebastian; Schoch, Nicolai; Dillmann, Rüdiger; Bendl, Rolf; Heuveline, Vincent; Speidel, Stefanie

    2014-01-01

    Modeling and simulation of the human body by means of continuum mechanics has become an important tool in diagnostics, computer-assisted interventions and training. This modeling approach seeks to construct patient-specific biomechanical models from tomographic data. Usually many different tools such as segmentation and meshing algorithms are involved in this workflow. In this paper we present a generalized and flexible description for biomechanical models. The unique feature of the new modeling language is that it not only describes the final biomechanical simulation, but also the workflow how the biomechanical model is constructed from tomographic data. In this way, the MSML can act as a middleware between all tools used in the modeling pipeline. The MSML thus greatly facilitates the prototyping of medical simulation workflows for clinical and research purposes. In this paper, we not only detail the XML-based modeling scheme, but also present a concrete implementation. Different examples highlight the flexibility, robustness and ease-of-use of the approach.

  11. Confidence crisis of results in biomechanics research.

    Science.gov (United States)

    Knudson, Duane

    2017-11-01

    Many biomechanics studies have small sample sizes and incorrect statistical analyses, so reporting of inaccurate inferences and inflated magnitude of effects are common in the field. This review examines these issues in biomechanics research and summarises potential solutions from research in other fields to increase the confidence in the experimental effects reported in biomechanics. Authors, reviewers and editors of biomechanics research reports are encouraged to improve sample sizes and the resulting statistical power, improve reporting transparency, improve the rigour of statistical analyses used, and increase the acceptance of replication studies to improve the validity of inferences from data in biomechanics research. The application of sports biomechanics research results would also improve if a larger percentage of unbiased effects and their uncertainty were reported in the literature.

  12. From cure to palliation: staff communication, documentation, and transfer of patient.

    Science.gov (United States)

    Löfmark, Rurik; Nilstun, Tore; Bolmsjö, Ingrid Agren

    2005-12-01

    In the transition from curative treatment to palliative care of a general end-of-life patient population, the internal communication of the acute care staff seems to be less than optimal. The communication had reference to the dialogue within the staff both before and after the decision to concentrate on palliative care, and possible transfer of the patient. This survey of Swedish nurses and physicians showed that most of 780 respondents wanted more internal communication, and a more individualized procedure of decision-making. All staff should be informed about the decision made but full agreement was not seen as realistic. The largest difference of opinion between nurses and physicians concerned the involvement of nurses in the decision-making about the transition. A uniform documentation of the decision to transfer care focus was the ideal. Approximately every fourth patient in acute care is transferred to receive palliative care. Only approximately half of the respondents had any training in palliative care and the majority wanted more training. There seems to be a need for more palliative care training, perhaps somewhat different for each specialty. Furthermore, a common language to enable nurses and physicians to communicate more easily may improve the transition process.

  13. A simulation framework for mapping risks in clinical processes: the case of in-patient transfers.

    Science.gov (United States)

    Dunn, Adam G; Ong, Mei-Sing; Westbrook, Johanna I; Magrabi, Farah; Coiera, Enrico; Wobcke, Wayne

    2011-05-01

    To model how individual violations in routine clinical processes cumulatively contribute to the risk of adverse events in hospital using an agent-based simulation framework. An agent-based simulation was designed to model the cascade of common violations that contribute to the risk of adverse events in routine clinical processes. Clinicians and the information systems that support them were represented as a group of interacting agents using data from direct observations. The model was calibrated using data from 101 patient transfers observed in a hospital and results were validated for one of two scenarios (a misidentification scenario and an infection control scenario). Repeated simulations using the calibrated model were undertaken to create a distribution of possible process outcomes. The likelihood of end-of-chain risk is the main outcome measure, reported for each of the two scenarios. The simulations demonstrate end-of-chain risks of 8% and 24% for the misidentification and infection control scenarios, respectively. Over 95% of the simulations in both scenarios are unique, indicating that the in-patient transfer process diverges from prescribed work practices in a variety of ways. The simulation allowed us to model the risk of adverse events in a clinical process, by generating the variety of possible work subject to violations, a novel prospective risk analysis method. The in-patient transfer process has a high proportion of unique trajectories, implying that risk mitigation may benefit from focusing on reducing complexity rather than augmenting the process with further rule-based protocols.

  14. A Structured Transfer of Care Process Reduces Perioperative Complications in Cardiac Surgery Patients.

    Science.gov (United States)

    Hall, Michael; Robertson, Jamie; Merkel, Matthias; Aziz, Michael; Hutchens, Michael

    2017-08-01

    Serious complications are common during the intensive care of postoperative cardiac surgery patients. Some of these complications may be influenced by communication during the process of handover of care from the operating room to the intensive care unit (ICU) team. A structured transfer of care process may reduce the rate of communication errors and perioperative complications. We hypothesized that a collaborative, comprehensive, structured handover of care from the intraoperative team to the ICU team would reduce a specific set of postoperative complications. We tested this hypothesis by developing and introducing a comprehensive multidisciplinary transfer of care process. We measured patient outcomes before and after the intervention using a linkage between 2 care databases: an Anesthesia Information Management System and a critical care complication registry database. There were 1127 total postoperative cardiac surgery admissions during the study period, 550 before and 577 after the intervention. There was no statistical difference between overall complications before and after the intervention (P = .154). However, there was a statistically significant reduction in preventable complications after the intervention (P = .023). The main finding of this investigation is that the introduction of a collaborative, comprehensive transfer of care process from the operating room to the ICU was associated with patients suffering fewer preventable complications.

  15. The study of diagnosis status and, transfer time of stroke patients transferred by pre-hospital emergency medical system (EMS to Vali-Asr hospital in Arak City

    Directory of Open Access Journals (Sweden)

    Saiedeh Bahrampouri

    2013-08-01

    Full Text Available Introduction: Stroke is main cause of death and disability in worldwide and emergency care can decrease complications. Emergency Medical System transferred half of stroke patients to hospital, so improve accuracy of diagnosis may accelerated treatment. This study aimed to determine diagnosis status and, transfer time of stroke patients transferred by prehospital Emergency Medical System to hospital in Arak City. Methods: This study was descriptive -analytic study and all 43 patient’s records with a diagnosis of stroke that transferred by Emergency Medical System to hospital in Arak City was selected. The study Checklist was contained information about age, sex, type of accident prehospital, response time, scene time, transfer time and total time from inpatients records and Emergency Center statistics .Regarding data analysis,SPSS19 software and descriptive statistical tests were used. Results: Mean (SD of age all patients were 73/7±3/8 and 51/2% were women. Ambulance paramedics' stroke diagnosis was correct in 15 (34/9%,20(46/5%of false and 8(18/6% not diagnosed for stroke patients who initially presented to them. The most common non stroke conditions were confusion. Mean response time and scene time, transfer time and total time were 6/9,16/9,9/1 and 35/3 minutes, respectively. In patients with correct diagnose stroke, mean response, scene, transfer and total time were 7,17/1,3/9 and 35/7 minutes. The people with the wrong diagnosis or no diagnosis of stroke by emergency medical personnel were taken to hospital, Mean response, scene, transfer and total time were 6/9, 16/8,9/7 and 33/5 minutes. Conclusions: The results of this study showed that, the correct diagnosis by EMS personnel could be resulted faster transferring patient to definite treatment center.It is recommended to develop prehospital diagnosis tool of stroke, which is contextually adapted and appropriate to facilitate diagnose of strokes and improve the quality of care.

  16. Biomechanical forces promote embryonic haematopoiesis

    Science.gov (United States)

    Adamo, Luigi; Naveiras, Olaia; Wenzel, Pamela L.; McKinney-Freeman, Shannon; Mack, Peter J.; Gracia-Sancho, Jorge; Suchy-Dicey, Astrid; Yoshimoto, Momoko; Lensch, M. William; Yoder, Mervin C.; García-Cardeña, Guillermo; Daley, George Q.

    2009-01-01

    Biomechanical forces are emerging as critical regulators of embryogenesis, particularly in the developing cardiovascular system1,2. After initiation of the heartbeat in vertebrates, cells lining the ventral aspect of the dorsal aorta, the placental vessels, and the umbilical and vitelline arteries initiate expression of the transcription factor Runx1 (refs 3–5), a master regulator of haematopoiesis, and give rise to haematopoietic cells4. It remains unknown whether the biomechanical forces imposed on the vascular wall at this developmental stage act as a determinant of haematopoietic potential6. Here, using mouse embryonic stem cells differentiated in vitro, we show that fluid shear stress increases the expression of Runx1 in CD41+c-Kit+ haematopoietic progenitor cells7,concomitantly augmenting their haematopoietic colony-forming potential. Moreover, we find that shear stress increases haematopoietic colony-forming potential and expression of haematopoietic markers in the paraaortic splanchnopleura/aorta–gonads–mesonephros of mouse embryos and that abrogation of nitric oxide, a mediator of shear-stress-induced signalling8, compromises haematopoietic potential in vitro and in vivo. Collectively, these data reveal a critical role for biomechanical forces in haematopoietic development. PMID:19440194

  17. Atrophy and magnetization transfer ratio of the corpus callosum in patients with Alzheimer's disease

    International Nuclear Information System (INIS)

    Imon, Yukari; Hanyu, Haruo; Iwamoto, Toshihiko; Takasaki, Masaru; Abe, Kimihiko

    1998-01-01

    We compared atrophy and magnetization transfer ratio (MTR) in the corpus callosum in patients with Alzheimer's disease and age-matched normal subjects. Fifteen patients with Alzheimer's disease and fourteen normal subjects received MRI. The corpus callosum was divided into three parts (anterior, middle, and posterior portions) on midsagittal slice, and their areas on T2-weighted reversed images and MTR on magnetization transfer contrast images in each portion were measured. The area and MTR decreased significantly in the posterior portion in patients with Alzheimer's disease. In the anterior portion, MTR decreased significantly, but although the area showed no significant change. In the middle portion, the area and MTR showed no significant change. MTR and the area was correlated in each portion in patients with Alzheimer's disease. The score of Hasegawa dementia scale-revised (HDS-R) and the area of the middle, posterior and total of corpus callosum were significantly related. The score of HDS-R and MTR in the anterior portion of corpus callosum were significantly related. The present study revealed decreases in MTR in the anterior portion of the corpus callosum of patients with Alzheimer's disease although the area showed no significant change, and this change suggests the increase in free water and/or the decrease in bound water in tissues, probably due to demyelination and axonal degeneration. (author)

  18. Qualitative biomechanical principles for application in coaching.

    Science.gov (United States)

    Knudson, Duane

    2007-01-01

    Many aspects of human movements in sport can be readily understood by Newtonian rigid-body mechanics. Many of these laws and biomechanical principles, however, are counterintuitive to a lot of people. There are also several problems in the application of biomechanics to sports, so the application of biomechanics in the qualitative analysis of sport skills by many coaches has been limited. Biomechanics scholars have long been interested in developing principles that facilitate the qualitative application of biomechanics to improve movement performance and reduce the risk of injury. This paper summarizes the major North American efforts to establish a set of general biomechanical principles of movement, and illustrates how principles can be used to improve the application of biomechanics in the qualitative analysis of sport technique. A coach helping a player with a tennis serve is presented as an example. The standardization of terminology for biomechanical principles is proposed as an important first step in improving the application ofbiomechanics in sport. There is also a need for international cooperation and research on the effectiveness of applying biomechanical principles in the coaching of sport techniques.

  19. Perceived barriers to communication between hospital and nursing home at time of patient transfer.

    Science.gov (United States)

    Shah, Faraaz; Burack, Orah; Boockvar, Kenneth S

    2010-05-01

    To identify perceived barriers to communication between hospital and nursing home at the time of patient transfer and examine associations between perceived barriers and hospital and nursing home characteristics. Mailed survey. Medicare- or Medicaid-certified nursing homes in New York State. Nursing home administrators, with input from other nursing home staff. Respondents rated the importance as a barrier to hospital-nursing home communication of (1) hospital providers' attitude, time, effort, training, payment, and familiarity with nursing home patients; (2) unplanned and off-hours transfers; (3) HIPAA privacy regulations; and (4) lost or failed information transmission. Associations were determined between barriers and the following organizational characteristics: (1) hospital-nursing home affiliations, pharmacy or laboratory agreements, cross-site staff visits, and cross-site physician care; (2) hospital size, teaching status, and frequency of geriatrics specialty care; (3) nursing home size, location, type, staffing, and Medicare quality indicators; and (4) hospital-to-nursing home communication, consistency of hospital care with health care goals, and communication quality improvement efforts. Of 647 questionnaires sent, 229 were returned (35.4%). The most frequently reported perceived barriers to communication were sudden or unplanned transfers (44.4%), transfers that occur at night or on the weekend (41.4%), and hospital providers' lack of effort (51.0%), lack of familiarity with patients (45.0%), and lack of time (43.5%). Increased hospital size, teaching hospitals, and urban nursing home location were associated with greater perceived importance of these barriers, and cross-site staff visits and hospital provision of laboratory and pharmacy services to the nursing home were associated with lower perceived importance of these barriers. Hospital and nursing home characteristics and interorganizational relationships were associated with nursing home

  20. Turning Over Patient Turnover: An Ethnographic Study of Admissions, Discharges, and Transfers

    Science.gov (United States)

    Mowinski Jennings, Bonnie; Sandelowski, Margarete; Boshamer, Cary C.; Higgins, Melinda K.

    2014-01-01

    The impact on nursing work of patient turnover (admissions, discharges, and transfers) became evident in an ethnographic study of turbulence. The patient turnover data were generated from extensive observations, 21 formal interviews, and a year of admission and discharge records on one medical and one surgical unit. Timing of turnover events on the two units differed, but on both units admissions typically interrupted workflow more than did discharges, clustered admissions were more disruptive than staggered admissions, and patient turnover during change of shift was more disruptive than during medication administration. Understanding the complexity of patient turnover will elucidate the work involved and improve the evidence base for nurse staffing, a key determinant of quality and safety of care. PMID:24242196

  1. Recovery of forward stepping in spinal cord injured patients does not transfer to untrained backward stepping.

    Science.gov (United States)

    Grasso, Renato; Ivanenko, Yuri P; Zago, Myrka; Molinari, Marco; Scivoletto, Giorgio; Lacquaniti, Francesco

    2004-08-01

    Six spinal cord injured (SCI) patients were trained to step on a treadmill with body-weight support for 1.5-3 months. At the end of training, foot motion recovered the shape and the step-by-step reproducibility that characterize normal gait. They were then asked to step backward on the treadmill belt that moved in the opposite direction relative to standard forward training. In contrast to healthy subjects, who can immediately reverse the direction of walking by time-reversing the kinematic waveforms, patients were unable to step backward. Similarly patients were unable to perform another untrained locomotor task, namely stepping in place on the idle treadmill. Two patients who were trained to step backward for 2-3 weeks were able to develop control of foot motion appropriate for this task. The results show that locomotor improvement does not transfer to untrained tasks, thus supporting the idea of task-dependent plasticity in human locomotor networks.

  2. A technique for transferring a patient's smile line to a cone beam computed tomography (CBCT) image.

    Science.gov (United States)

    Bidra, Avinash S

    2014-08-01

    Fixed implant-supported prosthodontic treatment for patients requiring a gingival prosthesis often demands that bone and implant levels be apical to the patient's maximum smile line. This is to avoid the display of the prosthesis-tissue junction (the junction between the gingival prosthesis and natural soft tissues) and prevent esthetic failures. Recording a patient's lip position during maximum smile is invaluable for the treatment planning process. This article presents a simple technique for clinically recording and transferring the patient's maximum smile line to cone beam computed tomography (CBCT) images for analysis. The technique can help clinicians accurately determine the need for and amount of bone reduction required with respect to the maximum smile line and place implants in optimal positions. Copyright © 2014 Editorial Council for the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.

  3. Extracorporeal circulatory systems in the interhospital transfer of critically ill patients: experience of a single institution

    International Nuclear Information System (INIS)

    Haneya, Assad; Philipp, Alois; Foltan, Maik; Camboni, Daniele; Rupprecht, Leopold; Puehler, Thomas; Hirt, Stephan; Hilker, Michael; Kobuch, Reinhard; Schmid, Christof; Arlt, Matthias; Mueller, Thomas

    2009-01-01

    Critically ill patients with acute circulatory failure cannot be moved to other institutions unless stabilized by mechanical support systems. Extracorporeal heart and lung assist systems are increasingly used as a bridge to end-organ recovery or transplantation, and as an ultimate rescue tool in cardiopulmonary resuscitation. From July 2001 to April 2008, we had 38 requests for extracorporeal support for interhospital transfer carried out by the air medical service. Respiratory failure was present in 29 patients, who were provided with pumpless extracorporeal lung assist (PECLA) or veno-venous extracorporeal membrane oxygenation (ECMO). Cardiac failure dominated in 9 patients, who underwent implantation of extracorporeal life support (ECLS). Underlying diseases were acute respiratory distress syndrome in 15 patients, pneumonia in 7, prior lung transplant status in 4, cardiogenic shock in 7, and septic shock in 4. All assist systems were connected via peripheral vessels by the Seldinger technique. Transport was uneventful in all cases with no technical failures. On arrival at the specialized care hospital, two patients had leg ischemia and underwent relocation of the arterial cannula. After a mean (SD) support of 5.1 (3.0) days for PECLA, 3.5 (2.9) days for ECLS, and 7.3 (5.8) days for ECMO, 60%, 66%, and 66% of patients, respectively, could be successfully weaned from the systems. Discharge rates were 45% for PECLA, 44% for ECLS, and 56% for ECMO. Our experience proves that minimized extracorporeal assist devices allow safe assistance of patients with isolated or combined heart and lung failure in need of interhospital transfer. Critically ill patients get a chance to reach a center of maximum medical care. (author)

  4. An Anatomic and Biomechanical Comparison of Bankart Repair Configurations.

    Science.gov (United States)

    Judson, Christopher H; Voss, Andreas; Obopilwe, Elifho; Dyrna, Felix; Arciero, Robert A; Shea, Kevin P

    2017-11-01

    biomechanical properties compared with single-row repair techniques. There was no difference in footprint coverage or biomechanical strength between the simple suture and horizontal mattress suture repair techniques. Although the double-row repair techniques had no difference in initial strength, they may improve healing in high-risk patients by improving the footprint coverage.

  5. Comparison of Healthcare Workers Transferring Patients Using Either Conventional Or Robotic Wheelchairs: Kinematic, Electromyographic, and Electrocardiographic Analyses

    Directory of Open Access Journals (Sweden)

    Hiromi Matsumoto

    2016-01-01

    Full Text Available Objectives. The aim of this study was to compare the musculoskeletal and physical strain on healthcare workers, by measuring range of motion (ROM, muscle activity, and heart rate (HR, during transfer of a simulated patient using either a robotic wheelchair (RWC or a conventional wheelchair (CWC. Methods. The subjects were 10 females who had work experience in transferring patients and another female adult as the simulated patient to be transferred from bed to a RWC or a CWC. In both experimental conditions, ROM, muscle activity, and HR were assessed in the subjects using motion sensors, electromyography, and electrocardiograms. Results. Peak ROM of shoulder flexion during assistive transfer with the RWC was significantly lower than that with the CWC. Values for back muscle activity during transfer were lower with the RWC than with the CWC. Conclusions. The findings suggest that the RWC may decrease workplace injuries and lower back pain in healthcare workers.

  6. [Evaluation of corneal biomechanics in keratoconus using dynamic ultra-high-speed Scheimpflug measurements].

    Science.gov (United States)

    Brettl, S; Franko Zeitz, P; Fuchsluger, T A

    2018-06-22

    The in vivo analysis of corneal biomechanics in patients with keratoconus is especially of interest with respect to diagnosis, follow-up and monitoring of the disease. For a better understanding it is necessary to describe the potential of dynamic Scheimpflug measurements for the detection and interpretation of biomechanical changes in keratoconus. The current state of analyzing biomechanical changes in keratoconus with the Corvis ST (Oculus Optikgeräte GmbH, Wetzlar, Germany) is described. This technique represents a new approach for understanding corneal biomechanics. Furthermore, it was investigated whether the device can biomechanically quantify a rigidity increasing effect of therapeutic UV-crosslinking and whether early stages of keratoconus can be detected using dynamic Scheimpflug analysis. In patients with keratoconus, the in vivo analysis of corneal biomechanics using dynamic Scheimpflug measurements as a supplementary procedure can be of advantage with respect to disease management. By optimization of screening of subclinical keratoconus stages, this method widens the analytic spectrum regarding diagnosis and follow-up of the disease; however, further studies are required to evaluate whether visual outcome of affected patients can be improved by earlier diagnosis.

  7. A novel biomechanical model assessing continuous orthodontic archwire activation

    Science.gov (United States)

    Canales, Christopher; Larson, Matthew; Grauer, Dan; Sheats, Rose; Stevens, Clarke; Ko, Ching-Chang

    2013-01-01

    Objective The biomechanics of a continuous archwire inserted into multiple orthodontic brackets is poorly understood. The purpose of this research was to apply the birth-death technique to simulate insertion of an orthodontic wire and consequent transfer of forces to the dentition in an anatomically accurate model. Methods A digital model containing the maxillary dentition, periodontal ligament (PDL), and surrounding bone was constructed from human computerized tomography data. Virtual brackets were placed on four teeth (central and lateral incisors, canine and first premolar), and a steel archwire (0.019″ × 0.025″) with a 0.5 mm step bend to intrude the lateral incisor was virtually inserted into the bracket slots. Forces applied to the dentition and surrounding structures were simulated utilizing the birth-death technique. Results The goal of simulating a complete bracket-wire system on accurate anatomy including multiple teeth was achieved. Orthodontic force delivered by the wire-bracket interaction was: central incisor 19.1 N, lateral incisor 21.9 N, and canine 19.9 N. Loading the model with equivalent point forces showed a different stress distribution in the PDL. Conclusions The birth-death technique proved to be a useful biomechanical simulation method for placement of a continuous archwire in orthodontic brackets. The ability to view the stress distribution throughout proper anatomy and appliances advances understanding of orthodontic biomechanics. PMID:23374936

  8. Mandibular reconstruction in the radiated patient: the role of osteocutaneous free tissue transfers

    International Nuclear Information System (INIS)

    Duncan, M.J.; Manktelow, R.T.; Zuker, R.M.; Rosen, I.B.

    1985-01-01

    This paper discusses our experience with the second metatarsal and iliac crest osteocutaneous transfers for mandibular reconstruction. The prime indication for this type of reconstruction was for anterior mandibular defects when the patient had been previously resected. Midbody to midbody defects were reconstructed with the metatarsal and larger defects with the iliac crest. In most cases, an osteotomy was done to create a mental angle. The evaluation of speech, oral continence, and swallowing revealed good results in all patients unless lip or tongue resection compromised function. Facial contour was excellent in metatarsal reconstructions. The iliac crest cutaneous flap provided a generous supply of skin for both intraoral reconstruction and external skin coverage but tended to be bulky, particularly when used in the submental area. Thirty three of 36 flaps survived completely. Flap losses were due to anastomosis thrombosis (1), pedicle compression (1), and pedicle destruction during exploration for suspected carotid blowout (1). Ninety three percent of bone junctions developed a solid bony union despite the mandible having had a full therapeutic dose of preoperative radiation. Despite wound infections in 8 patients, and intraoral dehiscence with bone exposure in 12 patients, all but one of these transfers went on to good bony union without infection in the bone graft

  9. Mandibular reconstruction in the radiated patient: the role of osteocutaneous free tissue transfers

    Energy Technology Data Exchange (ETDEWEB)

    Duncan, M.J.; Manktelow, R.T.; Zuker, R.M.; Rosen, I.B.

    1985-12-01

    This paper discusses our experience with the second metatarsal and iliac crest osteocutaneous transfers for mandibular reconstruction. The prime indication for this type of reconstruction was for anterior mandibular defects when the patient had been previously resected. Midbody to midbody defects were reconstructed with the metatarsal and larger defects with the iliac crest. In most cases, an osteotomy was done to create a mental angle. The evaluation of speech, oral continence, and swallowing revealed good results in all patients unless lip or tongue resection compromised function. Facial contour was excellent in metatarsal reconstructions. The iliac crest cutaneous flap provided a generous supply of skin for both intraoral reconstruction and external skin coverage but tended to be bulky, particularly when used in the submental area. Thirty three of 36 flaps survived completely. Flap losses were due to anastomosis thrombosis (1), pedicle compression (1), and pedicle destruction during exploration for suspected carotid blowout (1). Ninety three percent of bone junctions developed a solid bony union despite the mandible having had a full therapeutic dose of preoperative radiation. Despite wound infections in 8 patients, and intraoral dehiscence with bone exposure in 12 patients, all but one of these transfers went on to good bony union without infection in the bone graft.

  10. A review of biomechanics of the shoulder and biomechanical concepts of rotator cuff repair

    Directory of Open Access Journals (Sweden)

    Nobuyuki Yamamoto

    2015-01-01

    Full Text Available In this article, we describe the basic knowledge about shoulder biomechanics, which is thought to be useful for surgeons. Some clinical reports have described that the excellent outcome after cuff repair without acromioplasty and a limited acromioplasty might be enough for subacromial decompression. It was biomechanically demonstrated that a 10-mm medial shift of the tendon repair site has a minimum effect on biomechanics. Many biomechanical studies reported that the transosseous equivalent repair was superior to other techniques, although the tendon may lose its inherent elasticity. We herein introduce our recent experiment data and latest information on biomechanics.

  11. Biomechanical comparisons between a new avascular necrosis of femaral head stem based on Chinese patients with avascular necrosis and two other designs.

    Science.gov (United States)

    Zhang, Qiang; Cheng, Cheng-Kung; Wei, Hung-Wen; Dong, Xiang; Chen, Yi-Ting; Lai, Yu-Shu; Wang, Yan

    2013-01-01

    There is a relatively high failure rate of the femoral component in patients with avascular necrosis at the intermediate-term follow-up. Improving the geometrical fit of the femoral stem against the medullary canal may help to provide long-term survivorship of the hip replacement for patients with avascular necrosis. We designed a specific stem, based on morphometric studies of proximal femoral canals in Chinese avascular necrosis patients and evaluated the stem by finite element analyses, comparing the novel stem with two commercially available and commonly used stems. The morphometric data from avascular necrosis patients showed specific geometric differences in the proximal femoral canal, including profile curves in both the sagittal and coronary planes than the patients with femoral neck fracture. The shorter stemmed prostheses (Fitmore(®) and our stem) performed better than the longer stemmed prosthesis (VerSys(®)). This is the first study to investigate the femoral geometries of Chinese avascular necrosis patients. Our stem provides better stability and is theoretically beneficial to bone ingrowth, which may increase the long-term stability and fixation of the implant.

  12. Transfer of copper from a chelated 67Cu-antibody conjugate to ceruloplasmin in lymphoma patients

    International Nuclear Information System (INIS)

    Mirick, Gary R.; O'Donnell, Robert T.; DeNardo, Sally J.; Shen Sui; Meares, Claude F.; DeNardo, Gerald L.

    1999-01-01

    The Lym-1 monoclonal antibody was conjugated with the bifunctional chelating agent 6-[p-(bromoacetamido)benzyl]-1,4,8,11-tetraazacyclotetradecane-N,N',N'',N' -tetraacetic acid (BAT), using 2IT as a linker, and radiolabeled with 67 Cu to make the radiopharmaceutical, 67 Cu-2IT-BAT-Lym-1. Ten patients received a total of 18 doses of 67 Cu-2IT-BAT-Lym-1 as targeted, systemic radiotherapy. The beta phase of blood clearance, when corrected for 67 Cu decay, was positive or flat, a phenomenon not observed in similar patients treated with 131 I-Lym-1. The flat beta phase of blood clearance suggested recycling of 67 Cu from 67 Cu-2IT-BAT-Lym-1 to another plasma protein. Therefore, the amount of 67 Cu transferred from the radiopharmaceutical to CP, Alb, and TF was measured using affinity-purified polyclonal antibodies. The fraction of plasma 67 Cu precipitated by anti-human CP increased daily; most blood radioactivity was 67 Cu-CP after a median of 4 days (range 2-7 days). The transfer of 67 Cu to CP was observed in all patients and was consistent from dose to dose within the same patient. An average of 2.8±1.5% (range 0.8-7.8%) of the 67 Cu dose (%ID) was transferred to CP. The release rate of 67 Cu-CP from the liver into the blood was 0.9±0.4 %ID/day for the first 3 days. The 67 Cu-CP effective clearance half-life was 3.7 ± 0.7 days. Subtraction of the 67 Cu-CP activity from the total blood radioactivity yielded a biphasic blood clearance similar to that obtained for patients given 131 I-Lym-1. Cu-67-CP increased the AUC for whole blood by 24 ± 10%. The %ID of 67 Cu recycled correlated with GGT, ALT, and alkaline phosphatase levels; r=0.958 (p 67 Cu-2IT-BAT-Lym-1 and recycles a small fraction of the 67 Cu, transferring it to CP

  13. Applied Biomechanics in an Instructional Setting

    Science.gov (United States)

    Hudson, Jackie L.

    2006-01-01

    Biomechanics is the science of how people move better, meaning more skillfully and more safely. This article places more emphasis on skill rather than safety, though there are many parallels between them. It shares a few features of the author's paradigm of applied biomechanics and discusses an integrated approach toward a middle school football…

  14. Manual patient transfers used most often by student and staff nurses are consistent with their perceptions of transfer training, and performance confidence.

    Science.gov (United States)

    van Wyk, Paula M; Weir, Patricia L; Andrews, David M

    2015-01-01

    A disconnect in manual patient transfer (MPT) training practices for nurses, between what is taught and used in academic and clinical settings, could have implications for injury. This study aimed to determine: 1. what MPTs student and staff nurses use in clinical settings, and 2. if the MPTs used most often were also the ones they perceived that they received training for and had the most confidence performing. Survey responses from student nurses (n=163) (mid-sized university) and staff nurses (n=33) (local hospital) regarding 19 MPTs were analyzed to determine which transfers were perceived to be used most often, and which ones they had received training for and had the greatest confidence performing. The MPTs nurses perceived using most often were the same transfers they had the greatest confidence performing and for which they perceived receiving training. However, these MPTs were not taught at the university at the time of this investigation. Reducing the disconnect between manual patient transfer training obtained in the academic and clinical environments will hopefully reduce the risk of injury for nurses and improve the quality of care for patients.

  15. Patient Transfers and Risk of Back Injury: Protocol for a Prospective Cohort Study With Technical Measurements of Exposure.

    Science.gov (United States)

    Vinstrup, Jonas; Madeleine, Pascal; Jakobsen, Markus Due; Jay, Kenneth; Andersen, Lars Louis

    2017-11-08

    More than one third of nurses experience musculoskeletal pain several times during a normal work week. Consistent use of assistive devices during patient transfers is associated with a lower risk of occupational back injuries and low back pain (LBP). While uncertainties exist regarding which type of assistive devices most efficiently prevent LBP, exposure assessments using technological advancements allow for quantification of muscle load and body positions during common work tasks. The main objectives of this study are (1) to quantify low back and neck/shoulder muscle load in Danish nurses during patient transfers performed with different types of assistive devices, and (2) to combine the exposure profile for each type of assistive device with fortnightly questionnaires to identify the importance of muscle load (intensity and frequency of transfers) and body position (degree of back inclination and frequency) on LBP intensity and risk of back injury during a patient transfer. A combination of technical measurements (n=50) and a prospective study design (n=2000) will be applied on a cohort of female nurses in Danish hospitals. The technical measurements will be comprised of surface electromyography and accelerometers, with the aim of quantifying muscle load and body positions during various patient transfers, including different types of assistive devices throughout a workday. The study will thereby gather measurements during real-life working conditions. The prospective cohort study will consist of questionnaires at baseline and 1-year follow-up, as well as follow-up via email every other week for one year on questions regarding the frequency of patient transfers, use of assistive devices, intensity of LBP, and back injuries related to patient transfers. The objective measurements on muscle load and body positions during patient handlings will be applied to the fortnightly replies regarding frequency of patient transfer and use of different assistive devices, in

  16. Biomechanical properties of bone allografts

    International Nuclear Information System (INIS)

    Pelker, R.R.; Friedlaender, G.E.; Markham, T.C.

    1983-01-01

    The biomechanical properties of allograft bone can be altered by the methods chosen for its preservation and storage. These effects are minimal with deep-freezing or low-level radiation. Freeze-drying, however, markedly diminishes the torsional and bending strength of bone allografts but does not deleteriously affect the compressive or tensile strength. Irradiation of bone with more than 3.0 megarad or irradiation combined with freeze-drying appears to cause a significant reduction in breaking strength. These factors should be considered when choosing freeze-dried or irradiated allogeneic bone that will be subjected to significant loads following implantation

  17. A simulation framework for mapping risks in clinical processes: the case of in-patient transfers

    Science.gov (United States)

    Ong, Mei-Sing; Westbrook, Johanna I; Magrabi, Farah; Coiera, Enrico; Wobcke, Wayne

    2011-01-01

    Objective To model how individual violations in routine clinical processes cumulatively contribute to the risk of adverse events in hospital using an agent-based simulation framework. Design An agent-based simulation was designed to model the cascade of common violations that contribute to the risk of adverse events in routine clinical processes. Clinicians and the information systems that support them were represented as a group of interacting agents using data from direct observations. The model was calibrated using data from 101 patient transfers observed in a hospital and results were validated for one of two scenarios (a misidentification scenario and an infection control scenario). Repeated simulations using the calibrated model were undertaken to create a distribution of possible process outcomes. The likelihood of end-of-chain risk is the main outcome measure, reported for each of the two scenarios. Results The simulations demonstrate end-of-chain risks of 8% and 24% for the misidentification and infection control scenarios, respectively. Over 95% of the simulations in both scenarios are unique, indicating that the in-patient transfer process diverges from prescribed work practices in a variety of ways. Conclusions The simulation allowed us to model the risk of adverse events in a clinical process, by generating the variety of possible work subject to violations, a novel prospective risk analysis method. The in-patient transfer process has a high proportion of unique trajectories, implying that risk mitigation may benefit from focusing on reducing complexity rather than augmenting the process with further rule-based protocols. PMID:21486883

  18. Problems of Sport Biomechanics and Robotics

    Directory of Open Access Journals (Sweden)

    Wlodzimierz S. Erdmann

    2013-02-01

    Full Text Available This paper presents many common areas of interest of different specialists. There are problems described from sport, biomechanics, sport biomechanics, sport engineering, robotics, biomechanics and robotics, sport biomechanics and robotics. There are many approaches to sport from different sciences and engineering. Robotics is a relatively new area and has had moderate attention from sport specialists. The aim of this paper is to present several areas necessary to develop sport robots based on biomechanics and also to present different types of sport robots: serving balls, helping to provide sports training, substituting humans during training, physically participating in competitions, physically participating in competitions against humans, serving as models of real sport performance, helping organizers of sport events and robot toys. Examples of the application of robots in sports communities are also given.

  19. Acupuncture on the day of embryo transfer: a randomized controlled trial of 635 patients

    DEFF Research Database (Denmark)

    Andersen, Dorota; Løssl, Kristine; Nyboe Andersen, Anders

    2010-01-01

    group, the ongoing pregnancy rates were 27% (95% CI 22-32) and 32% (95% CI 27-37), respectively. Live birth rates were 25% (95% CI 20-30) in the acupuncture group and 30% (95% CI 25-30) in the placebo group. The differences were not statistically significant. These results suggest that acupuncture......This prospective, randomized, controlled and double-blinded trial studied whether acupuncture in relation to embryo transfer could increase the ongoing pregnancy rates and live birth rates in women undergoing assisted reproductive therapy. A total of 635 patients undergoing IVF or intracytoplasmic...

  20. Lost productivity in four European countries among patients with rheumatic disorders: are absenteeism and presenteeism transferable?

    Science.gov (United States)

    Knies, Saskia; Candel, Math J J M; Boonen, Annelies; Evers, Silvia M A A; Ament, Andre J H A; Severens, Johan L

    2012-09-01

    When national pharmacoeconomic guidelines are compared, different recommendations are identified on how to identify, measure and value lost productivity, leading to difficulties when comparing lost productivity estimates across countries. From a transferability point of view, the question arises of whether differences between countries regarding lost productivity are the result of using different calculation methods (methodological differences) or of other between-country differences. When lost productivity data differ significantly across countries, the transferability of lost productivity data across countries is hindered. The objective of this study was to investigate whether country of residence has a significant influence on the quantity of lost productivity among patients with rheumatic disorders. Confounding factors that might differ between countries were corrected for, while the methodology used to identify and measure lost productivity was kept the same. This question was investigated by means of an online questionnaire filled out by 200 respondents with a rheumatic disorder per country in four European countries, namely the Netherlands, the UK, Germany and France. In addition to those regarding lost productivity, the questionnaire contained questions about patient characteristics, disability insurance, disease characteristics, quality of life and job characteristics as these variables are expected to influence lost productivity in terms of absenteeism and presenteeism. The data were analysed by regression analyses, in which different components - being absent in last 3 months, number of days absent and presenteeism - of lost productivity were the main outcome measures and other variables, such as gender, impact of disease, shift work, job control, partial disability and overall general health, were corrected for. The results showed that country sometimes has a significant influence on lost productivity and that other variables such as, for example, age

  1. Benzodiazepines II: Waking Up on Sedatives: Providing Optimal Care When Inheriting Benzodiazepine Prescriptions in Transfer Patients

    Directory of Open Access Journals (Sweden)

    Jeffrey Guina

    2018-01-01

    Full Text Available This review discusses risks, benefits, and alternatives in patients already taking benzodiazepines when care transfers to a new clinician. Prescribers have the decision—sometimes mutually agreed-upon and sometimes unilateral—to continue, discontinue, or change treatment. This decision should be made based on evidence-based indications (conditions and timeframes, comorbidities, potential drug-drug interactions, and evidence of adverse effects, misuse, abuse, dependence, or diversion. We discuss management tools involved in continuation (e.g., monitoring symptoms, laboratory testing, prescribing contracts, state prescription databases, stages of change and discontinuation (e.g., tapering, psychotherapeutic interventions, education, handouts, reassurance, medications to assist with discontinuation, and alternative treatments.

  2. Biomechanical and neuromuscular adaptations during the landing phase of a stepping-down task in patients with early or established knee osteoarthritis

    NARCIS (Netherlands)

    Sanchez-Ramirez, Diana C.; Malfait, Bart; Baert, Isabel; van der Leeden, Marike; van Dieën, Jaap; Lems, Willem F.; Dekker, Joost; Luyten, Frank P.; Verschueren, Sabine

    Background: To compare the knee joint kinematics, kinetics and EMG activity patterns during a stepping-down task in patients with knee osteoarthritis (OA) with control subjects. Methods: 33 women with knee OA (early OA, n = 14; established OA n = 19) and 14 female control subjects performed a

  3. Nuclear overhauser enhancement mediated chemical exchange saturation transfer imaging at 7 Tesla in glioblastoma patients.

    Directory of Open Access Journals (Sweden)

    Daniel Paech

    Full Text Available BACKGROUND AND PURPOSE: Nuclear Overhauser Enhancement (NOE mediated chemical exchange saturation transfer (CEST is a novel magnetic resonance imaging (MRI technique on the basis of saturation transfer between exchanging protons of tissue proteins and bulk water. The purpose of this study was to evaluate and compare the information provided by three dimensional NOE mediated CEST at 7 Tesla (7T and standard MRI in glioblastoma patients. PATIENTS AND METHODS: Twelve patients with newly diagnosed histologically proven glioblastoma were enrolled in this prospective ethics committee-approved study. NOE mediated CEST contrast was acquired with a modified three-dimensional gradient-echo sequence and asymmetry analysis was conducted at 3.3 ppm (B1 = 0.7 µT to calculate the magnetization transfer ratio asymmetry (MTR(asym. Contrast enhanced T1 (CE-T1 and T2-weighted images were acquired at 3T and used for data co-registration and comparison. RESULTS: Mean NOE mediated CEST signal based on MTR(asym values over all patients was significantly increased (p<0.001 in CE-T1 tumor (-1.99 ± 1.22%, tumor necrosis (-1.36 ± 1.30% and peritumoral CEST hyperintensities (PTCH within T2 edema margins (-3.56 ± 1.24% compared to contralateral normal appearing white matter (-8.38 ± 1.19%. In CE-T1 tumor (p = 0.015 and tumor necrosis (p<0.001 mean MTR(asym values were significantly higher than in PTCH. Extent of the surrounding tumor hyperintensity was smaller in eight out of 12 patients on CEST than on T2-weighted images, while four displayed at equal size. In all patients, isolated high intensity regions (0.40 ± 2.21% displayed on CEST within the CE-T1 tumor that were not discernible on CE-T1 or T2-weighted images. CONCLUSION: NOE mediated CEST Imaging at 7 T provides additional information on the structure of peritumoral hyperintensities in glioblastoma and displays isolated high intensity regions within the CE-T1 tumor that cannot be acquired on CE-T1 or T2

  4. Magnetization transfer imaging of periventricular white matter lesions in patients with multi-infarct dementia

    International Nuclear Information System (INIS)

    Hanyu, Haruo; Imon, Yukari; Asano, Tetsuichi; Iwamoto, Toshihiko; Takasaki, Masaru

    1998-01-01

    Using magnetization transfer (MT) imaging, we studied the underlying pathological conditions of periventricular hyperintense (PVH) white matter changes seen on T2-weighted MR images of patients with multi-infarct dementia. Twenty-two patients with multiple lacunar infarcts and PVH lesions, including 11 with dementia (diagnosed as multi-infarct dementia) and 11 without dementia, and 10 control subjects (with multiple lacunes, but no PVH lesion) were studied using the MT technique. MT ratios (MTRs) were calculated for PVH lesions (normal-appearing frontal white matter in controls) and the genu of the corpus callosum. Signal intensities on T2-weighted images in PVH lesions of patients were significantly higher than those in normal-appearing white matter of controls, while there were no significant differences in signal intensity in the genu of the corpus callosum among the dementia, non-dementia and control groups. However, MTRs in patients with PVH lesions were significantly lower than those in controls, and MTRs in demented patients were significantly lower than those in non-demented patients. Moreover, MTRs in the genu of the corpus callosum of demented patients were significantly lower than in those in non-demented patients and controls. MTRs in PVH lesions and the genu of the corpus callosum significantly correlated with Hasegawa's dementia scale score. These results suggest that there is some difference in histopathologic changes of PVH lesions between demented and non-demented patients and that the pathological substrate in the corpus callosum may play a role in inducing cognitive decline. Studies with MT imaging may allow the characterization of different pathological conditions that cannot be visualized by conventional MRI. (author)

  5. ES-2 Dummy Biomechanical Responses.

    Science.gov (United States)

    Byrnes, Katie; Abramczyk, Joseph; Berliner, Jeff; Irwin, Annette; Jensen, Jack; Kowsika, Murthy; Mertz, Harold J; Rouhana, Stephen W; Scherer, Risa; Shi, Yibing; Sutterfield, Aleta; Xu, Lan; Tylko, Suzanne; Dalmotas, Dainius

    2002-11-01

    This technical paper presents the results of biomechanical testing conducted on the ES-2 dummy by the Occupant Safety Research Partnership and Transport Canada. The ES-2 is a production dummy, based on the EuroSID-1 dummy, that was modified to further improve testing capabilities as recommended by users of the EuroSID-1 dummy. Biomechanical response data were obtained by completing a series of drop, pendulum, and sled tests that are outlined in the International Organization of Standardization Technical Report 9790 that describes biofidelity requirements for the midsize adult male side impact dummy. A few of the biofidelity tests were conducted on both sides of the dummy to evaluate the symmetry of its responses. Full vehicle crash tests were conducted to verify if the changes in the EuroSID-1, resulting in the ES-2 design, did improve the dummy's testing capability. In addition to the biofidelity testing, the ES-2 dummy repeatability, reproducibility and durability are discussed. Finally, this technical paper will compare the biofidelity ratings of the current adult side impact dummies with the ES-2 dummy, which received an overall dummy biofidelity rating of 4.6.

  6. Toward characterization of craniofacial biomechanics.

    Science.gov (United States)

    Szwedowski, Tomasz D; Whyne, Cari M; Fialkov, Jeffrey A

    2010-01-01

    Surgical reconstruction of craniofacial deformities has advanced significantly in recent years. However, unlike orthopedic surgery of the appendicular skeleton, the biomechanical characterization of the human craniofacial skeleton (CFS) has yet to be elucidated. Attempts to simplify facial skeletal structure into straightforward mechanical device analogies have been insufficient in delineating craniofacial biomechanics. Advanced computational engineering analysis methods offer the potential to accurately and completely define the internal mechanical environment of the CFS. This study developed a finite element (FE) model in the I-deas 10 FEM software package of a preserved cadaveric human CFS and compared the predictions of this model against in vitro strain measurement of simulated occlusal loading forces from a single masseter muscle. The FE model applied shell element modeling to capture the behavior of the thin cortical bone that may play an important role in stabilizing the facial structures against functional loads. In vitro testing included strain measurements at 12 locations for a total of 16 independent channels with less than 150 N of tensile force applied through the masseter muscle into the zygomatic arch origin at 4 different orientations, with 3 trials of 500 recorded data points for each loading orientation. Linear regression analysis yielded a moderate prediction (r = 0.57) between the model and experimentally measured strains. Exclusion of strain comparisons in regions that required greater modeling assumptions greatly improved the correlation (r = 0.70). Future validation studies will benefit from improved placement of strain gauges as guided by FE model predicted strain patterns.

  7. Benefits of Repetitive Transcranial Magnetic Stimulation (rTMS for Spastic Subjects: Clinical, Functional, and Biomechanical Parameters for Lower Limb and Walking in Five Hemiparetic Patients

    Directory of Open Access Journals (Sweden)

    Luc Terreaux

    2014-01-01

    Full Text Available Introduction. Spasticity is a disabling symptom resulting from reorganization of spinal reflexes no longer inhibited by supraspinal control. Several studies have demonstrated interest in repetitive transcranial magnetic stimulation in spastic patients. We conducted a prospective, randomized, double-blind crossover study on five spastic hemiparetic patients to determine whether this type of stimulation of the premotor cortex can provide a clinical benefit. Material and Methods. Two stimulation frequencies (1 Hz and 10 Hz were tested versus placebo. Patients were assessed clinically, by quantitative analysis of walking and measurement of neuromechanical parameters (H and T reflexes, musculoarticular stiffness of the ankle. Results. No change was observed after placebo and 10 Hz protocols. Clinical parameters were not significantly modified after 1 Hz stimulation, apart from a tendency towards improved recruitment of antagonist muscles on the Fügl-Meyer scale. Only cadence and recurvatum were significantly modified on quantitative analysis of walking. Neuromechanical parameters were modified with significant decreases in Hmax⁡ /Mmax⁡ and T/Mmax⁡ ratios and stiffness indices 9 days or 31 days after initiation of TMS. Conclusion. This preliminary study supports the efficacy of low-frequency TMS to reduce reflex excitability and stiffness of ankle plantar flexors, while clinical signs of spasticity were not significantly modified.

  8. Benefits of repetitive transcranial magnetic stimulation (rTMS) for spastic subjects: clinical, functional, and biomechanical parameters for lower limb and walking in five hemiparetic patients.

    Science.gov (United States)

    Terreaux, Luc; Gross, Raphael; Leboeuf, Fabien; Desal, Hubert; Hamel, Olivier; Nguyen, Jean Paul; Pérot, Chantal; Buffenoir, Kévin

    2014-01-01

    Introduction. Spasticity is a disabling symptom resulting from reorganization of spinal reflexes no longer inhibited by supraspinal control. Several studies have demonstrated interest in repetitive transcranial magnetic stimulation in spastic patients. We conducted a prospective, randomized, double-blind crossover study on five spastic hemiparetic patients to determine whether this type of stimulation of the premotor cortex can provide a clinical benefit. Material and Methods. Two stimulation frequencies (1 Hz and 10 Hz) were tested versus placebo. Patients were assessed clinically, by quantitative analysis of walking and measurement of neuromechanical parameters (H and T reflexes, musculoarticular stiffness of the ankle). Results. No change was observed after placebo and 10 Hz protocols. Clinical parameters were not significantly modified after 1 Hz stimulation, apart from a tendency towards improved recruitment of antagonist muscles on the Fügl-Meyer scale. Only cadence and recurvatum were significantly modified on quantitative analysis of walking. Neuromechanical parameters were modified with significant decreases in H max⁡ /M max⁡ and T/M max⁡ ratios and stiffness indices 9 days or 31 days after initiation of TMS. Conclusion. This preliminary study supports the efficacy of low-frequency TMS to reduce reflex excitability and stiffness of ankle plantar flexors, while clinical signs of spasticity were not significantly modified.

  9. Revenue, relationships and routines: the social organization of acute myocardial infarction patient transfers in the United States.

    Science.gov (United States)

    Veinot, Tiffany C; Bosk, Emily A; Unnikrishnan, K P; Iwashyna, Theodore J

    2012-11-01

    Heart attack, or acute myocardial infarction (AMI), is a leading cause of death in the United States (U.S.). The most effective therapy for AMI is rapid revascularization: the mechanical opening of the clogged artery in the heart. Forty-four percent of patients with AMI who are admitted to a non-revascularization hospital in the U.S. are transferred to a hospital with that capacity. Yet, we know little about the process by which community hospitals complete these transfers, and why publicly available hospital quality data plays a small role in community hospitals' choice of transfer destinations. Therefore, we investigated how community hospital staff implement patient transfers and select destinations. We conducted a mixed methods study involving: interviews with staff at three community hospitals (n = 25) in a Midwestern state and analysis of U.S. national Medicare records for 1996-2006. Community hospitals in the U.S., including our field sites, typically had longstanding relationships with one key receiving hospital. Community hospitals addressed the need for rapid AMI patient transfers by routinizing the collective, interhospital work process. Routinization reduced staff uncertainty, coordinated their efforts and conserved their cognitive resources for patient care. While destination selection was nominally a physician role, the decision was routinized, such that staff immediately contacted a "usual" transfer destination upon AMI diagnosis. Transfer destination selection was primarily driven at an institutional level by organizational concerns and bed supply, rather than physician choice or patient preference. Transfer routinization emerged as a form of social order that invoked tradeoffs between process speed and efficiency and patient-centered, quality-driven decision making. We consider the implications of routinization and institutional imperatives for health policy, quality improvement and health informatics interventions. Copyright © 2012 Elsevier Ltd

  10. Simulation of facial expressions using person-specific sEMG signals controlling a biomechanical face model

    NARCIS (Netherlands)

    Eskes, M.; Balm, A.J.M.; van Alphen, M.J.A.; Smeele, L.E.; Stavness, I.; van der Heijden, F.

    2018-01-01

    Purpose: Functional inoperability in advanced oral cancer is difficult to assess preoperatively. To assess functions of lips and tongue, biomechanical models are required. Apart from adjusting generic models to individual anatomy, muscle activation patterns (MAPs) driving patient-specific functional

  11. Simulation of facial expressions using person-specific sEMG signals controlling a biomechanical face model

    NARCIS (Netherlands)

    Eskes, Merijn; Balm, Alfons J. M.; van Alphen, Maarten J. A.; Smeele, Ludi E.; Stavness, Ian; van der Heijden, Ferdinand

    2018-01-01

    Purpose Functional inoperability in advanced oral cancer is difficult to assess preoperatively. To assess functions of lips and tongue, biomechanical models are required. Apart from adjusting generic models to individual anatomy, muscle activation patterns (MAPs) driving patient-specific functional

  12. Translating ocular biomechanics into clinical practice: current state and future prospects.

    Science.gov (United States)

    Girard, Michaël J A; Dupps, William J; Baskaran, Mani; Scarcelli, Giuliano; Yun, Seok H; Quigley, Harry A; Sigal, Ian A; Strouthidis, Nicholas G

    2015-01-01

    Biomechanics is the study of the relationship between forces and function in living organisms and is thought to play a critical role in a significant number of ophthalmic disorders. This is not surprising, as the eye is a pressure vessel that requires a delicate balance of forces to maintain its homeostasis. Over the past few decades, basic science research in ophthalmology mostly confirmed that ocular biomechanics could explain in part the mechanisms involved in almost all major ophthalmic disorders such as optic nerve head neuropathies, angle closure, ametropia, presbyopia, cataract, corneal pathologies, retinal detachment and macular degeneration. Translational biomechanics in ophthalmology, however, is still in its infancy. It is believed that its use could make significant advances in diagnosis and treatment. Several translational biomechanics strategies are already emerging, such as corneal stiffening for the treatment of keratoconus, and more are likely to follow. This review aims to cultivate the idea that biomechanics plays a major role in ophthalmology and that the clinical translation, lead by collaborative teams of clinicians and biomedical engineers, will benefit our patients. Specifically, recent advances and future prospects in corneal, iris, trabecular meshwork, crystalline lens, scleral and lamina cribrosa biomechanics are discussed.

  13. Towards single embryo transfer? Modelling clinical outcomes of potential treatment choices using multiple data sources: predictive models and patient perspectives.

    Science.gov (United States)

    Roberts, Sa; McGowan, L; Hirst, Wm; Brison, Dr; Vail, A; Lieberman, Ba

    2010-07-01

    In vitro fertilisation (IVF) treatments involve an egg retrieval process, fertilisation and culture of the resultant embryos in the laboratory, and the transfer of embryos back to the mother over one or more transfer cycles. The first transfer is usually of fresh embryos and the remainder may be cryopreserved for future frozen cycles. Most commonly in UK practice two embryos are transferred (double embryo transfer, DET). IVF techniques have led to an increase in the number of multiple births, carrying an increased risk of maternal and infant morbidity. The UK Human Fertilisation and Embryology Authority (HFEA) has adopted a multiple birth minimisation strategy. One way of achieving this would be by increased use of single embryo transfer (SET). To collate cohort data from treatment centres and the HFEA; to develop predictive models for live birth and twinning probabilities from fresh and frozen embryo transfers and predict outcomes from treatment scenarios; to understand patients' perspectives and use the modelling results to investigate the acceptability of twin reduction policies. A multidisciplinary approach was adopted, combining statistical modelling with qualitative exploration of patients' perspectives: interviews were conducted with 27 couples at various stages of IVF treatment at both UK NHS and private clinics; datasets were collated of over 90,000 patients from the HFEA registry and nearly 9000 patients from five clinics, both over the period 2000-5; models were developed to determine live birth and twin outcomes and predict the outcomes of policies for selecting patients for SET or DET in the fresh cycle following egg retrieval and fertilisation, and the predictions were used in simulations of treatments; two focus groups were convened, one NHS and one web based on a patient organisation's website, to present the results of the statistical analyses and explore potential treatment policies. The statistical analysis revealed no characteristics that

  14. Adoptive cell transfer after chemotherapy enhances survival in patients with resectable HNSCC.

    Science.gov (United States)

    Jiang, Pan; Zhang, Yan; J Archibald, Steve; Wang, Hua

    2015-09-01

    The aims of this study were to evaluate the therapeutic efficacy and to determine the immune factors for treatment success in patients with head and neck squamous cell carcinoma (HNSCC) treated with chemotherapy followed by adoptive cell transfer (ACT). A total of 43 HNSCC patients who received radical resection and chemotherapy were analysed in this study. Twenty-one of the patients were repeatedly treated with ACT after chemotherapy (ACT group), and the other twenty-two patients without ACT treatment were included as part of the control group. To investigate the immunological differences underlying these observations, we expanded and profiled improving cytokine-induced killer cells (iCIK) from peripheral blood mononuclear cells (PBMCs) with the timed addition of RetroNectin, OKT3 mAb, IFN γ and IL-2. The median of progression-free survival (PFS) and overall survival (OS) in the ACT group were significantly higher as compared to the control group (56 vs. 40; 58 vs. 45 months). In iCIK culture, there was a significant reduction in CD3+CD4+ T-cell proliferation and cytokines (IL-2, TNF) production from patients who received chemotherapy compared to patients without chemotherapy. Intra-arterial infusion of iCIK, in coordination with chemotherapy, considerably rescued iCIK culture from the suppression of systemic immunity induced by chemotherapy and induced tumour regression. Altogether, these findings suggest that ACT is an effective neo-adjuvant therapy for rescuing systemic immune suppression and improving survival time in patients with HNSCC. Copyright © 2015 Elsevier B.V. All rights reserved.

  15. Biomechanical Remodeling of the Diabetic Gastrointestinal Tract

    DEFF Research Database (Denmark)

    Zhao, Jingbo; Liao, Donghua; Yang, Jian

    2010-01-01

    several years, several studies demonstrated that experimental diabetes induces GI morphological and biomechanical remodeling. Following the development of diabetes, the GI wall becomes thicker and the stiffness of the GI wall increases in a time-dependent manner. It is well known that mechanosensitive...... the biomechanical environment of the mechanosensitive nerve endings, therefore, the structure as well as the tension, stress and strain distribution in the GI wall is important for the sensory and motor function. Biomechanical remodeling of diabetic GI tract including alterations of residual strain and increase...

  16. Rehabilitation of the elbow extension with motor imagery in a patient with quadriplegia after tendon transfer.

    Science.gov (United States)

    Grangeon, Murielle; Guillot, Aymeric; Sancho, Pierre-Olivier; Picot, Marion; Revol, Patrice; Rode, Gilles; Collet, Christian

    2010-07-01

    To test the effect of a postsurgical motor imagery program in the rehabilitation of a patient with quadriplegia. Crossover design with kinematic analysis. Rehabilitation Hospital of Lyon. Study approved by the local Human Research Ethics Committee. C6-level injured patient (American Spinal Injury Association Impairment Scale grade A) with no voluntary elbow extension (triceps brachialis score 1). The surgical procedure was to transfer the distal insertion of the biceps brachii onto the triceps tendon of both arms. The postsurgical intervention on the left arm included 10 sessions of physical rehabilitation followed by 10 motor imagery sessions of 30 minutes each. The patient underwent 5 sessions a week during 2 consecutive weeks. The motor imagery content included mental representations based on elbow extension involved in goal-directed movements. The rehabilitation period of the right arm was reversed, with motor imagery performed first, followed by physical therapy. The kinematics of upper-limb movements was recorded (movement time and variability) before and after each type of rehabilitation period. A long-term retention test was performed 1 month later. Motor imagery training enhanced motor recovery by reducing hand trajectory variability-that is, improving smoothness. Motor performance then remained stable over 1 month. Motor imagery improved motor recovery when associated with physical therapy, with motor performance remaining stable over the 1-month period. We concluded that motor imagery should be successfully associated with classic rehabilitation procedure after tendon transfer. Physical sessions may thus be shortened if too stressful or painful. Copyright 2010 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

  17. Defining the eHealth Information Niche in the Family Physician/Patient Examination and Knowledge Transfer Process

    Science.gov (United States)

    Ellington, Virginia Beth Elder

    2012-01-01

    This research study was undertaken to gain a richer understanding of the use of patient-introduced online health information during the physician/patient examination and knowledge transfer process. Utilizing qualitative data obtained from ten family physician interviews and workflow modeling using activity diagrams and task structure charts, this…

  18. Simulator-based crew resource management training for interhospital transfer of critically ill patients by a mobile ICU

    NARCIS (Netherlands)

    Droogh, Joep M; Kruger, H. L.; Ligtenberg, Jack J M; Zijlstra, Jan G

    2012-01-01

    BACKGROUND: Transporting critically ill ICU patients by standard ambulances, with or without an accompanying physician, imposes safety risks. In 2007 the Dutch Ministry of Public Health required that all critically ill patients transferred between ICUs in different hospitals be transported by a

  19. Biomechanical aspects of playing surfaces.

    Science.gov (United States)

    Nigg, B M; Yeadon, M R

    1987-01-01

    The purpose of this paper is to discuss some biomechanical aspects of playing surfaces with special focus on (a) surface induced injuries, (b) methodologies used to assess surfaces and (c) findings from various sports. The paper concentrates primarily on questions related to load on the athlete's body. Data from epidemiological studies suggest strongly that the surface is an important factor in the aetiology of injuries. Injury frequencies are reported to be significantly different for different surfaces in several sports. The methodologies used to assess surfaces with respect to load or performance include material tests and tests using experimental subjects. There is only little correlation between the results of these two approaches. Material tests used in many standardized test procedures are not validated which suggests that one should exercise restraint in the interpretation of these results. Point elastic surfaces are widely studied while area elastic surfaces have received little attention to date. Questions of energy losses on sport surfaces have rarely been studied scientifically.

  20. Graphic-based musculoskeletal model for biomechanical analyses and animation.

    Science.gov (United States)

    Chao, Edmund Y S

    2003-04-01

    The ability to combine physiology and engineering analyses with computer sciences has opened the door to the possibility of creating the 'Virtual Human' reality. This paper presents a broad foundation for a full-featured biomechanical simulator for the human musculoskeletal system physiology. This simulation technology unites the expertise in biomechanical analysis and graphic modeling to investigate joint and connective tissue mechanics at the structural level and to visualize the results in both static and animated forms together with the model. Adaptable anatomical models including prosthetic implants and fracture fixation devices and a robust computational infrastructure for static, kinematic, kinetic, and stress analyses under varying boundary and loading conditions are incorporated on a common platform, the VIMS (Virtual Interactive Musculoskeletal System). Within this software system, a manageable database containing long bone dimensions, connective tissue material properties and a library of skeletal joint system functional activities and loading conditions are also available and they can easily be modified, updated and expanded. Application software is also available to allow end-users to perform biomechanical analyses interactively. This paper details the design, capabilities, and features of the VIMS development at Johns Hopkins University, an effort possible only through academic and commercial collaborations. Examples using these models and the computational algorithms in a virtual laboratory environment are used to demonstrate the utility of this unique database and simulation technology. This integrated system will impact on medical education, basic research, device development and application, and clinical patient care related to musculoskeletal diseases, trauma, and rehabilitation.

  1. Intraarticular arthrofibrosis of the knee alters patellofemoral contact biomechanics.

    Science.gov (United States)

    Mikula, Jacob D; Slette, Erik L; Dahl, Kimi D; Montgomery, Scott R; Dornan, Grant J; O'Brien, Luke; Turnbull, Travis Lee; Hackett, Thomas R

    2017-12-19

    Arthrofibrosis in the suprapatellar pouch and anterior interval can develop after knee injury or surgery, resulting in anterior knee pain. These adhesions have not been biomechanically characterized. The biomechanical effects of adhesions in the suprapatellar pouch and anterior interval during simulated quadriceps muscle contraction from 0 to 90° of knee flexion were assessed. Adhesions of the suprapatellar pouch and anterior interval were hypothesized to alter the patellofemoral contact biomechanics and increase the patellofemoral contact force compared to no adhesions. Across all flexion angles, suprapatellar adhesions increased the patellofemoral contact force compared to no adhesions by a mean of 80 N. Similarly, anterior interval adhesions increased the contact force by a mean of 36 N. Combined suprapatellar and anterior interval adhesions increased the mean patellofemoral contact force by 120 N. Suprapatellar adhesions resulted in a proximally translated patella from 0 to 60°, and anterior interval adhesions resulted in a distally translated patella at all flexion angles other than 15° (p patellofemoral contact forces were significantly increased by simulated adhesions in the suprapatellar pouch and anterior interval. Anterior knee pain and osteoarthritis may result from an increase in patellofemoral contact force due to patellar and quadriceps tendon adhesions. For these patients, arthroscopic lysis of adhesions may be beneficial.

  2. Whole brain magnetization transfer histogram analysis of pediatric acute lymphoblastic leukemia patients receiving intrathecal methotrexate therapy

    Energy Technology Data Exchange (ETDEWEB)

    Yamamoto, Akira [Department of Diagnostic Imaging and Nuclear Medicine, Graduate School of Medicine, Kyoto University, 54 Kawahara-cho, Shogoin, Sakyo-ku, Kyoto-shi Kyoto 606-8507 (Japan)]. E-mail: yakira@kuhp.kyoto-u.ac.jp; Miki, Yukio [Department of Diagnostic Imaging and Nuclear Medicine, Graduate School of Medicine, Kyoto University, 54 Kawahara-cho, Shogoin, Sakyo-ku, Kyoto-shi Kyoto 606-8507 (Japan)]. E-mail: mikiy@kuhp.kyoto-u.ac.jp; Adachi, Souichi [Department of Pediatrics, Graduate School of Medicine, Kyoto University, 54 Kawahara-cho, Shogoin, Sakyo-ku, Kyoto-shi Kyoto 606-8507 (Japan)]. E-mail: sadachi@kuhp.kyoto-u.ac.jp (and others)

    2006-03-15

    Background and purpose: The purpose of this prospective study was to evaluate the hypothesis that magnetization transfer ratio (MTR) histogram analysis of the whole brain could detect early and subtle brain changes nonapparent on conventional magnetic resonance imaging (MRI) in children with acute lymphoblastic leukemia (ALL) receiving methotrexate (MTX) therapy. Materials and methods: Subjects in this prospective study comprised 10 children with ALL (mean age, 6 years; range, 0-16 years). In addition to conventional MRI, magnetization transfer images were obtained before and after intrathecal and intravenous MTX therapy. MTR values were calculated and plotted as a histogram, and peak height and location were calculated. Differences in peak height and location between pre- and post-MTX therapy scans were statistically analyzed. Conventional MRI was evaluated for abnormal signal area in white matter. Results: MTR peak height was significantly lower on post-MTX therapy scans than on pre-MTX therapy scans (p = 0.002). No significant differences in peak location were identified between pre- and post-chemotherapy imaging. No abnormal signals were noted in white matter on either pre- or post-MTX therapy conventional MRI. Conclusions: This study demonstrates that MTR histogram analysis allows better detection of early and subtle brain changes in ALL patients who receive MTX therapy than conventional MRI.

  3. Impaired Corneal Biomechanical Properties and the Prevalence of Keratoconus in Mitral Valve Prolapse

    Directory of Open Access Journals (Sweden)

    Emine Kalkan Akcay

    2014-01-01

    Full Text Available Objective. To investigate the biomechanical characteristics of the cornea in patients with mitral valve prolapse (MVP and the prevalence of keratoconus (KC in MVP. Materials and Methods. Fifty-two patients with MVP, 39 patients with KC, and 45 control individuals were recruited in this study. All the participants underwent ophthalmologic examination, corneal analysis with the Sirius system (CSO, and the corneal biomechanical evaluation with Reichert ocular response analyzer (ORA. Results. KC was found in six eyes of four patients (5.7% and suspect KC in eight eyes of five patients (7.7% in the MVP group. KC was found in one eye of one patient (1.1% in the control group (P=0.035. A significant difference occurred in the mean CH and CRF between the MVP and control groups (P=0.006 and P=0.009, resp.. All corneal biomechanical and topographical parameters except IOPcc were significantly different between the KC-MVP groups (P<0.05. Conclusions. KC prevalence is higher than control individuals in MVP patients and the biomechanical properties of the cornea are altered in patients with MVP. These findings should be considered when the MVP patients are evaluated before refractive surgery.

  4. Using a simulated patient to transfer patient-centred skills from simulated practice to real patients in practice

    Directory of Open Access Journals (Sweden)

    Yolinda Uys

    2014-11-01

    Conclusion: Using a simulated patient to teach administration of an intramuscular injection enhanced students’ patient-centredness when performing the procedure in practice. Recommendations include making use of a bigger sample and including a pre-test the next time research of this nature is carried out.

  5. THE CENTER FOR MILITARY BIOMECHANICS RESEARCH

    Data.gov (United States)

    Federal Laboratory Consortium — The Center for Military Biomechanics Research is a 7,500 ft2 dedicated laboratory outfitted with state-of-the-art equipment for 3-D analysis of movement, measurement...

  6. Recent software developments for biomechanical assessment

    Science.gov (United States)

    Greaves, John O. B.

    1990-08-01

    While much of the software developed in research laboratories is narrow in focus and suited for a specific experiment, some of it is broad enough and of high enough quality to be useful to others in solving similar problems. Several biomechanical assessment packages are now beginning to emerge, including: * 3D research biomechanics (5- and 6-DOF) with kinematics, kinetics, 32-channel analog data subsystem, and project management. * 3D full-body gait analysis with kinematics, kinetics, EMG charts, and force plate charts. * 2D dynamic rear-foot assessment. * 2D occupational biomechanics lifting task and personnel assessments. * 2D dynamic gait analysis. * Multiple 2D dynamic spine assessments. * 2D sport and biomechanics assessments with kinematics and kinetics. * 2D and 3D equine gait assessments.

  7. Biomechanical aspects of bone microstructure in vertebrates ...

    Indian Academy of Sciences (India)

    Prakash

    2009-10-29

    Oct 29, 2009 ... Biomechanical or biophysical principles can be applied to study biological structures in their modern or .... Accounting for the flow in a horizontal pipe, z1 = z2, and ..... OH, USA for providing financial assistance and academic.

  8. Free tissue transfer in patients with sickle cell disease: Considerations for multi-disciplinary peri-operative management.

    Science.gov (United States)

    Cooper, Lilli; Seth, Rohit; Rhodes, Elizabeth; Alousi, Mohammed; Sivakumar, Bran

    2017-01-01

    Sickle cell disease (SCD) is an increasingly common condition in the UK. The safety of free tissue transfer in these patients is controversial, and no specific guidelines exist. The aim of this paper is to create recommendations for the plastic surgical multidisciplinary team for use in the assessment and management of SCD patients undergoing free tissue transfer and reconstruction. A literature review was performed in PubMed of 'sickle [TiAb] AND plast* adj3 surg*. Sickle cell disease is explained, as is the relative peri-operative risk in different genotypes of SCD. Acute and chronic manifestations of SCD are described by system, for consideration at pre-operative assessment and post-operative review. The evidence surrounding free tissue transfer and SCD is discussed and the outcomes in published cases summarised. An algorithm for peri-operative multi-disciplinary management is outlined and justified. Free tissue transfer theoretically carries a high risk of a crisis, due not only to long anaesthetic times, but the potential requirement for tourniquet use, and the relatively hypoxic state of the transferred tissue. This paper outlines a useful, practical algorithm to optimise the safety of free tissue transfer in patients with SCD. Copyright © 2016 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.

  9. Acute medical complications in patients admitted to a stroke unit and safe transfer to rehabilitation.

    Science.gov (United States)

    Bonaiuti, Donatella; Sioli, Paolo; Fumagalli, Lorenzo; Beghi, Ettore; Agostoni, Elio

    2011-08-01

    Acute medical complications often prevent patients with stroke from being transferred from stroke units to rehabilitation units, prolonging the occupation of hospital beds and delaying the start of intensive rehabilitation. This study defined incidence, timing, duration and risk factors of these complications during the acute phase of stroke. A retrospective case note review was made of hospital admissions of patients with stroke not associated with other disabling conditions, admitted to a stroke unit over 12 months and requiring rehabilitation for gait impairment. In this cohort, a search was made of hypertension, oxygen de-saturation, fever, and cardiac and pulmonary symptoms requiring medical intervention. Included were 135 patients. Hypertension was the most common complication (16.3%), followed by heart disease (14.8%), oxygen de-saturation (7.4%), fever (6.7%) and pulmonary disease (5.2%). Heart disease was the earliest and shortest complication. Most complications occurred during the first week. Except for hypertension, all complications resolved within 2 weeks.

  10. Country-to-country transfer of patients and the risk of multi-resistant bacterial infection.

    Science.gov (United States)

    Rogers, Benjamin A; Aminzadeh, Zohreh; Hayashi, Yoshiro; Paterson, David L

    2011-07-01

    Management of patients with a history of healthcare contact in multiple countries is now a reality for many clinicians. Leisure tourism, the burgeoning industry of medical tourism, military conflict, natural disasters, and changing patterns of human migration may all contribute to this emerging epidemiological trend. Such individuals may be both vectors and victims of healthcare-associated infection with multiresistant bacteria. Current literature describes intercountry transfer of multiresistant Acinetobacter spp and Klebsiella pneumoniae (including Klebsiella pneumoniae carbapenemase- and New Delhi metallo-β-lactamase-producing strains), methicillin-resistant Staphylococcus aureus, vancomycin-resistant enterococci, and hypervirulent Clostridium difficile. Introduction of such organisms to new locations has led to their dissemination within hospitals. Healthcare institutions should have sound infection prevention strategies to mitigate the risk of dissemination of multiresistant organisms from patients who have been admitted to hospitals in other countries. Clinicians may also need to individualize empiric prescribing patterns to reflect the risk of multiresistant organisms in these patients. © The Author 2011. Published by Oxford University Press on behalf of the Infectious Diseases Society of America. All rights reserved.

  11. Lingual biomechanics, case selection and success

    Directory of Open Access Journals (Sweden)

    Sanjay Labh

    2016-01-01

    Full Text Available Deeper understanding of lingual biomechanics is prerequisite for success with lingual appliance. The difference between labial and lingual force system must be understood and kept in mind during treatment planning, especially anchorage planning, and extraction decision-making. As point of application of force changes, it completely changes the force system in all planes. This article describes lingual biomechanics, anchorage planning, diagnostic considerations, treatment planning, and case selection criteria in lingual orthodontics.

  12. Preliminary evidence of altered biomechanics in adolescents with juvenile fibromyalgia.

    Science.gov (United States)

    Sil, Soumitri; Thomas, Staci; DiCesare, Christopher; Strotman, Daniel; Ting, Tracy V; Myer, Gregory; Kashikar-Zuck, Susmita

    2015-01-01

    Juvenile fibromyalgia (FM) is characterized by chronic musculoskeletal pain and marked reduction in physical activity. Despite recommendations for exercise to manage juvenile FM pain, exercise adherence is poor. Because of pain and activity avoidance, adolescents with juvenile FM are at risk for altered joint mechanics that may make them susceptible to increased pain and reduced tolerance for exercise. The primary aim of this study was to assess functional deficits in patients with juvenile FM compared to healthy controls using objective biomechanical assessment. Female adolescent patients with juvenile FM (n = 17) and healthy controls (n = 14) completed biomechanical assessments, including gait analysis and tests of lower extremity strength (isokinetic knee extension/flexion and hip abduction) and functional performance (drop vertical jump test) along with self-reported measures of disability (Functional Disability Inventory), pain intensity, depressive symptoms (Children's Depression Inventory), and fear of movement (Tampa Scale of Kinesiophobia). Patients with juvenile FM demonstrated mild deficiencies in walking gait and functional performance (P < 0.05 for both) and significantly lower left knee extension and flexion strength (18-22% deficit) and bilateral hip abduction strength (34-38%) compared with healthy controls (P < 0.008 for all). Patients with juvenile FM reported significantly higher functional disability, pain intensity, depressive symptoms, and fear of movement relative to controls (P < 0.01 for all). This study showed that adolescents with juvenile FM exhibited objective alterations in biomechanics and self-reported fear of movement that may have reinforced their activity avoidance. Interventions for juvenile FM should include a focus on correcting functional deficits and instilling greater confidence in adolescents with juvenile FM to engage in exercise to improve functional outcomes. Copyright © 2015 by the American College of Rheumatology.

  13. Adaptive sports technology and biomechanics: prosthetics.

    Science.gov (United States)

    De Luigi, Arthur Jason; Cooper, Rory A

    2014-08-01

    With the technologic advances in medicine and an emphasis on maintaining physical fitness, the population of athletes with impairments is growing. It is incumbent upon health care practitioners to make every effort to inform these individuals of growing and diverse opportunities and to encourage safe exercise and athletic participation through counseling and education. Given the opportunities for participation in sports for persons with a limb deficiency, the demand for new, innovative prosthetic designs is challenging the clinical and technical expertise of the physician and prosthetist. When generating a prosthetic prescription, physicians and prosthetists should consider the needs and preferences of the athlete with limb deficiency, as well as the functional demands of the chosen sporting activity. The intent of this article is to provide information regarding the current advancements in the adaptive sports technology and biomechanics in the field of prosthetics, and to assist clinicians and their patients in facilitating participation in sporting activities. Copyright © 2014 American Academy of Physical Medicine and Rehabilitation. Published by Elsevier Inc. All rights reserved.

  14. Transfer of patients from health care centres to special care services: analysis of travel distances in Nordic countries.

    Science.gov (United States)

    Vuori, Jari; Kylänen, Marika; Tritter, Jonathan

    2010-12-01

    This paper highlights the importance of analysing patient transportation in Nordic circumpolar areas. The research questions we asked are as follows: How many Finnish patients have been transferred to special care intra-country and inter-country in 2009? Does it make any difference to health care policymakers if patients are transferred inter-country? We analysed the differences in distances from health care centres to special care services within Finland, Sweden and Norway and considered the health care policy implications. An analysis of the time required to drive between service providers using the "Google distance meter" (http://maps.google.com/); conducting interviews with key Finnish stakeholders; and undertaking a quantitative analyses of referral data from the Lapland Hospital District. Finnish patients are generally not transferred for health care services across national borders even if the distances are shorter. Finnish patients have limited access to health care services in circumpolar areas across the Nordic countries for 2 reasons. First, health professionals in Norway and Sweden do not speak Finnish, which presents a language problem. Second, the Social Insurance Institution of Finland does not cover the expenditures of travel or the costs of medicine. In addition, it seems that in circumpolar areas the density of Finnish service providers is greater than Swedish ones, causing many Swedish citizens to transfer to Finnish health care providers every year. However, future research is needed to determine the precise reasons for this.

  15. Computational Biomechanics of the Wrist Joint

    CERN Document Server

    Nazri Bajuri, Mohd

    2013-01-01

    This book presents an analysis of the stress distribution and contact stresses in severe rheumatoid wrist after total wrist arthroplasty. It assesses and compares the load transfer throughout the joint and contact pressure at the articulations. The data obtained from this study is of importance as this provide greater evidence to the benefits of total wrist arthroplasty in rheumatoid arthritis patients.

  16. Biomechanics of far cortical locking.

    Science.gov (United States)

    Bottlang, Michael; Feist, Florian

    2011-02-01

    The development of far cortical locking (FCL) was motivated by a conundrum: locked plating constructs provide inherently rigid stabilization, yet they should facilitate biologic fixation and secondary bone healing that relies on flexible fixation to stimulate callus formation. Recent studies have confirmed that the high stiffness of standard locked plating constructs can suppress interfragmentary motion to a level that is insufficient to reliably promote secondary fracture healing by callus formation. Furthermore, rigid locking screws cause an uneven stress distribution that may lead to stress fracture at the end screw and stress shielding under the plate. This review summarizes four key features of FCL constructs that have been shown to enhance fixation and healing of fractures: flexible fixation, load distribution, progressive stiffening, and parallel interfragmentary motion. Specifically, flexible fixation provided by FCL reduces the stiffness of a locked plating construct by 80% to 88% to actively promote callus proliferation similar to an external fixator. Load is evenly distributed between FCL screws to mitigate stress risers at the end screw. Progressive stiffening occurs by near cortex support of FCL screws and provides additional support under elevated loading. Finally, parallel interfragmentary motion by the S-shaped flexion of FCL screws promotes symmetric callus formation. In combination, these features of FCL constructs have been shown to induce more callus and to yield significantly stronger and more consistent healing compared with standard locked plating constructs. As such, FCL constructs function as true internal fixators by replicating the biomechanical behavior and biologic healing response of external fixators.

  17. T2 relaxation time analysis in patients with multiple sclerosis: correlation with magnetization transfer ratio

    International Nuclear Information System (INIS)

    Papanikolaou, Nickolas; Papadaki, Eufrosini; Karampekios, Spyros; Maris, Thomas; Prassopoulos, Panos; Gourtsoyiannis, Nicholas; Spilioti, Martha

    2004-01-01

    The aim of the current study was to perform T2 relaxation time measurements in multiple sclerosis (MS) patients and correlate them with magnetization transfer ratio (MTR) measurements, in order to investigate in more detail the various histopathological changes that occur in lesions and normal-appearing white matter (NAWM). A total number of 291 measurements of MTR and T2 relaxation times were performed in 13 MS patients and 10 age-matched healthy volunteers. Measurements concerned MS plaques (105), NAWM (80), and ''dirty'' white matter (DWM; 30), evenly divided between the MS patients, and normal white matter (NWM; 76) in the healthy volunteers. Biexponential T2 relaxation-time analysis was performed, and also possible linearity between MTR and mean T2 relaxation times was evaluated using linear regression analysis in all subgroups. Biexponential relaxation was more pronounced in ''black-hole'' lesions (16.6%) and homogeneous enhancing plaques (10%), whereas DWM, NAWM, and mildly hypointense lesions presented biexponential behavior with a lower frequency(6.6, 5, and 3.1%, respectively). Non-enhancing isointense lesions and normal white matter did not reveal any biexponentional behavior. Linear regression analysis between monoexponential T2 relaxation time and MTR measurements demonstrated excellent correlation for DWM(r=-0.78, p<0.0001), very good correlation for black-hole lesions(r=-0.71, p=0.002), good correlation for isointense lesions(r=-0.60, p=0.005), moderate correlation for mildly hypointense lesions(r=-0.34, p=0.007), and non-significant correlation for homogeneous enhancing plaques, NAWM, and NWM. Biexponential T2 relaxation-time behavior is seen in only very few lesions (mainly on plaques with high degree of demyelination and axonal loss). A strong correlation between MTR and monoexponential T2 values was found in regions where either inflammation or demyelination predominates; however, when both pathological conditions coexist, this linear

  18. Increasing The Number of Embryos Transferred from Two to Three, Does not Increase Pregnancy Rates in Good Prognosis Patients

    Directory of Open Access Journals (Sweden)

    Mahnaz Ashrafi

    2015-10-01

    Full Text Available Background: To compare the pregnancy outcomes after two embryos versus three embryos transfers (ETs in women undergoing in vitro fertilization (IVF/intracytoplasmic sperm injection (ICSI cycles. Materials and Methods: This retrospective study was performed on three hundred eighty seven women with primary infertility and with at least one fresh embryo in good quality in order to transfer at each IVF/ICSI cycle, from September 2006 to June 2010. Patients were categorized into two groups according to the number of ET as follows: ET2 and ET3 groups, indicating two and three embryos were respectively transferred. Pregnancy outcomes were compared between ET2 and ET3 groups. Chi square and student t tests were used for data analysis. Results: Clinical pregnancy and live birth rates were similar between two groups. The rates of multiple pregnancies were 27 and 45.2% in ET2 and ET3 groups, respectively. The rate of multiple pregnancies in young women was significantly increased when triple instead of double embryos were transferred. Logistic regression analysis indicated two significant prognostic variables for live birth that included number and quality of transferred embryos; it means that the chance of live birth following ICSI treatment increased 3.2-fold when the embryo with top quality (grade A was transferred, but the number of ET had an inverse relationship with live birth rate; it means that probability of live birth in women with transfer of two embryos was three times greater than those who had three ET. Conclusion: Due to the difficulty of implementation of the elective single-ET technique in some infertility centers in the world, we suggest transfer of double instead of triple embryos when at least one good quality embryo is available for transfer in women aged 39 years or younger. However, to reduce the rate of multiple pregnancies, it is recommended to consider the elective single ET strategy.

  19. Transesophageal echocardiographic strain imaging predicts aortic biomechanics: Beyond diameter.

    Science.gov (United States)

    Emmott, Alexander; Alzahrani, Haitham; Alreishidan, Mohammed; Therrien, Judith; Leask, Richard L; Lachapelle, Kevin

    2018-03-11

    Clinical guidelines recommend resection of ascending aortic aneurysms at diameters 5.5 cm or greater to prevent rupture or dissection. However, approximately 40% of all ascending aortic dissections occur below this threshold. We propose new transesophageal echocardiography strain-imaging moduli coupled with blood pressure measurements to predict aortic dysfunction below the surgical threshold. A total of 21 patients undergoing aortic resection were recruited to participate in this study. Transesophageal echocardiography imaging of the aortic short-axis and invasive radial blood pressure traces were taken for 3 cardiac cycles. By using EchoPAC (GE Healthcare, Madison, Wis) and postprocessing in MATLAB (MathWorks, Natick, Mass), circumferential stretch profiles were generated and combined with the blood pressure traces. From these data, 2 in vivo stiffness moduli were calculated: the Cardiac Cycle Pressure Modulus and Cardiac Cycle Stress Modulus. From the resected aortic ring, testing squares were isolated for ex vivo mechanical analysis and histopathology. Each square underwent equibiaxial tensile testing to generate stress-stretch profiles for each patient. Two ex vivo indices were calculated from these profiles (energy loss and incremental stiffness) for comparison with the Cardiac Cycle Pressure Modulus and Cardiac Cycle Stress Modulus. The echo-derived stiffness moduli demonstrate positive significant covariance with ex vivo tensile biomechanical indices: energy loss (vs Cardiac Cycle Pressure Modulus: R 2  = 0.5873, P biomechanics and histopathology, which demonstrates the added benefit of using simple echocardiography-derived biomechanics to stratify patient populations. Copyright © 2018. Published by Elsevier Inc.

  20. Fusion of intraoperative force sensoring, surface reconstruction and biomechanical modeling

    Science.gov (United States)

    Röhl, S.; Bodenstedt, S.; Küderle, C.; Suwelack, S.; Kenngott, H.; Müller-Stich, B. P.; Dillmann, R.; Speidel, S.

    2012-02-01

    Minimally invasive surgery is medically complex and can heavily benefit from computer assistance. One way to help the surgeon is to integrate preoperative planning data into the surgical workflow. This information can be represented as a customized preoperative model of the surgical site. To use it intraoperatively, it has to be updated during the intervention due to the constantly changing environment. Hence, intraoperative sensor data has to be acquired and registered with the preoperative model. Haptic information which could complement the visual sensor data is still not established. In addition, biomechanical modeling of the surgical site can help in reflecting the changes which cannot be captured by intraoperative sensors. We present a setting where a force sensor is integrated into a laparoscopic instrument. In a test scenario using a silicone liver phantom, we register the measured forces with a reconstructed surface model from stereo endoscopic images and a finite element model. The endoscope, the instrument and the liver phantom are tracked with a Polaris optical tracking system. By fusing this information, we can transfer the deformation onto the finite element model. The purpose of this setting is to demonstrate the principles needed and the methods developed for intraoperative sensor data fusion. One emphasis lies on the calibration of the force sensor with the instrument and first experiments with soft tissue. We also present our solution and first results concerning the integration of the force sensor as well as accuracy to the fusion of force measurements, surface reconstruction and biomechanical modeling.

  1. Biomechanical determinants of elite rowing technique and performance.

    Science.gov (United States)

    Buckeridge, E M; Bull, A M J; McGregor, A H

    2015-04-01

    In rowing, the parameters of injury, performance, and technique are all interrelated and in dynamic equilibrium. Whilst rowing requires extreme physical strength and endurance, a high level of skill and technique is essential to enable an effective transfer of power through the rowing sequence. This study aimed to determine discrete aspects of rowing technique, which strongly influence foot force production and asymmetries at the foot-stretchers, as these are biomechanical parameters often associated with performance and injury risk. Twenty elite female rowers performed an incremental rowing test on an instrumented rowing ergometer, which measured force at the handle and foot-stretchers, while three-dimensional kinematic recordings of the ankle, knee, hip, and lumbar-pelvic joints were made. Multiple regression analyses identified hip kinematics as a key predictor of foot force output (R(2)  = 0.48), whereas knee and lumbar-pelvic kinematics were the main determinants in optimizing the horizontal foot force component (R(2)  = .41). Bilateral asymmetries of the foot-stretchers were also seen to significantly influence lumbar-pelvic kinematics (R(2)  = 0.43) and pelvic twisting (R(2)  = 0.32) during the rowing stroke. These results provide biomechanical evidence toward aspects of technique that can be modified to optimize force output and performance, which can be of direct benefit to coaches and athletes. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  2. Role of Aquaporin 0 in lens biomechanics

    International Nuclear Information System (INIS)

    Sindhu Kumari, S.; Gupta, Neha; Shiels, Alan; FitzGerald, Paul G.; Menon, Anil G.; Mathias, Richard T.; Varadaraj, Kulandaiappan

    2015-01-01

    Maintenance of proper biomechanics of the eye lens is important for its structural integrity and for the process of accommodation to focus near and far objects. Several studies have shown that specialized cytoskeletal systems such as the beaded filament (BF) and spectrin-actin networks contribute to mammalian lens biomechanics; mutations or deletion in these proteins alters lens biomechanics. Aquaporin 0 (AQP0), which constitutes ∼45% of the total membrane proteins of lens fiber cells, has been shown to function as a water channel and a structural cell-to-cell adhesion (CTCA) protein. Our recent ex vivo study on AQP0 knockout (AQP0 KO) mouse lenses showed the CTCA function of AQP0 could be crucial for establishing the refractive index gradient. However, biomechanical studies on the role of AQP0 are lacking. The present investigation used wild type (WT), AQP5 KO (AQP5 −/− ), AQP0 KO (heterozygous KO: AQP0 +/− ; homozygous KO: AQP0 −/− ; all in C57BL/6J) and WT-FVB/N mouse lenses to learn more about the role of fiber cell AQPs in lens biomechanics. Electron microscopic images exhibited decreases in lens fiber cell compaction and increases in extracellular space due to deletion of even one allele of AQP0. Biomechanical assay revealed that loss of one or both alleles of AQP0 caused a significant reduction in the compressive load-bearing capacity of the lenses compared to WT lenses. Conversely, loss of AQP5 did not alter the lens load-bearing ability. Compressive load-bearing at the suture area of AQP0 +/− lenses showed easy separation while WT lens suture remained intact. These data from KO mouse lenses in conjunction with previous studies on lens-specific BF proteins (CP49 and filensin) suggest that AQP0 and BF proteins could act co-operatively in establishing normal lens biomechanics. We hypothesize that AQP0, with its prolific expression at the fiber cell membrane, could provide anchorage for cytoskeletal structures like BFs and together they help to

  3. Biomechanics and mechanobiology in functional tissue engineering

    Science.gov (United States)

    Guilak, Farshid; Butler, David L.; Goldstein, Steven A.; Baaijens, Frank P.T.

    2014-01-01

    The field of tissue engineering continues to expand and mature, and several products are now in clinical use, with numerous other preclinical and clinical studies underway. However, specific challenges still remain in the repair or regeneration of tissues that serve a predominantly biomechanical function. Furthermore, it is now clear that mechanobiological interactions between cells and scaffolds can critically influence cell behavior, even in tissues and organs that do not serve an overt biomechanical role. Over the past decade, the field of “functional tissue engineering” has grown as a subfield of tissue engineering to address the challenges and questions on the role of biomechanics and mechanobiology in tissue engineering. Originally posed as a set of principles and guidelines for engineering of load-bearing tissues, functional tissue engineering has grown to encompass several related areas that have proven to have important implications for tissue repair and regeneration. These topics include measurement and modeling of the in vivo biomechanical environment; quantitative analysis of the mechanical properties of native tissues, scaffolds, and repair tissues; development of rationale criteria for the design and assessment of engineered tissues; investigation of the effects biomechanical factors on native and repair tissues, in vivo and in vitro; and development and application of computational models of tissue growth and remodeling. Here we further expand this paradigm and provide examples of the numerous advances in the field over the past decade. Consideration of these principles in the design process will hopefully improve the safety, efficacy, and overall success of engineered tissue replacements. PMID:24818797

  4. Detection of subclinical keratoconus through non-contact tonometry and the use of discriminant biomechanical functions.

    Science.gov (United States)

    Peña-García, Pablo; Peris-Martínez, Cristina; Abbouda, Alessandro; Ruiz-Moreno, José M

    2016-02-08

    The purpose of the present study was to develop a discriminant function departing from the biomechanical parameters provided by a non-contact tonometer (Corvis-ST, Oculus Optikgeräte, Wetzlar, Germany) to distinguish subclinical keratoconus from normal eyes. 212 eyes (120 patients) were divided in two groups: 184 healthy eyes of 92 patients aged 32.99 ± 7.85 (21-73 years) and 28 eyes of 28 patients aged 37.79 ± 14.21 (17-75 years) with subclinical keratoconus. The main outcome measures were age, sex, intraocular pressure (IOP), corneal central thickness (CCT) and other specific biomechanical parameters provided by the tonometer. Correlations between all biomechanical parameters and the rest of variables were evaluated. The biomechanical measures were corrected in IOP and CCT (since these variable are not directly related with the corneal structure and biomechanical behavior) to warrant an accurate comparison between both types of eyes. Two discriminant functions were created from the set of corrected variables. The best discriminant function created depended on three parameters: maximum Deformation Amplitude (corrected in IOP and CCT), First Applanation time (corrected in CCT) and CCT. Statistically significant differences were found between groups for this function (p=2·10(-10); Mann-Withney test). The area under the Receiving Operating Characteristic was 0.893 ± 0.028 (95% confidence interval 0.838-0.949). Sensitivity and specificity were 85.7% and 82.07% respectively. These results show that the use of biomechanical parameters provided by non-contact tonometry, previous normalization, combined with the theory of discriminant functions is a useful tool for the detection of subclinical keratoconus. Copyright © 2015 Elsevier Ltd. All rights reserved.

  5. Weightbath hydrotraction treatment: application, biomechanics, and clinical effects

    Directory of Open Access Journals (Sweden)

    Márta Kurutz

    2010-04-01

    Full Text Available Márta Kurutz1, Tamás Bender21Department of Structural Mechanics, Budapest University of Technology and Economics, Hungary; 2Department of Physical Medicine, Polyclinic and Hospital of the Hospitaller Brothers of St. John of God, Budapest, Medical University of Szeged, HungaryBackground and purpose: Weightbath hydrotraction treatment (WHT is a simple noninvasive effective method of hydro- or balneotherapy to stretch the spine or lower limbs, applied successfully in hospitals and health resort sanitaria in Hungary for more than fifty years. This study aims to introduce WHT with its biomechanical and clinical effects. History, development, equipment, modes of application, biomechanics, spinal traction forces and elongations, indications and contraindications of WHT are precented.Subjects and methods: The calculation of traction forces acting along the spinal column during the treatment is described together with the mode of suspension and the position of extra weight loads applied. The biomechanics of the treatment are completed by in vivo measured elongations of lumbar segments using a special underwater ultrasound measuring method. The clinical effects, indications, and contraindications of the treatment are also presented.Results: In the underwater cervical suspension of a human body, approximately 25 N stretching load occurs in the cervical spine, and about 11 N occurs in the lumbar spine. By applying extra weights, the above tensile forces along the spinal column can be increased. Thus, the traction effect can be controlled by applying such loads during the treatment. Elongations of segments L3–L4, L4–L5, and L5–S1 were measured during the usual WHT of patients suspended cervically in water for 20 minutes, loaded by 20–20 N lead weights on the ankles. The mean initial elastic elongations of spinal segments were about 0.8 mm for patients aged under 40 years, 0.5 mm between 40–60 years, and 0.2 mm for patients over 60 years. The mean

  6. Biomechanics-based in silico medicine: the manifesto of a new science.

    Science.gov (United States)

    Viceconti, Marco

    2015-01-21

    In this perspective article we discuss the role of contemporary biomechanics in the light of recent applications such as the development of the so-called Virtual Physiological Human technologies for physiology-based in silico medicine. In order to build Virtual Physiological Human (VPH) models, computer models that capture and integrate the complex systemic dynamics of living organisms across radically different space-time scales, we need to re-formulate a vast body of existing biology and physiology knowledge so that it is formulated as a quantitative hypothesis, which can be expressed in mathematical terms. Once the predictive accuracy of these models is confirmed against controlled experiments and against clinical observations, we will have VPH model that can reliably predict certain quantitative changes in health status of a given patient, but also, more important, we will have a theory, in the true meaning this word has in the scientific method. In this scenario, biomechanics plays a very important role, biomechanics is one of the few areas of life sciences where we attempt to build full mechanistic explanations based on quantitative observations, in other words, we investigate living organisms like physical systems. This is in our opinion a Copernican revolution, around which the scope of biomechanics should be re-defined. Thus, we propose a new definition for our research domain "Biomechanics is the study of living organisms as mechanistic systems". Copyright © 2014 Elsevier Ltd. All rights reserved.

  7. Age-related changes in biomechanical properties of transgenic porcine pulmonary and aortic conduits

    International Nuclear Information System (INIS)

    Wilczek, Piotr; Malota, Zbigniew; Lesiak, Anna; Niemiec-Cyganek, Aleksandra; Kubin, Barbara; Nozynski, Jerzy; Mzyk, Aldona; Gramatyka, Michalina; Slomski, Ryszard; Wilczek, Grazyna; Opiela, Jolanta

    2014-01-01

    The limitations associated with conventional valve prosthesis have led to a search for alternatives. One potential approach is tissue engineering. Most tissue engineering studies have described the biomechanical properties of heart valves derived from adult pigs. However, because one of the factors affecting the function of valve prosthesis after implantation is appropriate sizing for a given patient, it is important to evaluate the usefulness of a heart valve given the donor animal’s weight and age. The aim of this study was to evaluate how the age of a pig can influence the biomechanical and hemodynamical properties of porcine heart valve prosthesis after acellularization. Acellular porcine aortic and pulmonary valve conduits were used. Hearts were harvested from animals differing in weight and age. The biomechanical properties of the valves were then characterized using a uniaxial tensile test. Moreover, computer simulations based on the finite element method (FEM) were used to study the influence of biomechanical properties on the hemodynamic conditions. Studying biomechanical and morphological changes in porcine heart valve conduits according to the weight and age of the animals can be valuable for developing age-targeted therapy using tissue engineering techniques. (paper)

  8. Trunk biomechanics during hemiplegic gait after stroke: A systematic review.

    Science.gov (United States)

    Van Criekinge, Tamaya; Saeys, Wim; Hallemans, Ann; Velghe, Silke; Viskens, Pieter-Jan; Vereeck, Luc; De Hertogh, Willem; Truijen, Steven

    2017-05-01

    Stroke commonly results in trunk impairments that are associated with decreased trunk coordination and limited trunk muscle strength. These impairments often result in biomechanical changes during walking. Additionally, the so-called pelvic step might be influenced by these impairments. Therefore, the aim of this review was twofold. First, to gain more insight into trunk biomechanics during walking in stroke patients compared to healthy individuals. Second, to investigate the influence of walking speed on trunk biomechanics. The search strategy was performed by the PRISMA guidelines and registered in the PROSPERO database (no. CRD42016035797). Databases MEDLINE, Web of Science, Cochrane Library, ScienceDirect, and Rehabdata were systematically searched until December 2016. Sixteen of the 1099 studies met the eligibility criteria and were included in this review. Risk of bias was assessed by the Newcastle-Ottawa Scale. The majority of studies reported on trunk kinematics during walking, data on trunk kinetics and muscle activity is lacking. Following stroke, patients walk with increased mediolateral trunk sway and larger sagittal motion of the lower trunk. Although rotation of the upper trunk is increased, the trunk shows a more in-phase coordination. Acceleration of the trunk diminishes while instability and asymmetry increase as there are less movement towards the paretic side. However, it is of great importance to differentiate between compensatory trunk movements and intrinsic trunk control deficits. Specific exercise programs, assistive devices and orthoses might be of help in controlling these deficits. Importantly, studies suggested that more natural trunk movements were observed when walking speed was increased. Copyright © 2017 Elsevier B.V. All rights reserved.

  9. Quantitative Assessment of Dance Therapy Infulence on the Parkinson’s Disease Patients’ Lower Limb Biomechanics

    Directory of Open Access Journals (Sweden)

    Donatas Lukšys

    2017-01-01

    Full Text Available Parkinson’s disease – progressive neurologic disorder that damages a variety of motor function and reduces the quality of life. Patients with PD are subject to various physical therapy exercises, but recently is applied more often the dance – music therapy. This study aims assessing the therapeutic effect of the modified Lindy Hop dance therapy on lower extremity biomechanics. The experimental study was performed using inertial sensors that registered lower extremity biomechanical parameters during gait. Several spatio-temporal parameters of lower limb were calculated and were found statistically significant between groups, which allows quantifying the influence of dance therapy.

  10. 4th International Plant Biomechanics Conference Proceedings (Abstracts)

    Energy Technology Data Exchange (ETDEWEB)

    Frank W. Telewski; Lothar H. Koehler; Frank W. Ewers

    2003-07-20

    The 4th International Plant Biomechanics Conference facilitated an interdisciplinary exchange between scientists, engineers, and educators addressing the major questions encountered in the field of Plant Biomechanics. Subjects covered by the conference include: Evolution; Ecology; Mechanoreception; Cell Walls; Genetic Modification; Applied Biomechanics of Whole Plants, Plant Products, Fibers & Composites; Fluid Dynamics; Wood & Trees; Fracture Mechanics; Xylem Pressure & Water Transport; Modeling; and Introducing Plant Biomechanics in Secondary School Education.

  11. Sixth Computational Biomechanics for Medicine Workshop

    CERN Document Server

    Nielsen, Poul MF; Miller, Karol; Computational Biomechanics for Medicine : Deformation and Flow

    2012-01-01

    One of the greatest challenges for mechanical engineers is to extend the success of computational mechanics to fields outside traditional engineering, in particular to biology, biomedical sciences, and medicine. This book is an opportunity for computational biomechanics specialists to present and exchange opinions on the opportunities of applying their techniques to computer-integrated medicine. Computational Biomechanics for Medicine: Deformation and Flow collects the papers from the Sixth Computational Biomechanics for Medicine Workshop held in Toronto in conjunction with the Medical Image Computing and Computer Assisted Intervention conference. The topics covered include: medical image analysis, image-guided surgery, surgical simulation, surgical intervention planning, disease prognosis and diagnostics, injury mechanism analysis, implant and prostheses design, and medical robotics.

  12. Multiscale modeling in biomechanics and mechanobiology

    CERN Document Server

    Hwang, Wonmuk; Kuhl, Ellen

    2015-01-01

    Presenting a state-of-the-art overview of theoretical and computational models that link characteristic biomechanical phenomena, this book provides guidelines and examples for creating multiscale models in representative systems and organisms. It develops the reader's understanding of and intuition for multiscale phenomena in biomechanics and mechanobiology, and introduces a mathematical framework and computational techniques paramount to creating predictive multiscale models.   Biomechanics involves the study of the interactions of physical forces with biological systems at all scales – including molecular, cellular, tissue and organ scales. The emerging field of mechanobiology focuses on the way that cells produce and respond to mechanical forces – bridging the science of mechanics with the disciplines of genetics and molecular biology. Linking disparate spatial and temporal scales using computational techniques is emerging as a key concept in investigating some of the complex problems underlying these...

  13. Role of Aquaporin 0 in lens biomechanics.

    Science.gov (United States)

    Sindhu Kumari, S; Gupta, Neha; Shiels, Alan; FitzGerald, Paul G; Menon, Anil G; Mathias, Richard T; Varadaraj, Kulandaiappan

    2015-07-10

    Maintenance of proper biomechanics of the eye lens is important for its structural integrity and for the process of accommodation to focus near and far objects. Several studies have shown that specialized cytoskeletal systems such as the beaded filament (BF) and spectrin-actin networks contribute to mammalian lens biomechanics; mutations or deletion in these proteins alters lens biomechanics. Aquaporin 0 (AQP0), which constitutes ∼45% of the total membrane proteins of lens fiber cells, has been shown to function as a water channel and a structural cell-to-cell adhesion (CTCA) protein. Our recent ex vivo study on AQP0 knockout (AQP0 KO) mouse lenses showed the CTCA function of AQP0 could be crucial for establishing the refractive index gradient. However, biomechanical studies on the role of AQP0 are lacking. The present investigation used wild type (WT), AQP5 KO (AQP5(-/-)), AQP0 KO (heterozygous KO: AQP0(+/-); homozygous KO: AQP0(-/-); all in C57BL/6J) and WT-FVB/N mouse lenses to learn more about the role of fiber cell AQPs in lens biomechanics. Electron microscopic images exhibited decreases in lens fiber cell compaction and increases in extracellular space due to deletion of even one allele of AQP0. Biomechanical assay revealed that loss of one or both alleles of AQP0 caused a significant reduction in the compressive load-bearing capacity of the lenses compared to WT lenses. Conversely, loss of AQP5 did not alter the lens load-bearing ability. Compressive load-bearing at the suture area of AQP0(+/-) lenses showed easy separation while WT lens suture remained intact. These data from KO mouse lenses in conjunction with previous studies on lens-specific BF proteins (CP49 and filensin) suggest that AQP0 and BF proteins could act co-operatively in establishing normal lens biomechanics. We hypothesize that AQP0, with its prolific expression at the fiber cell membrane, could provide anchorage for cytoskeletal structures like BFs and together they help to confer

  14. Satisfaction Levels and Factors Influencing Satisfaction With Use of a Social App for Neonatal and Pediatric Patient Transfer Information Systems: A Questionnaire Study Among Doctors.

    Science.gov (United States)

    Choi, Iee; Kim, Jin Kyu; Kim, Sun Jun; Cho, Soo Chul; Kim, Il Nyeo

    2016-08-04

    The treatment of neonatal and pediatric patients is limited to certain medical institutions depending on treatment difficulty. Effective patient transfers are necessary in situations where there are limited medical resources. In South Korea, the government has made a considerable effort to establish patient transfer systems using various means, such as websites, telephone, and so forth. However, in reality, the effort has not yet been effective. In this study, we ran a patient transfer information system using a social app for effective patient transfer. We analyzed the results, satisfaction levels, and the factors influencing satisfaction. Naver Band is a social app and mobile community application which in Korea is more popular than Facebook. It facilitates group communication. Using Naver Band, two systems were created: one by the Neonatal Intensive Care Unit and the other by the Department of Pediatrics at Chonbuk National University Children's Hospital, South Korea. The information necessary for patient transfers was provided to participating obstetricians (n=51) and pediatricians (n=90). We conducted a survey to evaluate the systems and reviewed the results retrospectively. The number of patients transferred was reported to increase by 65% (26/40) obstetricians and 40% (23/57) pediatricians. The time taken for transfers was reported to decrease by 72% (29/40) obstetricians and 59% (34/57) pediatricians. Satisfaction was indicated by 83% (33/40) obstetricians and 89% (51/57) pediatricians. Regarding factors influencing satisfaction, the obstetricians reported communication with doctors in charge (P=.03) and time reduction during transfers (P=.02), whereas the pediatricians indicated review of the diagnosis and treatment of transferred patients (P=.01) and the time reduction during transfers (P=.007). The users were highly satisfied and different users indicated different factors of satisfaction. This finding implies that users' requirements should be

  15. Satisfaction Levels and Factors Influencing Satisfaction With Use of a Social App for Neonatal and Pediatric Patient Transfer Information Systems: A Questionnaire Study Among Doctors

    Science.gov (United States)

    Choi, Iee; Kim, Sun Jun; Cho, Soo Chul; Kim, Il Nyeo

    2016-01-01

    Background The treatment of neonatal and pediatric patients is limited to certain medical institutions depending on treatment difficulty. Effective patient transfers are necessary in situations where there are limited medical resources. In South Korea, the government has made a considerable effort to establish patient transfer systems using various means, such as websites, telephone, and so forth. However, in reality, the effort has not yet been effective. Objective In this study, we ran a patient transfer information system using a social app for effective patient transfer. We analyzed the results, satisfaction levels, and the factors influencing satisfaction. Methods Naver Band is a social app and mobile community application which in Korea is more popular than Facebook. It facilitates group communication. Using Naver Band, two systems were created: one by the Neonatal Intensive Care Unit and the other by the Department of Pediatrics at Chonbuk National University Children's Hospital, South Korea. The information necessary for patient transfers was provided to participating obstetricians (n=51) and pediatricians (n=90). We conducted a survey to evaluate the systems and reviewed the results retrospectively. Results The number of patients transferred was reported to increase by 65% (26/40) obstetricians and 40% (23/57) pediatricians. The time taken for transfers was reported to decrease by 72% (29/40) obstetricians and 59% (34/57) pediatricians. Satisfaction was indicated by 83% (33/40) obstetricians and 89% (51/57) pediatricians. Regarding factors influencing satisfaction, the obstetricians reported communication with doctors in charge (P=.03) and time reduction during transfers (P=.02), whereas the pediatricians indicated review of the diagnosis and treatment of transferred patients (P=.01) and the time reduction during transfers (P=.007). Conclusions The users were highly satisfied and different users indicated different factors of satisfaction. This finding

  16. A review of biomechanically informed breast image registration

    International Nuclear Information System (INIS)

    Hipwell, John H; Vavourakis, Vasileios; Mertzanidou, Thomy; Eiben, Björn; Hawkes, David J; Han, Lianghao

    2016-01-01

    Breast radiology encompasses the full range of imaging modalities from routine imaging via x-ray mammography, magnetic resonance imaging and ultrasound (both two- and three-dimensional), to more recent technologies such as digital breast tomosynthesis, and dedicated breast imaging systems for positron emission mammography and ultrasound tomography. In addition new and experimental modalities, such as Photoacoustics, Near Infrared Spectroscopy and Electrical Impedance Tomography etc, are emerging. The breast is a highly deformable structure however, and this greatly complicates visual comparison of imaging modalities for the purposes of breast screening, cancer diagnosis (including image guided biopsy), tumour staging, treatment monitoring, surgical planning and simulation of the effects of surgery and wound healing etc. Due primarily to the challenges posed by these gross, non-rigid deformations, development of automated methods which enable registration, and hence fusion, of information within and across breast imaging modalities, and between the images and the physical space of the breast during interventions, remains an active research field which has yet to translate suitable methods into clinical practice. This review describes current research in the field of breast biomechanical modelling and identifies relevant publications where the resulting models have been incorporated into breast image registration and simulation algorithms. Despite these developments there remain a number of issues that limit clinical application of biomechanical modelling. These include the accuracy of constitutive modelling, implementation of representative boundary conditions, failure to meet clinically acceptable levels of computational cost, challenges associated with automating patient-specific model generation (i.e. robust image segmentation and mesh generation) and the complexity of applying biomechanical modelling methods in routine clinical practice. (topical review)

  17. Evaluation of Corneal Topography and Biomechanical Parameters after Use of Systemic Isotretinoin in Acne Vulgaris

    Directory of Open Access Journals (Sweden)

    Yusuf Yildirim

    2014-01-01

    Full Text Available Purpose. We report the effect of isotretinoin on corneal topography, corneal thickness, and biomechanical parameters in patients with acne vulgaris. Method. Fifty-four eyes of 54 patients who received oral isotretinoin for treatment of acne vulgaris were evaluated. All patients underwent a corneal topographical evaluation with a Scheimpflug camera combined with Placido-disk (Sirius, ultrasonic pachymetry measurements, and corneal biomechanical evaluation with an ocular response analyzer at baseline, in the 1st, 3rd, and 6th months of treatment, and 6 months after isotretinoin discontinuation. Results. The thinnest corneal thickness measured with Sirius differed significantly in the 1st, 3rd, and 6th months compared with the baseline measurement; there was no significant change in ultrasonic central corneal thickness measurements and biomechanical parameters (corneal hysteresis and corneal resistance factor throughout the study. Average simulated keratometry and surface asymmetry index increased significantly only in the first month of treatment according to the baseline. All changes disappeared 6 months after the end of treatment. Conclusion. Basal tear secretion and corneal morphologic properties were significantly influenced during the systemic isotretinoin treatment and the changes were reversible after discontinuation. No statistical important biomechanical differences were found to be induced by isotretinoin.

  18. Biomechanics of Pediatric Manual Wheelchair Mobility.

    Science.gov (United States)

    Slavens, Brooke A; Schnorenberg, Alyssa J; Aurit, Christine M; Tarima, Sergey; Vogel, Lawrence C; Harris, Gerald F

    2015-01-01

    Currently, there is limited research of the biomechanics of pediatric manual wheelchair mobility. Specifically, the biomechanics of functional tasks and their relationship to joint pain and health is not well understood. To contribute to this knowledge gap, a quantitative rehabilitation approach was applied for characterizing upper extremity biomechanics of manual wheelchair mobility in children and adolescents during propulsion, starting, and stopping tasks. A Vicon motion analysis system captured movement, while a SmartWheel simultaneously collected three-dimensional forces and moments occurring at the handrim. A custom pediatric inverse dynamics model was used to evaluate three-dimensional upper extremity joint motions, forces, and moments of 14 children with spinal cord injury (SCI) during the functional tasks. Additionally, pain and health-related quality of life outcomes were assessed. This research found that joint demands are significantly different amongst functional tasks, with greatest demands placed on the shoulder during the starting task. Propulsion was significantly different from starting and stopping at all joints. We identified multiple stroke patterns used by the children, some of which are not standard in adults. One subject reported average daily pain, which was minimal. Lower than normal physical health and higher than normal mental health was found in this population. It can be concluded that functional tasks should be considered in addition to propulsion for rehabilitation and SCI treatment planning. This research provides wheelchair users and clinicians with a comprehensive, biomechanical, mobility assessment approach for wheelchair prescription, training, and long-term care of children with SCI.

  19. Expose Mechanical Engineering Students to Biomechanics Topics

    Science.gov (United States)

    Shen, Hui

    2011-01-01

    To adapt the focus of engineering education to emerging new industries and technologies nationwide and in the local area, a biomechanics module has been developed and incorporated into a mechanical engineering technical elective course to expose mechanical engineering students at ONU (Ohio Northern University) to the biomedical engineering topics.…

  20. Neck muscle biomechanics and neural control.

    Science.gov (United States)

    Fice, Jason Bradley; Siegmund, Gunter P; Blouin, Jean-Sebastien

    2018-04-18

    The mechanics, morphometry, and geometry of our joints, segments and muscles are fundamental biomechanical properties intrinsic to human neural control. The goal of our study was to investigate if the biomechanical actions of individual neck muscles predicts their neural control. Specifically, we compared the moment direction & variability produced by electrical stimulation of a neck muscle (biomechanics) to their preferred activation direction & variability (neural control). Subjects sat upright with their head fixed to a 6-axis load cell and their torso restrained. Indwelling wire electrodes were placed into the sternocleidomastoid (SCM), splenius capitis (SPL), and semispinalis capitis (SSC) muscles. The electrically stimulated direction was defined as the moment direction produced when a current (2-19mA) was passed through each muscle's electrodes. Preferred activation direction was defined as the vector sum of the spatial tuning curve built from RMS EMG when subjects produced isometric moments at 7.5% and 15% of their maximum voluntary contraction (MVC) in 26 3D directions. The spatial tuning curves at 15% MVC were well-defined (unimodal, pbiomechanics but, as activation increases, biomechanical constraints in part dictate the activation of synergistic neck muscles.

  1. Biomechanics of the pelvic floor musculature

    NARCIS (Netherlands)

    Janda, S.

    2006-01-01

    The present thesis was motivated by two main goals. The first research goal of the thesis was to understand the complex biomechanical behaviour of the pelvic floor muscles. The second goal was to study the mechanism of the pelvic organ prolapse (genital prolapse). The pelvic floor in humans is a

  2. Biomechanical aspects of bone microstructure in vertebrates

    Indian Academy of Sciences (India)

    2009-10-29

    Oct 29, 2009 ... Biomechanical or biophysical principles can be applied to study biological structures in their modern or fossil form. Bone is an important tissue in paleontological studies as it is a commonly preserved element in most fossil vertebrates, and can often allow its microstructures such as lacuna and canaliculi to ...

  3. Biomechanical analysis of drop and countermovement jumps

    NARCIS (Netherlands)

    Bobbert, M. F.; Mackay, M.T.; Schinkelshoek, D.; Huijing, P. A.; van Ingen Schenau, G. J.

    For 13 subjects the performance of drop jumps from a height of 40 cm (DJ) and of countermovement jumps (CMJ) was analysed and compared. From force plate and cine data biomechanical variables including forces, moments, power output and amount of work done were calculated for hip, knee and ankle

  4. Biomechanics and mechanobiology in functional tissue engineering

    NARCIS (Netherlands)

    Guilak, F.; Butler, D.L.; Goldstein, S.A.; Baaijens, F.P.T.

    2014-01-01

    The field of tissue engineering continues to expand and mature, and several products are now in clinical use, with numerous other preclinical and clinical studies underway. However, specific challenges still remain in the repair or regeneration of tissues that serve a predominantly biomechanical

  5. Biomechanics Scholar Citations across Academic Ranks

    Directory of Open Access Journals (Sweden)

    Knudson Duane

    2015-11-01

    Full Text Available Study aim: citations to the publications of a scholar have been used as a measure of the quality or influence of their research record. A world-wide descriptive study of the citations to the publications of biomechanics scholars of various academic ranks was conducted.

  6. Interdisciplinary Vertical Integration: The Future of Biomechanics

    Science.gov (United States)

    Gregor, Robert J.

    2008-01-01

    The field of biomechanics has grown rapidly in the past 30 years in both size and complexity. As a result, the term might mean different things to different people. This article addresses the issues facing the field in the form of challenges biomechanists face in the future. Because the field is so diverse, strength within the different areas of…

  7. Biomechanical comparison of transoral and transbuccal lateral ...

    African Journals Online (AJOL)

    Objectives: The purpose of this experimental study was to compare the biomechanical behaviors of two different types of osteosynthesis that are used in the treatment of mandibular angle fractures. Materials and Methods: Twenty synthetic polyurethane human mandible replicas, with medullar and cortical portions, were ...

  8. The Value of Biomechanical Research in Dance.

    Science.gov (United States)

    Ranney, D. A.

    Simple observation of dance movement, while very useful, can lead to misconceptions, about the physical realities of dance movement, that make learning difficult. This gap between reality and understanding can be reduced by the application of biomechanical techniques such as cinematography, electromyography, and force-plate analysis. Biomechanical…

  9. Effect of material property heterogeneity on biomechanical modeling of prostate under deformation

    International Nuclear Information System (INIS)

    Samavati, Navid; McGrath, Deirdre M; Ménard, Cynthia; Jewett, Michael A S; Van der Kwast, Theo; Brock, Kristy K

    2015-01-01

    Biomechanical model based deformable image registration has been widely used to account for prostate deformation in various medical imaging procedures. Biomechanical material properties are important components of a biomechanical model. In this study, the effect of incorporating tumor-specific material properties in the prostate biomechanical model was investigated to provide insight into the potential impact of material heterogeneity on the prostate deformation calculations. First, a simple spherical prostate and tumor model was used to analytically describe the deformations and demonstrate the fundamental effect of changes in the tumor volume and stiffness in the modeled deformation. Next, using a clinical prostate model, a parametric approach was used to describe the variations in the heterogeneous prostate model by changing tumor volume, stiffness, and location, to show the differences in the modeled deformation between heterogeneous and homogeneous prostate models. Finally, five clinical prostatectomy examples were used in separately performed homogeneous and heterogeneous biomechanical model based registrations to describe the deformations between 3D reconstructed histopathology images and ex vivo magnetic resonance imaging, and examine the potential clinical impact of modeling biomechanical heterogeneity of the prostate. The analytical formulation showed that increasing the tumor volume and stiffness could significantly increase the impact of the heterogeneous prostate model in the calculated displacement differences compared to the homogeneous model. The parametric approach using a single prostate model indicated up to 4.8 mm of displacement difference at the tumor boundary compared to a homogeneous model. Such differences in the deformation of the prostate could be potentially clinically significant given the voxel size of the ex vivo MR images (0.3  ×  0.3  ×  0.3 mm). However, no significant changes in the registration accuracy were

  10. MRI and CT lung biomarkers: Towards an in vivo understanding of lung biomechanics.

    Science.gov (United States)

    Young, Heather M; Eddy, Rachel L; Parraga, Grace

    2017-09-29

    The biomechanical properties of the lung are necessarily dependent on its structure and function, both of which are complex and change over time and space. This makes in vivo evaluation of lung biomechanics and a deep understanding of lung biomarkers, very challenging. In patients and animal models of lung disease, in vivo evaluations of lung structure and function are typically made at the mouth and include spirometry, multiple-breath gas washout tests and the forced oscillation technique. These techniques, and the biomarkers they provide, incorporate the properties of the whole organ system including the parenchyma, large and small airways, mouth, diaphragm and intercostal muscles. Unfortunately, these well-established measurements mask regional differences, limiting their ability to probe the lung's gross and micro-biomechanical properties which vary widely throughout the organ and its subcompartments. Pulmonary imaging has the advantage in providing regional, non-invasive measurements of healthy and diseased lung, in vivo. Here we summarize well-established and emerging lung imaging tools and biomarkers and how they may be used to generate lung biomechanical measurements. We review well-established and emerging lung anatomical, microstructural and functional imaging biomarkers generated using synchrotron x-ray tomographic-microscopy (SRXTM), micro-x-ray computed-tomography (micro-CT), clinical CT as well as magnetic resonance imaging (MRI). Pulmonary imaging provides measurements of lung structure, function and biomechanics with high spatial and temporal resolution. Imaging biomarkers that reflect the biomechanical properties of the lung are now being validated to provide a deeper understanding of the lung that cannot be achieved using measurements made at the mouth. Copyright © 2017 Elsevier Ltd. All rights reserved.

  11. Transfer from point-of-care Ultrasonography training to diagnostic performance on patients--a randomized controlled trial

    DEFF Research Database (Denmark)

    Todsen, Tobias; Jensen, Morten Lind; Tolsgaard, Martin Grønnebæk

    2016-01-01

    BACKGROUND: Clinicians are increasingly using point-of-care ultrasonography for bedside examinations of patients. However, proper training is needed in this technique, and it is unknown whether the skills learned from focused Ultrasonography courses are being transferred to diagnostic performance...... test and binary logistic regression, respectively. RESULTS: There was a significant difference in the performance score between the intervention group (27.4%) and the control group (18.0%, P = .004) and the diagnostic accuracy between the intervention group (65%) and the control group (39%, P = .014......). CONCLUSIONS: Clinicians could successfully transfer learning from an Ultrasonography course to improve diagnostic performance on patients. However, our results also indicate a need for more training when new technologies such as point-of-care ultrasonography are introduced....

  12. Hurdles overcome in technology transfer for AIET and Positive outcome in Indian patients

    Directory of Open Access Journals (Sweden)

    Dedeepiya V

    2012-01-01

    experienced. An increase in awareness about this least toxic method of Cancer treatment among physicians and the public for an early referral is necessary. Further studies on prevention of cancer using in vitro expanded autologous immune cells are underway. References: 1.Takayama T, Sekine T, Makuuchi M, Yamasaki S, Kosuge T, Yamamoto J, Shimada K, Sakamoto M, Hirohashi S, Ohashi Y, Kakizoe T. Adoptive immunotherapy to lower postsurgical recurrence rates of hepatocellular carcinoma: a randomised trial. Lancet. 2000 ;356(9232:802-7. 2.Kimura H, Yamaguchi Y. A phase III randomized study of interleukin-2 lymphokine-activated killer cell immunotherapy combined with chemotherapy or radiotherapy after curative or noncurative resection of primary lung carcinoma. Cancer. 1997;80(1:42-9. 3.Kono K, Takahashi A, Ichihara F, Amemiya H, Iizuka H, Fujii H, Sekikawa T, Matsumoto Y: Prognostic significance of adoptive immunotherapy with tumor-associated lymphocytes in patients with advanced gastric cancer: a randomized trial. Clin Cancer Res. 2002; 8 : 1767-71. 4.Fujita K, Ikarashi H, Takakuwa K, Kodama S, Tokunaga A, Takahashi T, Tanaka K. Prolonged disease-free period in patients with advanced epithelial ovarian cancer after adoptive transfer of tumor-infiltrating lymphocytes. Clin Cancer Res. 1995;1(5:501-7.5.Sivaraman G, Pandian A, Baskar S, Senthil KR, Senthilnagarajan R, Dedeepiya V, Abraham S. Autologous Immune Enhancement therapy for advanced carcinoma of pancreas a case report. PASRM 2008-004. J Stem Cells Regen Med. 2008; 4(1:136.Damodar S, Terunuma H , Sheriff AK , Farzana L , Manjunath S , Senthilkumar R , Shastikumar G , Abraham S , Wang FS. Autologous Immune Enhancement Therapy (AIET for a Case of Acute Myeloid Leukemia (AML - Our Experience. PASRM 2006-001. J Stem Cells Regen Med. 2006, 1(1: 40-417.Takada M, Terunuma H, Deng X, Dewan MZ, Saji S, Kuroi K, Yamamoto N, Toi M. Refractory lung metastasis from breast cancer treated with multidisciplinary therapy including an

  13. Effects of Transfer Training on Musculoskeletal pain in the Caregiver of a Stroke Patient: A Case Report

    Directory of Open Access Journals (Sweden)

    Atefeh Taghizadeh

    2015-06-01

    Full Text Available The purpose of this case report was to evaluate the effectiveness of training of transfer techniques to a caregiver of a person who had suffered a stroke in decreasing musculoskeletal pain, depression and anxiety. This study adopted a single subject research design to evaluate the effectiveness of transfer-techniques training on musculoskeletal pain, depression, and anxiety in a 25-year-old female caregiver of a person with a stroke. The study was completed in four phases, including a baseline evaluation (1st and 3rd week, training (3rd, 5th and 7th week, post-training (9th week, and follow-up evaluation (11th week. During the 1st week, demographic and descriptive information  (such as age, time since diagnosis, cognition and independence of daily living were collected from the stroke patient. Also, pain severity, anxiety and depression levels of the caregiver were evaluated. In weeks 3, 5 and 7, transfer training was undertaken. The patient was involved in the training with the caregiver under the supervision of an occupational therapist in their own home. The effectiveness of the training with regard to musculoskeletal pain and depression and anxiety levels of the caregiver was evaluated in the 5th, 9th and 11th weeks. The data were analyzed using a visual analysis of trends and levels. The results showed a decrease in pain severity, anxiety and depression during training and post-training. The changes continued during the follow-up stage. This study suggests promising results for the effectiveness of the transfer-techniques training and justifies further clinical trials. A larger trial is required to confirm the effectiveness of transfer training in improving pain management in caregivers of stroke survivors.

  14. Increasing transfers-out from an antiretroviral treatment service in South Africa: patient characteristics and rates of virological non-suppression.

    Directory of Open Access Journals (Sweden)

    Mweete D Nglazi

    Full Text Available To determine the proportion, characteristics and outcomes of patients who transfer-out from an antiretroviral therapy (ART service in a South African township.This retrospective cohort study included all patients aged ≥15 years who enrolled between September 2002 and December 2009. Follow-up data were censored in December 2010. Kaplan-Meier survival analysis was used to describe time to transfer-out and cox proportional hazard analysis was used to determine associated risk factors.4511 patients (4003 ART-naïve and 508 non-naïve at baseline received ART during the study period. Overall, 597 (13.2% transferred out. The probability of transferring out by one year of ART steadily increased from 1.4% in 2002/2004 cohort to 8.9% for the 2009 cohort. Independent risk factors for transfer-out were more recent calendar year of enrolment, younger age (≤25 years and being ART non-naïve at baseline (i.e., having previously transferred into this clinic from another facility. The proportions of patients transferred out who had a CD4 cell count 1000 copies/mL around the time of transfer, suggesting the need for careful adherence counseling and assessment of medication supplies among those planning transfer.

  15. Can biomechanical variables predict improvement in crouch gait?

    Science.gov (United States)

    Hicks, Jennifer L.; Delp, Scott L.; Schwartz, Michael H.

    2011-01-01

    Many patients respond positively to treatments for crouch gait, yet surgical outcomes are inconsistent and unpredictable. In this study, we developed a multivariable regression model to determine if biomechanical variables and other subject characteristics measured during a physical exam and gait analysis can predict which subjects with crouch gait will demonstrate improved knee kinematics on a follow-up gait analysis. We formulated the model and tested its performance by retrospectively analyzing 353 limbs of subjects who walked with crouch gait. The regression model was able to predict which subjects would demonstrate ‘improved’ and ‘unimproved’ knee kinematics with over 70% accuracy, and was able to explain approximately 49% of the variance in subjects’ change in knee flexion between gait analyses. We found that improvement in stance phase knee flexion was positively associated with three variables that were drawn from knowledge about the biomechanical contributors to crouch gait: i) adequate hamstrings lengths and velocities, possibly achieved via hamstrings lengthening surgery, ii) normal tibial torsion, possibly achieved via tibial derotation osteotomy, and iii) sufficient muscle strength. PMID:21616666

  16. Button fixation technique for Achilles tendon reinsertion: a biomechanical study.

    Science.gov (United States)

    Awogni, David; Chauvette, Guillaume; Lemieux, Marie-Line; Balg, Frédéric; Langelier, Ève; Allard, Jean-Pascal

    2014-01-01

    Chronic insertional tendinopathy of the Achilles tendon is a frequent and disabling pathologic entity. Operative treatment is indicated for patients for whom nonoperative management has failed. The treatment can consist of the complete detachment of the tendon insertion and extensive debridement. We biomechanically tested a new operative technique that uses buttons for fixation of the Achilles tendon insertion on the posterior calcaneal tuberosity and compared it with 2 standard bone anchor techniques. A total of 40 fresh-frozen cadaver specimens were used to compare 3 fixation techniques for reinserting the Achilles tendon: single row anchors, double row anchors, and buttons. The ultimate loads and failure mechanisms were recorded. The button assembly (median load 764 N, range 713 to 888) yielded a median fixation strength equal to 202% (range 137% to 251%) of that obtained with the double row anchors (median load 412 N, range 301 to 571) and 255% (range 213% to 317%) of that obtained with the single row anchors (median load 338 N, range 241 to 433N). The most common failure mechanisms were suture breakage with the buttons (55%) and pull out of the implant with the double row (70%) and single row (85%) anchors. The results of the present biomechanical cadaver study have shown that Achilles tendon reinsertion fixation using the button technique provides superior pull out strength than the bone anchors tested. Copyright © 2014 American College of Foot and Ankle Surgeons. Published by Elsevier Inc. All rights reserved.

  17. Coupled Immunological and Biomechanical Model of Emphysema Progression

    Directory of Open Access Journals (Sweden)

    Mario Ceresa

    2018-04-01

    Full Text Available Chronic Obstructive Pulmonary Disease (COPD is a disabling respiratory pathology, with a high prevalence and a significant economic and social cost. It is characterized by different clinical phenotypes with different risk profiles. Detecting the correct phenotype, especially for the emphysema subtype, and predicting the risk of major exacerbations are key elements in order to deliver more effective treatments. However, emphysema onset and progression are influenced by a complex interaction between the immune system and the mechanical properties of biological tissue. The former causes chronic inflammation and tissue remodeling. The latter influences the effective resistance or appropriate mechanical response of the lung tissue to repeated breathing cycles. In this work we present a multi-scale model of both aspects, coupling Finite Element (FE and Agent Based (AB techniques that we would like to use to predict the onset and progression of emphysema in patients. The AB part is based on existing biological models of inflammation and immunological response as a set of coupled non-linear differential equations. The FE part simulates the biomechanical effects of repeated strain on the biological tissue. We devise a strategy to couple the discrete biological model at the molecular /cellular level and the biomechanical finite element simulations at the tissue level. We tested our implementation on a public emphysema image database and found that it can indeed simulate the evolution of clinical image biomarkers during disease progression.

  18. Role of Aquaporin 0 in lens biomechanics

    Energy Technology Data Exchange (ETDEWEB)

    Sindhu Kumari, S.; Gupta, Neha [Physiology and Biophysics, Stony Brook University, Stony Brook, NY (United States); Shiels, Alan [Washington University School of Medicine, St. Louis, MO (United States); FitzGerald, Paul G. [Cell Biology and Human Anatomy, School of Medicine, University of California, Davis, CA (United States); Menon, Anil G. [University of Cincinnati College of Medicine, Cincinnati, OH (United States); Mathias, Richard T. [Physiology and Biophysics, Stony Brook University, Stony Brook, NY (United States); SUNY Eye Institute, NY (United States); Varadaraj, Kulandaiappan, E-mail: kulandaiappan.varadaraj@stonybrook.edu [Physiology and Biophysics, Stony Brook University, Stony Brook, NY (United States); SUNY Eye Institute, NY (United States)

    2015-07-10

    Maintenance of proper biomechanics of the eye lens is important for its structural integrity and for the process of accommodation to focus near and far objects. Several studies have shown that specialized cytoskeletal systems such as the beaded filament (BF) and spectrin-actin networks contribute to mammalian lens biomechanics; mutations or deletion in these proteins alters lens biomechanics. Aquaporin 0 (AQP0), which constitutes ∼45% of the total membrane proteins of lens fiber cells, has been shown to function as a water channel and a structural cell-to-cell adhesion (CTCA) protein. Our recent ex vivo study on AQP0 knockout (AQP0 KO) mouse lenses showed the CTCA function of AQP0 could be crucial for establishing the refractive index gradient. However, biomechanical studies on the role of AQP0 are lacking. The present investigation used wild type (WT), AQP5 KO (AQP5{sup −/−}), AQP0 KO (heterozygous KO: AQP0{sup +/−}; homozygous KO: AQP0{sup −/−}; all in C57BL/6J) and WT-FVB/N mouse lenses to learn more about the role of fiber cell AQPs in lens biomechanics. Electron microscopic images exhibited decreases in lens fiber cell compaction and increases in extracellular space due to deletion of even one allele of AQP0. Biomechanical assay revealed that loss of one or both alleles of AQP0 caused a significant reduction in the compressive load-bearing capacity of the lenses compared to WT lenses. Conversely, loss of AQP5 did not alter the lens load-bearing ability. Compressive load-bearing at the suture area of AQP0{sup +/−} lenses showed easy separation while WT lens suture remained intact. These data from KO mouse lenses in conjunction with previous studies on lens-specific BF proteins (CP49 and filensin) suggest that AQP0 and BF proteins could act co-operatively in establishing normal lens biomechanics. We hypothesize that AQP0, with its prolific expression at the fiber cell membrane, could provide anchorage for cytoskeletal structures like BFs and

  19. The Use of the Self-Standing Turning Transfer Device to Perform Bed-To-Chair Transfers Reduces Physical Stress among Caregivers of Older Patients in a Middle-Income Developing Country.

    Science.gov (United States)

    Goh, Choon Hian; Muslimah Y; Ng, Siew-Cheok; Subramanian, Pathmawathi; Tan, Maw Pin

    2014-01-01

    Manual transfer of elderly patients remains commonplace in many developing countries because the use of lifting equipment, such as hoists, is often considered unaffordable luxuries. The aim of this study was, therefore, to evaluate the usage and potential benefits of a low-cost, mechanical turning transfer device among elderly patients and their caregivers on a geriatric ward in a developing country in South East Asia. Fifty-six inpatients, aged 66-92 years, on a geriatric ward, and their caregivers were recruited. Participants were asked to transfer from bed-to-chair transfer with manual assistance, and the task was repeated using the Self-standing Turning Transfer Device (STurDi). The time taken to perform manual transfers and STurDi-assisted transfers was recorded. Physical strain was assessed using the perceived physical stress-rating tool for caregivers with and without the use of the device. User satisfaction was evaluated using the usefulness, satisfaction, and ease of use questionnaire. There was a significant reduction in transfer-time with manual transfers compared to STurDi-assisted transfers [mean (SD) = 48.39 (13.98) vs. 36.23 (10.96); p ≤ 0.001]. The physical stress rating was significantly lower in STurDi-aided transfers compared to manual transfers, shoulder [median (interquartile range) = 0 (1) vs. 4 (3); p = 0.001], upper back [0 (0) vs. 5 (4); p = 0.001], lower back [0 (1) vs. 5 (3), p = 0.001], whole body [1 (2) vs. 4 (3), p = 0.001], and knee [0 (1) vs. 1 (4), p = 0.001]. In addition, majority of patients and caregivers definitely or strongly agreed that the device was useful, saved time, and was easy to use. We have therefore demonstrated in a setting where manual handling was commonly performed that a low-cost mechanical transfer device reduced caregiver strain and was well received by older patients and caregivers.

  20. Sensitivity of tumor motion simulation accuracy to lung biomechanical modeling approaches and parameters.

    Science.gov (United States)

    Tehrani, Joubin Nasehi; Yang, Yin; Werner, Rene; Lu, Wei; Low, Daniel; Guo, Xiaohu; Wang, Jing

    2015-11-21

    Finite element analysis (FEA)-based biomechanical modeling can be used to predict lung respiratory motion. In this technique, elastic models and biomechanical parameters are two important factors that determine modeling accuracy. We systematically evaluated the effects of lung and lung tumor biomechanical modeling approaches and related parameters to improve the accuracy of motion simulation of lung tumor center of mass (TCM) displacements. Experiments were conducted with four-dimensional computed tomography (4D-CT). A Quasi-Newton FEA was performed to simulate lung and related tumor displacements between end-expiration (phase 50%) and other respiration phases (0%, 10%, 20%, 30%, and 40%). Both linear isotropic and non-linear hyperelastic materials, including the neo-Hookean compressible and uncoupled Mooney-Rivlin models, were used to create a finite element model (FEM) of lung and tumors. Lung surface displacement vector fields (SDVFs) were obtained by registering the 50% phase CT to other respiration phases, using the non-rigid demons registration algorithm. The obtained SDVFs were used as lung surface displacement boundary conditions in FEM. The sensitivity of TCM displacement to lung and tumor biomechanical parameters was assessed in eight patients for all three models. Patient-specific optimal parameters were estimated by minimizing the TCM motion simulation errors between phase 50% and phase 0%. The uncoupled Mooney-Rivlin material model showed the highest TCM motion simulation accuracy. The average TCM motion simulation absolute errors for the Mooney-Rivlin material model along left-right, anterior-posterior, and superior-inferior directions were 0.80 mm, 0.86 mm, and 1.51 mm, respectively. The proposed strategy provides a reliable method to estimate patient-specific biomechanical parameters in FEM for lung tumor motion simulation.

  1. Sensitivity of tumor motion simulation accuracy to lung biomechanical modeling approaches and parameters

    International Nuclear Information System (INIS)

    Tehrani, Joubin Nasehi; Wang, Jing; Yang, Yin; Werner, Rene; Lu, Wei; Low, Daniel; Guo, Xiaohu

    2015-01-01

    Finite element analysis (FEA)-based biomechanical modeling can be used to predict lung respiratory motion. In this technique, elastic models and biomechanical parameters are two important factors that determine modeling accuracy. We systematically evaluated the effects of lung and lung tumor biomechanical modeling approaches and related parameters to improve the accuracy of motion simulation of lung tumor center of mass (TCM) displacements. Experiments were conducted with four-dimensional computed tomography (4D-CT). A Quasi-Newton FEA was performed to simulate lung and related tumor displacements between end-expiration (phase 50%) and other respiration phases (0%, 10%, 20%, 30%, and 40%). Both linear isotropic and non-linear hyperelastic materials, including the neo-Hookean compressible and uncoupled Mooney–Rivlin models, were used to create a finite element model (FEM) of lung and tumors. Lung surface displacement vector fields (SDVFs) were obtained by registering the 50% phase CT to other respiration phases, using the non-rigid demons registration algorithm. The obtained SDVFs were used as lung surface displacement boundary conditions in FEM. The sensitivity of TCM displacement to lung and tumor biomechanical parameters was assessed in eight patients for all three models. Patient-specific optimal parameters were estimated by minimizing the TCM motion simulation errors between phase 50% and phase 0%. The uncoupled Mooney–Rivlin material model showed the highest TCM motion simulation accuracy. The average TCM motion simulation absolute errors for the Mooney–Rivlin material model along left-right, anterior–posterior, and superior–inferior directions were 0.80 mm, 0.86 mm, and 1.51 mm, respectively. The proposed strategy provides a reliable method to estimate patient-specific biomechanical parameters in FEM for lung tumor motion simulation. (paper)

  2. Clinical Improvement by Switching to an Integrase Strand Transfer Inhibitor in Hemophiliac Patients with HIV: The Japan Cohort Study of HIV Patients Infected through Blood Products.

    Science.gov (United States)

    Kawado, Miyuki; Hashimoto, Shuji; Oka, Shin-Ichi; Fukutake, Katsuyuki; Higasa, Satoshi; Yatsuhashi, Hiroshi; Ogane, Miwa; Okamoto, Manabu; Shirasaka, Takuma

    2017-01-01

    This study aimed to determine improvement in HIV RNA levels and the CD4 cell count by switching to an antiretroviral regimen with an integrase strand transfer inhibitor (INSTI) in patients with HIV. This study was conducted on Japanese patients with HIV who were infected by blood products in the 1980s. Data were collected between 2007 and 2014. Data of 564 male hemophiliac patients with HIV from the Japan Cohort Study of HIV Patients Infected through Blood Products were available. Changes in antiretroviral regimen use, HIV RNA levels, and the CD4 cell count between 2007 and 2014 were examined. From 2007 to 2014, the proportion of use of a regimen with an INSTI increased from 0.0% to 41.0%. For patients with HIV who used a regimen, including an INSTI, the proportion of HIV RNA levels products. This suggests that performing this switch in clinical practice will lead to favorable effects.

  3. Elastin density: Link between histological and biomechanical properties of vaginal tissue in women with pelvic organ prolapse?

    Science.gov (United States)

    de Landsheere, Laurent; Brieu, Mathias; Blacher, Silvia; Munaut, Carine; Nusgens, Betty; Rubod, Chrystèle; Noel, Agnès; Foidart, Jean-Michel; Nisolle, Michelle; Cosson, Michel

    2016-04-01

    The aim of the study was to correlate histological and biomechanical characteristics of the vaginal wall in women with pelvic organ prolapse (POP). Tissue samples were collected from the anterior [point Ba; POP Questionnaire (POP-Q)] and/or posterior (point Bp; POP-Q) vaginal wall of 15 women who underwent vaginal surgery for POP. Both histological and biomechanical assessments were performed from the same tissue samples in 14 of 15 patients. For histological assessment, the density of collagen and elastin fibers was determined by combining high-resolution virtual imaging and computer-assisted digital image analysis. For biomechanical testing, uniaxial tension tests were performed to evaluate vaginal tissue stiffness at low (C0) and high (C1) deformation rates. Biomechanical testing highlights the hyperelastic behavior of the vaginal wall. At low strains (C0), vaginal tissue appeared stiffer when elastin density was low. We found a statistically significant inverse relationship between C0 and the elastin/collagen ratio (p = 0.048) in the lamina propria. However, at large strain levels (C1), no clear relationship was observed between elastin density or elastin/collagen ratio and stiffness, likely reflecting the large dispersion of the mechanical behavior of the tissue samples. Histological and biomechanical properties of the vaginal wall vary from patient to patient. This study suggests that elastin density deserves consideration as a relevant factor of vaginal stiffness in women with POP.

  4. Structural and biomechanical basis of mitochondrial movement in eukaryotic cells

    Directory of Open Access Journals (Sweden)

    Wu M

    2013-10-01

    Full Text Available Min Wu,1 Aruna Kalyanasundaram,2 Jie Zhu1 1Laboratory of Biomechanics and Engineering, Institute of Biophysics, College of Science, Northwest A&F University, Yangling, Shaanxi, People's Republic of China; 2College of Pharmacology, University of Illinois at Chicago, Chicago, IL, USA Abstract: Mitochondria serve as energy-producing organelles in eukaryotic cells. In addition to providing the energy supply for cells, the mitochondria are also involved in other processes, such as proliferation, differentiation, information transfer, and apoptosis, and play an important role in regulation of cell growth and the cell cycle. In order to achieve these functions, the mitochondria need to move to the corresponding location. Therefore, mitochondrial movement has a crucial role in normal physiologic activity, and any mitochondrial movement disorder will cause irreparable damage to the organism. For example, recent studies have shown that abnormal movement of the mitochondria is likely to be the reason for Charcot–Marie–Tooth disease, amyotrophic lateral sclerosis, Alzheimer's disease, Huntington's disease, Parkinson's disease, and schizophrenia. So, in the cell, especially in the particular polarized cell, the appropriate distribution of mitochondria is crucial to the function and survival of the cell. Mitochondrial movement is mainly associated with the cytoskeleton and related proteins. However, those components play different roles according to cell type. In this paper, we summarize the structural basis of mitochondrial movement, including microtubules, actin filaments, motor proteins, and adaptin, and review studies of the biomechanical mechanisms of mitochondrial movement in different types of cells. Keywords: mitochondrial movement, microtubules, actin filaments, motor proteins, adaptin

  5. Using a Cloud Computing System to Reduce Door-to-Balloon Time in Acute ST-Elevation Myocardial Infarction Patients Transferred for Percutaneous Coronary Intervention.

    Science.gov (United States)

    Ho, Chi-Kung; Chen, Fu-Cheng; Chen, Yung-Lung; Wang, Hui-Ting; Lee, Chien-Ho; Chung, Wen-Jung; Lin, Cheng-Jui; Hsueh, Shu-Kai; Hung, Shin-Chiang; Wu, Kuan-Han; Liu, Chu-Feng; Kung, Chia-Te; Cheng, Cheng-I

    2017-01-01

    This study evaluated the impact on clinical outcomes using a cloud computing system to reduce percutaneous coronary intervention hospital door-to-balloon (DTB) time for ST segment elevation myocardial infarction (STEMI). A total of 369 patients before and after implementation of the transfer protocol were enrolled. Of these patients, 262 were transferred through protocol while the other 107 patients were transferred through the traditional referral process. There were no significant differences in DTB time, pain to door of STEMI receiving center arrival time, and pain to balloon time between the two groups. Pain to electrocardiography time in patients with Killip I/II and catheterization laboratory to balloon time in patients with Killip III/IV were significantly reduced in transferred through protocol group compared to in traditional referral process group (both p cloud computing system in our present protocol did not reduce DTB time.

  6. ANTERIOR CRUCIATE LIGAMENT RECONSTRUCTION USING THE DOUBLE-BUNDLE TECHNIQUE – EVALUATION IN THE BIOMECHANICS LABORATORY

    OpenAIRE

    D'Elia, Caio Oliveira; Bitar, Alexandre Carneiro; Castropil, Wagner; Garofo, Antônio Guilherme Padovani; Cantuária, Anita Lopes; Orselli, Maria Isabel Veras; Luques, Isabela Ugo; Duarte, Marcos

    2011-01-01

    Objective: The objective of this study was to describe the methodology of knee rotation analysis using biomechanics laboratory instruments and to present the preliminary results from a comparative study on patients who underwent anterior cruciate ligament (ACL) reconstruction using the double-bundle technique. Methods: The protocol currently used in our laboratory was described. Three-dimensional kinematic analysis was performed and knee rotation amplitude was measured on eight normal patient...

  7. Transfer of liraglutide from blood to cerebrospinal fluid is minimal in patients with type 2 diabetes

    DEFF Research Database (Denmark)

    Christensen, M; Sparre-Ulrich, A H; Hartmann, B

    2015-01-01

    Treatment with liraglutide leads to weight loss. We investigated whether blood-to-cerebrospinal fluid (CSF) transfer of liraglutide occurs, and if so, whether it associates with clinical weight loss following liraglutide treatment in humans. We performed lumbar puncture and blood sampling in eight...

  8. Biomechanical study of percutaneous lumbar diskectomy

    International Nuclear Information System (INIS)

    Li Yuan; Huang Xianglong; Shen Tianzhen; Hu Zhou; Hong Shuizong; Mei Haiying

    2003-01-01

    Objective: To investigate the stiffness of lumbar spine after the injury caused by percutaneous diskectomy and evaluate the efficiency of percutaneous lumbar diskectomy by biomechanical study. Methods: Four fresh lumbar specimens were used to analyse load-displacement curves in the intact lumbar spine and vertical disc-injured lumbar spine. The concepts of average flexibility coefficient (f) and standardized average flexibility coefficient (fs) were also introduced. Results: The load-displacement curves showed a good stabilization effect of the intact lumbar spine and disc-injured lumbar spine in flexion, extension, right and left bending. The decrease of anti-rotation also can be detected (P<0.05). Conclusion: In biomechanical study, percutaneous lumbar diskectomy is one of the efficiency methods to treat lumbar diac hernia

  9. Biomechanical considerations in mandibular incisor extraction cases.

    Science.gov (United States)

    Rachala, Madhukar Reddy; Aileni, Kaladhar Reddy; Dasari, Arun Kumar; Sinojiya, Jay

    2015-01-01

    Mandibular incisor extraction can be regarded as a valuable treatment option in certain malocclusions to obtain excellence in orthodontic results in terms of function, aesthetics and stability. This treatment alternative is indicated in clinical situations like mild to moderate class III malocclusion, mild anterior mandibular tooth size excess, periodontally compromised teeth, ectopic eruption of mandibular incisor and minimal openbite tendencies. Unlike in premolar extraction cases, space closure in mandibular incisor extraction cases is unique in which the extraction space will be in the middle of the arch. The end result of space closure in these cases should be well aligned, upright, anterior teeth with parallel roots and the goal can be achieved with the bodily tooth movement through proper application of biomechanics. The purpose of this article is to explain the biomechanics of space closure in mandibular incisor extraction cases.

  10. Comparison of Changes in Corneal Biomechanical Properties after Photorefractive Keratectomy and Small Incision Lenticule Extraction

    Directory of Open Access Journals (Sweden)

    Yusuf Yıldırım

    2016-04-01

    Full Text Available Objectives: To compare the postoperative biomechanical properties of the cornea after photorefractive keratectomy (PRK and small incision lenticule extraction (SMILE in eyes with low and moderate myopia. Materials and Methods: We retrospectively examined 42 eyes of 23 patients undergoing PRK and 42 eyes of 22 patients undergoing SMILE for the correction of low and moderate myopia. Corneal hysteresis (CH and corneal resistance factor (CRF were measured with an Ocular Response Analyzer before and 6 months after surgery. We also investigated the relationship between these biomechanical changes and the amount of myopic correction. Results: In the PRK group, CH was 10.4±1.3 mmHg preoperatively and significantly decreased to 8.5±1.3 mmHg postoperatively. In the SMILE group, CH was 10.9±1.7 mmHg preoperatively and decreased to 8.4±1.5 mmHg postoperatively. CRF was significantly decreased from 10.8±1.1 mmHg to 7.4±1.5 mmHg in the PRK group whereas it was decreased from 11.1±1.5 mmHg to 7.9±1.6 mmHg in the SMILE group postoperatively. There was a significant correlation between the amount of myopic correction and changes in biomechanical properties after PRK (r=-0.29, p=0.045 for CH; r=-0.07, p=0.05 for CRF and SMILE (r=-0.25, p=0.048 for CH; r=-0.37, p=0.011 for CRF. Conclusion: Both PRK and SMILE can affect the biomechanical strength of the cornea. SMILE resulted in larger biomechanical changes than PRK

  11. Numerical Simulation of Some Biomechanical Problems

    Czech Academy of Sciences Publication Activity Database

    Nedoma, Jiří; Klézl, Z.; Fousek, J.; Kestřánek, Zdeněk; Stehlík, J.

    2003-01-01

    Roč. 61, 3-6 (2003), s. 283-295 ISSN 0378-4754. [MODELLING 2001. IMACS Conference on Mathematical Modelling and Computational Methods in Mechanics, Physics , Biomechanics and Geodynamics /2./. Pilsen, 19.06.2001-25.06.2001] Institutional research plan: AV0Z1030915 Keywords : non-linear elasticity * contact problems * variational inequality * finite element method * wrist * spine * fracture Subject RIV: BA - General Mathematics Impact factor: 0.558, year: 2003

  12. Analysis of Biomechanical Factors in Bend Running

    OpenAIRE

    Bing Zhang; Xinping You; Feng Li

    2013-01-01

    Sprint running is the demonstration of comprehensive abilities of technology and tactics, under various conditions. However, whether it is just to allocate the tracks for short-distance athletes from different racetracks has been the hot topic. This study analyzes its forces, differences in different tracks and winding influences, in the aspects of sport biomechanics. The results indicate, many disadvantages exist in inner tracks, middle tracks are the best and outer ones are inferior to midd...

  13. Biomechanical Factors in Tibial Stress Fracture

    Science.gov (United States)

    2001-08-01

    Relationship between Loading Rates and Tibial Accelerometry in Forefoot Strike Runners. Presented at the Annual American Society of Biomechanics Mtg...of the APTA, Seattle, WA, 2/99. McClay, IS, Williams, DS, and Manal, KT. Lower Extremity Mechanics of Runners with a Converted Forefoot Strike ...Management, Inc, 1998-1999 The Effect of Different Orthotic Devices on Lower Extremity Mechanics of Rearfoot and Forefoot Strikers, $3,500. Foot Management

  14. Injury Biomechanics of C2 Dens Fractures

    OpenAIRE

    Yoganandan, Narayan; Pintar, Frank; Baisden, Jamie; Gennarelli, Thomas; Maiman, Dennis

    2004-01-01

    The objective of this study is to analyze the biomechanics of dens fractures of the second cervical vertebra in the adult population due to motor vehicle crashes. Case-by-case records from the Crash Injury Research and Engineering Network (CIREN) and National Automotive Sampling System (NASS) databases were used. Variables such as change in velocity, impact direction and body habitus were extracted. Results indicated that similarities exist in the two databases despite differences in sampling...

  15. Computational Biomechanics Theoretical Background and BiologicalBiomedical Problems

    CERN Document Server

    Tanaka, Masao; Nakamura, Masanori

    2012-01-01

    Rapid developments have taken place in biological/biomedical measurement and imaging technologies as well as in computer analysis and information technologies. The increase in data obtained with such technologies invites the reader into a virtual world that represents realistic biological tissue or organ structures in digital form and allows for simulation and what is called “in silico medicine.” This volume is the third in a textbook series and covers both the basics of continuum mechanics of biosolids and biofluids and the theoretical core of computational methods for continuum mechanics analyses. Several biomechanics problems are provided for better understanding of computational modeling and analysis. Topics include the mechanics of solid and fluid bodies, fundamental characteristics of biosolids and biofluids, computational methods in biomechanics analysis/simulation, practical problems in orthopedic biomechanics, dental biomechanics, ophthalmic biomechanics, cardiovascular biomechanics, hemodynamics...

  16. A method to investigate the biomechanical alterations in Perthes’ disease by hip joint contact modeling

    DEFF Research Database (Denmark)

    Salmingo, Remel A.; Skytte, Tina Lercke; Traberg, Marie Sand

    2017-01-01

    for the preoperative planning to obtain stress relief for the highly stressed areas in the malformed hip. This single-patient study demonstrated that the biomechanical alterations in Perthes’ disease can be evaluated individually by patient-specific finite element contact modeling using MRI. A multi-patient study...... was to develop a method to investigate the biomechanical alterations in Perthes’ disease by finite element (FE ) contact modeling using MRI. The MRI data of a unilateral Perthes’ case was obtained to develop the three-dimensional FE model of the hip joint. The stress and contact pressure patterns...... in the unaffected hip were well distrib uted. Elevated concentrations of stress and contact pressure were found in the Perthes’ hip. The highest femoral cartilagev on Mises stress 3.9 MPa and contact pressure 5.3 M P a were found in the Perthes’ hip, whereas 2.4 M P a and 4.9 MP a in the healthy hip, respectively...

  17. ANTERIOR CRUCIATE LIGAMENT RECONSTRUCTION USING THE DOUBLE-BUNDLE TECHNIQUE - EVALUATION IN THE BIOMECHANICS LABORATORY.

    Science.gov (United States)

    D'Elia, Caio Oliveira; Bitar, Alexandre Carneiro; Castropil, Wagner; Garofo, Antônio Guilherme Padovani; Cantuária, Anita Lopes; Orselli, Maria Isabel Veras; Luques, Isabela Ugo; Duarte, Marcos

    2011-01-01

    The objective of this study was to describe the methodology of knee rotation analysis using biomechanics laboratory instruments and to present the preliminary results from a comparative study on patients who underwent anterior cruciate ligament (ACL) reconstruction using the double-bundle technique. The protocol currently used in our laboratory was described. Three-dimensional kinematic analysis was performed and knee rotation amplitude was measured on eight normal patients (control group) and 12 patients who were operated using the double-bundle technique, by means of three tasks in the biomechanics laboratory. No significant differences between operated and non-operated sides were shown in relation to the mean amplitudes of gait, gait with change in direction or gait with change in direction when going down stairs (p > 0.13). The preliminary results did not show any difference in the double-bundle ACL reconstruction technique in relation to the contralateral side and the control group.

  18. ANTERIOR CRUCIATE LIGAMENT RECONSTRUCTION USING THE DOUBLE-BUNDLE TECHNIQUE – EVALUATION IN THE BIOMECHANICS LABORATORY

    Science.gov (United States)

    D'Elia, Caio Oliveira; Bitar, Alexandre Carneiro; Castropil, Wagner; Garofo, Antônio Guilherme Padovani; Cantuária, Anita Lopes; Orselli, Maria Isabel Veras; Luques, Isabela Ugo; Duarte, Marcos

    2015-01-01

    Objective: The objective of this study was to describe the methodology of knee rotation analysis using biomechanics laboratory instruments and to present the preliminary results from a comparative study on patients who underwent anterior cruciate ligament (ACL) reconstruction using the double-bundle technique. Methods: The protocol currently used in our laboratory was described. Three-dimensional kinematic analysis was performed and knee rotation amplitude was measured on eight normal patients (control group) and 12 patients who were operated using the double-bundle technique, by means of three tasks in the biomechanics laboratory. Results: No significant differences between operated and non-operated sides were shown in relation to the mean amplitudes of gait, gait with change in direction or gait with change in direction when going down stairs (p > 0.13). Conclusion: The preliminary results did not show any difference in the double-bundle ACL reconstruction technique in relation to the contralateral side and the control group. PMID:27027003

  19. [Cement augmentation on the spine : Biomechanical considerations].

    Science.gov (United States)

    Kolb, J P; Weiser, L; Kueny, R A; Huber, G; Rueger, J M; Lehmann, W

    2015-09-01

    Vertebral compression fractures are the most common osteoporotic fractures. Since the introduction of vertebroplasty and screw augmentation, the management of osteoporotic fractures has changed significantly. The biomechanical characteristics of the risk of adjacent fractures and novel treatment modalities for osteoporotic vertebral fractures, including pure cement augmentation by vertebroplasty, and cement augmentation of screws for posterior instrumentation, are explored. Eighteen human osteoporotic lumbar spines (L1-5) adjacent to vertebral bodies after vertebroplasty were tested in a servo-hydraulic machine. As augmentation compounds we used standard cement and a modified low-strength cement. Different anchoring pedicle screws were tested with and without cement augmentation in another cohort of human specimens with a simple pull-out test and a fatigue test that better reflects physiological conditions. Cement augmentation in the osteoporotic spine leads to greater biomechanical stability. However, change in vertebral stiffness resulted in alterations with the risk of adjacent fractures. By using a less firm cement compound, the risk of adjacent fractures is significantly reduced. Both screw augmentation techniques resulted in a significant increase in the withdrawal force compared with the group without cement. Augmentation using perforated screws showed the highest stability in the fatigue test. The augmentation of cement leads to a significant change in the biomechanical properties. Differences in the stability of adjacent vertebral bodies increase the risk of adjacent fractures, which could be mitigated by a modified cement compound with reduced strength. Screws that were specifically designed for cement application displayed greatest stability in the fatigue test.

  20. Advanced Computational Methods in Bio-Mechanics.

    Science.gov (United States)

    Al Qahtani, Waleed M S; El-Anwar, Mohamed I

    2018-04-15

    A novel partnership between surgeons and machines, made possible by advances in computing and engineering technology, could overcome many of the limitations of traditional surgery. By extending surgeons' ability to plan and carry out surgical interventions more accurately and with fewer traumas, computer-integrated surgery (CIS) systems could help to improve clinical outcomes and the efficiency of healthcare delivery. CIS systems could have a similar impact on surgery to that long since realised in computer-integrated manufacturing. Mathematical modelling and computer simulation have proved tremendously successful in engineering. Computational mechanics has enabled technological developments in virtually every area of our lives. One of the greatest challenges for mechanists is to extend the success of computational mechanics to fields outside traditional engineering, in particular to biology, the biomedical sciences, and medicine. Biomechanics has significant potential for applications in orthopaedic industry, and the performance arts since skills needed for these activities are visibly related to the human musculoskeletal and nervous systems. Although biomechanics is widely used nowadays in the orthopaedic industry to design orthopaedic implants for human joints, dental parts, external fixations and other medical purposes, numerous researches funded by billions of dollars are still running to build a new future for sports and human healthcare in what is called biomechanics era.

  1. Scleral Biomechanics in the Aging Monkey Eye

    Science.gov (United States)

    Girard, Michaël J. A.; Suh, J-K. Francis; Bottlang, Michael; Burgoyne, Claude F.; Downs, J. Crawford

    2010-01-01

    Purpose To investigate the age-related differences in the inhomogeneous, anisotropic, nonlinear biomechanical properties of posterior sclera from old (22.9 ± 5.3 years) and young (1.5 ± 0.7 years) rhesus monkeys. Methods The posterior scleral shell of each eye was mounted on a custom-built pressurization apparatus, then intraocular pressure (IOP) was elevated from 5 to 45 mmHg while the 3D displacements of the scleral surface were measured using speckle interferometry. Each scleral shell geometry was digitally reconstructed from data generated by a 3D digitizer (topography) and 20 MHz ultrasounds (thickness). An inverse finite element (FE) method incorporating a fiber-reinforced constitutive model was used to extract a unique set of biomechanical properties for each eye. Displacements, thickness, stress, strain, tangent modulus, structural stiffness, and preferred collagen fiber orientation were mapped for each posterior sclera. Results The model yielded 3-D deformations of posterior sclera that matched well with those observed experimentally. The posterior sclera exhibited inhomogeneous, anisotropic, nonlinear mechanical behavior. The sclera was significantly thinner (p = 0.038), and tangent modulus and structural stiffness were significantly higher in old monkeys (p biomechanics, and potentially contribute to age-related susceptibility to glaucomatous vision loss. PMID:19494203

  2. Current Biomechanical Concepts for Rotator Cuff Repair

    Science.gov (United States)

    2013-01-01

    For the past few decades, the repair of rotator cuff tears has evolved significantly with advances in arthroscopy techniques, suture anchors and instrumentation. From the biomechanical perspective, the focus in arthroscopic repair has been on increasing fixation strength and restoration of the footprint contact characteristics to provide early rehabilitation and improve healing. To accomplish these objectives, various repair strategies and construct configurations have been developed for rotator cuff repair with the understanding that many factors contribute to the structural integrity of the repaired construct. These include repaired rotator cuff tendon-footprint motion, increased tendon-footprint contact area and pressure, and tissue quality of tendon and bone. In addition, the healing response may be compromised by intrinsic factors such as decreased vascularity, hypoxia, and fibrocartilaginous changes or aforementioned extrinsic compression factors. Furthermore, it is well documented that torn rotator cuff muscles have a tendency to atrophy and become subject to fatty infiltration which may affect the longevity of the repair. Despite all the aforementioned factors, initial fixation strength is an essential consideration in optimizing rotator cuff repair. Therefore, numerous biomechanical studies have focused on elucidating the strongest devices, knots, and repair configurations to improve contact characteristics for rotator cuff repair. In this review, the biomechanical concepts behind current rotator cuff repair techniques will be reviewed and discussed. PMID:23730471

  3. Evaluación del riesgo de ruptura de aneurismas de aorta abdominal personalizados mediante factores biomecánicos/Patient-specific abdominal aortic aneurysms rupture risk assessment by means of biomechanical factors

    Directory of Open Access Journals (Sweden)

    Ariel Zúñiga‐Reyes

    2014-05-01

    Full Text Available El Aneurisma de Aorta Abdominal es la dilatación localizada, irreversible y progresiva que experimenta la pared aortica. Esta patología ha sido reconocida como un importante problema de salud, puesto que su ruptura está asociada mayormente a consecuencias fatales. La falta de criterios fiables, respecto a los actualmente utilizados, para la evaluación del riesgo de ruptura, constituye un inconveniente en la gestión clínica de la enfermedad. El presente trabajo tiene como objetivo evaluar el riesgo de ruptura de Aneurismas de Aorta Abdominal, mediante indicadores numéricos, como es previsto por el enfoque biomecánico. Fueron utilizadas técnicas de modelación por elementos finitos para determinar el comportamiento del flujo sanguíneo y el estado tensional de la pared arterial. Los resultados mostraron que ninguno de los aneurismas analizados presenta riesgo de ruptura elevado y que la evaluación del riesgo de ruptura mediante índices numéricos, es un camino viable para prever la ruptura de un aneurisma específico.Palabras claves: aneurisma de aorta abdominal, factores biomecánicos, interacción fluido-sólido, riesgo de ruptura.______________________________________________________________________________AbstractAbdominal Aortic Aneurysm is a localized, progressive and permanent dilation of the infra-renal aorta.AAA has increasingly been recognized as an important health problem in the last decades. The AAA rupture is mostly associated with fatal consequences. The lack of more reliable criteria for rupture riskassessing, results in a problem in the clinical management of the disease. This paper aims to assess the rupture risk of abdominal aortic aneurysms by means of numerical indexes, as envisaged by the biomechanical approach. Finite Volume Techniques were used to determine the blood flow behavior within aneurysmatic sac and the structural state of the arterial wall. The results showed that none of the assessed aneurysms is at

  4. Quality-of-life improvement after free gracilis muscle transfer for smile restoration in patients with facial paralysis.

    Science.gov (United States)

    Lindsay, Robin W; Bhama, Prabhat; Hadlock, Tessa A

    2014-01-01

    Facial paralysis can contribute to disfigurement, psychological difficulties, and an inability to convey emotion via facial expression. In patients unable to perform a meaningful smile, free gracilis muscle transfer (FGMT) can often restore smile function. However, little is known about the impact on disease-specific quality of life. To determine quantitatively whether FGMT improves quality of life in patients with facial paralysis. Prospective evaluation of 154 FGMTs performed at a facial nerve center on 148 patients with facial paralysis. The Facial Clinimetric Evaluation (FaCE) survey and Facial Assessment by Computer Evaluation software (FACE-gram) were used to quantify quality-of-life improvement, oral commissure excursion, and symmetry with smile. Free gracilis muscle transfer. Change in FaCE score, oral commissure excursion, and symmetry with smile. There were 127 successful FGMTs on 124 patients and 14 failed procedures on 13 patients. Mean (SD) FaCE score increased significantly after successful FGMT (42.30 [15.9] vs 58.5 [17.60]; paired 2-tailed t test, P improved significantly in all subgroups (nonflaccid cohort, 37.8 [19.9] vs 52.9 [19.3]; P = .02; flaccid cohort, 43.1 [15.1] vs 59.6 [17.2]; P improved from a mean (SD) of 13.8 (7.46) to 4.88 (3.47) (P improvement in quality of life after FGMT in patients who could not recover a meaningful smile after facial nerve insult. Quality-of-life improvement was not statistically different between donor nerve groups or facial paralysis types.

  5. An introduction to biomechanics solids and fluids, analysis and design

    CERN Document Server

    Humphrey, Jay D

    2004-01-01

    Designed to meet the needs of undergraduate students, Introduction to Biomechanics takes the fresh approach of combining the viewpoints of both a well-respected teacher and a successful student. With an eye toward practicality without loss of depth of instruction, this book seeks to explain the fundamental concepts of biomechanics. With the accompanying web site providing models, sample problems, review questions and more, Introduction to Biomechanics provides students with the full range of instructional material for this complex and dynamic field.

  6. Lumbar Spine Musculoskeletal Physiology and Biomechanics During Simulated Military Operations

    Science.gov (United States)

    2016-06-01

    AWARD NUMBER: W81XWH-13-2-0043 TITLE: Lumbar Spine Musculoskeletal Physiology and Biomechanics During Simulated Military Operations PRINCIPAL...31May2016 4. TITLE AND SUBTITLE Lumbar Spine Musculoskeletal Physiology and Biomechanics 5a. CONTRACT NUMBER During Simulated Military Operations 5b... Biomechanics , Cincinnati, 2015. § Website(s) or other Internet site(s) § Nothing to report § Technologies or techniques § Nothing to report

  7. Serial contrast-enhanced magnetic resonance and magnetization transfer in the study of patients with multiple sclerosis

    International Nuclear Information System (INIS)

    Rovira, A.; Alonso, J.; Cucurella, G.; Nos, C.; Tintore, M.; Pedraza, S.; Rio, J.; Montalban, X.

    1997-01-01

    To demonstrate the changes in the magnetization transfer ratio (MTR) of different demyelinating plaques, correlating them with the baseline values in T1-weighted contrast-enhanced magnetic resonance (MR) sequences in order to relate them more closely to the underlying disease. The study was based on 33 demyelinating plaques obtained from six patients clinically diagnosed as having remitting-recurring multiple sclerosis (MS). All the patients underwent two MR studies at a 3 to 5-month interval, including contrast-enhanced T1 and T2- weighted sequences and magnetization transfer images. The latter were used to calculate the MTR for each of the demyelinating plaques included in the study. The statistical analysis of the results obtained revealed statistically significant between initial MTR values and those of subsequent T1-weighted sequences. The MTR demonstrate significant differences between plaques according to contrast-enhanced T1-weigh tes sequences, probably indicating variable degrees of edema, demyelination and tissue destruction. These differences should be taken into account to enable the use of T1-weighted sequences to quantify the lesion load in MS patients. (Author) 35 refs

  8. Pathological Assessment of Brain White Matter in Relapsing-Remitting MS Patients using Quantitative Magnetization Transfer Imaging

    Directory of Open Access Journals (Sweden)

    Khodarahm Pahlevan

    2011-09-01

    Full Text Available Introduction: Multiple sclerosis (MS is characterized by lesions in the white matter (WM of the central nervous system. Magnetic resonance imaging is the most specific and sensitive method for diagnosis of multiple sclerosis. However, the ability of conventional MRI to show histopathologic heterogeneity of MS lesions is insufficient. Quantitative magnetization transfer imaging (qMTI is a relatively new method to investigate pathologic processes of the brain tissue occurring in MS patients. Material and Methods: Voxel-based analyses allow regional comparisons between groups to be made for the whole brain in a single analysis. This is done by coregistering data from all individual subjects to a reference brain, generally referred to as the "standard space", and then comparing them on a voxel-by-voxel basis. This study aimed to analyze whole-brain quantitative T1 maps, not to find global changes or changes in selected regions, but specifically to investigate the spatial distribution throughout the brain of T1 increases in MS WM with respect to control WM. In this study, 11 healthy controls, 10 relapsing-remitting (RR MS patients and 13 CIS patients were studied using MT-MRI imaging. MT parameters, including magnetization transfer ratio (MTR, magnetization transfer rate between free protons and restricted macromolecular protons, Ksat and longitudinal relaxation times (with and without MT saturation pulse, T1sat and T1free values were evaluated. Results: The results showed that, at a group level, there is widespread involvement of WM throughout the brain in CIS MS and especially in RRMS, where a significant T1 increase was found in 15.58% of WM voxels (normals < RR. Discussion and Conclusion: This study demonstrates that WM in large parts of the brain is susceptible to disease processes in RR and CIS MS

  9. Biomechanics of subcellular structures by non-invasive Brillouin microscopy

    Science.gov (United States)

    Antonacci, Giuseppe; Braakman, Sietse

    2016-11-01

    Cellular biomechanics play a pivotal role in the pathophysiology of several diseases. Unfortunately, current methods to measure biomechanical properties are invasive and mostly limited to the surface of a cell. As a result, the mechanical behaviour of subcellular structures and organelles remains poorly characterised. Here, we show three-dimensional biomechanical images of single cells obtained with non-invasive, non-destructive Brillouin microscopy with an unprecedented spatial resolution. Our results quantify the longitudinal elastic modulus of subcellular structures. In particular, we found the nucleoli to be stiffer than both the nuclear envelope (p biomechanics and its role in pathophysiology.

  10. [RESEARCH PROGRESS OF BIOMECHANICS OF PROXIMAL ROW CARPAL INSTABILITY].

    Science.gov (United States)

    Guo, Jinhai; Huang, Fuguo

    2015-01-01

    To review the research progress of the biomechanics of proximal row carpal instability (IPRC). The related literature concerning IPRC was extensively reviewed. The biomechanical mechanism of the surrounding soft tissue in maintaining the stability of the proximal row carpal (PRC) was analyzed, and the methods to repair or reconstruct the stability and function of the PRC were summarized from two aspects including basic biomechanics and clinical biomechanics. The muscles and ligaments of the PRC are critical to its stability. Most scholars have reached a consensus about biomechanical mechanism of the PRC, but there are still controversial conclusions on the biomechanics mechanism of the surrounding soft tissue to stability of distal radioulnar joint when the triangular fibrocartilage complex are damaged and the biomechanics mechanism of the scapholunate ligament. At present, there is no unified standard about the methods to repair or reconstruct the stability and function of the PRC. So, it is difficult for clinical practice. Some strides have been made in the basic biomechanical study on muscle and ligament and clinical biomechanical study on the methods to repair or reconstruct the stability and function of PRC, but it will be needed to further study the morphology of carpal articular surface and the adjacent articular surface, the pressure of distal carpals to proximal carpal and so on.

  11. An Evidence-Based Videotaped Running Biomechanics Analysis.

    Science.gov (United States)

    Souza, Richard B

    2016-02-01

    Running biomechanics play an important role in the development of injuries. Performing a running biomechanics analysis on injured runners can help to develop treatment strategies. This article provides a framework for a systematic video-based running biomechanics analysis plan based on the current evidence on running injuries, using 2-dimensional (2D) video and readily available tools. Fourteen measurements are proposed in this analysis plan from lateral and posterior video. Identifying simple 2D surrogates for 3D biomechanic variables of interest allows for widespread translation of best practices, and have the best opportunity to impact the highly prevalent problem of the injured runner. Copyright © 2016 Elsevier Inc. All rights reserved.

  12. Harnessing biomechanics to develop cartilage regeneration strategies.

    Science.gov (United States)

    Athanasiou, Kyriacos A; Responte, Donald J; Brown, Wendy E; Hu, Jerry C

    2015-02-01

    As this review was prepared specifically for the American Society of Mechanical Engineers H.R. Lissner Medal, it primarily discusses work toward cartilage regeneration performed in Dr. Kyriacos A. Athanasiou's laboratory over the past 25 years. The prevalence and severity of degeneration of articular cartilage, a tissue whose main function is largely biomechanical, have motivated the development of cartilage tissue engineering approaches informed by biomechanics. This article provides a review of important steps toward regeneration of articular cartilage with suitable biomechanical properties. As a first step, biomechanical and biochemical characterization studies at the tissue level were used to provide design criteria for engineering neotissues. Extending this work to the single cell and subcellular levels has helped to develop biochemical and mechanical stimuli for tissue engineering studies. This strong mechanobiological foundation guided studies on regenerating hyaline articular cartilage, the knee meniscus, and temporomandibular joint (TMJ) fibrocartilage. Initial tissue engineering efforts centered on developing biodegradable scaffolds for cartilage regeneration. After many years of studying scaffold-based cartilage engineering, scaffoldless approaches were developed to address deficiencies of scaffold-based systems, resulting in the self-assembling process. This process was further improved by employing exogenous stimuli, such as hydrostatic pressure, growth factors, and matrix-modifying and catabolic agents, both singly and in synergistic combination to enhance neocartilage functional properties. Due to the high cell needs for tissue engineering and the limited supply of native articular chondrocytes, costochondral cells are emerging as a suitable cell source. Looking forward, additional cell sources are investigated to render these technologies more translatable. For example, dermis isolated adult stem (DIAS) cells show potential as a source of

  13. Improvement in Patient Transfer Process From the Operating Room to the PICU Using a Lean and Six Sigma-Based Quality Improvement Project.

    Science.gov (United States)

    Gleich, Stephen J; Nemergut, Michael E; Stans, Anthony A; Haile, Dawit T; Feigal, Scott A; Heinrich, Angela L; Bosley, Christopher L; Tripathi, Sandeep

    2016-08-01

    Ineffective and inefficient patient transfer processes can increase the chance of medical errors. Improvements in such processes are high-priority local institutional and national patient safety goals. At our institution, nonintubated postoperative pediatric patients are first admitted to the postanesthesia care unit before transfer to the PICU. This quality improvement project was designed to improve the patient transfer process from the operating room (OR) to the PICU. After direct observation of the baseline process, we introduced a structured, direct OR-PICU transfer process for orthopedic spinal fusion patients. We performed value stream mapping of the process to determine error-prone and inefficient areas. We evaluated primary outcome measures of handoff error reduction and the overall efficiency of patient transfer process time. Staff satisfaction was evaluated as a counterbalance measure. With the introduction of the new direct OR-PICU patient transfer process, the handoff communication error rate improved from 1.9 to 0.3 errors per patient handoff (P = .002). Inefficiency (patient wait time and non-value-creating activity) was reduced from 90 to 32 minutes. Handoff content was improved with fewer information omissions (P improved among nearly all PICU providers. By using quality improvement methodology to design and implement a new direct OR-PICU transfer process with a structured multidisciplinary verbal handoff, we achieved sustained improvements in patient safety and efficiency. Handoff communication was enhanced, with fewer errors and content omissions. The new process improved efficiency, with high staff satisfaction. Copyright © 2016 by the American Academy of Pediatrics.

  14. "One for Sorrow, Two for Joy?": American embryo transfer guideline recommendations, practices, and outcomes for gestational surrogate patients.

    Science.gov (United States)

    White, Pamela M

    2017-04-01

    In January 2016, Melissa Cook, a California gestational surrogate experiencing a multiple-birth pregnancy following the in vitro fertilization (IVF) transfer of three embryos comprised of donor eggs and sperm provided by the intended father, went to the media when the intended father requested that she undergo a fetal reduction because twins were less expensive to raise than triplets. Much of the legal interest in this case to date has centered on the enforceability of surrogacy contracts. However, the Cook case also raises troubling issues about fertility treatment practices involving gestational surrogates, twin preference, and third-party reproduction medical decision-making. This paper focuses on multiple-embryo transfers in the context of US surrogacy arrangements. Offering an original analysis of data obtained from the US national-assisted reproduction registry, it examines single- and multiple-embryo transfer trends over a 12-year period (2003 to 2014). Findings reveal that recommended guidelines were followed in fewer than 42% of the cases in 2014. The paper argues that ensuring equitable medical treatment for all recipients of IVF requires the adoption of treatment guidelines tailored to, and offering protections for, specific patient groups, and that, once in place, guidelines must be robustly implemented.

  15. Using a Cloud Computing System to Reduce Door-to-Balloon Time in Acute ST-Elevation Myocardial Infarction Patients Transferred for Percutaneous Coronary Intervention

    Directory of Open Access Journals (Sweden)

    Chi-Kung Ho

    2017-01-01

    Full Text Available Background. This study evaluated the impact on clinical outcomes using a cloud computing system to reduce percutaneous coronary intervention hospital door-to-balloon (DTB time for ST segment elevation myocardial infarction (STEMI. Methods. A total of 369 patients before and after implementation of the transfer protocol were enrolled. Of these patients, 262 were transferred through protocol while the other 107 patients were transferred through the traditional referral process. Results. There were no significant differences in DTB time, pain to door of STEMI receiving center arrival time, and pain to balloon time between the two groups. Pain to electrocardiography time in patients with Killip I/II and catheterization laboratory to balloon time in patients with Killip III/IV were significantly reduced in transferred through protocol group compared to in traditional referral process group (both p<0.05. There were also no remarkable differences in the complication rate and 30-day mortality between two groups. The multivariate analysis revealed that the independent predictors of 30-day mortality were elderly patients, advanced Killip score, and higher level of troponin-I. Conclusions. This study showed that patients transferred through our present protocol could reduce pain to electrocardiography and catheterization laboratory to balloon time in Killip I/II and III/IV patients separately. However, this study showed that using a cloud computing system in our present protocol did not reduce DTB time.

  16. Heat-transfer-based detection of SNPs in the PAH gene of PKU patients

    Directory of Open Access Journals (Sweden)

    Vanden Bon N

    2014-03-01

    Full Text Available Natalie Vanden Bon,1 Bart van Grinsven,2 Mohammed Sharif Murib,2 Weng Siang Yeap,2 Ken Haenen,2,3 Ward De Ceuninck,2,3 Patrick Wagner,2,3 Marcel Ameloot,1 Veronique Vermeeren,1 Luc Michiels11Biomedical Research Institute, Hasselt University, Diepenbeek, Belgium; 2Institute for Materials Research, Hasselt University, Diepenbeek, Belgium; 3IMOMEC, Diepenbeek, BelgiumAbstract: Conventional neonatal diagnosis of phenylketonuria is based on the presence of abnormal levels of phenylalanine in the blood. However, for carrier detection and prenatal diagnosis, direct detection of disease-correlated mutations is needed. To speed up and simplify mutation screening in genes, new technologies are developed. In this study, a heat-transfer method is evaluated as a mutation-detection technology in entire exons of the phenylalanine hydroxylase (PAH gene. This method is based on the change in heat-transfer resistance (Rth upon thermal denaturation of dsDNA (double-stranded DNA on nanocrystalline diamond. First, ssDNA (single-stranded DNA fragments that span the size range of the PAH exons were successfully immobilized on nanocrystalline diamond. Next, it was studied whether an Rth change could be observed during the thermal denaturation of these DNA fragments after hybridization to their complementary counterpart. A clear Rth shift during the denaturation of exon 5, exon 9, and exon 12 dsDNA was observed, corresponding to lengths of up to 123 bp. Finally, Rth was shown to detect prevalent single-nucleotide polymorphisms, c.473G>A (R158Q, c.932T>C (p.L311P, and c.1222C>T (R408W, correlated with phenylketonuria, displaying an effect related to the different melting temperatures of homoduplexes and heteroduplexes.Keywords: mutation detection, heat-transfer resistance, melting temperature, nanocrystalline diamond, persistence length

  17. HIV-particles in spermatozoa of patients with AIDS and their transfer into the oocyte

    Science.gov (United States)

    Baccetti, B; Benedetto, A; Burrini, AG; Collodel, G; Ceccarini, EC; Crisa, N; Di Caro, A; Estenoz, M; Garbuglia, AR; Massacesi, A; Piomboni, P; Renieri, T; Solazzo, D

    1994-01-01

    By immunocytochemistry and in situ hybridization at the electron microscopy level, and by the PCR technique, we have shown that HIV-1 binds and enters normal sperm; that viral particles, their antigens, and nucleic acid are present in sperm from HIV-1 infected men; and that such sperm can transfer HIV-1 like particles to normal human oocytes. We also present evidence that a galactosylceramide-like compound is present on the sperm membrane and could function as an alternative receptor for HIV. PMID:7962075

  18. Biomechanical and biophysical environment of bone from the macroscopic to the pericellular and molecular level.

    Science.gov (United States)

    Ren, Li; Yang, Pengfei; Wang, Zhe; Zhang, Jian; Ding, Chong; Shang, Peng

    2015-10-01

    Bones with complicated hierarchical configuration and microstructures constitute the load-bearing system. Mechanical loading plays an essential role in maintaining bone health and regulating bone mechanical adaptation (modeling and remodeling). The whole-bone or sub-region (macroscopic) mechanical signals, including locomotion-induced loading and external actuator-generated vibration, ultrasound, oscillatory skeletal muscle stimulation, etc., give rise to sophisticated and distinct biomechanical and biophysical environments at the pericellular (microscopic) and collagen/mineral molecular (nanoscopic) levels, which are the direct stimulations that positively influence bone adaptation. While under microgravity, the stimulations decrease or even disappear, which exerts a negative influence on bone adaptation. A full understanding of the biomechanical and biophysical environment at different levels is necessary for exploring bone biomechanical properties and mechanical adaptation. In this review, the mechanical transferring theories from the macroscopic to the microscopic and nanoscopic levels are elucidated. First, detailed information of the hierarchical structures and biochemical composition of bone, which are the foundations for mechanical signal propagation, are presented. Second, the deformation feature of load-bearing bone during locomotion is clarified as a combination of bending and torsion rather than simplex bending. The bone matrix strains at microscopic and nanoscopic levels directly induced by bone deformation are critically discussed, and the strain concentration mechanism due to the complicated microstructures is highlighted. Third, the biomechanical and biophysical environments at microscopic and nanoscopic levels positively generated during bone matrix deformation or by dynamic mechanical loadings induced by external actuators, as well as those negatively affected under microgravity, are systematically discussed, including the interstitial fluid flow

  19. The role of biomechanical factors in ankylosing spondylitis: the patient’s perspective

    Directory of Open Access Journals (Sweden)

    R.C. Ansell

    2016-02-01

    Full Text Available Biomechanical factors including occupational joint physical stressing and joint injury have been linked to spondyloarthritis. We explored such factors in ankylosing spondylitis (AS. A retrospective, online survey was developed alongside the UK National Ankylosing Spondylitis Society (NASS. Questions on early entheseal symptoms, potential precipitating trauma, sporting activity, and physiotherapy were asked. A total of 1026 patients responded with 44% recalling an instance of injury or trauma as a potential trigger for their AS. After symptom onset, 55% modified sporting activities and 28% reported that the initial AS recommended exercises exacerbated symptoms. Patients report physical trauma, exercise and physiotherapy as potential triggers for AS symptoms. These findings further support the experimental evidence for the role of biomechanical factors in disease.

  20. Decreased trabecular bone biomechanical competence, apparent density, IGF-II and IGFBP-5 content in acromegaly

    DEFF Research Database (Denmark)

    Ueland, Thor; Ebbesen, Ebbe Nils; Thomsen, Jesper Skovhus

    2002-01-01

    of these growth factors in relation to biomechanical properties in acromegaly. MATERIALS AND METHODS: Trabecular bone biomechanical competence (compression test), apparent density (peripheral quantitative computed tomography, pQCT), and bone matrix contents of calcium (HCl hydrolysis) and IGFs (guanidinium......-HCl extraction) were measured in iliac crest biopsies from 13 patients with active acromegaly (two women and 11 men, aged 21-61 years) and 21 age- and sex-matched controls (four women and 17 men, aged 23-64 years). RESULTS: Trabecular bone pQCT was reduced in acromegalic patients compared with controls (P = 0...... bone content of IGF-I, IGFBP-3, or osteocalcin. However, IGF-II and IGFBP-5 content was decreased (P acromegaly, supporting previous observations...

  1. [Development of Patient Transfer Techniques based on Postural-stability Principles for the Care Helpers in Nursing Homes and Evaluation of Effectiveness].

    Science.gov (United States)

    Ma, Ryewon; Jung, Dukyoo

    2016-02-01

    This study was done to develop a postural-stability patient transfer technique for care helpers in nursing homes and to evaluate its effectiveness. Four types of patient transfer techniques (Lifting towards the head board of the bed, turning to the lateral position, sitting upright on the bed, transferring from wheel chair to bed) were practiced in accordance with the following three methods; Care helpers habitually used transfer methods (Method 1), patient transfer methods according to care helper standard textbooks (Method 2), and a method developed by the author ensuring postural-stability (Method 3). The care helpers' muscle activity and four joint angles were measured. The collected data were analyzed using the program SPSS Statistic 21.0. To differentiate the muscle activity and joint angle, the Friedman test was executed and the post-hoc analysis was conducted using the Wilcoxon Signed Rank test. Muscle activity was significantly lower during Method 3 compared to Methods 1 and 2. In addition, the joint angle was significantly lower for the knee and shoulder joint angle while performing Method 3 compared to Methods 1 and 2. Findings indicate that using postural-stability patient transfer techniques can contribute to the prevention of musculoskeletal disease which care helpers suffer from due to physically demanding patient care in nursing homes.

  2. Altered corneal biomechanical properties in children with osteogenesis imperfecta.

    Science.gov (United States)

    Lagrou, Lisa M; Gilbert, Jesse; Hannibal, Mark; Caird, Michelle S; Thomas, Inas; Moroi, Sayoko E; Bohnsack, Brenda L

    2018-04-07

    To evaluate biomechanical corneal properties in children with osteogenesis imperfecta (OI). A prospective, observational, case-control study was conducted on children 6-19 years of age diagnosed with OI. Patients with OI and healthy control subjects underwent complete ophthalmic examinations. Additional tests included Ocular Response Analyzer (ORA) and ultrasonic pachymetry. Primary outcomes were central corneal thickness (CCT), corneal hysteresis (CH), and corneal resistance factor (CRF). Intraocular pressure (IOP) was measured directly by either iCare or Goldmann applanation and indirectly by the ORA (Goldmann-correlated and corneal-compensated IOP). Statistically significant differences between OI and control groups were determined using independent samples t test. A total of 10 of 18 OI cases (mean age, 13 ± 4.37 years; 8 males) and 30 controls (mean age, 12.76 ± 2.62 years; 16 males) were able to complete the corneal biomechanics and pachymetry testing. Children with OI had decreased CH (8.5 ± 1.0 mm Hg vs 11.6 ± 1.2 mm Hg [P < 0.001]), CRF (9.0 ± 1.9 mm Hg vs 11.5 ± 1.5 [P < 0.001]) and CCT (449.8 ± 30.8 μm vs 568 ± 47.6 μm [P < 0.001]) compared to controls. The corneal-compensated IOP was significantly higher in OI cases (18.8 ± 3.1 mm Hg) than in controls (15.0 ± 1.6 mm Hg, P < 0.004), but there was no significant difference in Goldmann-correlated IOP (16.3 ± 4.2 mm Hg vs 15.8 ± 2.2 mm Hg). Collagen defects in OI alter corneal structure and biomechanics. Children with OI have decreased CH, CRF, and CCT, resulting in IOPs that are likely higher than measured by tonometry. These corneal alterations are present at a young age in OI. Affected individuals should be routinely screened for glaucoma and corneal pathologies. Copyright © 2018 American Association for Pediatric Ophthalmology and Strabismus. Published by Elsevier Inc. All rights reserved.

  3. Correction of glucocerebrosidase deficiency after retroviral-mediated gene transfer into hematopoietic progenitor cells from patients with Gaucher disease

    International Nuclear Information System (INIS)

    Fink, J.K.; Correll, P.H.; Perry, L.K.; Brady, R.O.; Karlsson, S.

    1990-01-01

    Retroviral gene transfer has been used successfully to correct the glucocerebrosidase (GCase) deficiency in primary hematopoietic cells from patients with Gaucher disease. For this model of somatic gene therapy, the authors developed a high-titer, amphotropic retroviral vector designated NTG in which the human GCase gene was driven by the mutant polyoma virus enhancer/herpesvirus thymidine kinase gene (tk) promoter (Py + /Htk). NTG normalized GCase activity in transduced Gaucher fibroblasts and efficiently infected human monocytic and erythroleukemic cell lines. RNA blot-hybridization (Northern blot) analysis of these hemaptopoietic cell lines showed unexpectedly high-level expression from the Moloney murine leukemia virus long terminal repeat (Mo-MLV LTR) and levels of Py + /Htk enhancer/promoter-initiated human GCase RNA that approximated endogenous GCase RNA levels. Furthermore, NTG efficiently infected human hematopoietic progenitor cells. Detection of the provirus in approximately one-third of NTG-infected progenitor colonies that had not been selected in G418-containing medium indicates that relative resistance to G418 underestimated the actual gene transfer efficiency. Northern blot analysis of NTG-infected, progenitor-derived cells showed expression from both the Mo-MLV LTR and the Py + /Htk enhancer/promoter. NTG-transduced hematopoietic progenitor cells from patients with Gaucher disease generated progeny in which GCase activity has been normalized

  4. Correction of glucocerebrosidase deficiency after retroviral-mediated gene transfer into hematopoietic progenitor cells from patients with Gaucher disease

    Energy Technology Data Exchange (ETDEWEB)

    Fink, J.K.; Correll, P.H.; Perry, L.K.; Brady, R.O.; Karlsson, S. (National Institutes of Health, Bethesda, MD (USA))

    1990-03-01

    Retroviral gene transfer has been used successfully to correct the glucocerebrosidase (GCase) deficiency in primary hematopoietic cells from patients with Gaucher disease. For this model of somatic gene therapy, the authors developed a high-titer, amphotropic retroviral vector designated NTG in which the human GCase gene was driven by the mutant polyoma virus enhancer/herpesvirus thymidine kinase gene (tk) promoter (Py{sup +}/Htk). NTG normalized GCase activity in transduced Gaucher fibroblasts and efficiently infected human monocytic and erythroleukemic cell lines. RNA blot-hybridization (Northern blot) analysis of these hemaptopoietic cell lines showed unexpectedly high-level expression from the Moloney murine leukemia virus long terminal repeat (Mo-MLV LTR) and levels of Py{sup +}/Htk enhancer/promoter-initiated human GCase RNA that approximated endogenous GCase RNA levels. Furthermore, NTG efficiently infected human hematopoietic progenitor cells. Detection of the provirus in approximately one-third of NTG-infected progenitor colonies that had not been selected in G418-containing medium indicates that relative resistance to G418 underestimated the actual gene transfer efficiency. Northern blot analysis of NTG-infected, progenitor-derived cells showed expression from both the Mo-MLV LTR and the Py{sup +}/Htk enhancer/promoter. NTG-transduced hematopoietic progenitor cells from patients with Gaucher disease generated progeny in which GCase activity has been normalized.

  5. Clinical validity of a relocation stress scale for the families of patients transferred from intensive care units.

    Science.gov (United States)

    Oh, HyunSoo; Lee, Seul; Kim, JiSun; Lee, EunJu; Min, HyoNam; Cho, OkJa; Seo, WhaSook

    2015-07-01

    This study was conducted to develop a family relocation stress scale by modifying the Son's Relocation Stress Syndrome Scale, to examine its clinical validity and reliability and to confirm its suitability for measuring family relocation stress. The transfer of ICU patients to general wards is a significant anxiety-producing event for family members. However, no relocation stress scale has been developed specifically for families. A nonexperimental, correlation design was adopted. The study subjects were 95 family members of 95 ICU patients at a university hospital located in Incheon, South Korea. Face and construct validities of the devised family relocation stress scale were examined. Construct validity was examined using factor analysis and by using a nomological validity test. Reliability was also examined. Face and content validity of the scale were verified by confirming that its items adequately measured family relocation stress. Factor analysis yielded four components, and the total variance explained by these four components was 63·0%, which is acceptable. Nomological validity was well supported by significant relationships between relocation stress and degree of preparation for relocation, patient self-care ability, family burden and satisfaction with the relocation process. The devised scale was also found to have good reliability. The family relocation stress scale devised in this study was found to have good validity and reliability, and thus, is believed to offer a means of assessing family relocation stress. The findings of this study provide a reliable and valid assessment tool when nurses prepare families for patient transfer from an ICU to a ward setting, and may also provide useful information to those developing an intervention programme for family relocation stress management. © 2015 John Wiley & Sons Ltd.

  6. Outcome following phrenic nerve transfer to musculocutaneous nerve in patients with traumatic brachial palsy: a qualitative systematic review.

    Science.gov (United States)

    de Mendonça Cardoso, Marcio; Gepp, Ricardo; Correa, José Fernando Guedes

    2016-09-01

    The phrenic nerve can be transferred to the musculocutaneous nerve in patients with traumatic brachial plexus palsy in order to recover biceps strength, but the results are controversial. There is also a concern about pulmonary function after phrenic nerve transection. In this paper, we performed a qualitative systematic review, evaluating outcomes after this procedure. A systematic review of published studies was undertaken in accordance with the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) statement. Data were extracted from the selected papers and related to: publication, study design, outcome (biceps strength in accordance with BMRC and pulmonary function) and population. Study quality was assessed using the "strengthening the reporting of observational studies in epidemiology" (STROBE) standard or the CONSORT checklist, depending on the study design. Seven studies were selected for this systematic review after applying inclusion and exclusion criteria. One hundred twenty-four patients completed follow-up, and most of them were graded M3 or M4 (70.1 %) for biceps strength at the final evaluation. Pulmonary function was analyzed in five studies. It was not possible to perform a statistical comparison between studies because the authors used different parameters for evaluation. Most of the patients exhibited a decrease in pulmonary function tests immediately after surgery, with recovery in the following months. Study quality was determined using STROBE in six articles, and the global score varied from 8 to 21. Phrenic nerve transfer to the musculocutaneous nerve can recover biceps strength ≥M3 (BMRC) in most patients with traumatic brachial plexus injury. Early postoperative findings revealed that the development of pulmonary symptoms is rare, but it cannot be concluded that the procedure is safe because there is no study evaluating pulmonary function in old age.

  7. Effects of sex and obesity on gait biomechanics before and six months after total knee arthroplasty: A longitudinal cohort study.

    Science.gov (United States)

    Paterson, K L; Sosdian, L; Hinman, R S; Wrigley, T V; Kasza, J; Dowsey, M; Choong, P; Bennell, K L

    2018-03-01

    Gait biomechanics, sex, and obesity can contribute to suboptimal outcomes from primary total knee arthroplasty. The aims of this study were to i) determine if sex and/or obesity influence the amount of change in gait biomechanics from pre-surgery to six months post-surgery and; ii) assess if gait returns to normal in men and women. Three-dimensional gait analysis was performed on 43 patients undergoing primary total knee arthroplasty for knee osteoarthritis (pre- and six months post-operative) and 40 asymptomatic controls. Mixed linear regression models were fit to assess which factors influenced change in gait biomechanics within the arthroplasty cohort, and interaction terms were included to assess if biomechanics returned to normal following surgery. Male peak knee adduction moment (p biomechanics after arthroplasty. Men retained abnormal gait patterns after surgery, whilst women did not. Further research should determine the long-term implications of gait abnormalities seen in men after arthroplasty. Copyright © 2018 Elsevier B.V. All rights reserved.

  8. Evaluation of Outcomes in Adolescent Inflammatory Bowel Disease Patients Following Transfer From Pediatric to Adult Health Care Services: Case for Transition.

    Science.gov (United States)

    Cole, Rebecca; Ashok, Dhandapani; Razack, Abdul; Azaz, Amer; Sebastian, Shaji

    2015-08-01

    We aimed to evaluate the impact of a transition service on clinical and developmental outcomes in adolescent Inflammatory Bowel Disease (IBD) patients on transfer to adult health care services. We reviewed the records of IBD patients diagnosed in pediatric care following their transfer/attendance to the adult IBD service. The data on patients who attended the transition service were compared with those who did not pass through the transition service. Seventy-two patients were included in the study 41M and 31F. Forty-four patients went through the transition system (Group A), and 28 had no formalized transition arrangement before transfer (Group B). A significantly higher number of Group B patients needed surgery within 2 years of transfer when compared with patients in Group A (46% vs. 25%, p = .01). Sixty-one percent of patients in Group B needed at least one admission within 2 years of transfer when compared with 29% of Group A patients (p = .002). Nonattendance at clinics was higher in Group B patients with 78% having at least one nonattendance, whereas 29% of Group A failed to attend at least one appointment (p = .001). In addition, drug compliance rates were higher in the transition group when compared with Group B (89% and 46%, respectively; p = .002). A higher proportion of transitioned patients achieved their estimated maximum growth potential when completing adolescence. There was a trend toward higher dependence on opiates and smoking in Group B patients. In adolescent IBD patients, transition care is associated with better disease specific and developmental outcomes. Prospective studies of different models of transition care in IBD are needed. Copyright © 2015 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

  9. A patient-specific model of the biomechanics of hip reduction for neonatal Developmental Dysplasia of the Hip: Investigation of strategies for low to severe grades of Developmental Dysplasia of the Hip.

    Science.gov (United States)

    Huayamave, Victor; Rose, Christopher; Serra, Sheila; Jones, Brendan; Divo, Eduardo; Moslehy, Faissal; Kassab, Alain J; Price, Charles T

    2015-07-16

    A physics-based computational model of neonatal Developmental Dysplasia of the Hip (DDH) following treatment with the Pavlik Harness (PV) was developed to obtain muscle force contribution in order to elucidate biomechanical factors influencing the reduction of dislocated hips. Clinical observation suggests that reduction occurs in deep sleep involving passive muscle action. Consequently, a set of five (5) adductor muscles were identified as mediators of reduction using the PV. A Fung/Hill-type model was used to characterize muscle response. Four grades (1-4) of dislocation were considered, with one (1) being a low subluxation and four (4) a severe dislocation. A three-dimensional model of the pelvis-femur lower limb of a representative 10 week-old female was generated based on CT-scans with the aid of anthropomorphic scaling of anatomical landmarks. The model was calibrated to achieve equilibrium at 90° flexion and 80° abduction. The hip was computationally dislocated according to the grade under investigation, the femur was restrained to move in an envelope consistent with PV restraints, and the dynamic response under passive muscle action and the effect of gravity was resolved. Model results with an anteversion angle of 50° show successful reduction Grades 1-3, while Grade 4 failed to reduce with the PV. These results are consistent with a previous study based on a simplified anatomically-consistent synthetic model and clinical reports of very low success of the PV for Grade 4. However our model indicated that it is possible to achieve reduction of Grade 4 dislocation by hyperflexion and the resultant external rotation. Copyright © 2015 Elsevier Ltd. All rights reserved.

  10. Possible addiction transference from cocaine insufflation to oral bupropion in bipolar patient.

    Science.gov (United States)

    Costa, Carolina; Araujo, Alberto; Brasil, Marco; Cruz, Marcelo

    2015-01-01

    Alert for the risk of oral bupropion addiction in patients with cocaine dependence. Single-case study. After a period of cocaine and alcohol abstinence, a 42-year-old patient started taking oral bupropion to relieve the symptoms of cocaine craving. He increased the bupropion dose up to 2250 mg/d without seizures. This case highlights the possibility of oral bupropion addiction after cocaine dependence. To our knowledge, it is the first case in the literature and emphasizes the risk of bupropion's misuse. Therefore, physicians should carefully examine the patient's profile before prescribing it, as well as follow appropriate measures.

  11. Shoulder arthroplasty in osteoarthritis: current concepts in biomechanics and surgical technique

    Science.gov (United States)

    Merolla, G; Nastrucci, G; Porcellini, G

    Shoulder arthroplasty is a technically demanding procedure to restore shoulder function in patients with severe osteoarthritis of the glenohumeral joint. The modern prosthetic system exploit the benefits of modularity and the availibility of additional sizes of the prosthetic components. In this paper we describe the biomechanics of shoulder arthroplasty and the technique for shoulder replacement including total shoulder arthroplasty (TSA) with all-polyethylene and metal-backed glenoid component, humeral head resurfacing and stemless humeral replacement. PMID:24251240

  12. CT-derived Biomechanical Metrics Improve Agreement Between Spirometry and Emphysema

    Science.gov (United States)

    Bhatt, Surya P.; Bodduluri, Sandeep; Newell, John D.; Hoffman, Eric A.; Sieren, Jessica C.; Han, Meilan K.; Dransfield, Mark T.; Reinhardt, Joseph M.

    2016-01-01

    Rationale and Objectives Many COPD patients have marked discordance between FEV1 and degree of emphysema on CT. Biomechanical differences between these patients have not been studied. We aimed to identify reasons for the discordance between CT and spirometry in some patients with COPD. Materials and Methods Subjects with GOLD stage I–IV from a large multicenter study (COPDGene) were arranged by percentiles of %predicted FEV1 and emphysema on CT. Three categories were created using differences in percentiles: Catspir with predominant airflow obstruction/minimal emphysema, CatCT with predominant emphysema/minimal airflow obstruction, and Catmatched with matched FEV1 and emphysema. Image registration was used to derive Jacobian determinants, a measure of lung elasticity, anisotropy and strain tensors, to assess biomechanical differences between groups. Regression models were created with the above categories as outcome variable, adjusting for demographics, scanner type, quantitative CT-derived emphysema, gas trapping, and airway thickness (Model 1), and after adding biomechanical CT metrics (Model 2). Results Jacobian determinants, anisotropy and strain tensors were strongly associated with FEV1. With Catmatched as control, Model 2 predicted Catspir and CatCT better than Model 1 (Akaike Information Criterion, AIC 255.8 vs. 320.8). In addition to demographics, the strongest independent predictors of FEV1 were Jacobian mean (β= 1.60,95%CI = 1.16 to 1.98; p<0.001), coefficient of variation (CV) of Jacobian (β= 1.45,95%CI = 0.86 to 2.03; p<0.001) and CV strain (β= 1.82,95%CI = 0.68 to 2.95; p = 0.001). CVs of Jacobian and strain are both potential markers of biomechanical lung heterogeneity. Conclusions CT-derived measures of lung mechanics improve the link between quantitative CT and spirometry, offering the potential for new insights into the linkage between regional parenchymal destruction and global decrement in lung function in COPD patients. PMID:27055745

  13. The effect of the COACH program (Continuity Of Appropriate pharmacotherapy, patient Counselling and information transfer in Healthcare) on readmission rates in a multicultural population of internal medicine patients.

    Science.gov (United States)

    Karapinar-Carkit, Fatma; Borgsteede, Sander D; Zoer, Jan; Siegert, Carl; van Tulder, Maurits; Egberts, Antoine C G; van den Bemt, Patricia M L A

    2010-02-16

    Medication errors occur frequently at points of transition in care. The key problems causing these medication errors are: incomplete and inappropriate medication reconciliation at hospital discharge (partly arising from inadequate medication reconciliation at admission), insufficient patient information (especially within a multicultural patient population) and insufficient communication to the next health care provider. Whether interventions aimed at the combination of these aspects indeed result in less discontinuity and associated harm is uncertain. Therefore the main objective of this study is to determine the effect of the COACH program (Continuity Of Appropriate pharmacotherapy, patient Counselling and information transfer in Healthcare) on readmission rates in patients discharged from the internal medicine department. An experimental study is performed at the internal medicine ward of a general teaching hospital in Amsterdam, which serves a multicultural population. In this study the effects of the COACH program is compared with usual care using a pre-post study design. All patients being admitted with at least one prescribed drug intended for chronic use are included in the study unless they meet one of the following exclusion criteria: no informed consent, no medication intended for chronic use prescribed at discharge, death, transfer to another ward or hospital, discharge within 24 hours or out of office hours, discharge to a nursing home and no possibility to counsel the patient.The intervention consists of medication reconciliation, patient counselling and communication between the hospital and primary care healthcare providers.The following outcomes are measured: the primary outcome readmissions within six months after discharge and the secondary outcomes number of interventions, adherence, patient's attitude towards medicines, patient's satisfaction with medication information, costs, quality of life and finally satisfaction of general practitioners

  14. The effect of the COACH program (Continuity Of Appropriate pharmacotherapy, patient Counselling and information transfer in Healthcare on readmission rates in a multicultural population of internal medicine patients

    Directory of Open Access Journals (Sweden)

    van Tulder Maurits

    2010-02-01

    Full Text Available Abstract Background Medication errors occur frequently at points of transition in care. The key problems causing these medication errors are: incomplete and inappropriate medication reconciliation at hospital discharge (partly arising from inadequate medication reconciliation at admission, insufficient patient information (especially within a multicultural patient population and insufficient communication to the next health care provider. Whether interventions aimed at the combination of these aspects indeed result in less discontinuity and associated harm is uncertain. Therefore the main objective of this study is to determine the effect of the COACH program (Continuity Of Appropriate pharmacotherapy, patient Counselling and information transfer in Healthcare on readmission rates in patients discharged from the internal medicine department. Methods/Design An experimental study is performed at the internal medicine ward of a general teaching hospital in Amsterdam, which serves a multicultural population. In this study the effects of the COACH program is compared with usual care using a pre-post study design. All patients being admitted with at least one prescribed drug intended for chronic use are included in the study unless they meet one of the following exclusion criteria: no informed consent, no medication intended for chronic use prescribed at discharge, death, transfer to another ward or hospital, discharge within 24 hours or out of office hours, discharge to a nursing home and no possibility to counsel the patient. The intervention consists of medication reconciliation, patient counselling and communication between the hospital and primary care healthcare providers. The following outcomes are measured: the primary outcome readmissions within six months after discharge and the secondary outcomes number of interventions, adherence, patient's attitude towards medicines, patient's satisfaction with medication information, costs, quality of

  15. Moving Along: In biomechanics, rehabilitation engineering, and movement analysis, Italian researchers are making great strides.

    Science.gov (United States)

    Gugliellmelli, Eugenio; Micera, Silvestro; Migliavacca, Francesco; Pedotti, Antonio

    2015-01-01

    In Italy, biomechanics research and the analysis of human and animal movement have had a very long history, beginning with the exceptional pioneering work of Leonardo da Vinci. In 1489, da Vinci began investigating human anatomy, including an examination of human tendons, muscles, and the skeletal system. He continued this line of inquiry later in life, identifying what he called "the four powers--movement, weight, force, and percussion"--and how he thought they worked in the human body. His approach, by the way, was very modern--analyzing nature through anatomy, developing models for interpretation, and transferring this knowledge to bio-inspired machines.

  16. Transfers to metropolitan hospitals and coronary angiography for rural Aboriginal and non-Aboriginal patients with acute ischaemic heart disease in Western Australia.

    Science.gov (United States)

    Lopez, Derrick; Katzenellenbogen, Judith M; Sanfilippo, Frank M; Woods, John A; Hobbs, Michael S T; Knuiman, Matthew W; Briffa, Tom G; Thompson, Peter L; Thompson, Sandra C

    2014-05-01

    Aboriginal people have a disproportionately higher incidence rate of ischaemic heart disease (IHD) than non-Aboriginal people. The findings on Aboriginal disparity in receiving coronary artery procedures are inconclusive. We describe the profile and transfers of IHD patients admitted to rural hospitals as emergency admissions and investigate determinants of transfers and coronary angiography. Person-linked hospital and mortality records were used to identify 28-day survivors of IHD events commencing at rural hospitals in Western Australia. Outcome measures were receipt of coronary angiography, transfer to a metropolitan hospital, and coronary angiography if transferred to a metropolitan hospital. Compared to non-Aboriginal patients, Aboriginal patients with IHD were more likely to be younger, have more co-morbidities, reside remotely, but less likely to have private insurance. After adjusting for demographic characteristics, Aboriginal people with MI were less likely to be transferred to a metropolitan hospital, and if transferred were less likely to receive coronary angiography. These disparities were not significant after adjusting for comorbidities and private insurance. In the full multivariate model age, comorbidities and private insurance were adversely associated with transfer to a metropolitan hospital and coronary angiography. Disparity in receiving coronary angiography following emergency admission for IHD to rural hospitals is mediated through the lower likelihood of being transferred to metropolitan hospitals where this procedure is performed. The likelihood of a transfer is increased if the patient has private insurance, however, rural Aboriginal people have a lower rate of private insurance than their non-Aboriginal counterparts. Health practitioners and policy makers can continue to claim that they treat Aboriginal and non-Aboriginal people alike based upon clinical indications, as private insurance is acting as a filter to reduce rural residents

  17. Modelling biomechanics of bark patterning in grasstrees.

    Science.gov (United States)

    Dale, Holly; Runions, Adam; Hobill, David; Prusinkiewicz, Przemyslaw

    2014-09-01

    Bark patterns are a visually important characteristic of trees, typically attributed to fractures occurring during secondary growth of the trunk and branches. An understanding of bark pattern formation has been hampered by insufficient information regarding the biomechanical properties of bark and the corresponding difficulties in faithfully modelling bark fractures using continuum mechanics. This study focuses on the genus Xanthorrhoea (grasstrees), which have an unusual bark-like structure composed of distinct leaf bases connected by sticky resin. Due to its discrete character, this structure is well suited for computational studies. A dynamic computational model of grasstree development was created. The model captures both the phyllotactic pattern of leaf bases during primary growth and the changes in the trunk's width during secondary growth. A biomechanical representation based on a system of masses connected by springs is used for the surface of the trunk, permitting the emergence of fractures during secondary growth to be simulated. The resulting fracture patterns were analysed statistically and compared with images of real trees. The model reproduces key features of grasstree bark patterns, including their variability, spanning elongated and reticulate forms. The patterns produced by the model have the same statistical character as those seen in real trees. The model was able to support the general hypothesis that the patterns observed in the grasstree bark-like layer may be explained in terms of mechanical fractures driven by secondary growth. Although the generality of the results is limited by the unusual structure of grasstree bark, it supports the hypothesis that bark pattern formation is primarily a biomechanical phenomenon.

  18. Head Impact Biomechanics in Women's College Soccer.

    Science.gov (United States)

    Lynall, Robert C; Clark, Michael D; Grand, Erin E; Stucker, Jaclyn C; Littleton, Ashley C; Aguilar, Alain J; Petschauer, Meredith A; Teel, Elizabeth F; Mihalik, Jason P

    2016-09-01

    There are limited nonlaboratory soccer head impact biomechanics data. This is surprising given soccer's global popularity. Epidemiological data suggest that female college soccer players are at a greater concussion injury risk than their male counterparts. Therefore, the purposes of our study were to quantify head impact frequency and magnitude during women's soccer practices and games in the National Collegiate Athletic Association and to characterize these data across event type, playing position, year on the team, and segment of game (first and second halves). Head impact biomechanics were collected from female college soccer players (n = 22; mean ± SD age = 19.1 ± 0.1 yr, height = 168.0 ± 3.5 cm, mass = 63.7 ± 6.0 kg). We employed a helmetless head impact measurement device (X2 Biosystems xPatch) before each competition and practice across a single season. Peak linear and rotational accelerations were categorized based on impact magnitude and subsequently analyzed using appropriate nonparametric analyses. Overall, women's college soccer players experience approximately seven impacts per 90 min of game play. The overwhelming majority (~90%) of all head impacts were categorized into our mildest linear acceleration impact classification (10g-20g). Interestingly, a higher percentage of practice impacts in the 20g-40g range compared with games (11% vs 7%) was observed. Head impact biomechanics studies have provided valuable insights into understanding collision sports and for informing evidence-based rule and policy changes. These have included changing the football kickoff, ice hockey body checking ages, and head-to-head hits in both sports. Given soccer's global popularity, and the growing public concern for the potential long-term neurological implications of collision and contact sports, studying soccer has the potential to impact many athletes and the sports medicine professionals caring for them.

  19. Biomechanical studies: science (f)or common sense?

    NARCIS (Netherlands)

    Mellema, Jos J.; Doornberg, Job N.; Guitton, Thierry G.; Ring, David; van der Zwan, A. L.; Spoor, A. B.; van Vugt, A. B.; Armstrong, A. D.; Shrivastava, A.; Wahegaonkar, A. L.; Shafritz, A. B.; Adams, J.; Ilyas, A.; Vochteloo, A. J. H.; Castillo, A. P.; Basak, A.; Andreas, P.; Barquet, A.; Kristan, A.; Berner, A.; Ranade, A. B.; Ashish, S.; Terrono, A. L.; Jubel, A.; Frieman, B.; Bamberger, H. B.; van den Bekerom, M. P. J.; Belangero, W. D.; Hearon, B. F.; Boler, J. M.; Walter, F. L.; Boyer, M.; Wills, B. P. D.; Broekhuyse, H.; Buckley, R.; Watkins, B.; Sears, B. W.; Calfee, R. P.; Ekholm, C.; Fernandes, C. H.; Swigart, C.; Cassidy, C.; Wilson, C. J.; Bainbridge, L. C.; Wilson, C.; Eygendaal, D.; Goslings, J. C.; Schep, N.; Kloen, P.; Haverlag, R.

    2014-01-01

    It is our impression that many biomechanical studies invest substantial resources studying the obvious: that more and larger metal is stronger. The purpose of this study is to evaluate if a subset of biomechanical studies comparing fixation constructs just document common sense. Using a web-based

  20. Biomechanical factors associated with the development of tibiofemoral knee osteoarthritis

    DEFF Research Database (Denmark)

    van Tunen, Joyce A C; Dell'Isola, Andrea; Juhl, Carsten

    2016-01-01

    INTRODUCTION: Altered biomechanics, increased joint loading and tissue damage, might be related in a vicious cycle within the development of knee osteoarthritis (KOA). We have defined biomechanical factors as joint-related factors that interact with the forces, moments and kinematics in and aroun...... publications in peer-reviewed journals and presentations at (inter)national conferences. TRIAL REGISTRATION NUMBER: CRD42015025092....

  1. Biomechanical factors associated with the risk of knee injury when ...

    African Journals Online (AJOL)

    Objectives. To systematically assess the literature investigating biomechanical knee injury risk factors when an individual lands from a jump. Data sources. Four electronic databases were searched for peer-reviewed English journals containing landing biomechanical studies published over 14 years (1990 - 2003).

  2. Factors Related to Students' Learning of Biomechanics Concepts

    Science.gov (United States)

    Hsieh, ChengTu; Smith, Jeremy D.; Bohne, Michael; Knudson, Duane

    2012-01-01

    The purpose of this study was to replicate and expand a previous study to identify the factors that affect students' learning of biomechanical concepts. Students were recruited from three universities (N = 149) located in the central and western regions of the United States. Data from 142 students completing the Biomechanics Concept Inventory…

  3. [The development of an oral biomechanical testing instrument].

    Science.gov (United States)

    Zhang, X H; Sun, X D; Lin, Z

    2000-03-01

    An oral biomechanical testing instrument, which is portable, powered with batteries and controlled by single chip microcomputer, was described. The instrument was characterized by its multichannel, high accuracy, low power dissipation, wide rage of force measurement and stable performance. It can be used for acquisiting, displaying and storing data. And it may be expected to be an ideal instrument for oral biomechanical measurements.

  4. Dance band on the Titanic: biomechanical signaling in cardiac hypertrophy.

    Science.gov (United States)

    Sussman, Mark A; McCulloch, Andrew; Borg, Thomas K

    2002-11-15

    Biomechanical signaling is a complex interaction of both intracellular and extracellular components. Both passive and active components are involved in the extracellular environment to signal through specific receptors to multiple signaling pathways. This review provides an overview of extracellular matrix, specific receptors, and signaling pathways for biomechanical stimulation in cardiac hypertrophy.

  5. The Undergraduate Biomechanics Experience at Iowa State University.

    Science.gov (United States)

    Francis, Peter R.

    This paper discusses the objectives of a program in biomechanics--the analysis of sports skills and movement--and the evolution of the biomechanics program at Iowa State University. The primary objective of such a course is to provide the student with the basic tools necessary for adequate analysis of human movement, with special emphasis upon…

  6. Biomechanics, Exercise Physiology, and the 75th Anniversary of RQES

    Science.gov (United States)

    Hamill, Joseph; Haymes, Emily M.

    2005-01-01

    The purpose of this paper is to review the biomechanics and exercise physiology studies published in the Research Quarterly for Exercise and Sport (RQES) over the past 75 years. Studies in biomechanics, a relatively new subdiscipline that evolved from kinesiology, first appeared in the journal about 40 years ago. Exercise physiology studies have…

  7. High resolution extremity CT for biomechanics modeling

    International Nuclear Information System (INIS)

    Ashby, A.E.; Brand, H.; Hollerbach, K.; Logan, C.M.; Martz, H.E.

    1995-01-01

    With the advent of ever more powerful computing and finite element analysis (FEA) capabilities, the bone and joint geometry detail available from either commercial surface definitions or from medical CT scans is inadequate. For dynamic FEA modeling of joints, precise articular contours are necessary to get appropriate contact definition. In this project, a fresh cadaver extremity was suspended in parafin in a lucite cylinder and then scanned with an industrial CT system to generate a high resolution data set for use in biomechanics modeling

  8. Biomechanical evaluation of the Nice knot

    OpenAIRE

    Hill, Shannon W.; Chapman, Christopher R.; Adeeb, Samer; Duke, Kajsa; Beaupre, Lauren; Bouliane, Martin J.

    2016-01-01

    Background: The Nice knot is a bulky double-stranded knot. Biomechanical data supporting its use as well as the number of half hitches required to ensure knot security is lacking. Materials and Methods: Nice knots with, one, two, or three half-hitches were compared with the surgeon′s and Tennessee slider knots with three half hitches. Each knot was tied 10 times around a fixed diameter using four different sutures: FiberWire (Arthrex, Naples, FL), Ultrabraid (Smith and Nephew, Andover, MA...

  9. Anatomy, normal variants, and basic biomechanics

    International Nuclear Information System (INIS)

    Berquist, T.H.; Johnson, K.A.

    1989-01-01

    This paper reports on the anatomy and basic functions of the foot and ankle important to physicians involved in imaging procedures, clinical medicine, and surgery. New radiographic techniques especially magnetic resonance imaging, provide more diagnostic information owing to improved tissue contrast and the ability to obtain multiple image planes (axial, sagittal, coronal, oblique). Therefore, a thorough knowledge of skeletal and soft tissue anatomy is even more essential. Normal variants must also be understood in order to distinguish normal from pathologic changes in the foot and ankle. A basic understanding of biomechanics is also essential for selecting the proper diagnostic techniques

  10. High resolution extremity CT for biomechanics modeling

    Energy Technology Data Exchange (ETDEWEB)

    Ashby, A.E.; Brand, H.; Hollerbach, K.; Logan, C.M.; Martz, H.E.

    1995-09-23

    With the advent of ever more powerful computing and finite element analysis (FEA) capabilities, the bone and joint geometry detail available from either commercial surface definitions or from medical CT scans is inadequate. For dynamic FEA modeling of joints, precise articular contours are necessary to get appropriate contact definition. In this project, a fresh cadaver extremity was suspended in parafin in a lucite cylinder and then scanned with an industrial CT system to generate a high resolution data set for use in biomechanics modeling.

  11. BIOMECHANICS AND PATHOMECHANICS OF THE PATELLOFEMORAL JOINT

    Science.gov (United States)

    2016-01-01

    The patellofemoral joint is a joint that can be an area of concern for athletes of various sports and ages. The joint is somewhat complex with multiple contact points and numerous tissues that attach to the patella. Joint forces are variable and depend on the degree of knee flexion and whether the foot is in contact with the ground. The sports medicine specialist must have a good working knowledge of the anatomy and biomechanics of the patellofemoral joint in order to treat it effectively. PMID:27904787

  12. Cumulative effective radiation dose received by blunt trauma patients arriving to a military level I trauma center from point of injury and interhospital transfers.

    Science.gov (United States)

    Van Arnem, Kerri A; Supinski, David P; Tucker, Jonathan E; Varney, Shawn

    2016-12-01

    Trauma patients sustaining blunt injuries are exposed to multiple radiologic studies. Evidence indicates that the risk of cancer from exposure to ionizing radiation rises in direct proportion to the cumulative effective dose (CED) received. The purpose of this study is to quantify the amount of ionizing radiation accumulated when arriving directly from point of injury to San Antonio Military Medical Center (SAMMC), a level I trauma center, compared with those transferred from other facilities. A retrospective record review was conducted from 1st January 2010 through 31st December 2012. The SAMMC trauma registry, electronic medical records, and the digital radiology imaging system were searched for possible candidates. The medical records were then analyzed for sex, age, mechanism of injury, received directly from point of injury (direct group), transfer from another medical facility (transfer group), computed tomographic scans received, dose-length product, CED of radiation, and injury severity score. A diagnostic imaging physicist then calculated the estimated CED each subject received based on the dose-length product of each computed tomographic scan. A total of 300 patients were analyzed, with 150 patients in the direct group and 150 patients in the transfer group. Both groups were similar in age and sex. Patients in the transfer group received a significantly greater CED of radiation compared with the direct group (mean, 37.6 mSv vs 28 mSv; P=.001). The radiation received in the direct group correlates with a lifetime attributable risk (LAR) of 1 in 357 compared with the transfer group with an increase in LAR to 1 in 266. Patients transferred to our facility received a 34% increase in ionizing radiation compared with patients brought directly from the injury scene. This increased dose of ionizing radiation contributes to the LAR of cancer and needs to be considered before repeating imaging studies. III. Published by Elsevier Inc.

  13. BIOMECHANICAL PRINCIPLES PHYSICAL REHABILITATION OF CHILDREN WITH CEREBRAL PALSY

    Directory of Open Access Journals (Sweden)

    S. D. Korshunov

    2016-01-01

    Full Text Available Aim. We studied the basic biomechanical principles of physical rehabilitation of children with cerebral palsy.Materials and methods. Methods of Motion Tracking and electromyography investigated the biomechanical characteristics of gait in children with cerebral palsy. It is shown that the main differences between dynamic stereotype walk pediatric patients is to delay moving forward center of gravity and the disorganization of the lower limb movements (especially knee in the vertical plane. Prevailing flexion - leading position of the lower extremities during locomotion cycle associated with limitation of motion in the hip joint, offset by an increase swinging body, weakening activity in the rear shock phase and its sharp increase in the fourth phase. Changes in the structure of the movement of the shoulder girdle and upper extremities can be considered as compensatory. Characteristically excessive involvement in the locomotion of the calf muscles and the rectus muscles of the back, with the central mechanisms gipersinhronizatsii activity of motor units are the primary mechanism for adaptation in a group of children that are capable of self-locomotion.Results. As a result of the research it shows that in motor rehabilitation of children with cerebral palsy should include the following elements: exercise to maintain the body balance when performing arm movements, exercises for coordination of hand movements, including motor brushes, exercises to increase mobility in the hip joints and in the back, exercises designed to exercise the calf muscles, the front thigh muscles and the rectus muscles of the back, massage to relieve hyper calf muscles. 

  14. Biomechanics in dermatology: Recent advances and future directions.

    Science.gov (United States)

    Lewinson, Ryan T; Haber, Richard M

    2017-02-01

    Biomechanics is increasingly being recognized as an important research area in dermatology. To highlight only a few examples, biomechanics has contributed to the development of novel topical therapies for aesthetic and medical purposes, enhanced our understanding of the pathogenesis of plantar melanoma, and provided insight into the epidemiology of psoriatic disease. This article summarizes the findings from recent studies to demonstrate the important role that biomechanics may have in dermatologic disease and therapy and places these biomechanical findings in a clinical context for the practicing physician. In addition, areas for future biomechanics research and development in dermatology are discussed. Copyright © 2016 American Academy of Dermatology, Inc. Published by Elsevier Inc. All rights reserved.

  15. Simulated settings; powerful arenas for learning patient safety practices and facilitating transference to clinical practice. A mixed method study.

    Science.gov (United States)

    Reime, Marit Hegg; Johnsgaard, Tone; Kvam, Fred Ivan; Aarflot, Morten; Breivik, Marit; Engeberg, Janecke Merethe; Brattebø, Guttorm

    2016-11-01

    Poor teamwork is an important factor in the occurrence of critical incidents because of a lack of non-technical skills. Team training can be a key to prevent these incidents. The purpose of this study was to explore the experience of nursing and medical students after a simulation-based interprofessional team training (SBITT) course and its impact on professional and patient safety practices, using a concurrent mixed-method design. The participants (n = 262) were organized into 44 interprofessional teams. The results showed that two training sequences the same day improved overall team performance. Making mistakes during SBITT appeared to improve the quality of patient care once the students returned to clinical practice as it made the students more vigilant. Furthermore, the video-assisted oral debriefing provided an opportunity to strengthen interprofessional teamwork and share situational awareness. SBITT gave the students an opportunity to practice clinical reasoning skills and to share professional knowledge. The students conveyed the importance of learning to speak up to ensure safe patient practices. Simulated settings seem to be powerful arenas for learning patient safety practices and facilitating transference of this awareness to clinical practice. Copyright © 2016 Elsevier Ltd. All rights reserved.

  16. A pilot study of biomechanical assessment before and after an integrative training program for adolescents with juvenile fibromyalgia.

    Science.gov (United States)

    Tran, Susan T; Thomas, Staci; DiCesare, Christopher; Pfeiffer, Megan; Sil, Soumitri; Ting, Tracy V; Williams, Sara E; Myer, Gregory D; Kashikar-Zuck, Susmita

    2016-07-22

    Adolescents with juvenile fibromyalgia (JFM) tend to be very sedentary and avoid participation in physical activity. A prior study suggested that JFM patients show altered biomechanics compared to healthy adolescents which may make them more prone to pain/injury during exercise. A new intervention combining well established cognitive behavioral therapy (CBT) techniques with specialized neuromuscular exercise -Fibromyalgia Integrative Training for Teens (FIT Teens) was developed and shown to be promising in improving functioning in adolescents with JFM. In contrast to traditional exercise programs such as aerobic or resistance training, neuromuscular training is a tailored approach which targets gait, posture, balance and movement mechanics which form the foundation for safe exercise participation with reduced risk for injury or pain (and hence more tolerable by JFM patients). The aim of this pilot feasibility study was to establish whether objective biomechanical assessment including sophisticated 3-D motion analysis would be useful in measuring improvements in strength, balance, gait, and functional performance after participation in the 8-week FIT Teens program. Eleven female participants with JFM (ages 12-18 years) completed pre- and post-treatment assessments of biomechanics, including walking gait analysis, lower extremity strength assessment, functional performance, and dynamic postural stability. Descriptive data indicated that mechanics of walking gait and functional performance appeared to improve after treatment. Hip abduction strength and dynamic postural control also demonstrated improvements bilaterally. Overall, the results of this pilot study offer initial evidence for the utility of biomechanical assessment to objectively demonstrate observable changes in biomechanical performance after an integrated training intervention for youth with JFM. If replicated in larger controlled studies, findings would suggest that through the FIT Teens intervention

  17. [The biomechanics of hyperextension injuries of the subaxial cervical spine].

    Science.gov (United States)

    Stein, G; Meyer, C; Ingenhoff, L; Bredow, J; Müller, L P; Eysel, P; Schiffer, G

    2017-07-01

    Hyperextension injuries of the subaxial cervical spine are potentially hazardous due to relevant destabilization. Depending on the clinical condition, neurologic or vascular damage may occur. Therefore an exact knowledge of the factors leading to destabilization is essential. In a biomechanical investigation, 10 fresh human cadaver cervical spine specimens were tested in a spine simulator. The tested segments were C4 to 7. In the first step, physiologic motion was investigated. Afterwards, the three steps of injury were dissection of the anterior longitudinal ligament, removal of the intervertebral disc/posterior longitudinal ligament, and dissection of the interspinous ligaments/ligamentum flavum. After each step, the mobility was determined. Regarding flexion and extension, an increase in motion of 8.36 % after the first step, 90.45 % after the second step, and 121.67 % after the last step was observed. Testing of lateral bending showed an increase of mobility of 7.88 %/27.48 %/33.23 %; axial rotation increased by 2.87 %/31.16 %/45.80 %. Isolated dissection of the anterior longitudinal ligament led to minor destabilization, whereas the intervertebral disc has to be seen as a major stabilizer of the cervical spine. Few finite-element studies showed comparable results. If a transfer to clinical use is undertaken, an isolated rupture of the anterior longitudinal ligament can be treated without surgical stabilization.

  18. Biomechanics of the osteoporotic spine, pain, and principles of training.

    Science.gov (United States)

    Schröder, Guido; Knauerhase, Andreas; Willenberg, Holger S; Kundt, Guenther; Wendig, Detlef; Schober, Hans-Christof

    2017-05-01

    A fracture is a clinical manifestation of osteoporosis and is one of the main causes of functional limitations and chronic pain in patients with osteoporosis. Muscle and coordination training are recommended to the patients as general measures. We inquired whether sling training is better than traditional physiotherapy in relieving pain and improving abilities of daily living. Fifty patients with osteoporosis were divided into two groups. Group A performed conventional physiotherapy, while Group B performed sling training exercises. Data were collected before and after the intervention and after 3 months. The registered parameters were stamina, posture, and pain. Posture, torques, and the associated strength of spinal muscles were studied in a biomechanical model in order to estimate the forces acting on the spine. Furthermore, the factors that exerted a positive impact on the success of therapy were registered. Forty-four patients (88%) completed the study. Positive effects of the training were noted in both groups, but significantly better effects were observed in the group that performed sling training. A reduction of pain independent of the number of fractures, significantly reduced torques, and reduced muscle strength were registered. Specific training programs helped to increase muscle strength and straightening the back thereby reducing the force needed on a permanent basis and decreasing torque in the spine. Sling training was more effective in that than traditional physiotherapy.

  19. Patients’ follow-up using biomechanical analysis of rehabilitation exercises

    Directory of Open Access Journals (Sweden)

    Bruno Bonnechère

    2017-03-01

    Full Text Available Thanks to the evolution of game controllers video games are becoming more and more popular in physical rehabilitation. The integration of serious games in rehabilitation has been tested for various pathologies. Parallel to this clinical research, a lot of studies have been done in order to validate the use of these game controllers for simple biomechanical evaluation. Currently, it is thus possible to record the motions performed by the patients during serious gaming exercises for later analysis. Therefore, data collected during the exercises could be used for monitoring the evolution of the patients during long term rehabilitation. Before using the parameters extracted from the games to assess patients’ evolution two important aspects must be verified: the reproducibility of measurement and a possible effect of learning of the task to be performed. Ten healthy adults played 9 sessions of specific games developed for rehabilitation over a 3-weeks period. Nineteen healthy children played 2 sessions to study the influence of age. Different parameters were extracted from the games: time, range of motion, reaching area. Results of this study indicates that it is possible to follow the evolution of the patients during the rehabilitation process. The majority of the learning effect occurred during the very first session. Therefore, in order to allow proper regular monitoring, the results of this first session should not be included in the follow-up of the patient.

  20. High prevalence of lipid transfer protein sensitization in apple allergic patients with systemic symptoms.

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    Francisca Gomez

    Full Text Available Apple allergy manifests as two main groups of clinical entities reflecting different patterns of allergen sensitization: oral allergy syndrome (OAS and generalized symptoms (GS.We analysed the sensitization profile to a wide panel of different components of food allergens (rMal d 1, Mal d 2, rMal d 3, rMal d 4, rPru p 3, rBet v 1 and Pho d 2 for a population of Mediterranean patients with OAS and GS to apple.Patients (N = 81 with a history of apple allergy that could be confirmed by positive prick-prick test and/or double-blind-placebo-controlled food challenge (DBPCFC, were included. Skin prick test (SPT and ELISA were performed using a panel of inhalant, fruit and nut allergens. ELISA and ELISA inhibition studies were performed in order to analyse the sensitization patterns.Thirty-five cases (43.2% had OAS and 46 (56.8% GS. SPT showed a significantly higher number of positive results with peach, cherry and hazelnut in those with GS. ELISA showed a significantly high percentage of positive cases to rMal d 3, rMal d 4, rPru p 3 and Pho d 2 in patients with OAS and GS compared to controls, and to rBet v 1 in patients with OAS vs controls and between OAS and GS patients. Three different patterns of recognition were detected: positive to LTP (rMal d 3 or rPru p 3, positive to profilin (rMal d 4 and Pho d 2, or positive to both. There were also patients with rMal d 1 recognition who showed cross-reactivity to rBet v 1.In an apple allergy population with a high incidence of pollinosis different patterns of sensitization may occur. LTP is most often involved in those with GS. Profilin, though more prevalent in patients with OAS, has been shown to sensitise patients with both types of symptoms.

  1. Biomechanical paradigm and interpretation of female pelvic floor conditions before a treatment

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    Lucente V

    2017-08-01

    Full Text Available Vincent Lucente,1 Heather van Raalte,2 Miles Murphy,1 Vladimir Egorov3 1The Institute for Female Pelvic Medicine and Reconstructive Surgery, Allentown, PA, USA; 2Princeton Urogynecology, Princeton, NJ, USA; 3Artann Laboratories, Trenton, NJ, USA Background: Further progress in restoring a woman’s health may be possible if a patient with a damaged pelvic floor could undergo medical imaging and biomechanical diagnostic tests. The results of such tests could contribute to the analysis of multiple treatment options and suggest the optimal one for that patient.Aim: To develop a new approach for the biomechanical characterization of vaginal conditions, muscles, and connective tissues in the female pelvic floor.Methods: Vaginal tactile imaging (VTI allows biomechanical assessment of the soft tissue along the entire length of the anterior, posterior, and lateral vaginal walls at rest, with manually applied deflection pressures and with muscle contraction, muscle relaxation, and Valsalva maneuver. VTI allows a large body of measurements to evaluate individual variations in tissue elasticity, support defects, as well as pelvic muscle function. Presuming that 1 the female pelvic floor organs are suspended by ligaments against which muscles contract to open or close the outlets and 2 damaged ligaments weaken the support and may reduce the force of muscle contraction, we made an attempt to characterize multiple pelvic floor structures from VTI data.Results: All of the 138 women enrolled in the study were successfully examined with the VTI. The study subjects have had normal pelvic support or pelvic organ prolapse (stages I–IV. The average age of this group of subjects was 60±15 years. We transposed a set of 31 VTI parameters into a quantitative characterization of pelvic muscles and ligamentous structures. Interpretation of the acquired VTI data for normal pelvic floor support and prolapse conditions is proposed based on biomechanical assessment of the

  2. Patient considerations and clinical impact of cholesteryl ester transfer protein inhibitors in the management of dyslipidemia: focus on anacetrapib

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    Miyares MA

    2012-08-01

    Full Text Available Marta A Miyares, Kyle DavisPharmacy Department, Jackson Memorial Hospital, Miami, FL, USAAbstract: Cardiovascular disease (CVD is responsible for significant morbidity and mortality within the United States and worldwide. Although targeting low-density lipoprotein cholesterol (LDL-C in the prevention of CVD has been shown to be effective, evidence exists to indicate that significant cardiovascular (CV risk remains in patients receiving 3-hydroxy-3-methylglutaryl-coenzyme A reductase inhibitors (statins – a risk that may be correlated with low levels of high-density lipoprotein cholesterol (HDL-C. Among the various tactics under investigation to increase HDL-C, inhibition of cholesteryl ester transfer protein (CETP appears the most adept to raise these levels. Although torcetrapib, a CETP inhibitor, demonstrated significant beneficial changes in HDL-C and LDL-C after 12 months of therapy when coadministered with atorvastatin, patients in the torcetrapib arm experienced a rise in mortality, including increased risk of death from CV and non-CV causes as well as a significant rise in major CV events. Later studies established that the adverse effects of torcetrapib were produced from molecule-specific off-target effects and not to the mechanism of CETP inhibition. These untoward outcomes have not been detected with anacetrapib, the third of the CETP inhibitors to enter Phase III trials. Furthermore, treatment with anacetrapib revealed both a statistically significant decrease in LDL-C and increase in HDL-C over placebo. While the place in therapy of niacin and fibrates to reduce CV events is currently in question secondary to the Atherothrombosis Intervention in Metabolic Syndrome with Low HDL Cholesterol/High Triglyceride and Impact on Global Health Outcomes and the Action to Control CV Risk in Diabetes trials, the ongoing large-scale, randomized–placebo, controlled-outcomes study with anacetrapib coadministered with statin treatment will not

  3. Adaptive sports technology and biomechanics: wheelchairs.

    Science.gov (United States)

    Cooper, Rory A; De Luigi, Arthur Jason

    2014-08-01

    Wheelchair sports are an important tool in the rehabilitation of people with severe chronic disabilities and have been a driving force for innovation in technology and practice. In this paper, we will present an overview of the adaptive technology used in Paralympic sports with a special focus on wheeled technology and the impact of design on performance (defined as achieving the greatest level of athletic ability and minimizing the risk of injury). Many advances in manual wheelchairs trace their origins to wheelchair sports. Features of wheelchairs that were used for racing and basketball 25 or more years ago have become integral to the manual wheelchairs that people now use every day; moreover, the current components used on ultralight wheelchairs also have benefitted from technological advances developed for sports wheelchairs. For example, the wheels now used on chairs for daily mobility incorporate many of the components first developed for sports chairs. Also, advances in manufacturing and the availability of aerospace materials have driven current wheelchair design and manufacture. Basic principles of sports wheelchair design are universal across sports and include fit; minimizing weight while maintaining high stiffness; minimizing rolling resistance; and optimizing the sports-specific design of the chair. However, a well-designed and fitted wheelchair is not sufficient for optimal sports performance: the athlete must be well trained, skilled, and use effective biomechanics because wheelchair athletes face some unique biomechanical challenges. Copyright © 2014 American Academy of Physical Medicine and Rehabilitation. Published by Elsevier Inc. All rights reserved.

  4. Integrative Structural Biomechanical Concepts of Ankylosing Spondylitis

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    Alfonse T. Masi

    2011-01-01

    Full Text Available Ankylosing spondylitis (AS is not fully explained by inflammatory processes. Clinical, epidemiological, genetic, and course of disease features indicate additional host-related risk processes and predispositions. Collectively, the pattern of predisposition to onset in adolescent and young adult ages, male preponderance, and widely varied severity of AS is unique among rheumatic diseases. However, this pattern could reflect biomechanical and structural differences between the sexes, naturally occurring musculoskeletal changes over life cycles, and a population polymorphism. During juvenile development, the body is more flexible and weaker than during adolescent maturation and young adulthood, when strengthening and stiffening considerably increase. During middle and later ages, the musculoskeletal system again weakens. The novel concept of an innate axial myofascial hypertonicity reflects basic mechanobiological principles in human function, tissue reactivity, and pathology. However, these processes have been little studied and require critical testing. The proposed physical mechanisms likely interact with recognized immunobiological pathways. The structural biomechanical processes and tissue reactions might possibly precede initiation of other AS-related pathways. Research in the combined structural mechanobiology and immunobiology processes promises to improve understanding of the initiation and perpetuation of AS than prevailing concepts. The combined processes might better explain characteristic enthesopathic and inflammatory processes in AS.

  5. Integrated biomechanical and topographical surface characterization (IBTSC)

    Energy Technology Data Exchange (ETDEWEB)

    Löberg, Johanna, E-mail: Johanna.Loberg@dentsply.com [Dentsply Implants, Box 14, SE-431 21 Mölndal (Sweden); Mattisson, Ingela [Dentsply Implants, Box 14, SE-431 21 Mölndal (Sweden); Ahlberg, Elisabet [Department of Chemistry and Molecular Biology, University of Gothenburg, SE-41296 Gothenburg (Sweden)

    2014-01-30

    In an attempt to reduce the need for animal studies in dental implant applications, a new model has been developed which combines well-known surface characterization methods with theoretical biomechanical calculations. The model has been named integrated biomechanical and topographical surface characterization (IBTSC), and gives a comprehensive description of the surface topography and the ability of the surface to induce retention strength with bone. IBTSC comprises determination of 3D-surface roughness parameters by using 3D-scanning electron microscopy (3D-SEM) and atomic force microscopy (AFM), and calculation of the ability of different surface topographies to induce retention strength in bone by using the local model. Inherent in this integrated approach is the use of a length scale analysis, which makes it possible to separate different size levels of surface features. The IBTSC concept is tested on surfaces with different level of hierarchy, induced by mechanical as well as chemical treatment. Sequential treatment with oxalic and hydrofluoric acid results in precipitated nano-sized features that increase the surface roughness and the surface slope on the sub-micro and nano levels. This surface shows the highest calculated shear strength using the local model. The validity, robustness and applicability of the IBTSC concept are demonstrated and discussed.

  6. Ergonomic evaluation of slide boards used by home care aides to assist client transfers.

    Science.gov (United States)

    Sun, Chuan; Buchholz, Bryan; Quinn, Margaret; Punnett, Laura; Galligan, Catherine; Gore, Rebecca

    2018-07-01

    Home care aides risk musculoskeletal injury because they lift and move clients; the body weight of most adults exceeds the NIOSH recommended limit for lifting. Methods to reduce manual patient lifting in institutional settings are often technically or economically infeasible in home care. Our goal was to identify suitable, safe, low-technology transfer devices for home care use. Sixteen experienced home care aides performed client transfers from wheelchair to bed (upward) and bed to wheelchair (downward) in a simulated home care environment (laboratory), using four different slide boards and by hand without a device. Aides' hand forces were measured during client transfers; aides also evaluated usability of each board. Hand forces exerted while using slide boards were mostly lower than in manual transfer, and forces were lower in downward versus upward transfers. Aides judged a board with a sliding mechanism easier to use than boards without a sliding mechanism. Practitioner Summary: This paper provides quantitative biomechanical measurements showing that slide boards reduced the hand forces needed by home care aides to transfer clients from bed to wheel chair and vice versa, compared to manual lifting. Using a semi-quantitative usability survey, aides identified boards with a sliding mechanism easiest to use.

  7. A review on application of finite element modelling in bone biomechanics

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    Sandeep Kumar Parashar

    2016-09-01

    Full Text Available In the past few decades the finite element modelling has been developed as an effective tool for modelling and simulation of the biomedical engineering system. Finite element modelling (FEM is a computational technique which can be used to solve the biomedical engineering problems based on the theories of continuum mechanics. This paper presents the state of art review on finite element modelling application in the four areas of bone biomechanics, i.e., analysis of stress and strain, determination of mechanical properties, fracture fixation design (implants, and fracture load prediction. The aim of this review is to provide a comprehensive detail about the development in the area of application of FEM in bone biomechanics during the last decades. It will help the researchers and the clinicians alike for the better treatment of patients and future development of new fixation designs.

  8. Biomechanical testing of zirconium dioxide osteosynthesis system for Le Fort I advancement osteotomy fixation.

    Science.gov (United States)

    Hingsammer, Lukas; Grillenberger, Markus; Schagerl, Martin; Malek, Michael; Hunger, Stefan

    2018-01-01

    The following work is the first evaluating the applicability of 3D printed zirconium dioxide ceramic miniplates and screws to stabilize maxillary segments following a Le-Fort I advancement surgery. Conventionally used titanium and individual fabricated zirconium dioxide miniplates were biomechanically tested and compared under an occlusal load of 120N and 500N using 3D finite element analysis. The overall model consisted of 295,477 elements. Under an occlusal load of 500N a safety factor before plastic deformation respectively crack of 2.13 for zirconium dioxide and 4.51 for titanium miniplates has been calculated. From a biomechanical point of view 3D printed ZrO 2 mini-plates and screws are suggested to constitute an appropriate patient specific and metal-free solution for maxillary stabilization after Le Fort I osteotomy. Copyright © 2017 Elsevier Ltd. All rights reserved.

  9. Relations between Biomechanical Parameters and Static Power of Arms in Children with Disturbed Posture

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    Slobodan Andrašić

    2017-02-01

    Full Text Available This study is aimed at determining the parameters and biomechanical analysis of their impact on the static arm strength in children with impaired posture as poor kyphotic posture, lordotic poor posture and children with flat feet. A transversal study included a sample of 67 children on the territory of the municipality of Subotica. The structure of the sample is as follows: 22 subjects with impaired kyphotic posture, 18 patients with impaired lordotic posture, and 27 subjects with flat feet. Measuring the level of static arm strength was done by the standardized "folding endurance" test. Observing the morphological development of children with kyphotic, lordotic poor posture and flat feet determined statistically significant differences in biomechanical variables.

  10. Hospital networks and the dispersal of hospital-acquired pathogens by patient transfer.

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    Tjibbe Donker

    Full Text Available Hospital-acquired infections (HAI are often seen as preventable incidents that result from unsafe practices or poor hospital hygiene. This however ignores the fact that transmissibility is not only a property of the causative organisms but also of the hosts who can translocate bacteria when moving between hospitals. In an epidemiological sense, hospitals become connected through the patients they share. We here postulate that the degree of hospital connectedness crucially influences the rates of infections caused by hospital-acquired bacteria. To test this hypothesis, we mapped the movement of patients based on the UK-NHS Hospital Episode Statistics and observed that the proportion of patients admitted to a hospital after a recent episode in another hospital correlates with the hospital-specific incidence rate of MRSA bacteraemia as recorded by mandatory reporting. We observed a positive correlation between hospital connectedness and MRSA bacteraemia incidence rate that is significant for all financial years since 2001 except for 2008-09. All years combined, this correlation is positive and significantly different from zero (partial correlation coefficient r = 0.33 (0.28 to 0.38. When comparing the referral pattern for English hospitals with referral patterns observed in the Netherlands, we predict that English hospitals more likely see a swifter and more sustained spread of HAIs. Our results indicate that hospitals cannot be viewed as individual units but rather should be viewed as connected elements of larger modular networks. Our findings stress the importance of cooperative effects that will have a bearing on the planning of health care systems, patient management and hospital infection control.

  11. Estimating retention in HIV care accounting for patient transfers: A national laboratory cohort study in South Africa.

    Science.gov (United States)

    Fox, Matthew P; Bor, Jacob; Brennan, Alana T; MacLeod, William B; Maskew, Mhairi; Stevens, Wendy S; Carmona, Sergio

    2018-06-01

    Systematic reviews have described high rates of attrition in patients with HIV receiving antiretroviral therapy (ART). However, migration and clinical transfer may lead to an overestimation of attrition (death and loss to follow-up). Using a newly linked national laboratory database in South Africa, we assessed national retention in South Africa's national HIV program. Patients receiving care in South Africa's national HIV program are monitored through regular CD4 count and viral load testing. South Africa's National Health Laboratory Service has maintained a database of all public-sector CD4 count and viral load results since 2004. We linked individual laboratory results to patients using probabilistic matching techniques, creating a national HIV cohort. Validation of our approach in comparison to a manually matched dataset showed 9.0% undermatching and 9.5% overmatching. We analyzed data on patients initiating ART in the public sector from April 1, 2004, to December 31, 2006, when ART initiation could be determined based on first viral load among those whose treatment followed guidelines. Attrition occurred on the date of a patient's last observed laboratory measure, allowing patients to exit and reenter care prior to that date. All patients had 6 potential years of follow-up, with an additional 2 years to have a final laboratory measurement to be retained at 6 years. Data were censored at December 31, 2012. We assessed (a) national retention including all laboratory tests regardless of testing facility and (b) initiating facility retention, where laboratory tests at other facilities were ignored. We followed 55,836 patients initiating ART between 2004 and 2006. At ART initiation, median age was 36 years (IQR: 30-43), median CD4 count was 150 cells/mm3 (IQR: 81-230), and 66.7% were female. Six-year initiating clinic retention was 29.1% (95% CI: 28.7%-29.5%). After allowing for transfers, national 6-year retention was 63.3% (95% CI: 62.9%-63.7%). Results differed

  12. Shoe heel abrasion and its possible biomechanical cause: a transversal study with infantry recruits.

    Science.gov (United States)

    Baumfeld, Daniel; Raduan, Fernando C; Macedo, Benjamim; Silva, Thiago Alexandre Alves; Baumfeld, Tiago; Favato, Danilo Fabrino; de Andrade, Marco Antonio Percope; Nery, Caio

    2015-11-19

    Excessive shoe heel abrasion is of concern to patients and shoe manufacturers, but little scientific information is available about this feature and its possible causes. The purpose of this study was to relate this phenomenon with biomechanical factors that could predispose to shoe heel abrasion. Ninety-seven recruits (median age 25) were enrolled in this study. Shoe abrasion was assessed manually with a metric plastic tape on the posterior part of the heel that comes in contact with the ground. The number of sprains, foot alignment, and calf muscle shortening (Silfverskiold test) was also assessed in order to relate it with shoe heel abrasion. After using our exclusion criteria, 86 recruits and 172 were considered for this study. The most common abrasion site was the lateral portion of the heel surface (50 %). Forty-four percent of the participants had neutral hind-foot alignment and 39 % had valgus alignment. Twenty-six (30 %) patients have had previous ankle or foot sprains. Neutral foot was related with less calf muscle shortening. On the other hand, valgus hind-foot alignment was more associated with Achilles shortening (p study was able to correlate shoe heel abrasion with biomechanical causes (neutral alignment-uniform abrasion/varus alignment-central and lateral abrasion). More effort has to be done to continue evaluating outsole abrasion with its possible biomechanical cause in order to predict and treat possible associated injuries.

  13. Resistance Analyses of Integrase Strand Transfer Inhibitors within Phase 3 Clinical Trials of Treatment-Naive Patients

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    Kirsten L. White

    2014-07-01

    Full Text Available The integrase (IN strand transfer inhibitors (INSTIs, raltegravir (RAL, elvitegravir (EVG and dolutegravir (DTG, comprise the newest drug class approved for the treatment of HIV-1 infection, which joins the existing classes of reverse transcriptase, protease and binding/entry inhibitors. The efficacy of first-line regimens has attained remarkably high levels, reaching undetectable viral loads in 90% of patients by Week 48; however, there remain patients who require a change in regimen due to adverse events, virologic failure with emergent resistance or other issues of patient management. Large, randomized clinical trials conducted in antiretroviral treatment-naive individuals are required for drug approval in this population in the US, EU and other countries, with the primary endpoint for virologic success at Week 48. However, there are differences in the definition of virologic failure and the evaluation of drug resistance among the trials. This review focuses on the methodology and tabulation of resistance to INSTIs in phase 3 clinical trials of first-line regimens and discusses case studies of resistance.

  14. A hybrid biomechanical intensity based deformable image registration of lung 4DCT

    International Nuclear Information System (INIS)

    Samavati, Navid; Velec, Michael; Brock, Kristy

    2015-01-01

    Deformable image registration (DIR) has been extensively studied over the past two decades due to its essential role in many image-guided interventions (IGI). IGI demands a highly accurate registration that maintains its accuracy across the entire region of interest. This work evaluates the improvement in accuracy and consistency by refining the results of Morfeus, a biomechanical model-based DIR algorithm.A hybrid DIR algorithm is proposed based on, a biomechanical model–based DIR algorithm and a refinement step based on a B-spline intensity-based algorithm. Inhale and exhale reconstructions of four-dimensional computed tomography (4DCT) lung images from 31 patients were initially registered using the biomechanical DIR by modeling contact surface between the lungs and the chest cavity. The resulting deformations were then refined using the intensity-based algorithm to reduce any residual uncertainties. Important parameters in the intensity-based algorithm, including grid spacing, number of pyramids, and regularization coefficient, were optimized on 10 randomly-chosen patients (out of 31). Target registration error (TRE) was calculated by measuring the Euclidean distance of common anatomical points on both images after registration. For each patient a minimum of 30 points/lung were used.Grid spacing of 8 mm, 5 levels of grid pyramids, and regularization coefficient of 3.0 were found to provide optimal results on 10 randomly chosen patients. Overall the entire patient population (n = 31), the hybrid method resulted in mean ± SD (90th%) TRE of 1.5 ± 1.4 (2.9) mm compared to 3.1 ± 1.9 (5.6) using biomechanical DIR and 2.6 ± 2.5 (6.1) using intensity-based DIR alone.The proposed hybrid biomechanical modeling intensity based algorithm is a promising DIR technique which could be used in various IGI procedures. The current investigation shows the efficacy of this approach for the registration of 4DCT images of the lungs with average accuracy of 1.5

  15. Lower limb biomechanics in femoroacetabular impingement syndrome: a systematic review and meta-analysis.

    Science.gov (United States)

    King, Matthew G; Lawrenson, Peter R; Semciw, Adam I; Middleton, Kane J; Crossley, Kay M

    2018-05-01

    (1) Identify differences in hip and pelvic biomechanics in patients with femoroacetabular impingement syndrome (FAIS) compared with controls during everyday activities (eg, walking, squatting); and (2) evaluate the effects of interventions on hip and pelvic biomechanics during everyday activities. Systematic review. Medline, CINAHL, EMBASE, Scopus and SPORTDiscus until February 2017. Primary aim: studies that investigated hip or pelvic kinematics and/or joint torques of everyday activities in patients with FAIS compared with the asymptomatic contralateral limb or a control group. Secondary aim: studies that evaluated effects of conservative or surgical interventions on patients with FAIS using pre-post or controlled clinical trial designs. Biomechanical data must have been collected using three-dimensional motion capture devices. Reporting quality was assessed using the Epidemiological Appraisal Instrument and data were pooled (standardised mean difference (SMD), 95% CI) where populations and primary outcomes were similar. Fourteen studies were included (11 cross-sectional and three pre/post intervention), varying between low and moderate reporting quality. Patients with FAIS walked with a lower: peak hip extension angle (SMD -0.40, 95% CI -0.71 to -0.09), peak internal rotation angle (-0.67, 95% CI -1.19 to -0.16) and external rotation joint torque (-0.71, 95% CI -1.07 to -0.35), and squatted to a lesser depth with no difference in hip flexion range. Pre/post intervention data were limited in number and quality, and to surgical cohorts. This review suggests that patients with FAIS may demonstrate hip biomechanical impairments during walking and squatting, with minimal literature available to comment on other tasks. The information presented in the review provides insight into the biomechanical differences associated with FAIS; however, the between-group differences were small to moderate. This information may aid in the development of management strategies for

  16. Teaching undergraduate biomechanics with Just-in-Time Teaching.

    Science.gov (United States)

    Riskowski, Jody L

    2015-06-01

    Biomechanics education is a vital component of kinesiology, sports medicine, and physical education, as well as for many biomedical engineering and bioengineering undergraduate programmes. Little research exists regarding effective teaching strategies for biomechanics. However, prior work suggests that student learning in undergraduate physics courses has been aided by using the Just-in-Time Teaching (JiTT). As physics understanding plays a role in biomechanics understanding, the purpose of study was to evaluate the use of a JiTT framework in an undergraduate biomechanics course. This two-year action-based research study evaluated three JiTT frameworks: (1) no JiTT; (2) mathematics-based JiTT; and (3) concept-based JiTT. A pre- and post-course assessment of student learning used the biomechanics concept inventory and a biomechanics concept map. A general linear model assessed differences between the course assessments by JiTT framework in order to evaluate learning and teaching effectiveness. The results indicated significantly higher learning gains and better conceptual understanding in a concept-based JiTT course, relative to a mathematics-based JiTT or no JiTT course structure. These results suggest that a course structure involving concept-based questions using a JiTT strategy may be an effective method for engaging undergraduate students and promoting learning in biomechanics courses.

  17. Artificial intelligence in sports biomechanics: new dawn or false hope?

    Science.gov (United States)

    Bartlett, Roger

    2006-12-15

    This article reviews developments in the use of Artificial Intelligence (AI) in sports biomechanics over the last decade. It outlines possible uses of Expert Systems as diagnostic tools for evaluating faults in sports movements ('techniques') and presents some example knowledge rules for such an expert system. It then compares the analysis of sports techniques, in which Expert Systems have found little place to date, with gait analysis, in which they are routinely used. Consideration is then given to the use of Artificial Neural Networks (ANNs) in sports biomechanics, focusing on Kohonen self-organizing maps, which have been the most widely used in technique analysis, and multi-layer networks, which have been far more widely used in biomechanics in general. Examples of the use of ANNs in sports biomechanics are presented for javelin and discus throwing, shot putting and football kicking. I also present an example of the use of Evolutionary Computation in movement optimization in the soccer throw in, which predicted an optimal technique close to that in the coaching literature. After briefly overviewing the use of AI in both sports science and biomechanics in general, the article concludes with some speculations about future uses of AI in sports biomechanics. Key PointsExpert Systems remain almost unused in sports biomechanics, unlike in the similar discipline of gait analysis.Artificial Neural Networks, particularly Kohonen Maps, have been used, although their full value remains unclear.Other AI applications, including Evolutionary Computation, have received little attention.

  18. A risk scoring model based on vital signs and laboratory data predicting transfer to the intensive care unit of patients admitted to gastroenterology wards.

    Science.gov (United States)

    Kim, Won-Young; Lee, Jinmi; Lee, Ju-Ry; Jung, Youn Kyung; Kim, Hwa Jung; Huh, Jin Won; Lim, Chae-Man; Koh, Younsuck; Hong, Sang-Bum

    2017-08-01

    To compare the ability of a score based on vital signs and laboratory data with that of the modified early warning score (MEWS) to predict ICU transfer of patients with gastrointestinal disorders. Consecutive events triggering medical emergency team activation in adult patients admitted to the gastroenterology wards of the Asan Medical Center were reviewed. Binary logistic regression was used to identify factors predicting transfer to the ICU. Gastrointestinal early warning score (EWS-GI) was calculated as the sum of simplified regression weights (SRW). Of the 1219 included patients, 468 (38%) were transferred to the ICU. Multivariate analysis identified heart rate≥105bpm (SRW 1), respiratory rate≥26bpm (SRW 2), ACDU (Alert, Confused, Drowsy, Unresponsive) score≥1 (SRW 2), SpO 2 /FiO 2 ratiogastroenterology wards. The EWS-GI should be prospectively validated. Copyright © 2017 Elsevier Inc. All rights reserved.

  19. Role of biomechanics in the understanding of normal, injured, and healing ligaments and tendons

    Directory of Open Access Journals (Sweden)

    Jung Ho-Joong

    2009-05-01

    Full Text Available Abstract Ligaments and tendons are soft connective tissues which serve essential roles for biomechanical function of the musculoskeletal system by stabilizing and guiding the motion of diarthrodial joints. Nevertheless, these tissues are frequently injured due to repetition and overuse as well as quick cutting motions that involve acceleration and deceleration. These injuries often upset this balance between mobility and stability of the joint which causes damage to other soft tissues manifested as pain and other morbidity, such as osteoarthritis. The healing of ligament and tendon injuries varies from tissue to tissue. Tendinopathies are ubiquitous and can take up to 12 months for the pain to subside before one could return to normal activity. A ruptured medial collateral ligament (MCL can generally heal spontaneously; however, its remodeling process takes years and its biomechanical properties remain inferior when compared to the normal MCL. It is also known that a midsubstance anterior cruciate ligament (ACL tear has limited healing capability, and reconstruction by soft tissue grafts has been regularly performed to regain knee function. However, long term follow-up studies have revealed that 20–25% of patients experience unsatisfactory results. Thus, a better understanding of the function of ligaments and tendons, together with knowledge on their healing potential, may help investigators to develop novel strategies to accelerate and improve the healing process of ligaments and tendons. With thousands of new papers published in the last ten years that involve biomechanics of ligaments and tendons, there is an increasing appreciation of this subject area. Such attention has positively impacted clinical practice. On the other hand, biomechanical data are complex in nature, and there is a danger of misinterpreting them. Thus, in these review, we will provide the readers with a brief overview of ligaments and tendons and refer them to

  20. Role of biomechanics in the understanding of normal, injured, and healing ligaments and tendons

    Science.gov (United States)

    Jung, Ho-Joong; Fisher, Matthew B; Woo, Savio L-Y

    2009-01-01

    Ligaments and tendons are soft connective tissues which serve essential roles for biomechanical function of the musculoskeletal system by stabilizing and guiding the motion of diarthrodial joints. Nevertheless, these tissues are frequently injured due to repetition and overuse as well as quick cutting motions that involve acceleration and deceleration. These injuries often upset this balance between mobility and stability of the joint which causes damage to other soft tissues manifested as pain and other morbidity, such as osteoarthritis. The healing of ligament and tendon injuries varies from tissue to tissue. Tendinopathies are ubiquitous and can take up to 12 months for the pain to subside before one could return to normal activity. A ruptured medial collateral ligament (MCL) can generally heal spontaneously; however, its remodeling process takes years and its biomechanical properties remain inferior when compared to the normal MCL. It is also known that a midsubstance anterior cruciate ligament (ACL) tear has limited healing capability, and reconstruction by soft tissue grafts has been regularly performed to regain knee function. However, long term follow-up studies have revealed that 20–25% of patients experience unsatisfactory results. Thus, a better understanding of the function of ligaments and tendons, together with knowledge on their healing potential, may help investigators to develop novel strategies to accelerate and improve the healing process of ligaments and tendons. With thousands of new papers published in the last ten years that involve biomechanics of ligaments and tendons, there is an increasing appreciation of this subject area. Such attention has positively impacted clinical practice. On the other hand, biomechanical data are complex in nature, and there is a danger of misinterpreting them. Thus, in these review, we will provide the readers with a brief overview of ligaments and tendons and refer them to appropriate methodologies used to

  1. Analysis of expiration gas in intensive care patients with SIRS/sepsis using proton-transfer-reaction-mass-spectrometry

    International Nuclear Information System (INIS)

    Bodrogi, F.B.M.

    2003-11-01

    In 1971, Pauling and co-workers were the first to detect volatile organic compounds (VOC) in human breath. Since then, a number of technical applications for breath gas analyses have been designed and processed, among them gas chromatography and proton transfer reaction-mass spectrometry (PTR-MS). Due to this technical progress it is meanwhile possible to correlate different kinds and stages of diseases with measurable changes in the patient's VOC profile. The aim of the present study was to investigate the composition of VOC in exhaled air of patients with sepsis via PTR-MS. To isolate distinct volatile organic compounds that may serve as clinical markers for the onset, the progress, as well as the outcome of the disease, the results obtained from septic patients were compared with two different control groups: 25 healthy, non-smoking volunteers enrolled in the day-case-surgery and 25 post-operative in-patients residing in post-anaesthetic care units (PACU). PTR-MS is capable to analyze VOC according to their molecular weight with a range between 21-230 Da. A total of 210 different masses has been detected in the present study. 54 masses were significantly different in exhaled air of septic patients as compared to healthy controls as well as post-operative patients. Among them, mass 69 representing isoprene might be of special interest for the diagnosis of sepsis. Although no exact biochemical properties of isoprene have been described to date, it is known that isoprene synthesis is increased in plants following exposure to oxidative stress. Chronic, systemic infectious diseases like sepsis are accompanied by the production of reactive oxygen species, indicating that isoprene might be increased in the course of sepsis, too. In the present study, isoprene values were markedly higher in septic patients as compared to PACU residents (3.3-fold increase in mean value) and to healthy volunteers (2.2-fold increase in mean value). In addition (and in contrast to other VOC

  2. The role of biomechanics in maximising distance and accuracy of golf shots.

    Science.gov (United States)

    Hume, Patria A; Keogh, Justin; Reid, Duncan

    2005-01-01

    Golf biomechanics applies the principles and technique of mechanics to the structure and function of the golfer in an effort to improve golf technique and performance. A common recommendation for technical correction is maintaining a single fixed centre hub of rotation with a two-lever one-hinge moment arm to impart force on the ball. The primary and secondary spinal angles are important for conservation of angular momentum using the kinetic link principle to generate high club-head velocity. When the golfer wants to maximise the distance of their drives, relatively large ground reaction forces (GRF) need to be produced. However, during the backswing, a greater proportion of the GRF will be observed on the back foot, with transfer of the GRF on to the front foot during the downswing/acceleration phase. Rapidly stretching hip, trunk and upper limb muscles during the backswing, maximising the X-factor early in the downswing, and uncocking the wrists when the lead arm is about 30 degrees below the horizontal will take advantage of the summation of force principle. This will help generate large angular velocity of the club head, and ultimately ball displacement. Physical conditioning will help to recruit the muscles in the correct sequence and to optimum effect. To maximise the accuracy of chipping and putting shots, the golfer should produce a lower grip on the club and a slower/shorter backswing. Consistent patterns of shoulder and wrist movements and temporal patterning result in successful chip shots. Qualitative and quantitative methods are used to biomechanically assess golf techniques. Two- and three-dimensional videography, force plate analysis and electromyography techniques have been employed. The common golf biomechanics principles necessary to understand golf technique are stability, Newton's laws of motion (inertia, acceleration, action reaction), lever arms, conservation of angular momentum, projectiles, the kinetic link principle and the stretch

  3. Integrated genomic and interfacility patient-transfer data reveal the transmission pathways of multidrug-resistant Klebsiella pneumoniae in a regional outbreak.

    Science.gov (United States)

    Snitkin, Evan S; Won, Sarah; Pirani, Ali; Lapp, Zena; Weinstein, Robert A; Lolans, Karen; Hayden, Mary K

    2017-11-22

    Development of effective strategies to limit the proliferation of multidrug-resistant organisms requires a thorough understanding of how such organisms spread among health care facilities. We sought to uncover the chains of transmission underlying a 2008 U.S. regional outbreak of carbapenem-resistant Klebsiella pneumoniae by performing an integrated analysis of genomic and interfacility patient-transfer data. Genomic analysis yielded a high-resolution transmission network that assigned directionality to regional transmission events and discriminated between intra- and interfacility transmission when epidemiologic data were ambiguous or misleading. Examining the genomic transmission network in the context of interfacility patient transfers (patient-sharing networks) supported the role of patient transfers in driving the outbreak, with genomic analysis revealing that a small subset of patient-transfer events was sufficient to explain regional spread. Further integration of the genomic and patient-sharing networks identified one nursing home as an important bridge facility early in the outbreak-a role that was not apparent from analysis of genomic or patient-transfer data alone. Last, we found that when simulating a real-time regional outbreak, our methodology was able to accurately infer the facility at which patients acquired their infections. This approach has the potential to identify facilities with high rates of intra- or interfacility transmission, data that will be useful for triggering targeted interventions to prevent further spread of multidrug-resistant organisms. Copyright © 2017 The Authors, some rights reserved; exclusive licensee American Association for the Advancement of Science. No claim to original U.S. Government Works.

  4. Biomechanical ToolKit: Open-source framework to visualize and process biomechanical data.

    Science.gov (United States)

    Barre, Arnaud; Armand, Stéphane

    2014-04-01

    C3D file format is widely used in the biomechanical field by companies and laboratories to store motion capture systems data. However, few software packages can visualize and modify the integrality of the data in the C3D file. Our objective was to develop an open-source and multi-platform framework to read, write, modify and visualize data from any motion analysis systems using standard (C3D) and proprietary file formats (used by many companies producing motion capture systems). The Biomechanical ToolKit (BTK) was developed to provide cost-effective and efficient tools for the biomechanical community to easily deal with motion analysis data. A large panel of operations is available to read, modify and process data through C++ API, bindings for high-level languages (Matlab, Octave, and Python), and standalone application (Mokka). All these tools are open-source and cross-platform and run on all major operating systems (Windows, Linux, MacOS X). Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  5. Simulator-based crew resource management training for interhospital transfer of critically ill patients by a mobile ICU.

    Science.gov (United States)

    Droogh, Joep M; Kruger, Hanneke L; Ligtenberg, Jack J M; Zijlstra, Jan G

    2012-12-01

    Transporting critically ill ICU patients by standard ambulances, with or without an accompanying physician, imposes safety risks. In 2007 the Dutch Ministry of Public Health required that all critically ill patients transferred between ICUs in different hospitals be transported by a mobile ICU (MICU). Since March 2009 a specially designed MICU and a retrieval team have served the region near University Medical Center Groningen, in the northeastern region of the Netherlands. The MICU transport program includes simulator-based crew resource management (CRM) training for the intensivists and ICU nurses, who, with the drivers, constitute the MICU crews. Training entails five pivotal aspects: (1) preparation, (2) teamwork, (3) new equipment, (4) mobility, and (5) safety. For example, the training accustoms participants to working in the narrow, moving ambulance and without benefit of additional manpower. The scenario-based team training, which takes about four hours, occurs in a training facility, with its reconstructed ICU, and then in the MICU itself. A "wireless" patient simulator that is able to mimic hemodynamic and respiratory patterns and to simulate lung and heart sounds is used. All scenarios can be adjusted to simulate medical, logistic, or technical problems. Since the start of MICU training in 2009, more than 70 training sessions, involving 100 team members, have been conducted. Quality issues identified include failure to anticipate possible problems (such as failing to ask for intubation of a respiratory-compromised patient at intake); late responses to alarms of the ventilator, perfusor pump, or monitor; and not anticipating a possible shortage of medication. Setting up and implementing simulator-based CRM training provides feasible and helpful preparation for an MICU team.

  6. Clinical effectiveness of elective single versus double embryo transfer: meta-analysis of individual patient data from randomised trials

    NARCIS (Netherlands)

    McLernon, D. J.; Harrild, K.; Bergh, C.; Davies, M. J.; de Neubourg, D.; Dumoulin, J. C. M.; Gerris, J.; Kremer, J. A. M.; Martikainen, H.; Mol, B. W.; Norman, R. J.; Thurin-Kjellberg, A.; Tiitinen, A.; van Montfoort, A. P. A.; van Peperstraten, A. M.; van Royen, E.; Bhattacharya, S.

    2010-01-01

    Objective To compare the effectiveness of elective single embryo transfer versus double embryo transfer on the outcomes of live birth, multiple live birth, miscarriage, preterm birth, term singleton birth, and low birth weight after fresh embryo transfer, and on the outcomes of cumulative live birth

  7. The use of clinical analysis of movements in evaluation of motor functional status of patients after total hip replacement

    Directory of Open Access Journals (Sweden)

    Romakina N.A.

    2016-06-01

    Full Text Available Aim: to estimate functional status of coxarthrosis in patients requiring total hip replacement of the two hip joints. Material and methods. The biomechanical examination of 94 patients with bilateral primary coxarthrosis before and after total hip replacement was performed using clinical stabilometric software complex. The ability to perceive the mechanical load during standing and walking was evaluated at different stages of the treatment. The difference between the samples was estimated with the use of Mann — Whitney U-test. The rank correlation of biomechanical parameters was measured by Spearman coefficient. Results. It was revealed that the most responsive indicators are the transfer period, the first and second periods of double support and the deviation of the center of pressure relative to the average position in the frontal plane. Conclusion. After surgical treatment there was observed some improvement: the-left-and-right-step asymmetry decrease, rhythm rate increase, improved ability to maintain body balance, jog reactions increase.

  8. Research in biomechanics of occupant protection.

    Science.gov (United States)

    King, A I; Yang, K H

    1995-04-01

    This paper discusses the biomechanical bases for occupant protection against frontal and side impact. Newton's Laws of Motion are used to illustrate the effect of a crash on restrained and unrestrained occupants, and the concept of ride down is discussed. Occupant protection through the use of energy absorbing materials is described, and the mechanism of injury of some of the more common injuries is explained. The role of the three-point belt and the airbag in frontal protection is discussed along with the potential injuries that can result from the use of these restraint systems. Side impact protection is more difficult to attain but some protection can be derived from the use of padding or a side impact airbag. It is concluded that the front seat occupants are adequately protected against frontal impact if belts are worn in an airbag equipped vehicle. Side impact protection may not be uniform in all vehicles.

  9. Patellofemoral anatomy and biomechanics: current concepts

    Science.gov (United States)

    ZAFFAGNINI, STEFANO; DEJOUR, DAVID; GRASSI, ALBERTO; BONANZINGA, TOMMASO; MUCCIOLI, GIULIO MARIA MARCHEGGIANI; COLLE, FRANCESCA; RAGGI, FEDERICO; BENZI, ANDREA; MARCACCI, MAURILIO

    2013-01-01

    The patellofemoral joint, due to its particular bone anatomy and the numerous capsuloligamentous structures and muscles that act dynamically on the patella, is considered one of the most complex joints in the human body from the biomechanical point of view. The medial patellofemoral ligament (MPFL) has been demonstrated to contribute 60% of the force that opposes lateral displacement of the patella, and MPFL injury results in an approximately 50% reduction in the force needed to dislocate the patella laterally with the knee extended. For this reason, recent years have seen a growing interest in the study of this important anatomical structure, whose aponeurotic nature has thus been demonstrated. The MPFL acts as a restraint during motion, playing an active role under conditions of laterally applied stress, but an only marginal role during natural knee flexion. However, it remains extremely difficult to clearly define the anatomy of the MPFL and its relationships with other anatomical structures. PMID:25606512

  10. Integrative Role Of Cinematography In Biomechanics Research

    Science.gov (United States)

    Zernicke, Ronald F.; Gregor, Robert J.

    1982-02-01

    Cinematography is an integral element in the interdisciplinary biomechanics research conducted in the Department of Kinesiology at the University of California, Los Angeles. For either an isolated recording of a movement phenomenon or as a recording component which is synchronized with additional transducers and recording equipment, high speed motion picture film has been effectively incorporated into resr'arch projects ranging from two and three dimensional analyses of human movements, locomotor mechanics of cursorial mammals and primates, to the structural responses and dynamic geometries of skeletal muscles, tendons, and ligaments. The basic equipment used in these studies includes three, 16 mm high speed, pin-registered cameras which have the capacity for electronic phase-locking. Crystal oscillators provide the generator pulses to synchronize the timing lights of the cameras and the analog-to-digital recording equipment. A rear-projection system with a sonic digitizer permits quantification of film coordinates which are stored on computer disks. The capacity for synchronizing the high speed films with additional recording equipment provides an effective means of obtaining not only position-time data from film, but also electromyographic, force platform, tendon force transducer, and strain gauge recordings from tissues or moving organisms. During the past few years, biomechanics research which comprised human studies has used both planar and three-dimensional cinematographic techniques. The studies included planar analyses which range from the gait characteristics of lower extremity child amputees to the running kinematics and kinetics of highly skilled sprinters and long-distance runners. The dynamics of race cycling and kinetics of gymnastic maneuvers were studied with cinematography and either a multi-dimensional force platform or a bicycle pedal with strain gauges to determine the time histories of the applied forces. The three-dimensional technique

  11. Biomechanics trends in modeling and simulation

    CERN Document Server

    Ogden, Ray

    2017-01-01

    The book presents a state-of-the-art overview of biomechanical and mechanobiological modeling and simulation of soft biological tissues. Seven well-known scientists working in that particular field discuss topics such as biomolecules, networks and cells as well as failure, multi-scale, agent-based, bio-chemo-mechanical and finite element models appropriate for computational analysis. Applications include arteries, the heart, vascular stents and valve implants as well as adipose, brain, collagenous and engineered tissues. The mechanics of the whole cell and sub-cellular components as well as the extracellular matrix structure and mechanotransduction are described. In particular, the formation and remodeling of stress fibers, cytoskeletal contractility, cell adhesion and the mechanical regulation of fibroblast migration in healing myocardial infarcts are discussed. The essential ingredients of continuum mechanics are provided. Constitutive models of fiber-reinforced materials with an emphasis on arterial walls ...

  12. A magnetization transfer imaging study of bilateral optic radiation and visual cortex in patients with primary glaucoma

    International Nuclear Information System (INIS)

    Liang Wenwen; Zhang Xuelin; Jiang Xiaoyong; Xu Yongming; Yang Zhihui; Zhang Yan; Chang Renmin; Wang Jianping; Wu Guijun

    2012-01-01

    Objective: To analyse the changes in bilateral optic radiation and visual cortex in patients with primary glaucoma detected by magnetization transfer imaging (MTI), and try to explore the influence of the disease on posterior visual pathway. Methods: MTI was performed in 20 patients with primary glaucoma with normal signal on conventional magnetic resonance imaging (MRI). The same scanning was performed in 31 matched healthy controls. MTI was obtained using spoiled gradient recalled acquisition sequence (SPGR). Magnetization transfer ratio (MTR) of bilateral optic radiation and visual cortex was measured after post-processing. The MTR value differences of the same area between two groups were compared by independent-sample t test or Satterthwaite t test if variances were not equality. Result: The MTR value in the left and right optic radiation were (32.8 ± 2.2)% and (32.7 ± 2.0)% in the glaucoma group, (34.6 ± 1.4 )% and (34.8 ± 1.3)% in the control group. There was a statistically significant difference between the two groups (left t=3.284, right t=4.040; P<0.01). The MTR value of the left and right visual cortex were (30.1± 2.0)% and (30.8 ± 1.8)% in the glaucoma group, and (32.3 ± 1.2 )% and (32.4 ± 1.2)% in the control group. Statistically significant difference was found between the two groups (left t=4.319, right t=3.445; P<0.01). Conclusions: Potential neuropathology changes occurring in the posterior visual pathway of patients with glaucoma indicate that the whole visual pathway may be involved by glaucoma.The micro physiological changes can be detected by MTI which can not be found by conventional MRI. It is a useful method of studying trans-synaptic damage of visual pathway n vivo glaucoma which provides more information for guiding the clinic diagnosis, cure and prognosis of glaucoma. (authors)

  13. Diaphragmatic reinnervation in ventilator-dependent patients with cervical spinal cord injury and concomitant phrenic nerve lesions using simultaneous nerve transfers and implantable neurostimulators.

    Science.gov (United States)

    Kaufman, Matthew R; Elkwood, Andrew I; Aboharb, Farid; Cece, John; Brown, David; Rezzadeh, Kameron; Jarrahy, Reza

    2015-06-01

    Patients who are ventilator dependent as a result of combined cervical spinal cord injury and phrenic nerve lesions are generally considered to be unsuitable candidates for diaphragmatic pacing due to loss of phrenic nerve integrity and denervation of the diaphragm. There is limited data regarding efficacy of simultaneous nerve transfers and diaphragmatic pacemakers in the treatment of this patient population. A retrospective review was conducted of 14 consecutive patients with combined lesions of the cervical spinal cord and phrenic nerves, and with complete ventilator dependence, who were treated with simultaneous microsurgical nerve transfer and implantation of diaphragmatic pacemakers. Parameters of interest included time to recovery of diaphragm electromyographic activity, average time pacing without the ventilator, and percent reduction in ventilator dependence. Recovery of diaphragm electromyographic activity was demonstrated in 13 of 14 (93%) patients. Eight of these 13 (62%) patients achieved sustainable periods (> 1 h/d) of ventilator weaning (mean = 10 h/d [n = 8]). Two patients recovered voluntary control of diaphragmatic activity and regained the capacity for spontaneous respiration. The one patient who did not exhibit diaphragmatic reinnervation remains within 12 months of initial treatment. Surgical intervention resulted in a 25% reduction (p nerve transfers and pacemaker implantation can result in reinnervation of the diaphragm and lead to successful ventilator weaning. Our favorable outcomes support consideration of this surgical method for appropriate patients who would otherwise have no alternative therapy to achieve sustained periods of ventilator independence. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

  14. A biomechanical model of mammographic compressions.

    Science.gov (United States)

    Chung, J H; Rajagopal, V; Nielsen, P M F; Nash, M P

    2008-02-01

    A number of biomechanical models have been proposed to improve nonrigid registration techniques for multimodal breast image alignment. A deformable breast model may also be useful for overcoming difficulties in interpreting 2D X-ray projections (mammograms) of 3D volumes (breast tissues). If a deformable model could accurately predict the shape changes that breasts undergo during mammography, then the model could serve to localize suspicious masses (visible in mammograms) in the unloaded state, or in any other deformed state required for further investigations (such as biopsy or other medical imaging modalities). In this paper, we present a validation study that was conducted in order to develop a biomechanical model based on the well-established theory of continuum mechanics (finite elasticity theory with contact mechanics) and demonstrate its use for this application. Experimental studies using gel phantoms were conducted to test the accuracy in predicting mammographic-like deformations. The material properties of the gel phantom were estimated using a nonlinear optimization process, which minimized the errors between the experimental and the model-predicted surface data by adjusting the parameter associated with the neo-Hookean constitutive relation. Two compressions (the equivalent of cranio-caudal and medio-lateral mammograms) were performed on the phantom, and the corresponding deformations were recorded using a MRI scanner. Finite element simulations were performed to mimic the experiments using the estimated material properties with appropriate boundary conditions. The simulation results matched the experimental recordings of the deformed phantom, with a sub-millimeter root-mean-square error for each compression state. Having now validated our finite element model of breast compression, the next stage is to apply the model to clinical images.

  15. WorldSID Prototype Dummy Biomechanical Responses.

    Science.gov (United States)

    Cesari, D; Compigne, S; Scherer, R; Xu, L; Takahashi, N; Page, M; Asakawa, K; Kostyniuk, G; Hautmann, E; Bortenschlager, K; Sakurai, M; Harigae, T

    2001-11-01

    The results of biomechanical testing of the WorldSID prototype dummy are presented in this paper. The WorldSID dummy is a new, advanced Worldwide Side Impact Dummy that has the anthropometry of a mid-sized adult male. The first prototype of this dummy has been evaluated by the WorldSID Task Group against previously established corridors for its critical body regions. The response corridors are defined in the International Organization of Standardization (ISO) Technical Report 9790. The prototype is the first version of the WorldSID dummy to be built and tested. This dummy has been subjected to a rigorous program of testing to evaluate, first and foremost its biofidelity, but also its repeatability. Following this initial evaluation, any required modifications will be incorporated into a pre-production version of the WorldSID dummy so that it rates "good" to "excellent" on the ISO dummy biofidelity scale - a rating exceeding that of all current side impact dummies. Also, the overall WorldSID repeatability must not exceed a coefficient of variation of 7% at injury assessment level and this has to be verified for the different body regions. The dummy's head, neck, thorax, abdomen and pelvis were evaluated against the ISO technical report requirements. Testing included drop tests, pendulum impacts, and sled tests. The biofidelity rating of the WorldSID prototype was calculated using the weighted biomechanical test response procedure developed by ISO. The paper presents the results of the testing, which give a very positive indication of the dummy's potential. Based on this evaluation of the dummy biofidelity, the WorldSID prototype dummy exhibits a biofidelity rating of 6.15 that corresponds to an ISO biofidelity classification of "fair". In addition, the dummy shows good repeatability with a global coefficient of variation of 3.30% for the pendulum and rigid sled tests.

  16. Biomechanical implications of walking with indigenous footwear.

    Science.gov (United States)

    Willems, Catherine; Stassijns, Gaetane; Cornelis, Wim; D'Août, Kristiaan

    2017-04-01

    This study investigates biomechanical implications of walking with indigenous "Kolhapuri" footwear compared to barefoot walking among a population of South Indians. Ten healthy adults from South India walked barefoot and indigenously shod at voluntary speed on an artificial substrate. The experiment was repeated outside, on a natural substrate. Data were collected from (1) a heel-mounted 3D-accelerometer recording peak impact at heel contact, (2) an ankle-mounted 3D-goniometer (plantar/dorsiflexion and inversion/eversion), and (3) sEMG electrodes at the m. tibialis anterior and the m. gastrocnemius medialis. Data show that the effect of indigenous footwear on the measured variables, compared to barefoot walking, is relatively small and consistent between substrates (even though subjects walked faster on the natural substrate). Walking barefoot, compared to shod walking yields higher impact accelerations, but the differences are small and only significant for the artificial substrate. The main rotations of the ankle joint are mostly similar between conditions. Only the shod condition shows a faster ankle rotation over the rapid eversion motion on the natural substrate. Maximal dorsiflexion in late stance differs between the footwear conditions on an artificial substrate, with the shod condition involving a less dorsiflexed ankle, and the plantar flexion at toe-off is more extreme when shod. Overall the activity pattern of the external foot muscles is similar. The indigenous footwear studied (Kolhapuri) seems to alter foot biomechanics only in a subtle way. While offering some degree of protection, walking in this type of footwear resembles barefoot gait and this type of indigenous footwear might be considered "minimal". © 2017 The Authors American Journal of Physical Anthropology Published by Wiley Periodicals, Inc.

  17. Application of Corvis ST to evaluate the effect of femtosecond laser-assisted cataract surgery on corneal biomechanics.

    Science.gov (United States)

    Wei, Yinjuan; Xu, Lingxiao; Song, Hui

    2017-08-01

    The aim of the present study was to evaluate the effects of femtosecond laser-assisted cataract surgery (FLACS) and phacoemulsification on corneal biomechanics using corneal visualization Scheimpflug technology. The medical records of 50 eyes from 50 patients who received phacoemulsification and intraocular lens implantation because of age-related factors between June 2014 and September 2014 were retrospectively analyzed. FLACS was used in 12 eyes (FLACS group), and conventional phacoemulsification in 38 eyes (PHACO group). The evaluation of corneal biomechanical parameters included the first/second applanation time (A-time1/A-time2), the first/second applanation length (A-length1/A-length2), corneal velocity during the first/second applanation moment (Vin/Vout), highest concavity time, highest concavity-radius (HC-radius), peak distance (PD), deformation amplitude (DA), central corneal thickness (CCT), and intraocular pressure (IOP). The differences in A-length1/A-length2, IOP, CCT, PD, and DA were significant in the PHACO group between those before, 1 week after, and 1 month after surgery. No significant differences in corneal biomechanical parameters were found between those at 1 month after surgery and before surgery. There were significant differences in IOP and CCT in the FLACS group between those before, 1 week after, and 1 month after surgery. There were no significant differences in the other corneal biomechanical parameters. No significant differences were found in corneal biomechanical parameters between those 1 month after surgery and before surgery. There were significant differences in A-length1/A-length2, CCT, PD, and DA between the two groups at 1 week after surgery. There were no significant differences in corneal biomechanical parameters between the two groups at 1 month after surgery. In conclusion, the effect of FLACS on corneal biomechanics is smaller than that of phacoemulsification. The corneal biomechanical parameters are restored to

  18. Biomechanics of unilateral and bilateral sacroiliac joint stabilization: laboratory investigation.

    Science.gov (United States)

    Lindsey, Derek P; Parrish, Robin; Gundanna, Mukund; Leasure, Jeremi; Yerby, Scott A; Kondrashov, Dimitriy

    2018-03-01

    OBJECTIVE Bilateral symptoms have been reported in 8%-35% of patients with sacroiliac (SI) joint dysfunction. Stabilization of a single SI joint may significantly alter the stresses on the contralateral SI joint. If the contralateral SI joint stresses are significantly increased, degeneration may occur; alternatively, if the stresses are significantly reduced, bilateral stabilization may be unnecessary for patients with bilateral symptoms. The biomechanical effects of 1) unilateral stabilization on the contralateral SI joint and 2) bilateral stabilization on both SI joints are currently unknown. The objectives of this study were to characterize bilateral SI joint range of motion (ROM) and evaluate and compare the biomechanical effects of unilateral and bilateral implant placement for SI joint fusion. METHODS A lumbopelvic model (L5-pelvis) was used to test the ROM of both SI joints in 8 cadavers. A single-leg stance setup was used to load the lumbar spine and measure the ROM of each SI joint in flexion-extension, lateral bending, and axial rotation. Both joints were tested 1) while intact, 2) after unilateral stabilization, and 3) after bilateral stabilization. Stabilization consisted of lateral transiliac placement of 3 triangular titanium plasma-sprayed (TPS) implants. RESULTS Intact testing showed that during single-leg stance the contralateral SI joint had less ROM in flexion-extension (27%), lateral bending (32%), and axial rotation (69%) than the loaded joint. Unilateral stabilization resulted in significant reduction of flexion-extension ROM (46%) on the treated side; no significant ROM changes were observed for the nontreated side. Bilateral stabilization resulted in significant reduction of flexion-extension ROM of the primary (45%) and secondary (75%) SI joints. CONCLUSIONS This study demonstrated that during single-leg loading the ROMs for the stance (loaded) and swing (unloaded) SI joints are significantly different. Unilateral stabilization for SI

  19. Surgical options for lumbosacral fusion: biomechanical stability, advantage, disadvantage and affecting factors in selecting options.

    Science.gov (United States)

    Yoshihara, Hiroyuki

    2014-07-01

    Numerous surgical procedures and instrumentation techniques for lumbosacral fusion (LSF) have been developed. This is probably because of its high mechanical demand and unique anatomy. Surgical options include anterior column support (ACS) and posterior stabilization procedures. Biomechanical studies have been performed to verify the stability of those options. The options have their own advantage but also disadvantage aspects. This review article reports the surgical options for lumbosacral fusion, their biomechanical stability, advantages/disadvantages, and affecting factors in option selection. Review of literature. LSF has lots of options both for ACS and posterior stabilization procedures. Combination of posterior stabilization procedures is an option. Furthermore, combinations of ACS and posterior stabilization procedures are other options. It is difficult to make a recommendation or treatment algorithm of LSF from the current literature. However, it is important to know all aspects of the options and decision-making of surgical options for LSF needs to be tailored for each patient, considering factors such as biomechanical stress and osteoporosis.

  20. Biomechanical rupture risk assessment of abdominal aortic aneurysms based on a novel probabilistic rupture risk index.

    Science.gov (United States)

    Polzer, Stanislav; Gasser, T Christian

    2015-12-06

    A rupture risk assessment is critical to the clinical treatment of abdominal aortic aneurysm (AAA) patients. The biomechanical AAA rupture risk assessment quantitatively integrates many known AAA rupture risk factors but the variability of risk predictions due to model input uncertainties remains a challenging limitation. This study derives a probabilistic rupture risk index (PRRI). Specifically, the uncertainties in AAA wall thickness and wall strength were considered, and wall stress was predicted with a state-of-the-art deterministic biomechanical model. The discriminative power of PRRI was tested in a diameter-matched cohort of ruptured (n = 7) and intact (n = 7) AAAs and compared to alternative risk assessment methods. Computed PRRI at 1.5 mean arterial pressure was significantly (p = 0.041) higher in ruptured AAAs (20.21(s.d. 14.15%)) than in intact AAAs (3.71(s.d. 5.77)%). PRRI showed a high sensitivity and specificity (discriminative power of 0.837) to discriminate between ruptured and intact AAA cases. The underlying statistical representation of stochastic data of wall thickness, wall strength and peak wall stress had only negligible effects on PRRI computations. Uncertainties in AAA wall stress predictions, the wide range of reported wall strength and the stochastic nature of failure motivate a probabilistic rupture risk assessment. Advanced AAA biomechanical modelling paired with a probabilistic rupture index definition as known from engineering risk assessment seems to be superior to a purely deterministic approach. © 2015 The Author(s).

  1. Biomechanical analysis of clavicle hook plate implantation with different hook angles in the acromioclavicular joint.

    Science.gov (United States)

    Hung, Li-Kun; Su, Kuo-Chih; Lu, Wen-Hsien; Lee, Cheng-Hung

    2017-08-01

    A clavicle hook plate is a simple and effective method for treating acromioclavicular dislocation and distal clavicle fractures. However, subacromial osteolysis and peri-implant fractures are complicated for surgeons to manage. This study uses finite element analysis (FEA) to investigate the post-implantation biomechanics of clavicle hook plates with different hook angles. This FEA study constructed a model with a clavicle, acromion, clavicle hook plate, and screws to simulate the implantation of clavicle hook plates at different hook angles (90°, 95°, 100°, 105°, and 110°) for treating acromioclavicular joint dislocations. This study investigated the biomechanics of the acromion, clavicle, hook plate, and screws. A smaller hook angle increases the stress on the middle third of the clavicle. A larger hook angle increases the force exerted by the clavicle hook plate on the acromion. The screw at the most medial position on the plate generated the highest stress. The highest stress on the implanted clavicle hook plate was on the turning corner of the hook. A clavicle hook plate with different hook angles may induce different biomechanical behaviors in the clavicle and acromion. Orthopedic surgeons must select a suitable clavicle hook plate based on the anatomical structure of each patient.

  2. Identification of the contribution of contact and aerial biomechanical parameters in acrobatic performance.

    Directory of Open Access Journals (Sweden)

    Diane Haering

    Full Text Available Teaching acrobatic skills with a minimal amount of repetition is a major challenge for coaches. Biomechanical, statistical or computer simulation tools can help them identify the most determinant factors of performance. Release parameters, change in moment of inertia and segmental momentum transfers were identified in the prediction of acrobatics success. The purpose of the present study was to evaluate the relative contribution of these parameters in performance throughout expertise or optimisation based improvements. The counter movement forward in flight (CMFIF was chosen for its intrinsic dichotomy between the accessibility of its attempt and complexity of its mastery.Three repetitions of the CMFIF performed by eight novice and eight advanced female gymnasts were recorded using a motion capture system. Optimal aerial techniques that maximise rotation potential at regrasp were also computed. A 14-segment-multibody-model defined through the Rigid Body Dynamics Library was used to compute recorded and optimal kinematics, and biomechanical parameters. A stepwise multiple linear regression was used to determine the relative contribution of these parameters in novice recorded, novice optimised, advanced recorded and advanced optimised trials. Finally, fixed effects of expertise and optimisation were tested through a mixed-effects analysis.Variation in release state only contributed to performances in novice recorded trials. Moment of inertia contribution to performance increased from novice recorded, to novice optimised, advanced recorded, and advanced optimised trials. Contribution to performance of momentum transfer to the trunk during the flight prevailed in all recorded trials. Although optimisation decreased transfer contribution, momentum transfer to the arms appeared.Findings suggest that novices should be coached on both contact and aerial technique. Inversely, mainly improved aerial technique helped advanced gymnasts increase their

  3. Trunk, pelvis and hip biomechanics in individuals with femoroacetabular impingement syndrome: Strategies for step ascent.

    Science.gov (United States)

    Diamond, Laura E; Bennell, Kim L; Wrigley, Tim V; Hinman, Rana S; Hall, Michelle; O'Donnell, John; Hodges, Paul W

    2018-03-01

    Femoroacetabular impingment (FAI) syndrome is common among young active adults and a proposed risk factor for the future development of hip osteoarthritis. Pain is dominant and drives clinical decision-making. Evidence for altered hip joint function in this patient population is inconsistent, making the identification of treatment targets challenging. A broader assessment, considering adjacent body segments (i.e. pelvis, trunk) and individual movement strategies, may better inform treatment programs. This exploratory study aimed to compare trunk, pelvis, and hip biomechanics during step ascent between individuals with and without FAI syndrome. Fifteen participants diagnosed with symptomatic cam-type or combined (cam plus pincer) FAI who were scheduled for arthroscopic surgery, and 11 age-, and sex-comparable pain- and disease-free individuals, underwent three-dimensional motion analysis during a step ascent task. Trunk, pelvis and hip biomechanics were compared between groups. Participants with FAI syndrome exhibited altered ipsilateral trunk lean and pelvic rise towards the symptomatic side during single-leg support compared to controls. Alterations were not uniformly adopted across all individuals with FAI syndrome; those who exhibited more pronounced alterations to frontal plane pelvis control tended to report pain during the task. There were minimal between-group differences for hip biomechanics. Exploratory data suggest biomechanics at the trunk and pelvis during step ascent differ between individuals with and without FAI syndrome. Those with FAI syndrome implement a range of proximal strategies for task completion, some of which may have relevance for rehabilitation. Longitudinal investigations of larger cohorts are required to evaluate hypothesized clinical and structural consequences. Copyright © 2018 Elsevier B.V. All rights reserved.

  4. Assessment of corneal biomechanical parameters in myopes and emmetropes using the Corvis ST.

    Science.gov (United States)

    Lee, Rachel; Chang, Robert T; Wong, Ian Y H; Lai, Jimmy S M; Lee, Jacky W Y; Singh, Kuldev

    2016-03-01

    Prior studies have demonstrated conflicting results regarding the relationship between corneal biomechanical properties and refractive error. Thus, the purpose of this study was to compare the corneal biomechanical parameters of myopes and emmetropes. Ninety-four subjects with varying degrees of myopia (aged 29 to 74 years, spherical equivalent [SE] -0.5 to -17.5 D) and 25 emmetropes (aged 19 to 75 years, SE: -0.5 to +0.5 D) presenting at the Queen Mary Hospital, Hong Kong were recruited sequentially for this prospective study. All patients were phakic with no history of coexisting ocular disease. The corneal biomechanical parameters of the right eye of each subject were analysed using the Corvis ST non-contact tonometer. Intraocular pressure (IOP) was measured using both the Corvis ST and the Topcon Non-Contact Tonometer CT-80. Refractive error was measured by non-cycloplegic subjective and objective refractometry. High myopes (SE greater than -6.00 D) demonstrated greater mean outward applanation velocities (p < 0.001) and peak distance measurements (p = 0.009) compared to both low to moderate myopes (SE -0.50 to -6.00 D) and emmetropes. Both outward applanation velocity and peak distance were moderately correlated with refractive error (p ≤ 0.001), strongly correlated with IOP and weakly correlated with central corneal thickness. There were no statistically significant differences in age, IOP or central corneal thickness among emmetropes, low to moderate myopes or high myopes. Within this study of Chinese subjects, high myopes demonstrate greater corneal mean outward applanation velocity on Corvis ST testing, than emmetropes. In particular, those with high myopia (SE greater than -6.00 D) show a distinct corneal biomechanical profile relative to those with either emmetropia or low to moderate myopia using the Corvis ST. © 2016 Optometry Australia.

  5. Soft Tissue Biomechanical Modeling for Computer Assisted Surgery

    CERN Document Server

    2012-01-01

      This volume focuses on the biomechanical modeling of biological tissues in the context of Computer Assisted Surgery (CAS). More specifically, deformable soft tissues are addressed since they are the subject of the most recent developments in this field. The pioneering works on this CAS topic date from the 1980's, with applications in orthopaedics and biomechanical models of bones. More recently, however, biomechanical models of soft tissues have been proposed since most of the human body is made of soft organs that can be deformed by the surgical gesture. Such models are much more complicated to handle since the tissues can be subject to large deformations (non-linear geometrical framework) as well as complex stress/strain relationships (non-linear mechanical framework). Part 1 of the volume presents biomechanical models that have been developed in a CAS context and used during surgery. This is particularly new since most of the soft tissues models already proposed concern Computer Assisted Planning, with ...

  6. The increasing importance of the biomechanics of impact trauma

    Indian Academy of Sciences (India)

    Like most engineering subjects, impact biomechanics has evolved from early ... show that the primary deceleration forces acting in the majority of car ... the natural history of falls in old age' showed how the routine observations of a practicing.

  7. The Impact of Biomechanics in Tissue Engineering and Regenerative Medicine

    Science.gov (United States)

    Butler, David L.; Goldstein, Steven A.; Guo, X. Edward; Kamm, Roger; Laurencin, Cato T.; McIntire, Larry V.; Mow, Van C.; Nerem, Robert M.; Sah, Robert L.; Soslowsky, Louis J.; Spilker, Robert L.; Tranquillo, Robert T.

    2009-01-01

    Biomechanical factors profoundly influence the processes of tissue growth, development, maintenance, degeneration, and repair. Regenerative strategies to restore damaged or diseased tissues in vivo and create living tissue replacements in vitro have recently begun to harness advances in understanding of how cells and tissues sense and adapt to their mechanical environment. It is clear that biomechanical considerations will be fundamental to the successful development of clinical therapies based on principles of tissue engineering and regenerative medicine for a broad range of musculoskeletal, cardiovascular, craniofacial, skin, urinary, and neural tissues. Biomechanical stimuli may in fact hold the key to producing regenerated tissues with high strength and endurance. However, many challenges remain, particularly for tissues that function within complex and demanding mechanical environments in vivo. This paper reviews the present role and potential impact of experimental and computational biomechanics in engineering functional tissues using several illustrative examples of past successes and future grand challenges. PMID:19583462

  8. Emulating facial biomechanics using multivariate partial least squares surrogate models.

    Science.gov (United States)

    Wu, Tim; Martens, Harald; Hunter, Peter; Mithraratne, Kumar

    2014-11-01

    A detailed biomechanical model of the human face driven by a network of muscles is a useful tool in relating the muscle activities to facial deformations. However, lengthy computational times often hinder its applications in practical settings. The objective of this study is to replace precise but computationally demanding biomechanical model by a much faster multivariate meta-model (surrogate model), such that a significant speedup (to real-time interactive speed) can be achieved. Using a multilevel fractional factorial design, the parameter space of the biomechanical system was probed from a set of sample points chosen to satisfy maximal rank optimality and volume filling. The input-output relationship at these sampled points was then statistically emulated using linear and nonlinear, cross-validated, partial least squares regression models. It was demonstrated that these surrogate models can mimic facial biomechanics efficiently and reliably in real-time. Copyright © 2014 John Wiley & Sons, Ltd.

  9. Biomechanical comparison of osteosynthesis with poly‑L‑lactic acid ...

    African Journals Online (AJOL)

    2015-01-21

    Jan 21, 2015 ... Fractures of the mandibular condylar process are common fractures affecting the ... mandible replicas are having a medullar and a cortical portion (Synbone ... Based on the biomechanical simulations they performed Neff et al ...

  10. Recent microfluidic devices for studying gamete and embryo biomechanics.

    Science.gov (United States)

    Lai, David; Takayama, Shuichi; Smith, Gary D

    2015-06-25

    The technical challenges of biomechanic research such as single cell analysis at a high monetary cost, labor, and time for just a small number of measurements is a good match to the strengths of microfluidic devices. New scientific discoveries in the fertilization and embryo development process, of which biomechanics is a major subset of interest, is crucial to fuel the continual improvement of clinical practice in assisted reproduction. The following review will highlight some recent microfluidic devices tailored for gamete and embryo biomechanics where biomimicry arises as a major theme of microfluidic device design and function, and the application of fundamental biomechanic principles are used to improve outcomes of cryopreservation. Copyright © 2015 Elsevier Ltd. All rights reserved.

  11. Low-Back Biomechanics and Static Stability During Isometric Pushing

    Science.gov (United States)

    Granata, Kevin P.; Bennett, Bradford C.

    2006-01-01

    Pushing and pulling tasks are increasingly prevalent in industrial workplaces. Few studies have investigated low-back biomechanical risk factors associated with pushing, and we are aware of none that has quantified spinal stability during pushing exertions. Data recorded from 11 healthy participants performing isometric pushing exertions demonstrated that trunk posture, vector force direction of the applied load, and trunk moment were influenced (p pushing task, and foot position. A biomechanical model was used to analyze the posture and hand force data gathered from the pushing exertions. Model results indicate that pushing exertions provide significantly (p pushing exertions. If one maintains stability by means of cocontraction, additional spinal load is thereby created, increasing the risk of overload injury. Thus it is important to consider muscle cocontraction when evaluating the biomechanics of pushing exertions. Potential applications of this research include improved assessment of biomechanical risk factors for the design of industrial pushing tasks. PMID:16435695

  12. Interpreting locomotor biomechanics from the morphology of human footprints.

    Science.gov (United States)

    Hatala, Kevin G; Wunderlich, Roshna E; Dingwall, Heather L; Richmond, Brian G

    2016-01-01

    Fossil hominin footprints offer unique direct windows to the locomotor behaviors of our ancestors. These data could allow a clearer understanding of the evolution of human locomotion by circumventing issues associated with indirect interpretations of habitual locomotor patterns from fossil skeletal material. However, before we can use fossil hominin footprints to understand better the evolution of human locomotion, we must first develop an understanding of how locomotor biomechanics are preserved in, and can be inferred from, footprint morphologies. In this experimental study, 41 habitually barefoot modern humans created footprints under controlled conditions in which variables related to locomotor biomechanics could be quantified. Measurements of regional topography (depth) were taken from 3D models of those footprints, and principal components analysis was used to identify orthogonal axes that described the largest proportions of topographic variance within the human experimental sample. Linear mixed effects models were used to quantify the influences of biomechanical variables on the first five principal axes of footprint topographic variation, thus providing new information on the biomechanical variables most evidently expressed in the morphology of human footprints. The footprint's overall depth was considered as a confounding variable, since biomechanics may be linked to the extent to which a substrate deforms. Three of five axes showed statistically significant relationships with variables related to both locomotor biomechanics and substrate displacement; one axis was influenced only by biomechanics and another only by the overall depth of the footprint. Principal axes of footprint morphological variation were significantly related to gait type (walking or running), kinematics of the hip and ankle joints and the distribution of pressure beneath the foot. These results provide the first quantitative framework for developing hypotheses regarding the

  13. Advances in Proximal Interphalangeal Joint Arthroplasty: Biomechanics and Biomaterials.

    Science.gov (United States)

    Zhu, Andy F; Rahgozar, Paymon; Chung, Kevin C

    2018-05-01

    Proximal interphalangeal (PIP) joint arthritis is a debilitating condition. The complexity of the joint makes management particularly challenging. Treatment of PIP arthritis requires an understanding of the biomechanics of the joint. PIP joint arthroplasty is one treatment option that has evolved over time. Advances in biomaterials have improved and expanded arthroplasty design. This article reviews biomechanics and arthroplasty design of the PIP joint. Copyright © 2018 Elsevier Inc. All rights reserved.

  14. Biomechanics of compensatory mechanisms in spinal-pelvic complex

    Science.gov (United States)

    Ivanov, D. V.; Hominets, V. V.; Kirillova, I. V.; Kossovich, L. Yu; Kudyashev, A. L.; Teremshonok, A. V.

    2018-04-01

    3D geometric solid computer model of spinal-pelvic complex was constructed on the basis of computed tomography and full body X-ray in standing position data. The constructed model was used for biomechanical analysis of compensatory mechanisms arising in the spine with anteversion and retroversion of the pelvis. The results of numerical biomechanical 3D modeling are in good agreement with the clinical data.

  15. Emulating facial biomechanics using multivariate partial least squares surrogate models

    OpenAIRE

    Martens, Harald; Wu, Tim; Hunter, Peter; Mithraratne, Kumar

    2014-01-01

    This is the author’s final, accepted and refereed manuscript to the article. Locked until 2015-05-06 A detailed biomechanical model of the human face driven by a network of muscles is a useful tool in relating the muscle activities to facial deformations. However, lengthy computational times often hinder its applications in practical settings. The objective of this study is to replace precise but computationally demanding biomechanical model by a much faster multivariate meta-mode...

  16. Search and rescue helicopter-assisted transfer of ST-elevation myocardial infarction patients from an island in the Baltic Sea

    DEFF Research Database (Denmark)

    Schoos, Mikkel Malby; Kelbæk, Henning; Pedersen, Frants

    2014-01-01

    BACKGROUND: Since 2005, ST-elevation myocardial infarction (STEMI) patients from the island of Bornholm in the Baltic Sea have been transferred for primary percutaneous coronary intervention (pPCI) by an airborne service. We describe the result of pPCI as part of the Danish national reperfusion s...

  17. Gait biomechanics in the era of data science.

    Science.gov (United States)

    Ferber, Reed; Osis, Sean T; Hicks, Jennifer L; Delp, Scott L

    2016-12-08

    Data science has transformed fields such as computer vision and economics. The ability of modern data science methods to extract insights from large, complex, heterogeneous, and noisy datasets is beginning to provide a powerful complement to the traditional approaches of experimental motion capture and biomechanical modeling. The purpose of this article is to provide a perspective on how data science methods can be incorporated into our field to advance our understanding of gait biomechanics and improve treatment planning procedures. We provide examples of how data science approaches have been applied to biomechanical data. We then discuss the challenges that remain for effectively using data science approaches in clinical gait analysis and gait biomechanics research, including the need for new tools, better infrastructure and incentives for sharing data, and education across the disciplines of biomechanics and data science. By addressing these challenges, we can revolutionize treatment planning and biomechanics research by capitalizing on the wealth of knowledge gained by gait researchers over the past decades and the vast, but often siloed, data that are collected in clinical and research laboratories around the world. Copyright © 2016 Elsevier Ltd. All rights reserved.

  18. ARTIFICIAL INTELLIGENCE IN SPORTS BIOMECHANICS: NEW DAWN OR FALSE HOPE?

    Directory of Open Access Journals (Sweden)

    Roger Bartlett

    2006-12-01

    Full Text Available This article reviews developments in the use of Artificial Intelligence (AI in sports biomechanics over the last decade. It outlines possible uses of Expert Systems as diagnostic tools for evaluating faults in sports movements ('techniques' and presents some example knowledge rules for such an expert system. It then compares the analysis of sports techniques, in which Expert Systems have found little place to date, with gait analysis, in which they are routinely used. Consideration is then given to the use of Artificial Neural Networks (ANNs in sports biomechanics, focusing on Kohonen self-organizing maps, which have been the most widely used in technique analysis, and multi-layer networks, which have been far more widely used in biomechanics in general. Examples of the use of ANNs in sports biomechanics are presented for javelin and discus throwing, shot putting and football kicking. I also present an example of the use of Evolutionary Computation in movement optimization in the soccer throw in, which predicted an optimal technique close to that in the coaching literature. After briefly overviewing the use of AI in both sports science and biomechanics in general, the article concludes with some speculations about future uses of AI in sports biomechanics.

  19. Biomechanically Excited SMD Model of a Walking Pedestrian

    DEFF Research Database (Denmark)

    Zhang, Mengshi; Georgakis, Christos T.; Chen, Jun

    2016-01-01

    Through their biomechanical properties, pedestrians interact with the structures they occupy. Although this interaction has been recognized by researchers, pedestrians' biomechanical properties have not been fully addressed. In this paper, a spring-mass-damper (SMD) system, with a pair of biomech......Through their biomechanical properties, pedestrians interact with the structures they occupy. Although this interaction has been recognized by researchers, pedestrians' biomechanical properties have not been fully addressed. In this paper, a spring-mass-damper (SMD) system, with a pair...... produced the pedestrian's center of mass (COM) trajectories from the captured motion markers. The vertical COM trajectory was approximated to be the pedestrian SMD dynamic responses under the excitation of biomechanical forces. SMD model parameters of a pedestrian for a specific walking frequency were...... estimated from a known walking frequency and the pedestrian's weight, assuming that pedestrians always walk in displacement resonance and retain a constant damping ratio of 0.3. Thus, biomechanical forces were extracted using the measured SMD dynamic responses and the estimated SMD parameters. Extracted...

  20. The corneoscleral shell of the eye: potentials of assessing biomechanical parameters in normal and pathological conditions

    Directory of Open Access Journals (Sweden)

    E. N. Iomdina

    2016-01-01

    Full Text Available The paper reviews modern methods of evaluating the biomechanical properties of the corneoscleral shell of the eye that can be used both in the studies of the pathogenesis of various ophthalmic pathologies and in clinical practice. The biomechanical parameters of the cornea and the sclera have been shown to be diagnostically significant in assessing the risk of complications and the effectiveness of keratorefractive interventions, in the diagnosis and the prognosis of keratoconus, progressive myopia, or glaucoma. In clinical practice, a special device, Ocular Response Analyzer (ORA, has been used on a large scale. The analyzer is used to assess two parameters that characterize viscoelastic properties of the cornea — corneal hysteresis (CH and corneal resistance factor (CRF. Reduced levels of CH and CRF have been noted after eximer laser surgery, especially that administered to patients who demonstrate a regression in the refraction effect or suffer from keratoconus. This fact justifies the use of these biomechanical parameters as additional diagnostic criteria in the evaluation of the state of the cornea. At the same time, ORA data are shown to reflect the biomechanical response to the impact of the air pulse not only from the cornea alone but also from the whole corneoscleral capsule. This is probably the cause of reduced CH in children with progressive myopia and a weakened supportive function of the sclera, as well as such reduction in glaucomatous adult patients. It is hypothesized that a low CH value is a result of remodeling of the connective tissue matrix of the corneoscleral shell of the eye and can be an independent factor testifying to a risk of glaucoma progression. Reduced CH in primary open-angle glaucoma occurs in parallel with the development of pathological structural changes of the optic disc, and deterioration of visual fields, which is an evidence of a specific character and sensitivity of this parameter. The

  1. Restoring tactile and erogenous penile sensation in low-spinal-lesion patients: procedural and technical aspects following 43 TOMAX nerve transfer procedures.

    Science.gov (United States)

    Overgoor, Max L E; de Jong, Tom P V M; Kon, Moshe

    2014-08-01

    The "TOMAX" (TO MAX-imize sensation, sexuality, and quality of life) procedure restores genital sensation in men with low spinal lesions, improving sexual health, as shown previously. It connects the dorsal nerve of the penis to the intact ipsilateral ilioinguinal nerve, unilaterally or bilaterally. This study reports on the technical aspects based on 43 TOMAX nerve transfers. In 40 patients with no penile but intact groin sensation, 43 nerve transfers were performed. Data on patient selection, surgical history, anatomy of the ilioinguinal nerve and dorsal nerve of the penis, unilateral or bilateral surgery, surgical technique, complications, and patient information were collected prospectively. Regardless of origin, all patients with no penile but good groin sensation are eligible for the procedure, provided the ilioinguinal nerve is not damaged because of former inguinal surgery or absent because of anatomical variations. Selection of a unilateral or bilateral procedure depends on the presence or absence of reflex erections and bulbocavernosus reflex. Preliminary experience with the first three bilateral cases shows that it is technically feasible, with encouraging results. The surgical technique has evolved (described in detail, including video) to enhance outcome and reduce complications. Patients are better informed, resulting in realistic expectations. This article synthesizes the procedural and technical experience of 43 TOMAX nerve transfers. Anyone skilled in peripheral nerve surgery and microsurgery can adopt this concept and further develop it. The TOMAX procedure can then be used to restore erogenous penile sensation and improve the quality of sexual health in patients with absent penile but good groin sensation.

  2. Three-Dimensional Biomechanical Analysis of Rearfoot and Forefoot Running.

    Science.gov (United States)

    Knorz, Sebastian; Kluge, Felix; Gelse, Kolja; Schulz-Drost, Stefan; Hotfiel, Thilo; Lochmann, Matthias; Eskofier, Björn; Krinner, Sebastian

    2017-07-01

    In the running community, a forefoot strike (FFS) pattern is increasingly preferred compared with a rearfoot strike (RFS) pattern. However, it has not been fully understood which strike pattern may better reduce adverse joint forces within the different joints of the lower extremity. To analyze the 3-dimensional (3D) stress pattern in the ankle, knee, and hip joint in runners with either a FFS or RFS pattern. Descriptive laboratory study. In 22 runners (11 habitual rearfoot strikers, 11 habitual forefoot strikers), RFS and FFS patterns were compared at 3.0 m/s (6.7 mph) on a treadmill with integrated force plates and a 3D motion capture analysis system. This combined analysis allowed characterization of the 3D biomechanical forces differentiated for the ankle, knee, and hip joint. The maximum peak force (MPF) and maximum loading rate (LR) were determined in their 3 ordinal components: vertical, anterior-posterior (AP), and medial-lateral (ML). For both strike patterns, the vertical components of the MPF and LR were significantly greater than their AP or ML components. In the vertical axis, FFS was generally associated with a greater MPF but significantly lower LR in all 3 joints. The AP components of MPF and LR were significantly lower for FFS in the knee joint but significantly greater in the ankle and hip joints. The ML components of MPF and LR tended to be greater for FFS but mostly did not reach a level of significance. FFS and RFS were associated with different 3D stress patterns in the ankle, knee, and hip joint, although there was no global advantage of one strike pattern over the other. The multimodal individual assessment for the different anatomic regions demonstrated that FFS seems favorable for patients with unstable knee joints in the AP axis and RFS may be recommended for runners with unstable ankle joints. Different strike patterns show different 3D stress in joints of the lower extremity. Due to either rehabilitation after injuries or training in

  3. Level of training and experience in physicians performing interhospital transfers of adult patients in the internal medicine department

    DEFF Research Database (Denmark)

    Hallas, P; Folkestad, L; Brabrand, M

    2009-01-01

    AIM: To establish the level of training doctors who participate in interhospital transfers in Denmark. METHODS: A questionnaire was sent to every hospital department in Denmark with acute internal medicine admissions. RESULTS: Eighty-nine internal medicine departments were contacted and 84...... responded (response rate 94.4%). Of the 84 hospitals, 75 (89.3%) indicated that they perform interhospital transfers. Most transfers were performed by interns (61.3%) or senior house officers (10.7%) with only a few months' experience in their current speciality. Training in interhospital transfer...

  4. Comparative characteristics of morphometric, biometric and biomechanical parameters of myopic eyes in children with different types of progressive myopia

    Directory of Open Access Journals (Sweden)

    T. E. Tsybulskaya

    2014-10-01

    Full Text Available Aim. With the progression of myopic process in children the changes of morphometric, biometric and biomechanical parameters of eyeball are observed. In order to study these parameters in the axial and refractive myopia 32 patients (64 eyes with axial and 26 patients (46 eyes with refractive myopia have been examined. Methods and results. It has been established that in patients with axial and refractive progressive myopia in 56.4% of cases there is a decrease of peripapillary zone thickness of nerve fiber and decrease of ganglion cells layer thickness, an increase of corneal-compensated intraocular pressure by 1.3 times, and also the reduce of corneal hysteresis by 1.2 times. Conclusion. These changes do not depend on the degree of refraction and are associated with an increase in axial length of the eye and decrease in the biomechanical properties of the root-scleral capsule regardless the type of myopia.

  5. Efficient decellularization for tissue engineering of the tendon-bone interface with preservation of biomechanics.

    Directory of Open Access Journals (Sweden)

    Kai Xu

    Full Text Available Interfaces between tendon/ligament and bone ("entheses" are highly specialized tissues that allow for stress transfer between mechanically dissimilar materials. Entheses show very low regenerative capacity resulting in high incidences of failure after surgical repair. Tissue engineering is a promising approach to recover functionality of entheses. Here, we established a protocol to decellularize porcine entheses as scaffolds for enthesis tissue engineering. Chemical detergents as well as physical treatments were investigated with regard to their efficiency to decellularize 2 mm thick porcine Achilles tendon entheses. A two-phase approach was employed: study 1 investigated the effect of various concentrations of sodium dodecyl sulfate (SDS and t-octylphenoxypolyethoxy-ethanol (Triton X-100 as decellularization agents. The most efficient combination of SDS and Triton was then carried forward into study 2, where different physical methods, including freeze-thaw cycles, ultrasound, perfusion, and hydrostatic washing were used to enhance the decellularization effect. Cell counts, DNA quantification, and histology showed that washing with 0.5% SDS + 1% Triton X-100 for 72 h at room temperature could remove ~ 98% cells from the interface. Further investigation of physical methods proved that washing under 200 mmHg hydrostatic pressure shortened the detergent exposing time from 72 h to 48 h. Biomechanical tensile testing showed that the biomechanical features of treated samples were preserved. Washing under 200 mmHg hydrostatic pressure with 0.5% SDS + 1% Triton X-100 for 48 h efficiently decellularized entheses with preservation of matrix structure and biomechanical features. This protocol can be used to efficiently decellularize entheses as scaffolds for tissue engineering.

  6. CT-derived Biomechanical Metrics Improve Agreement Between Spirometry and Emphysema.

    Science.gov (United States)

    Bhatt, Surya P; Bodduluri, Sandeep; Newell, John D; Hoffman, Eric A; Sieren, Jessica C; Han, Meilan K; Dransfield, Mark T; Reinhardt, Joseph M

    2016-10-01

    Many patients with chronic obstructive pulmonary disease (COPD) have marked discordance between forced expiratory volume in 1 second (FEV1) and degree of emphysema on computed tomography (CT). Biomechanical differences between these patients have not been studied. We aimed to identify reasons for the discordance between CT and spirometry in some patients with COPD. Subjects with Global initiative for chronic Obstructive Lung Disease stages I-IV from a large multicenter study (The Genetic Epidemiology of COPD) were arranged by percentiles of %predicted FEV1 and emphysema on CT. Three categories were created using differences in percentiles: Catspir with predominant airflow obstruction/minimal emphysema, CatCT with predominant emphysema/minimal airflow obstruction, and Catmatched with matched FEV1 and emphysema. Image registration was used to derive Jacobian determinants, a measure of lung elasticity, anisotropy, and strain tensors, to assess biomechanical differences between groups. Regression models were created with the previously mentioned categories as outcome variable, adjusting for demographics, scanner type, quantitative CT-derived emphysema, gas trapping, and airway thickness (model 1), and after adding biomechanical CT metrics (model 2). Jacobian determinants, anisotropy, and strain tensors were strongly associated with FEV1. With Catmatched as control, model 2 predicted Catspir and CatCT better than model 1 (Akaike information criterion 255.8 vs. 320.8). In addition to demographics, the strongest independent predictors of FEV1 were Jacobian mean (β = 1.60,95%confidence intervals [CI] = 1.16 to 1.98; P spirometry, offering the potential for new insights into the linkage between regional parenchymal destruction and global decrement in lung function in patients with COPD. Copyright © 2016 The Association of University Radiologists. Published by Elsevier Inc. All rights reserved.

  7. DYNAMIC MAGNIFICATION OF BIOMECHANICAL SYSTEM MOTION

    Directory of Open Access Journals (Sweden)

    A. E. Pokatilov

    2017-01-01

    Full Text Available Methods for estimation of dynamic magnification pertaining to motion in biomechanics have been developed and approbаted in the paper. It has been ascertained that widely-used characteristics for evaluation of motion influence on mechanisms and machinery such as a dynamic coefficient and acceleration capacity factor become irrelevant while investigating human locomotion under elastic support conditions. The reason is an impossibility to compare human motion in case when there is a contact with elastic and rigid supports because while changing rigidity of the support exercise performing technique is also changing. In this case the technique still depends on a current state of a specific sportsman. Such situation is observed in sports gymnastics. Structure of kinematic and dynamic models for human motion has been investigated in the paper. It has been established that properties of an elastic support are reflected in models within two aspects: in an explicit form, when models have parameters of dynamic deformation for a gymnastic apparatus, and in an implicit form, when we have numerically changed parameters of human motion. The first part can be evaluated quantitatively while making comparison with calculations made in accordance with complete models. For this reason notions of selected and complete models have been introduced in the paper. It has been proposed to specify models for support and models of biomechanical system that represent models pertaining only to human locomotor system. It has been revealed that the selected models of support in kinematics and dynamics have structural difference. Kinematics specifies only parameters of elastic support deformation and dynamics specifies support parameters in an explicit form and additionally in models of human motion in an explicit form as well. Quantitative estimation of a dynamic motion magnification in kinematics and dynamics models has been given while using computing experiment for grand

  8. Lipid transfers to HDL are diminished in long-term bedridden patients: association with low HDL-cholesterol and increased inflammatory markers.

    Science.gov (United States)

    de Oliveira, Wilson Pascoalino Camargo; Tavoni, Thauany Martins; Freitas, Fatima Rodrigues; Silva, Bruna Miranda Oliveira; Maranhão, Raul Cavalcante

    2017-08-01

    Plasma lipids have been extensively studied in sedentary and in subjects practicing exercise training, but not in extreme inactivity as occurs in bedridden patients. This is important for the care of bedridden patients and understanding the overall plasma lipid regulation. Here, we investigated plasma lipids, lipid transfers to HDL and inflammatory markers in bedridden patients. Fasting blood samples were collected from 23 clinically stable bedridden patients under long-term care (>90 days) and 26 normolipidemic sedentary subjects, paired for age and gender. In vitro transfer of four lipids to HDL was performed by incubating plasma with donor nanoparticles containing radioactive lipids. Total (193 ± 36 vs 160 ± 43, p = 0.005), LDL (124 ± 3 vs 96 ± 33 p = 0.003) and HDL-cholesterol (45 ± 10 vs 36 ± 13, p = 0.008), apolipoprotein A-I (134 ± 20 vs 111 ± 24, p = 0.001) and oxidized LDL (53 ± 13 vs 43 ± 12, p = 0.011) were lower in bedridden patients, whereas triglycerides, apolipoprotein B, CETP and LCAT were equal in both groups. Transfers of all lipids, namely unesterified cholesterol, cholesterol esters, triglycerides and phospholipids, to HDL were lower in bedridden patients, probably due to their lower HDL-cholesterol levels. Concentrations of IL-1β, IL-6, IL-8, HGF and NGF were higher in bedridden patients compared to sedentary subjects. In conclusion, inactivity had great impact on HDL, by lowering HDL-cholesterol, apolipoprotein A-I and thereby cholesterol transfers to the lipoprotein, which suggests that inactivity may deteriorate HDL protection beyond the ordinary sedentary condition.

  9. Comprehensive approach to functional palatomaxillary reconstruction using regional and free tissue transfer: Report of reconstructive and prosthodontic outcomes of 140 patients.

    Science.gov (United States)

    Urken, Mark L; Roche, Ansley M; Kiplagat, Kimberly J; Dewey, Eliza H; Lazarus, Cathy; Likhterov, Ilya; Buchbinder, Daniel; Okay, Devin J

    2018-03-14

    Palatomaxillary defects were historically restored with a prosthetic obturator; however, advances in local and free tissue transfer has provided a viable alternative for appropriately selected patients with palatomaxillary defects. A retrospective chart review of patients who underwent palatomaxillary reconstruction by the lead author between 1998 and 2016 was conducted. Patients who were restored with a palatal obturator were excluded. One hundred forty patients were reconstructed with a total of 159 local, regional, and free flaps with a 96.7% success rate. Seventy-four patients (52.8%) underwent prosthodontic rehabilitation, with 183 implants placed and an 86% success rate. Palatomaxillary reconstruction applying a systematic approach, using a multitude of techniques, is a safe and effective way to restore patients without compromising the ability to maintain surveillance. Prosthodontic rehabilitation can be achieved in a high percentage of patients using dental implants, leading to optimal aesthetic and functional results. © 2018 Wiley Periodicals, Inc.

  10. The application of 3D-printed transparent facemask for facial scar management and its biomechanical rationale.

    Science.gov (United States)

    Wei, Yating; Wang, Yan; Zhang, Ming; Yan, Gang; Wu, Shixue; Liu, Wenjun; Ji, Gang; Li-Tsang, Cecilia W P

    2018-03-01

    Deep facial burns leave conspicuous scar to the patients and affect their quality of life. Transparent facemask has been adopted for the prevention and treatment of facial hypertrophic scars for decades. Recently, with the advancement of 3D printing, the transparent facemask could facilitate the fitting of the facial contour. However, the effectiveness of the device and its biomechanical characteristics on pressure management of hypertrophic scar would need more objective evaluation. A biomechanical model of the transparent 3D-printed facemask was established through finite element analysis. Ten patients with extensive deep facial burns within 6 months were recruited for clinical study using 3D-printed facemask designed according to biomechanical model, and the interface pressure was measured on each patient. The patients in the treatment group (n=5) was provided with the 3D-printed transparent face mask soon after initial scar assessment, while the delayed treatment group (n=5) began the treatment one month after the initial scar assessment. The scar assessment was performed one month post intervention for both groups. The biomechanical modeling showed that the 3D, computer-generated facemask resulted in unbalanced pressure if design modifications were not incorporated to address these issues. The interface pressure between the facemask and patient's face was optimized through individualized design adjustments and the addition of silicone lining. After optimization of pressure through additional lining, the mean thickness and hardness of the scars of all 10 patients were decreased significantly after 1-month of intervention. In the delayed treatment group, the mean thickness of the scars was increased within the month without intervention, but it was also decreased after intervention. Facemask design and the silicone lining are important to ensure adequate compression pressure of 3D-printed transparent facemask. The intervention using the 3D-printed facemask

  11. Transfer between hospitals as a predictor of delay in diagnosis and treatment of patients with Non-Small Cell Lung Cancer

    DEFF Research Database (Denmark)

    Iachina, Maria; Jakobsen, Erik; Fallesen, Anne Kudsk

    2017-01-01

    with treatment facilities during the care pathway. We wanted to investigate whether this organizational set-up influenced the time that patients wait for the diagnosis and treatment. Therefore, the objective of this study was to uncover the impact of transfer between hospitals on the delay in the diagnosis......BACKGROUND: Lung cancer is the second most frequent cancer diagnosis in Denmark. Although improved during the last decade, the prognosis of lung cancer is still poor with an overall 5-year survival rate of approximately 12%. Delay in diagnosis and treatment of lung cancer has been suggested...... and incomplete data on the dates of referral, diagnosis and treatment were excluded. RESULTS: A total of 11 273 patients were included for further analyses. Transfer patients waited longer for treatment after the diagnosis, (Hazard ratio (HR) 0.81 (0.68-0.96)) and in total time from referral to treatment (HR 0...

  12. Functional connectivity of motor cortical network in patients with brachial plexus avulsion injury after contralateral cervical nerve transfer: a resting-state fMRI study

    Energy Technology Data Exchange (ETDEWEB)

    Yu, Aihong; Cheng, Xiaoguang; Liang, Wei; Bai, Rongjie [The 4th Medical College of Peking University, Department of Radiology, Beijing Jishuitan Hospital, Xicheng Qu, Beijing (China); Wang, Shufeng; Xue, Yunhao; Li, Wenjun [The 4th Medical College of Peking University, Department of Hand Surgery, Beijing Jishuitan Hospital, Beijing (China)

    2017-03-15

    The purpose of this study is to assess the functional connectivity of the motor cortical network in patients with brachial plexus avulsion injury (BPAI) after contralateral C7 nerve transfer, using resting-state functional magnetic resonance imaging (RS-fMRI). Twelve patients with total brachial plexus root avulsion underwent RS-fMRI after contralateral C7 nerve transfer. Seventeen healthy volunteers were also included in this fMRI study as controls. The hand motor seed regions were defined as region of interests in the bilateral hemispheres. The seed-based functional connectivity was calculated in all the subjects. Differences in functional connectivity of the motor cortical network between patients and healthy controls were compared. The inter-hemispheric functional connectivity of the M1 areas was increased in patients with BPAI compared with the controls. The inter-hemispheric functional connectivity between the supplementary motor areas was reduced bilaterally. The resting-state inter-hemispheric functional connectivity of the bilateral M1 areas is altered in patients after contralateral C7 nerve transfer, suggesting a functional reorganization of cerebral cortex. (orig.)

  13. Functional connectivity of motor cortical network in patients with brachial plexus avulsion injury after contralateral cervical nerve transfer: a resting-state fMRI study

    International Nuclear Information System (INIS)

    Yu, Aihong; Cheng, Xiaoguang; Liang, Wei; Bai, Rongjie; Wang, Shufeng; Xue, Yunhao; Li, Wenjun

    2017-01-01

    The purpose of this study is to assess the functional connectivity of the motor cortical network in patients with brachial plexus avulsion injury (BPAI) after contralateral C7 nerve transfer, using resting-state functional magnetic resonance imaging (RS-fMRI). Twelve patients with total brachial plexus root avulsion underwent RS-fMRI after contralateral C7 nerve transfer. Seventeen healthy volunteers were also included in this fMRI study as controls. The hand motor seed regions were defined as region of interests in the bilateral hemispheres. The seed-based functional connectivity was calculated in all the subjects. Differences in functional connectivity of the motor cortical network between patients and healthy controls were compared. The inter-hemispheric functional connectivity of the M1 areas was increased in patients with BPAI compared with the controls. The inter-hemispheric functional connectivity between the supplementary motor areas was reduced bilaterally. The resting-state inter-hemispheric functional connectivity of the bilateral M1 areas is altered in patients after contralateral C7 nerve transfer, suggesting a functional reorganization of cerebral cortex. (orig.)

  14. Active surveillance for asymptomatic colonisation by multidrug-resistant bacteria in patients transferred to a tertiary care hospital in the occupied Palestinian territory.

    Science.gov (United States)

    Taha, Adham Abu; Daoud, Ayman; Zaid, Sawsan; Sammour, Sajida; Belleh, Maram; Daifi, Refqa

    2018-02-21

    Active surveillance is important in infection control programmes, allowing the detection of patients colonised with multi-drug resistant organisms and preventing the spread of multi-drug resistant organisms. The aim of this study was to determine the rate of asymptomatic colonisation with multi-drug resistant organisms and the prevalence of each organism in patients transferred to An-Najah National University Hospital, Nablus, occupied Palestinian territory. Patients transferred from other hospitals between January and December, 2015, were screened at time of admission by taking nasal, groin, and axillary swabs. Swabs were cultured and assessed for the presence of multi-drug resistant organisms (extended spectrum β-lactamase producers, Pseudomonas aeroginosae, Acinetobacter baumannii, methicillin-resistant Staphylococcus aureus, vancomycin-resistant enterococcus, and carbapenem-resistant enterobacteriaceae. Of the 822 screened patients, 265 (32%) had infections with multi-drug resistant organisms. 394 isolates of multi-drug resistant organisms were obtained: 131 (33%) isolates were extended spectrum β-lactamase producers, 119 (30%) isolates were P aeroginosae, 26 (9%) isolates were A baumannii, 94 (24%) isolates were methicillin-resistant S aureus, 13 (3%) isolates were vancomycin-resistant enterococci, and one (<1%) isolate was carbapenem-resistant enterobacteriaceae. We identified a high prevalence of asymptomatic colonisation with multidrug-resistant bacteria in transferred patients. These findings emphasise the need for a national strategy to combat the spread of multi-drug resistant organisms in the occupied Palestinian territory. An-Najah National University. Copyright © 2018 Elsevier Ltd. All rights reserved.

  15. S1 nuclease analysis of α-globin gene expression in preleukemic patients with acquired hemoglobin H disease after transfer to mouse erythroleukemia cells

    International Nuclear Information System (INIS)

    Helder, J.; Deisseroth, A.

    1987-01-01

    The loss of α-globin gene transcriptional activity rarely occurs as an acquired abnormality during the evolution of myeloproliferative disease or preleukemia. To test whether the mutation responsible for the loss of α-globin gene expression (hemoglobin H disease) in these patients is linked with the α-globin genes on chromosome 16, the authors transferred chromosome 16 from preleukemic patients with acquired hemoglobin H disease to mouse erythroleukemia cells and measured the transcriptional activity of the human α-globin genes. After transfer to mouse erythroleukemia cells, the expression of human α-globin genes from the peripheral blood or marrow cells of preleukemic patients with acquired hemoglobin H disease was similar to that of human α-globin genes transferred to mouse erythroleukemia cells from normal donors. These data showed that factor(s) in the mouse erythroleukemia cell can genetically complement the α-globin gene defect in these preleukemia patients with acquired hemoglobin H disease and suggest that altered expression of a gene in trans to the α-globin gene may be responsible for the acquisition of hemoglobin H disease in these patients

  16. Knee Biomechanics During Jogging After Arthroscopic Partial Meniscectomy: A Longitudinal Study.

    Science.gov (United States)

    Hall, Michelle; Wrigley, Tim V; Metcalf, Ben R; Hinman, Rana S; Cicuttini, Flavia M; Dempsey, Alasdair R; Lloyd, David G; Bennell, Kim L

    2017-07-01

    Altered knee joint biomechanics is thought to play a role in the pathogenesis of knee osteoarthritis and has been reported in patients after arthroscopic partial meniscectomy (APM) while performing various activities. Longitudinally, understanding knee joint biomechanics during jogging may assist future studies to assess the implications of jogging on knee joint health in this population. To investigate knee joint biomechanics during jogging in patients 3 months after APM and a healthy control group at baseline and 2 years later at follow-up. Controlled laboratory study. Seventy-eight patients who underwent medial APM and 38 healthy controls underwent a 3-dimensional motion analysis during barefoot overground jogging at baseline. Sixty-four patients who underwent APM and 23 controls returned at follow-up. External peak moments (flexion and adduction) and the peak knee flexion angle during stance were evaluated for the APM leg, non-APM leg (nonoperated leg), and control leg. At baseline, the peak knee flexion angle was 1.4° lower in the APM leg compared with the non-APM leg ( P = .03). No differences were found between the moments in the APM leg compared with the control leg (all P > .05). However, the normalized peak knee adduction moment was 35% higher in the non-APM leg compared with the control leg ( P = .008). In the non-APM leg, the normalized peak knee adduction and flexion moments were higher compared with the APM leg by 16% and 10%, respectively, at baseline ( P ≤ .004). Despite the increase in the peak knee flexion moment in the APM leg compared with the non-APM leg ( P .05). Comparing the APM leg and control leg, no differences in knee joint biomechanics during jogging for the variables assessed were observed. Higher knee moments in the non-APM leg may have clinical implications for the noninvolved leg. Kinematic differences were small (~1.4°) and therefore of questionable clinical relevance. These results may facilitate future clinical research

  17. Factor IX expression in skeletal muscle of a severe hemophilia B patient 10 years after AAV-mediated gene transfer.

    Science.gov (United States)

    Buchlis, George; Podsakoff, Gregory M; Radu, Antonetta; Hawk, Sarah M; Flake, Alan W; Mingozzi, Federico; High, Katherine A

    2012-03-29

    In previous work we transferred a human factor IX-encoding adeno-associated viral vector (AAV) into skeletal muscle of men with severe hemophilia B. Biopsy of injected muscle up to 1 year after vector injection showed evidence of gene transfer by Southern blot and of protein expression by IHC and immunofluorescent staining. Although the procedure appeared safe, circulating F.IX levels remained subtherapeutic (< 1%). Recently, we obtained muscle tissue from a subject injected 10 years earlier who died of causes unrelated to gene transfer. Using Western blot, IHC, and immunofluorescent staining, we show persistent factor IX expression in injected muscle tissue. F.IX transcripts were detected in injected skeletal muscle using RT-PCR, and isolated whole genomic DNA tested positive for the presence of the transferred AAV vector sequence. This is the longest reported transgene expression to date from a parenterally administered AAV vector, with broad implications for the future of muscle-directed gene transfer.

  18. Biomechanical comments about Triassic dinosaurs from Brazil

    Directory of Open Access Journals (Sweden)

    Rafael Delcourt

    2012-01-01

    Full Text Available Triassic dinosaurs of Brazil are found in Santa Maria and Caturrita formations, Rio Grande do Sul state, Brazil. There are three species known from the Santa Maria Formation (Staurikosaurus pricei, Saturnalia tupiniquim and Pampadromaeus barberenai, and two from Caturrita Formation (Guaibasaurus candelariensis and Unaysaurus tolentinoi. These dinosaur materials are, for the most part, well preserved and allow for descriptions of musculature and biomechanical studies. The lateral rotation of the Saturnalia femur is corroborated through calculations of muscle moment arms. The enhanced supracetabular crest of Saturnalia, Guaibasaurus, Staurikosaurus, Herrerasaurus ischigualastensis, Efraasia minor and Chormogisaurus novasi suggests that basal dinosaurs may have maintained an inclination of the trunk at least 20º on the horizontal axis. The pectoral girdle articulation of basal sauropodomorphs (Saturnalia and Unaysaurus was established using a new method, the Clavicular Ring, and the scapular blade remains near 60º on the horizontal axis. This is a plesiomorphic condition among sauropodomorphs and is also seen in the articulated plateosauridae Seitaad ruessi. The Brazilian basal dinosaurs were lightweight with a body mass estimated around 18.5 kg for Staurikosaurus, 6.5 kg for Saturnalia, and 17 kg for Guaibasaurus. Pampadromaeus probably weighed 2.5 kg, but measures of its femur are necessary to confirm this hypothesis. The Triassic dinosaurs from Brazil were diversified but shared some functional aspects that were important in an evolutionary context.

  19. Physiological and biomechanical aspects of orienteering.

    Science.gov (United States)

    Creagh, U; Reilly, T

    1997-12-01

    Orienteering is an endurance running event which differs from other running sports both in its cognitive element and in the type of terrain encountered. The demands of overcoming this terrain are not manifest in significant differences between orienteers and road runners in somatotype, though elite female orienteers have consistently been shown to have higher levels of adiposity (> 19%) than elite road runners. High aerobic power in orienteers (up to 63 and 76 ml/kg/min in women and men, respectively) is coupled with lower anaerobic performance. While leg strength is generally not high when compared with other athletic specialties, female orienteers have relatively good leg flexion strength. The energy cost of running is greatly increased in rough terrain. Oxygen cost was 26% higher while running in a forest when compared with road running. Biomechanical differences in stride pattern contribute towards this increased demand. Despite the high energy demands during competition, orienteers pace themselves such that their mean heart rate remains within the range of 167 to 172 beats/min, despite large fluctuations. The rough terrain encountered in orienteering results not only in a high energy cost but also in a higher incidence of sport-specific injuries, particularly to the ankle. Minor injuries such as cuts and bruises are common during competition.

  20. Functional anatomy and biomechanics of the carpus

    International Nuclear Information System (INIS)

    Schmitt, R.

    2006-01-01

    The wrist is an exceedingly complex structure composed of several joints and a dedicated ligamentous system. Its functional principles allow a wide range of carpal motion and make the wrist remarkably resistant to external stress forces: The proximal carpal row serves as an intercalated link interposed between the static elements of both the forearm and the distal carpal row. Like a flexible placeholder, the proximal row synchronously adapts to the spatial and temporal requirements of the wrist. There are synergistic movement patterns including simultaneous flexion of the proximal row as the wrist is deviated radially and simultaneous extension during ulnar deviation. Together with pronosupination of the radioulnar joints, the combined radial/ulnar inclination and flexion/extension enable spherical, out-of-plane movements of the hand. Carpal function is best explained by the ''model of a ring under tension.'' This review addresses the anatomy and the biomechanics of the wrist and illustrates systematic image analysis by using carpal lines and angles as well as indices of carpal height. (orig.) [de

  1. Biomechanical influences on balance recovery by stepping.

    Science.gov (United States)

    Hsiao, E T; Robinovitch, S N

    1999-10-01

    Stepping represents a common means for balance recovery after a perturbation to upright posture. Yet little is known regarding the biomechanical factors which determine whether a step succeeds in preventing a fall. In the present study, we developed a simple pendulum-spring model of balance recovery by stepping, and used this to assess how step length and step contact time influence the effort (leg contact force) and feasibility of balance recovery by stepping. We then compared model predictions of step characteristics which minimize leg contact force to experimentally observed values over a range of perturbation strengths. At all perturbation levels, experimentally observed step execution times were higher than optimal, and step lengths were smaller than optimal. However, the predicted increase in leg contact force associated with these deviations was substantial only for large perturbations. Furthermore, increases in the strength of the perturbation caused subjects to take larger, quicker steps, which reduced their predicted leg contact force. We interpret these data to reflect young subjects' desire to minimize recovery effort, subject to neuromuscular constraints on step execution time and step length. Finally, our model predicts that successful balance recovery by stepping is governed by a coupling between step length, step execution time, and leg strength, so that the feasibility of balance recovery decreases unless declines in one capacity are offset by enhancements in the others. This suggests that one's risk for falls may be affected more by small but diffuse neuromuscular impairments than by larger impairment in a single motor capacity.

  2. Comparative biomechanics: life's physical world (second edition)

    CERN Document Server

    Vogel, Steven

    2013-01-01

    Why do you switch from walking to running at a specific speed? Why do tall trees rarely blow over in high winds? And why does a spore ejected into air at seventy miles per hour travel only a fraction of an inch? Comparative Biomechanics is the first and only textbook that takes a comprehensive look at the mechanical aspects of life--covering animals and plants, structure and movement, and solids and fluids. An ideal entry point into the ways living creatures interact with their immediate physical world, this revised and updated edition examines how the forms and activities of animals and plants reflect the materials available to nature, considers rules for fluid flow and structural design, and explores how organisms contend with environmental forces. Drawing on physics and mechanical engineering, Steven Vogel looks at how animals swim and fly, modes of terrestrial locomotion, organism responses to winds and water currents, circulatory and suspension-feeding systems, and the relationship between size and mech...

  3. Injury biomechanics of C2 dens fractures.

    Science.gov (United States)

    Yoganandan, Narayan; Pintar, Frank; Baisden, Jamie; Gennarelli, Thomas; Maiman, Dennis

    2004-01-01

    The objective of this study is to analyze the biomechanics of dens fractures of the second cervical vertebra in the adult population due to motor vehicle crashes. Case-by-case records from the Crash Injury Research and Engineering Network (CIREN) and National Automotive Sampling System (NASS) databases were used. Variables such as change in velocity, impact direction and body habitus were extracted. Results indicated that similarities exist in the two databases despite differences in sampling methods between the two sources (e.g., CIREN is not population based). Trauma is predominantly associated with the frontal mode of impact. Majority of injuries occur with change in velocities below current federal guideline thresholds. No specific bias exists with respect to variables such as age, height, weight, and gender. Because similar conclusions can be drawn with regard to vehicle model years, design changes during these years may have had little effect on this injury. To ameliorate trauma, emphasis should be placed on the frontal impact mode and entire adult population. Because of clinical implications in the fracture type (II being most critical) and lack of specific coding, CIREN data demonstrates the need to improve injury coding in the AIS and application in the NASS to enhance occupant safety and treatment in the field of automotive medicine.

  4. A tailored relocation stress intervention programme for family caregivers of patients transferred from a surgical intensive care unit to a general ward.

    Science.gov (United States)

    Lee, Seul; Oh, HyunSoo; Suh, YeonOk; Seo, WhaSook

    2017-03-01

    To develop and examine a relocation stress intervention programme tailored for the family caregivers of patients scheduled for transfer from a surgical intensive care unit to a general ward. Family relocation stress syndrome has been reported to be similar to that exhibited by patients, and investigators have emphasised that nurses should make special efforts to relieve family relocation stress to maximise positive contributions to the well-being of patients by family caregivers. A nonequivalent control group, nonsynchronised pretest-post-test design was adopted. The study subjects were 60 family caregivers of patients with neurosurgical or general surgical conditions in the surgical intensive care unit of a university hospital located in Incheon, South Korea. Relocation stress and family burden were evaluated at three times, that is before intervention, immediately after transfer and four to five days after transfer. This relocation stress intervention programme was developed for the family caregivers based on disease characteristics and relocation-related needs. In the experimental group, relocation stress levels significantly and continuously decreased after intervention, whereas in the control group, a slight nonsignificant trend was observed. Family burden levels in the control group increased significantly after transfer, whereas burden levels in the experimental group increased only marginally and nonsignificantly. No significant between-group differences in relocation stress or family burden levels were observed after intervention. Relocation stress levels of family caregivers were significantly decreased after intervention in the experimental group, which indicates that the devised family relocation stress intervention programme effectively alleviated family relocation stress. The devised intervention programme, which was tailored to disease characteristics and relocation-related needs, may enhance the practicality and efficacy of relocation stress

  5. Advanced scheduling for zygote intrafallopian transfer is possible via the use of a hormone replacement cycle for patients who have experienced repeated implantation failures.

    Science.gov (United States)

    Nakagawa, Koji; Juen, Hiroyasu; Nishi, Yayoi; Sugiyama, Rie; Motoyama, Hiroshi; Kuribayashi, Yasushi; Inoue, Masato; Akira, Shigeo; Sugiyama, Rikikazu

    2014-11-01

    Zygote intrafallopian transfer (ZIFT) is an effective option for patients who have experienced repeated implantation failures (RIF) in assisted reproductive technology (ART) treatment. However, advance planning for the day of the operation can be problematic. Using a hormone replacement cycle (HRC) makes it possible to plan for the day of ZIFT. In the present study, we evaluated whether HRC-ZIFT is useful for RIF patients who have experienced difficulties obtaining morphologically good embryos in vitro. A total of 55 patients with a history of five or more unsuccessful transfers received HRC-ZIFT between June 2008 and June 2013. The oocyte pick-ups were performed and the oocytes showing two pronuclei (2PN) were cryopreserved. After receiving more than five 2PN oocytes, the operation day was scheduled in advance, and as a consequence, a HRC was started and ZIFT was performed. The clinical outcomes were evaluated. The average age of the patients was 39.3 years, and the previous OPU and ET attempts numbered 7.5 and 6.9, respectively. The number of previously transferred embryos was 11.8, and the number of morphologically good embryos (MGEs) was only 1.2. The number of transferred 2PN oocytes was 6.7, and the subsequent pregnancy rate was 23.6 %. No ectopic or multiple pregnancies were observed, but there were 6 cases of miscarriage. Among RIF patients, in particular those who have difficulty obtaining MGEs in vitro, ZIFT might be a useful option. The HRC allows patients and medical staff to plan for the operation day in advance.

  6. The effect of intraosseous injection of calcium sulfate on microstructure and biomechanics of osteoporotic lumbar vertebrae in sheep

    Directory of Open Access Journals (Sweden)

    Da LIU

    2014-10-01

    Full Text Available Objective To investigate the effect of calcium sulfate (CS on improvement of microstructure and biomechanical performance of osteoporotic lumbar vertebrae in sheep. Methods Osteoporosis model was reproduced in 8 female sheep by bilateral ovariectomy and methylprednisolone administration. Then the lumbar vertebrae (L1-L4 in each sheep were randomly divided into CS group and blank group (2 vertebrae in each sheep. CS was injected into the vertebral bodies through the pedicle in CS group, and no treatment was given in blank group. All of the animals were sacrificed 3 months later, and vertebrae L1-L4 were harvested. The microstructure and biomechanical performance of vertebral bodies were assessed by micro-CT scanning, histological observation and biomechanical test. Results After ovariectomy and methylprednisolone administration, the mean bone mineral density of the lumbar vertebrae in the sheep was significantly decreased (>25% compared with that before induction (P<0.05, demonstrating a successful reproduction of osteoporosis model. Three months after injection, it was shown that CS was completely degraded without any remnant in the bone tissue. The quality of the bone tissue (trabecular number and tissue mineral density in CS group was significantly better than that in blank group (P<0.05, and the biomechanical performance in CS group was significantly superior to that in blank group (P<0.05. Conclusions  Local injection of CS could significantly improve the microstructure and biomechanical performance of osteoporotic vertebrae, and it may decrease the risk of fracture of patients with osteoporosis. DOI: 10.11855/j.issn.0577-7402.2014.09.02

  7. Rehabilitation System based on the Use of Biomechanical Analysis and Videogames through the Kinect Sensor

    Directory of Open Access Journals (Sweden)

    John E. Muñoz-Cardona

    2013-11-01

    Full Text Available This paper presents development of a novel system for physical rehabilitation of patients with multiple pathologies, through dynamic with exercise videogames (exergames and analysis of the movements of patients using developed software. This system is based on the use of the Kinect sensor for both purposes: amusing the patient in therapy through of specialist exergames and provide a tool to record and analyze MoCap data taken through the Kinect sensor and processed using biomechanical analysis through Euler angles. All interactive system is installed in a rehabilitation center and works with different pathologies (stroke, IMOC, craneoencephallic trauma, etc., patients interact with the platform while the specialist records data for later analysis, which is performed by software designed for this purpose. The motion graphics are shown in the sagittal, frontal and rotationalplanefrom20 points distributed in the body. The final system is portable, non-invasive, inexpensive, natural interaction with the patient and easily implemented for medical purposes.

  8. A traumatic central cord syndrome occurring after adequate decompression for cervical spondylosis: biomechanics of injury: case report.

    Science.gov (United States)

    Dickerman, Rob D; Lefkowitz, Michael; Epstein, Joseph A

    2005-10-15

    Case report with review of the literature. To present the first case of a central cord syndrome occurring after adequate decompression, and review the mechanics of the cervical spinal cord injury and postoperative biomechanical and anatomic changes occurring after cervical decompressive laminectomy. Cervical spondylosis is a common pathoanatomic occurrence in the elderly population and is thought to be one of the primary causes for a central cord syndrome. Decompressive laminectomy with or without fusion has been a primary treatment for spondylotic disease and is thought to be protective against further injury. To our knowledge, there are no cases of a central cord syndrome occurring after adequate decompression reported in the literature. Case study with extensive review of the literature. The patient underwent C3-C7 cervical laminectomy without complications. After surgery, the patient's spasticity and gait difficulties improved. She was discharged to inpatient rehabilitation for further treatment of upper extremity weakness. The patient fell in the rehabilitation center, with a central cord syndrome despite adequate decompression of her spinal canal. The patient was treated conservatively for the central cord and had minimal improvement. Decompressive laminectomy provides an immediate decompressive effect on the spinal cord as seen by the dorsal migration of the cord, however, the biomechanics of the cervical spine after decompressive laminectomy remain uncertain. This case supports the ongoing research and need for more intensive research on postoperative cervical spine biomechanics, including decompressive laminectomies, decompressive laminectomy and fusion, and laminoplasty.

  9. Stakeholder Perspectives on the Optimizing Patient Transfers, Impacting Medical Quality, and Improving Symptoms: Transforming Institutional Care (OPTIMISTIC) Project.

    Science.gov (United States)

    Ersek, Mary; Hickman, Susan E; Thomas, Anne C; Bernard, Brittany; Unroe, Kathleen T

    2017-10-17

    The need to reduce burdensome and costly hospitalizations of frail nursing home residents is well documented. The Optimizing Patient Transfers, Impacting Medical Quality, and Improving Symptoms: Transforming Institutional Care (OPTIMISTIC) project achieved this reduction through a multicomponent collaborative care model. We conducted an implementation-focused project evaluation to describe stakeholders' perspectives on (a) the most and least effective components of the intervention; (b) barriers to implementation; and (c) program features that promoted its adoption. Nineteen nursing homes participated in OPTIMISTIC. We conducted semistructured, qualitative interviews with 63 stakeholders: 23 nursing home staff and leaders, 4 primary care providers, 10 family members, and 26 OPTIMISTIC clinical staff. We used directed content analysis to analyze the data. We found universal endorsement of the value of in-depth advance care planning (ACP) discussions in reducing hospitalizations and improving care. Similarly, all stakeholder groups emphasized that nursing home access to specially trained, project registered nurses (RNs) and nurse practitioners (NPs) with time to focus on ACP, comprehensive resident assessment, and staff education was particularly valuable in identifying residents' goals for care. Challenges to implementation included inadequately trained facility staff and resistance to changing practice. In addition, the program sometimes failed to communicate its goals and activities clearly, leaving facilities uncertain about the OPTIMISTIC clinical staff's roles in the facilities. These findings are important for dissemination efforts related to the OPTIMISTIC care model and may be applicable to other innovations in nursing homes. Published by Oxford University Press on behalf of The Gerontological Society of America 2017. This work is written by (a) US Government employee(s) and is in the public domain in the US.

  10. Biomechanics of the Treadmill Locomotion on the International Space Station

    Science.gov (United States)

    DeWitt, John; Cromwell, R. L.; Ploutz-Snyder, L. L.

    2014-01-01

    Exercise prescriptions completed by International Space Station (ISS) crewmembers are typically based upon evidence obtained during ground-based investigations, with the assumption that the results of long-term training in weightlessness will be similar to that attained in normal gravity. Coupled with this supposition are the assumptions that exercise motions and external loading are also similar between gravitational environments. Normal control of locomotion is dependent upon learning patterns of muscular activation and requires continual monitoring of internal and external sensory input [1]. Internal sensory input includes signals that may be dependent on or independent of gravity. Bernstein hypothesized that movement strategy planning and execution must include the consideration of segmental weights and inertia [2]. Studies of arm movements in microgravity showed that individuals tend to make errors but that compensation strategies result in adaptations, suggesting that control mechanisms must include peripheral information [3-5]. To date, however, there have been no studies examining a gross motor activity such as running in weightlessness other than using microgravity analogs [6-8]. The objective of this evaluation was to collect biomechanical data from crewmembers during treadmill exercise before and during flight. The goal was to determine locomotive biomechanics similarities and differences between normal and weightless environments. The data will be used to optimize future exercise prescriptions. This project addresses the Critical Path Roadmap risks 1 (Accelerated Bone Loss and Fracture Risk) and 11 (Reduced Muscle Mass, Strength, and Endurance). Data were collected from 7 crewmembers before flight and during their ISS missions. Before launch, crewmembers performed a single data collection session at the NASA Johnson Space Center. Three-dimensional motion capture data were collected for 30 s at speeds ranging from 1.5 to 9.5 mph in 0.5 mph increments

  11. A quantitative study of ramped radio frequency, magnetization transfer, and slab thickness in three-dimensional time-of-flight magnetic resonance angiography in a patient population.

    Science.gov (United States)

    Goodrich, K C; Blatter, D D; Parker, D L; Du, Y P; Meyer, K J; Bernstein, M A

    1996-06-01

    The authors compare the effectiveness of various magnetic resonance (MR) angiography acquisition strategies in enhancing the visibility of small intracranial vessels. Blood vessel contrast-to-noise ratio (CNR) in time-of-flight MR angiography was studied as a function of vessel size and several selectable imaging parameters. Contrast-to-noise measurements were made on 257 vessel segments ranging in size from 0.3 mm to 4.2 mm in patients who recently had undergone intraarterial cerebral angiography. Imaging parameters studied included magnetization transfer, spatially variable radio frequency (RF) pulse profile (ramped RF), and imaging slab thickness. The combination of thin slabs (16 slices/slab), ramped RF, and magnetization transfer resulted in the highest CNR for all but the smallest vessel sizes. The smallest vessels (slab (64 slices/slab) with ramped RF and magnetization transfer. Magnetization transfer always improved vessel CNR, but the improvement diminished as the slab thickness was reduced. The CNR increased with a decrease in slab thickness for all but the smallest vessel sizes. Overall, the results provide a quantitative demonstration that inflow enhancement of blood is reduced for small vessels. Thus, whereas magnetization transfer is important at all vessel sizes, it becomes the primary factor in improving the visibility of the smallest vessels.

  12. Trampoline-related injuries in children: a preliminary biomechanical model of multiple users.

    Science.gov (United States)

    Menelaws, Simon; Bogacz, Andrew R; Drew, Tim; Paterson, Brodie C

    2011-07-01

    The recent popularity of domestic trampolines has seen a corresponding increase in injured children. Most injuries happen on the trampoline mat when there are multiple users present. This study sought to examine and simulate the forces and energy transferred to a child's limbs when trampolining with another person of greater mass. The study used a computational biomechanical model. The simulation demonstrated that when two masses bounce out of phase on a trampoline, a transfer of kinetic energy from the larger mass to the smaller mass is likely to occur. It predicted that when an 80 kg adult is on a trampoline with a 25 kg child, the energy transfer is equivalent to the child falling 2.8 m onto a solid surface. Additionally, the rate of loading on the child's bones and ligaments is greater than that on the accompanying adult. Current guidelines are clear that more than one user on a trampoline at a time is a risk factor for serious injury; however, the majority of injuries happen in this scenario. The model predicted that there are high energy transfers resulting in serious fracture and ligamentous injuries to children and that this could be equated to equivalent fall heights. This provides a clear take-home message, which can be conveyed to parents to reduce the incidence of trampoline-related injuries.

  13. The best way to reduce reulcerations: if you understand biomechanics of the diabetic foot, you can do it.

    Science.gov (United States)

    Lázaro-Martínez, José Luis; Aragón-Sánchez, Javier; Alvaro-Afonso, Francisco Javier; García-Morales, Esther; García-Álvarez, Yolanda; Molines-Barroso, Raúl Juan

    2014-12-01

    Foot ulcer recurrence is still an unresolved issue. Although several therapies have been described for preventing foot ulcers, the rates of reulcerations are very high. Footwear and insoles have been recommended as effective therapies that prevent the development of new ulcers; however, the majority of studies have analyzed their effects in terms of reducing peak plantar pressure rather than ulcer relapse. Knowledge of biomechanical considerations is low, in general, in the team approach to diabetic foot because heterogeneous professionals having competence in recurrence prevention are involved. Assessment of biomechanical alterations define a foot type position; examining foot structure and recording plantar pressure could help in appropriate insole and footwear prescription and design. Patient education and compliance should be taken into consideration for better therapy success. When patients suffer from rigid deformities or have undergone an amputation, surgical offloading should be considered as an alternative. © The Author(s) 2014.

  14. Knee joint biomechanics and neuromuscular control during gait before and after total knee arthroplasty are sex-specific.

    Science.gov (United States)

    Astephen Wilson, Janie L; Dunbar, Michael J; Hubley-Kozey, Cheryl L

    2015-01-01

    The future of total knee arthroplasty (TKA) surgery will involve planning that incorporates more patient-specific characteristics. Despite known biological, morphological, and functional differences between men and women, there has been little investigation into knee joint biomechanical and neuromuscular differences between men and women with osteoarthritis, and none that have examined sex-specific biomechanical and neuromuscular responses to TKA surgery. The objective of this study was to examine sex-associated differences in knee kinematics, kinetics and neuromuscular patterns during gait before and after TKA. Fifty-two patients with end-stage knee OA (28 women, 24 men) underwent gait and neuromuscular analysis within the week prior to and one year after surgery. A number of sex-specific differences were identified which suggest a different manifestation of end-stage knee OA between the sexes. Copyright © 2014 Elsevier Inc. All rights reserved.

  15. Optic nerve head biomechanics in aging and disease.

    Science.gov (United States)

    Downs, J Crawford

    2015-04-01

    This nontechnical review is focused upon educating the reader on optic nerve head biomechanics in both aging and disease along two main themes: what is known about how mechanical forces and the resulting deformations are distributed in the posterior pole and ONH (biomechanics) and what is known about how the living system responds to those deformations (mechanobiology). We focus on how ONH responds to IOP elevations as a structural system, insofar as the acute mechanical response of the lamina cribrosa is confounded with the responses of the peripapillary sclera, prelaminar neural tissues, and retrolaminar optic nerve. We discuss the biomechanical basis for IOP-driven changes in connective tissues, blood flow, and cellular responses. We use glaucoma as the primary framework to present the important aspects of ONH biomechanics in aging and disease, as ONH biomechanics, aging, and the posterior pole extracellular matrix (ECM) are thought to be centrally involved in glaucoma susceptibility, onset and progression. Copyright © 2015 Elsevier Ltd. All rights reserved.

  16. Special article: Creation of a guide for the transfer of care of the malignant hyperthermia patient from ambulatory surgery centers to receiving hospital facilities.

    Science.gov (United States)

    Larach, Marilyn Green; Dirksen, Sharon J Hirshey; Belani, Kumar G; Brandom, Barbara W; Metz, Keith M; Policastro, Michael A; Rosenberg, Henry; Valedon, Arnaldo; Watson, Charles B

    2012-01-01

    Volatile anesthetics and/or succinylcholine may trigger a potentially lethal malignant hyperthermia (MH) event requiring critical care crisis management. If the MH triggering anesthetic is given in an ambulatory surgical center (ASC), then the patient will need to be transferred to a receiving hospital. Before May 2010, there was no clinical guide regarding the development of a specific transfer plan for MH patients in an ASC. MECHANISM BY WHICH THE STATEMENT WAS GENERATED: A consensual process lasting 18 months among 13 representatives of the Malignant Hyperthermia Association of the United States, the Ambulatory Surgery Foundation, the Society for Ambulatory Anesthesia, the Society for Academic Emergency Medicine, and the National Association of Emergency Medical Technicians led to the creation of this guide. EVIDENCE FOR THE STATEMENT: Most of the guide is based on the clinical experience and scientific expertise of the 13 representatives. The list of representatives appears in Appendix 1. The recommendation that IV dantrolene should be initiated pending transfer is also supported by clinical research demonstrating that the likelihood of significant MH complications doubles for every 30-minute delay in dantrolene administration (Anesth Analg 2010;110:498-507). This guide includes a list of potential clinical problems and therapeutic interventions to assist each ASC in the development of its own unique MH transfer plan. Points to consider include receiving health care facility capabilities, indicators of patient stability and necessary report data, transport team considerations and capabilities, implementation of transfer decisions, and coordination of communication among the ASC, the receiving hospital, and the transport team. See Appendix 2 for the guide.

  17. Patient and cycle characteristics predicting high pregnancy rates with single-embryo transfer: an analysis of the Society for Assisted Reproductive Technology outcomes between 2004 and 2013.

    Science.gov (United States)

    Mersereau, Jennifer; Stanhiser, Jamie; Coddington, Charles; Jones, Tiffany; Luke, Barbara; Brown, Morton B

    2017-11-01

    To analyze factors associated with high live birth rate and low multiple birth rate in fresh and frozen-thawed assisted reproductive technology (ART) cycles. Retrospective cohort analysis. Not applicable. The study population included 181,523 women undergoing in vitro fertilization with autologous fresh first cycles, 27,033 with fresh first oocyte donor cycles, 37,658 with fresh second cycles, and 35,446 with frozen-thawed second cycles. None. Live birth rate and multiple birth rate after single-embryo transfer (SET) and double embryo transfer (DET) were measured, in addition to cycle characteristics. In patients with favorable prognostic factors, including younger maternal age, transfer of a blastocyst, and additional embryos cryopreserved, the gain in the live birth rate from SET to DET was approximately 10%-15%; however, the multiple birth rate increased from approximately 2% to greater than 49% in both autologous and donor fresh and frozen-thawed transfer cycles. This study reports a 10%-15% reduction in live birth rate and a 47% decrement in multiple birth rate with SET compared with DET in the setting of favorable patient prognostic factors. Our findings present an opportunity to increase the rate of SET across the United States and thereby reduce the multiple birth rate and its associated poor perinatal outcomes with assisted reproductive technology pregnancies. Copyright © 2017 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

  18. Biomechanical and clinical evaluation of posterior malleolar fractures. A systematic review of the literature

    NARCIS (Netherlands)

    van den Bekerom, Michel P. J.; Haverkamp, Daniel; Kloen, Peter

    2009-01-01

    INTRODUCTION: Ankle fractures often have involvement of the posterior malleolus. Treatment guidelines exist based on limited biomechanical evidence and still is considered controversial. The objective of this article is to review the biomechanical literature concerning changes in tibiotalar contract

  19. Factor IX expression in skeletal muscle of a severe hemophilia B patient 10 years after AAV-mediated gene transfer

    OpenAIRE

    Buchlis, George; Podsakoff, Gregory M.; Radu, Antonetta; Hawk, Sarah M.; Flake, Alan W.; Mingozzi, Federico; High, Katherine A.

    2012-01-01

    In previous work we transferred a human factor IX–encoding adeno-associated viral vector (AAV) into skeletal muscle of men with severe hemophilia B. Biopsy of injected muscle up to 1 year after vector injection showed evidence of gene transfer by Southern blot and of protein expression by IHC and immunofluorescent staining. Although the procedure appeared safe, circulating F.IX levels remained subtherapeutic (< 1%). Recently, we obtained muscle tissue from a subject injected 10 years earlier ...

  20. Hip joint biomechanics in those with and without post-traumatic knee osteoarthritis after anterior cruciate ligament injury.

    Science.gov (United States)

    Wellsandt, E; Zeni, J A; Axe, M J; Snyder-Mackler, L

    2017-12-01

    Anterior cruciate ligament injury results in altered kinematics and kinetics in the knee and hip joints that persist despite surgical reconstruction and rehabilitation. Abnormal movement patterns and a history of osteoarthritis are risk factors for articular cartilage degeneration in additional joints. The purpose of this study was to determine if hip joint biomechanics early after anterior cruciate ligament injury and reconstruction differ between patients with and without post-traumatic knee osteoarthritis 5years after reconstruction. The study's rationale was that individuals who develop knee osteoarthritis after anterior cruciate ligament injury may also demonstrate large alterations in hip joint biomechanics. Nineteen athletes with anterior cruciate ligament injury completed standard gait analysis before (baseline) and after (post-training) extended pre-operative rehabilitation and at 6months, 1year, and 2years after reconstruction. Weightbearing knee radiographs were completed 5years after reconstruction to identify medial compartment osteoarthritis. Five of 19 patients had knee osteoarthritis at 5years after anterior cruciate ligament reconstruction. Patients with knee osteoarthritis at 5years walked with smaller sagittal plane hip angles (P: 0.043) and lower sagittal (P: 0.021) and frontal plane (P: 0.042) external hip moments in the injured limb before and after reconstruction compared to those without knee osteoarthritis. The current findings suggest hip joint biomechanics may be altered in patients who develop post-traumatic knee osteoarthritis. Further study is needed to confirm whether the risk of non-traumatic hip pathology is increased after anterior cruciate ligament injury and if hip joint biomechanics influence its development. Copyright © 2017 Elsevier Ltd. All rights reserved.

  1. A pilot study of biomechanical assessment before and after an integrative training program for adolescents with juvenile fibromyalgia

    OpenAIRE

    Tran, Susan T.; Thomas, Staci; DiCesare, Christopher; Pfeiffer, Megan; Sil, Soumitri; Ting, Tracy V.; Williams, Sara E.; Myer, Gregory D.; Kashikar-Zuck, Susmita

    2016-01-01

    Background Adolescents with juvenile fibromyalgia (JFM) tend to be very sedentary and avoid participation in physical activity. A prior study suggested that JFM patients show altered biomechanics compared to healthy adolescents which may make them more prone to pain/injury during exercise. A new intervention combining well established cognitive behavioral therapy (CBT) techniques with specialized neuromuscular exercise ?Fibromyalgia Integrative Training for Teens (FIT Teens) was developed and...

  2. Biomechanical analysis using Kinovea for sports application

    Science.gov (United States)

    Muaza Nor Adnan, Nor; Patar, Mohd Nor Azmi Ab; Lee, Hokyoo; Yamamoto, Shin-Ichiroh; Jong-Young, Lee; Mahmud, Jamaluddin

    2018-04-01

    This paper assesses the reliability of HD VideoCam–Kinovea as an alternative tool in conducting motion analysis and measuring knee relative angle of drop jump movement. The motion capture and analysis procedure were conducted in the Biomechanics Lab, Shibaura Institute of Technology, Omiya Campus, Japan. A healthy subject without any gait disorder (BMI of 28.60 ± 1.40) was recruited. The volunteered subject was asked to per the drop jump movement on preset platform and the motion was simultaneously recorded using an established infrared motion capture system (Hawk–Cortex) and a HD VideoCam in the sagittal plane only. The capture was repeated for 5 times. The outputs (video recordings) from the HD VideoCam were input into Kinovea (an open-source software) and the drop jump pattern was tracked and analysed. These data are compared with the drop jump pattern tracked and analysed earlier using the Hawk–Cortex system. In general, the results obtained (drop jump pattern) using the HD VideoCam–Kinovea are close to the results obtained using the established motion capture system. Basic statistical analyses show that most average variances are less than 10%, thus proving the repeatability of the protocol and the reliability of the results. It can be concluded that the integration of HD VideoCam–Kinovea has the potential to become a reliable motion capture–analysis system. Moreover, it is low cost, portable and easy to use. As a conclusion, the current study and its findings are found useful and has contributed to enhance significant knowledge pertaining to motion capture-analysis, drop jump movement and HD VideoCam–Kinovea integration.

  3. ANALYSIS OF BIOMECHANICAL PARAMETERS IN COLONIC ANASTOMOSIS.

    Science.gov (United States)

    Iwanaga, Tiago Cavalcanti; Aguiar, José Lamartine de Andrade; Martins-Filho, Euclides Dias; Kreimer, Flávio; Silva-Filho, Fernando Luiz; Albuquerque, Amanda Vasconcelos de

    2016-01-01

    The use of measures in colonic anastomoses to prevent dehiscences is of great medical interest. Sugarcane molasses, which has adequate tolerability and compatibility in vivo, has not yet been tested for this purpose. To analyze the biomechanical parameters of colonic suture in rats undergoing colectomy, using sugarcane molasses polysaccharide as tape or gel. 45 Wistar rats (Rattus norvegicus albinus) were randomized into three groups of 15 animals: irrigation of enteric sutures with 0.9% saline solution; application of sugarcane molasses polysaccharide as tape; and sugarcane molasses polysaccharide as gel. The rats underwent colon ressection, with subsequent reanastomosis using polypropylene suture; they were treated according to their respective groups. Five rats from each group were evaluated at different times after the procedure: 30, 90 and 180 days postoperatively. The following variables were evaluated: maximum rupture force, modulus of elasticity and specific deformation of maximum force. The biomechanical variables among the scheduled times and treatment groups were statistically calculated. The characteristics of maximum rupture force and modulus of elasticity of the specimens remained identical, regardless of treatment with saline, polysaccharide gel or tape, and treatment time. However, it was found that the specific deformation of maximum force of the intestinal wall was higher after 180 days in the group treated with sugarcane polysaccharide gel (p=0.09). Compared to control, it was detected greater elasticity of the intestinal wall in mice treated with sugarcane polysaccharide gel, without changing other biomechanical characteristics, regardless of type or time of treatment. A aplicação de produtos em anastomoses colônicas que possam prevenir o surgimento de deiscências são de grande interesse médico. O emprego do polissacarídeo de melaço de cana-de-açúcar (Saccharum officinarum), que possui adequada tolerabilidade e compatibilidade in vivo

  4. Corneal biomechanical changes in diabetes mellitus and their influence on intraocular pressure measurements.

    Science.gov (United States)

    Sahin, Afsun; Bayer, Atilla; Ozge, Gökhan; Mumcuoğlu, Tarkan

    2009-10-01

    To investigate possible corneal biomechanical changes in patients with diabetes mellitus and understand the influence of such changes on intraocular pressure measurements. The study group was composed of 120 eyes from 61 healthy control subjects and 81 eyes from 43 diabetic subjects. IOP was measured first with an ocular response analyzer (ORA) and subsequently with a Goldmann applanation tonometer (GAT). Central corneal thickness (CCT) was measured with an ultrasonic pachymeter attached to the ORA. Axial length (AL), anterior chamber depth (ACD), and keratometry readings were acquired with partial coherence laser interferometry during the same visit before all IOP and CCT determinations were made. Corneal hysteresis (CH) was found to be significantly lower in diabetic patients when compared with healthy control subjects (9.51 +/- 1.82 mm Hg vs. 10.41 +/- 1.66 mm Hg, P < 0.0001). There was no significant difference in terms of corneal resistance factor (CRF; P = 0.8). Mean CCT, GAT IOP, Goldmann-correlated IOP (IOPg), and corneal-compensated IOP (IOPcc) were significantly higher in diabetic patients than in healthy control subjects (P = 0.01 for CCT, P < 0.0001 for GAT IOP, IOPg, and IOPcc). Diabetes affects corneal biomechanics and results in lower CH values than those in healthy control subjects, which may cause clinically relevant high IOP measurements independent of CCT.

  5. Diabetic Foot and Exercise Therapy: Step by Step The Role of Rigid Posture and Biomechanics Treatment

    Science.gov (United States)

    Francia, Piergiorgio; Gulisano, Massimo; Anichini, Roberto; Seghieri, Giuseppe

    2014-01-01

    Lower extremity ulcers represent a serious and costly complication of diabetes mellitus. Many factors contribute to the development of diabetic foot. Peripheral neuropathy and peripheral vascular disease are the main causes of foot ulceration and contribute in turn to the growth of additional risk factors such as limited joint mobility, muscular alterations and foot deformities. Moreover, a deficit of balance, posture and biomechanics can be present, in particular in patients at high risk for ulceration. The result of this process may be the development of a vicious cycle which leads to abnormal distribution of the foot's plantar pressures in static and dynamic postural conditions. This review shows that some of these risk factors significantly improve after a few weeks of exercise therapy (ET) intervention. Accordingly it has been suggested that ET can be an important weapon in the prevention of foot ulcer. The aim of ET can relate to one or more alterations typically found in diabetic patients, although greater attention should be paid to the evaluation and possible correction of body balance, rigid posture and biomechanics. Some of the most important limitations of ET are difficult access to therapy, patient compliance and the transitoriness of the results if the training stops. Many proposals have been made to overcome such limitations. In particular, it is important that specialized centers offer the opportunity to participate in ET and during the treatment the team should work to change the patient’s lifestyle by improving the execution of appropriate daily physical activity. PMID:24807636

  6. Cholesteryl Ester Transfer Protein Intimately Involved in Dyslipidemia-Related Susceptibility to Cognitive Deficits in Type 2 Diabetic Patients.

    Science.gov (United States)

    Sun, Jie; Cai, Rongrong; Huang, Rong; Wang, Pin; Tian, Sai; Sun, Haixia; Xia, Wenqing; Wang, Shaohua

    2016-08-01

    Cholesteryl ester transfer protein (CETP) is involved in diabetic dyslipidemia. We aim to test the hypothesis that CETP might be of importance in mediating dyslipidemia-related susceptibility to cognitive deficits in diabetic patients. We recruited 190 type 2 diabetic patients and divided them into two groups according to the Montreal Cognitive Assessment (MoCA) score. The association between CETP and cognitive decline was analyzed with logistic regression and stratification. There were 110 diabetic patients with mild cognition impairment (MCI) and 80 healthy cognition subjects as controls. Dyslipidemia is more common among diabetic patients with MCI; they had a significant increase of serum CETP concentrations, which was negatively correlated with MoCA (r = -0.638; p dyslipidemia-related susceptibility to cognitive decline, especially memory function in type 2 diabetic patients.

  7. Intestinal morphometric and biomechanical changes during aging in rats

    DEFF Research Database (Denmark)

    Zhao, Jingbo; Gregersen, Hans

    2015-01-01

    Background and aim: Previously we demonstrated pronounced morphometric and biomechanical remodeling in the rat intestine during physiological growth up to 32 weeks of age. The aim of the present study is to study intestinal geometric and biomechanical changes in aging rats. Materials and methods...... in the circumferential direction. In conclusion pronounced morphometric and biomechanical remodeling occurred in the rat intestine during aging. The observed changes likely reflect the changes of the physiological function of the intestine during ageing, similar to other tissues where function, mechanical loading......: Twenty-four male Wistar rats, aged from 6 to 22 months, were used in the study. The body weight and the wet weight per length of duodenal and ileal segments were measured at the termination of experiment. Morphometric data were obtained by measuring the wall thickness and wall cross-sectional area...

  8. Computational biomechanics for medicine imaging, modeling and computing

    CERN Document Server

    Doyle, Barry; Wittek, Adam; Nielsen, Poul; Miller, Karol

    2016-01-01

    The Computational Biomechanics for Medicine titles provide an opportunity for specialists in computational biomechanics to present their latest methodologies and advancements. This volume comprises eighteen of the newest approaches and applications of computational biomechanics, from researchers in Australia, New Zealand, USA, UK, Switzerland, Scotland, France and Russia. Some of the interesting topics discussed are: tailored computational models; traumatic brain injury; soft-tissue mechanics; medical image analysis; and clinically-relevant simulations. One of the greatest challenges facing the computational engineering community is to extend the success of computational mechanics to fields outside traditional engineering, in particular to biology, the biomedical sciences, and medicine. We hope the research presented within this book series will contribute to overcoming this grand challenge.

  9. Biomechanical analysis technique choreographic movements (for example, "grand battman jete"

    Directory of Open Access Journals (Sweden)

    Batieieva N.P.

    2015-04-01

    Full Text Available Purpose : biomechanical analysis of the execution of choreographic movement "grand battman jete". Material : the study involved students (n = 7 of the department of classical choreography faculty of choreography. Results : biomechanical analysis of choreographic movement "grand battman jete" (classic exercise, obtained kinematic characteristics (path, velocity, acceleration, force of the center of mass (CM bio parts of the body artist (foot, shin, thigh. Built bio kinematic model (phase. The energy characteristics - mechanical work and kinetic energy units legs when performing choreographic movement "grand battman jete". Conclusions : It was found that the ability of an athlete and coach-choreographer analyze the biomechanics of movement has a positive effect on the improvement of choreographic training of qualified athletes in gymnastics (sport, art, figure skating and dance sports.

  10. Biomechanics of Wheat/Barley Straw and Corn Stover

    Energy Technology Data Exchange (ETDEWEB)

    Christopher T. Wright; Peter A. Pryfogle; Nathan A. Stevens; Eric D. Steffler; J. Richard Hess; Thomas H. Ulrich

    2005-03-01

    The lack of understanding of the mechanical characteristics of cellulosic feedstocks is a limiting factor in economically collecting and processing crop residues, primarily wheat and barley stems and corn stover. Several testing methods, including compression, tension, and bend have been investigated to increase our understanding of the biomechanical behavior of cellulosic feedstocks. Biomechanical data from these tests can provide required input to numerical models and help advance harvesting, handling, and processing techniques. In addition, integrating the models with the complete data set from this study can identify potential tools for manipulating the biomechanical properties of plant varieties in such a manner as to optimize their physical characteristics to produce higher value biomass and more energy efficient harvesting practices.

  11. Vesicle biomechanics in a time-varying magnetic field.

    Science.gov (United States)

    Ye, Hui; Curcuru, Austen

    2015-01-01

    Cells exhibit distortion when exposed to a strong electric field, suggesting that the field imposes control over cellular biomechanics. Closed pure lipid bilayer membranes (vesicles) have been widely used for the experimental and theoretical studies of cellular biomechanics under this electrodeformation. An alternative method used to generate an electric field is by electromagnetic induction with a time-varying magnetic field. References reporting the magnetic control of cellular mechanics have recently emerged. However, theoretical analysis of the cellular mechanics under a time-varying magnetic field is inadequate. We developed an analytical theory to investigate the biomechanics of a modeled vesicle under a time-varying magnetic field. Following previous publications and to simplify the calculation, this model treated the inner and suspending media as lossy dielectrics, the membrane thickness set at zero, and the electric resistance of the membrane assumed to be negligible. This work provided the first analytical solutions for the surface charges, electric field, radial pressure, overall translational forces, and rotational torques introduced on a vesicle by the time-varying magnetic field. Frequency responses of these measures were analyzed, particularly the frequency used clinically by transcranial magnetic stimulation (TMS). The induced surface charges interacted with the electric field to produce a biomechanical impact upon the vesicle. The distribution of the induced surface charges depended on the orientation of the coil and field frequency. The densities of these charges were trivial at low frequency ranges, but significant at high frequency ranges. The direction of the radial force on the vesicle was dependent on the conductivity ratio between the vesicle and the medium. At relatively low frequencies (biomechanics under a time-varying magnetic field. Biological effects of clinical TMS are not likely to occur via alteration of the biomechanics of brain

  12. Biomechanical comparison of expanded polytetrafluoroethylene (ePTFE) and PTFE interpositional patches and direct tendon-to-bone repair for massive rotator cuff tears in an ovine model.

    Science.gov (United States)

    McKeown, Andrew Dj; Beattie, Rebekah F; Murrell, George Ac; Lam, Patrick H

    2016-01-01

    Massive irreparable rotator cuff tears are a difficult problem. Modalities such as irrigation and debridement, partial repair, tendon transfer and grafts have been utilized with high failure rates and mixed results. Synthetic interpositional patch repairs are a novel and increasingly used approach. The present study aimed to examine the biomechanical properties of common synthetic materials for interpositional repairs in contrast to native tendon. Six ovine tendons, six polytetrafluoroethylene (PTFE) felt sections and six expanded PTFE (ePTFE) patch sections were pulled-to-failure to analyze their biomechanical and material properties. Six direct tendon-to-bone surgical method repairs, six interpositional PTFE felt patch repairs and six interpositional ePTFE patch repairs were also constructed in ovine shoulders and pulled-to-failure to examine the biomechanical properties of each repair construct. Ovine tendon had higher load-to-failure (591 N) and had greater stiffness (108 N/mm) than either PTFE felt (296 N, 28 N/mm) or ePTFE patch sections (323 N, 34 N/mm). Both PTFE felt and ePTFE repair techniques required greater load-to-failure (225 N and 177 N, respectively) than direct tendon-to-bone surgical repairs (147 N) in ovine models. Synthetic materials lacked several biomechanical properties, including strength and stiffness, compared to ovine tendon. Interpositional surgical repair models with these materials were significantly stronger than direct tendon-to-bone model repairs.

  13. Heel-Rise Height Deficit 1 Year After Achilles Tendon Rupture Relates to Changes in Ankle Biomechanics 6 Years After Injury.

    Science.gov (United States)

    Brorsson, Annelie; Willy, Richard W; Tranberg, Roy; Grävare Silbernagel, Karin

    2017-11-01

    It is unknown whether the height of a heel-rise performed in the single-leg standing heel-rise test 1 year after an Achilles tendon rupture (ATR) correlates with ankle biomechanics during walking, jogging, and jumping in the long-term. To explore the differences in ankle biomechanics, tendon length, calf muscle recovery, and patient-reported outcomes at a mean of 6 years after ATR between 2 groups that, at 1-year follow-up, had less than 15% versus greater than 30% differences in heel-rise height. Cohort study; Level of evidence, 3. Seventeen patients with less than 15% (30% group) side-to-side difference in heel-rise height at 1 year after ATR were evaluated at a mean (SD) 6.1 (2.0) years after their ATR. Ankle kinematics and kinetics were sampled via standard motion capture procedures during walking, jogging, and jumping. Patient-reported outcome was evaluated with Achilles tendon Total Rupture Score (ATRS), Physical Activity Scale (PAS), and Foot and Ankle Outcome Score (FAOS). Tendon length was evaluated by ultrasonography. The Limb Symmetry Index (LSI = [Injured Side ÷ Healthy Side] × 100) was calculated for side differences. The >30% group had significantly more deficits in ankle kinetics during all activities compared with patients in the 30% group, compared with the biomechanics. Minimizing tendon elongation and regaining heel-rise height may be important for the long-term recovery of ankle biomechanics, particularly during more demanding activities such as jumping.

  14. Biomechanical Response and Behavior of Users under Emergency Buffer Crash

    Directory of Open Access Journals (Sweden)

    R. Miralbes

    2013-01-01

    Full Text Available This paper aims to study the biomechanical effects on elevator users and the injuries sustained should an elevator crash happen. The analysis will focus on buffer impact, signaling that the earlier mentioned buffer is usually located at the bottom of the pit. In order to carry out this analysis, a numerical technique based on finite element method will be used, while elevator users will be simulated by means of automotive dummies. Two crash factors will be studied, namely, location of dummy and fall velocity. The analysis criteria will be damages sustained by the dummy, based on biomechanical index such as HIC, CSI, forces, and accelerations.

  15. Development of esMOCA Biomechanic, Motion Capture Instrumentation for Biomechanics Analysis

    Science.gov (United States)

    Arendra, A.; Akhmad, S.

    2018-01-01

    This study aims to build motion capture instruments using inertial measurement unit sensors to assist in the analysis of biomechanics. Sensors used are accelerometer and gyroscope. Estimation of orientation sensors is done by digital motion processing in each sensor nodes. There are nine sensor nodes attached to the upper limbs. This sensor is connected to the pc via a wireless sensor network. The development of kinematics and inverse dynamamic models of the upper limb is done in simulink simmechanic. The kinematic model receives streaming data of sensor nodes mounted on the limbs. The output of the kinematic model is the pose of each limbs and visualized on display. The dynamic inverse model outputs the reaction force and reaction moment of each joint based on the limb motion input. Model validation in simulink with mathematical model of mechanical analysis showed results that did not differ significantly

  16. Scapula fracture incidence in reverse total shoulder arthroplasty using screws above or below metaglene central cage: clinical and biomechanical outcomes.

    Science.gov (United States)

    Kennon, Justin C; Lu, Caroline; McGee-Lawrence, Meghan E; Crosby, Lynn A

    2017-06-01

    Reverse total shoulder arthroplasty (R