Prediction of joint center location by customizable multiple regressions: Application to clavicle,scapula and humerus

Accurate spatial location of joint center (JC) is a key issue in motion analysis since JC locations are used to define standardized anatomical frames, in which results are represented. Accurate and reproducible JC location is important for data comparison and data exchange. This paper presents a method for JC locations based on the multiple regression algorithms without preliminary assumption on the behavior of the joint-of-interest. Regression equations were obtained from manually palpable ALs on each bone-of-interest. Results are presented for all joint surfaces found on the clavicle, scapula and humeral bone. Mean accuracy errors on the JC locations obtained on dry bones were 5.2±2.5 mm for the humeral head, 2.5±1.1 mm for the humeral trochlea, 2.3±0.9 mm for the humeral capitulum, 8.2±3.9 mm for the scapula glenoid cavity, 7.2±3.2 mm for the scapular aspect of the acromio-clavicular joint, 3.5±1.8 mm for the clavicular aspect of the sternoclavicular joint and 3.2±1.4 mm for the clavicular aspect of the acromio-clavicular joint. In-vitro and in-vivo validation accuracy was 5.3 and 8.5 mm, respectively, for the humeral head center location. Regression coefficients for joint radius dimension and joint surface orientation were also processed and reported in this paper.     

Measuring humeral head translation using fluoroscopy: A validation study

Numerous techniques have been employed to monitor humeral head translation due to its involvement with several shoulder pathologies. However, most of the techniques were not validated. The objective of this study is to compare the accuracy of manual digitization and contour registration in measuring superior translation of the humeral head. Eight pairs of cadaver scapulae and humerii bones were harvested for this study. Each scapula and humerus was secured in a customized jig that allowed for control of humeral head translations and a vise that permitted rotations of the scapula about three axes. Fluoroscopy was used to take images of the shoulder bones. Scapular orientation was manipulated in different positions while the humerus was at 90° of humeral elevation in the scapular plane. Humeral head translation was measured using the two methods and was compared to the known translation. Additionally, accuracy of the contour registration method to measure 2-D scapular rotations was assessed. The range for the root mean square (RMS) error for manual digitization method was 0.27 mm - 0.43 mm and the contour registration method had a RMS error ranging from 0.18 mm - 0.40 mm. In addition, the RMS error for the scapular angle rotation using the contour registration method was 2.4°. Both methods showed acceptable errors. However, on average, the contour registration method showed lesser measurement error compared to the manual digitization method. In addition, the contour registration method was able to show good accuracy in measuring rotation that is useful in 2-D image analysis.     

Dynamic in vivo 3D atlantoaxial spine kinematics during upright rotation

Diagnosing dysfunctional atlantoaxial motion is challenging given limitations of current diagnostic imaging techniques. Three-dimensional imaging during upright functional motion may be useful in identifying dynamic instability not apparent on static imaging. Abnormal atlantoaxial motion has been linked to numerous pathologies including whiplash, cervicogenic headaches, C2 fractures, and rheumatoid arthritis. However, normal C1/C2 rotational kinematics under dynamic physiologic loading have not been previously reported owing to imaging difficulties. The objective of this study was to determine dynamic three-dimensional in vivo C1/C2 kinematics during upright axial rotation. Twenty young healthy adults performed full head rotation while seated within a biplane X-ray system while radiographs were collected at 30 images per second. Six degree-of-freedom kinematics were determined for C1 and C2 via a validated volumetric model-based tracking process. The maximum global head rotation (to one side) was 73.6 ± 8.3°, whereas maximum C1 rotation relative to C2 was 36.8 ± 6.7°. The relationship between C1/C2 rotation and head rotation was linear through midrange motion (±20° head rotation from neutral) in a nearly 1:1 ratio. Coupled rotation between C1 and C2 included 4.5 ± 3.1° of flexion and 6.4 ± 8.2° of extension, and 9.8 ± 3.8° of contralateral bending. Translational motion of C1 relative to C2 was 7.8 ± 1.5 mm ipsilaterally, 2.2 ± 1.2 mm inferiorly, and 3.3 ± 1.0 mm posteriorly. We believe this is the first study describing 3D dynamic atlantoaxial kinematics under true physiologic conditions in healthy subjects. C1/C2 rotation accounts for approximately half of total head axial rotation. Additionally, C1 undergoes coupled flexion/extension and contralateral bending, in addition to inferior, lateral and posterior translation.     

Quantification of residual dose estimation error on log file-based patient dose calculation

PurposeThe log file-based patient dose estimation includes a residual dose estimation error caused by leaf miscalibration, which cannot be reflected on the estimated dose. The purpose of this study is to determine this residual dose estimation error.Methods and materialsModified log files for seven head-and-neck and prostate volumetric modulated arc therapy (VMAT) plans simulating leaf miscalibration were generated by shifting both leaf banks (systematic leaf gap errors: ±2.0, ±1.0, and ±0.5 mm in opposite directions and systematic leaf shifts: ±1.0 mm in the same direction) using MATLAB-based (MathWorks, Natick, MA) in-house software. The generated modified and non-modified log files were imported back into the treatment planning system and recalculated. Subsequently, the generalized equivalent uniform dose (gEUD) was quantified for the definition of the planning target volume (PTV) and organs at risks.ResultsFor MLC leaves calibrated within ±0.5 mm, the quantified residual dose estimation errors that obtained from the slope of the linear regression of gEUD changes between non- and modified log file doses per leaf gap are in head-and-neck plans 1.32 ± 0.27% and 0.82 ± 0.17 Gy for PTV and spinal cord, respectively, and in prostate plans 1.22 ± 0.36%, 0.95 ± 0.14 Gy, and 0.45 ± 0.08 Gy for PTV, rectum, and bladder, respectively.ConclusionsIn this work, we determine the residual dose estimation errors for VMAT delivery using the log file-based patient dose calculation according to the MLC calibration accuracy.     

Multi-institutional comparison of simulated treatment delivery errors in ssIMRT,manually planned VMAT and autoplan-VMAT plans for nasopharyngeal radiotherapy

PurposeTo quantify the impact of simulated errors for nasopharynx radiotherapy across multiple institutions and planning techniques (auto-plan generated Volumetric Modulated Arc Therapy (ap-VMAT), manually planned VMAT (mp-VMAT) and manually planned step and shoot Intensity Modulated Radiation Therapy (mp-ssIMRT)).MethodsTen patients were retrospectively planned with VMAT according to three institution’s protocols. Within one institution two further treatment plans were generated using differing treatment planning techniques. This resulted in mp-ssIMRT, mp-VMAT, and ap-VMAT plans. Introduced treatment errors included Multi Leaf Collimator (MLC) shifts, MLC field size (MLCfs), gantry and collimator errors. A change of more than 5% in most selected dose metrics was considered to have potential clinical impact. The original patient plan total Monitor Units (MUs) were correlated to the total number of dose metrics exceeded.ResultsThe impact of different errors was consistent, with ap-VMAT plans (two institutions) showing larger dose deviations than mp-VMAT created plans (one institution). Across all institutions’ VMAT plans the significant errors included; ±5° for the collimator angle, ±5 mm for the MLC shift and +1, ±2 and ±5 mm for the MLC field size. The total number of dose metrics exceeding tolerance was positively correlated to the VMAT total plan MUs (r = 0.51, p < 0.001), across all institutions and techniques.ConclusionsDifferences in VMAT robustness to simulated errors across institutions occurred due to planning method differences. Whilst ap-VMAT was most sensitive to MLC errors, it also produced the best quality treatment plans. Mp-ssIMRT was most robust to errors. Higher VMAT treatment plan complexity led to less robust plans.     

Low frequency-low voltage alternating electric current-induced anoxic granulation in biofilm-electrode reactor: A study of granule properties

We characterized anoxic nitrate granules produced by an alternating current biofilm electrode reactor operating at low voltage-low frequency under optimum conditions. Hydrodynamic results revealed that the settling velocity for the granules ranged from 0.12 to 2.85 cm/s, while that of settling velocities ranged from 0.07 to 3.42 cm/s. Granule diameter varied, with a mean mass of 3.65 ± 1.29 mm and corresponding dry mass ranging from 0.52 to 5.64 mg. Roundness ratio of the sampled granules was determined to be 0.78 ± 0.11. Integrity coefficient obtained from a shear strength test was 87.05 ± 2.07% after 2 min and 74.1 ± 4.14% after 5 min. An adhesion test revealed hydrophilic properties of bacteria. The Most probable number (MPN) value was 2.0 × 10⁶ for HDB and 2.0 × 10³ for ADB. An apoptosis assay by flow cytometry confirmed that the majority of cells (87.7%) were viable and non-apoptotic (Annexin V-PI) and dehydrogenase activity was 15.05 ± 1.76 μg TF/mg biomass cm⁻² d. Comparison of seed and granules by ¹H NMR spectra showed different signals in the range of 0.279–1, 1–1.5, and 1.5–7.5 ppm. Therefore, the biofilm in ACBER can be easily granulated and used to generate dense and fast-settling sludge granules.     

The role of anticipatory postural adjustments in compensatory control of posture: 2. Biomechanical analysis

The central nervous system (CNS) utilizes anticipatory (APAs) and compensatory (CPAs) postural adjustments to maintain equilibrium while standing. It is known that these postural adjustments involve displacements of the center of mass (COM) and center of pressure (COP). The purpose of the study was to investigate the relationship between APAs and CPAs from a kinetic and kinematic perspective. Eight subjects were exposed to external predictable and unpredictable perturbations induced at the shoulder level while standing. Kinematic and kinetic data were recorded and analyzed during the time duration typical for anticipatory and compensatory postural adjustments. When the perturbations were unpredictable, the COM and COP displacements were larger compared to predictable conditions with APAs. Thus, the peak of COM displacement, after the pendulum impact, in the posterior direction reached 28 ± 9.6 mm in the unpredictable conditions with no APAs whereas it was 1.6 times smaller, reaching 17 ± 5.5 mm during predictable perturbations. Similarly, after the impact, the peak of COP displacement in the posterior direction was 60 ± 14 mm for unpredictable conditions and 28 ± 3.6 mm for predictable conditions. Finally, the times of the peak COM and COP displacements were similar in the predictable and unpredictable conditions. This outcome provides additional knowledge about how body balance is controlled in presence and in absence of information about the forthcoming perturbation. Moreover, it suggests that control of posture could be enhanced by better utilization of APAs and such an approach could be considered as a valuable modality in the rehabilitation of individuals with balance impairment.     

Multi-channel electromyography during maximal isometric and dynamic contractions

Motor unit behavior differs between contraction types at submaximal contraction levels, however is challenging to study during maximal voluntary contractions (MVCs). With multi-channel surface electromyography (sEMG), mean physiological characteristics of the active motor units can be extracted. Two 8-electrode sEMG arrays were attached on biceps brachii muscle (one on each head) to examine behavior of sEMG variables during isometric, eccentric and concentric MVCs of elbow flexors in 36 volunteers.On average, isometric (364 ± 88 N) and eccentric (353 ± 74 N) MVCs were higher than concentric (290 ± 73 N) MVC (p < 0.001). Mean muscle fiber conduction velocity (CV) was highest during eccentric MVC (4.42 ± 0.49 m/s) than concentric (4.25 ± 0.49 m/s, p < 0.01) and isometric (4.14 ± 0.45 m/s, p < 0.001) MVCs. Furthermore, eccentric MVC showed lower sEMG amplitude at the largest elbow joint angles (120–170°) and higher CV at the smallest (70–150°) elbow joint angles (p < 0.05–0.001) than concentric MVC.The differences in CV and sEMG amplitude between the MVCs suggest that the control strategy of motor units differs between the contraction types during MVCs, and is dependent on the muscle length between the dynamic MVCs.     

Translational and rotational localization errors in cone-beam CT based image-guided lung stereotactic radiotherapy

PurposeAccurate localization is crucial in delivering safe and effective stereotactic body radiation therapy (SBRT). The aim of this study was to analyse the accuracy of image-guidance using the cone-beam computed tomography (CBCT) of the VERO system in 57 patients treated for lung SBRT and to calculate the treatment margins.Materials and methodsThe internal target volume (ITV) was obtained by contouring the tumor on maximum and mean intensity projection CT images reconstructed from a respiration correlated 4D-CT. Translational and rotational tumor localization errors were identified by comparing the manual registration of the ITV to the motion-blurred tumor on the CBCT and they were corrected by means of the robotic couch and the ring rotation. A verification CBCT was acquired after correction in order to evaluate residual errors.ResultsThe mean 3D vector at initial set-up was 6.6 ± 2.3 mm, which was significantly reduced to 1.6 ± 0.8 mm after 6D automatic correction. 94% of the rotational errors were within 3°. The PTV margins used to compensate for residual tumor localization errors were 3.1, 3.5 and 3.3 mm in the LR, SI and AP directions, respectively.ConclusionsOn-line image guidance with the ITV–CBCT matching technique and automatic 6D correction of the VERO system allowed a very accurate tumor localization in lung SBRT.     

Changes in force and tendinous tissue elongation during the early phase of tetanic summation in in vivo human tibialis anterior muscle

The purpose of this study was to determine the changes that occur in tendinous tissue properties during the early phase of tetanic summation in the in vivo human tibialis anterior muscle (TA). The torque response and tendinous tissue elongation following single stimuli, two-pulse trains, and three-pulse trains were recorded in the TA during isometric contractions. The elongation, compliance, and lengthening velocity of tendinous tissue were determined by real-time ultrasonography. The contribution of the response to the second stimulation (C2) was obtained by subtracting the response to the single stimulation (C1) from the response of doublet. The third contribution (C3) was obtained by subtracting the response to the doublet from that of the triplet. C2 (7.8±0.5 Nm) and C3 (7.3±0.6 Nm) had torque responses significantly higher than C1 (3.6±0.7 Nm). In contrast, the elongations of tendinous tissue for C2 (2.8±0.4 mm) and C3 (1.7±0.2 mm) were significantly lower than for C1 (4.9±0.3 mm), indicating that the summation pattern of tendinous tissue elongation is different from the summation pattern of torque response. In addition, this showed considerable difference both between C1 (0.12±0.01 mm/N; 83±4.6 mm/s) and C2 (0.03±0.005 mm/N; 50±6.3 mm/s) and between C1 and C3 (0.02±0.002 mm/N; 39±6.4 mm/s) in the compliance and lengthening velocity of tendinous tissue. These results suggest that changes in tendinous tissue properties between first and second contraction are related to different summation patterns of force and tendinous tissue elongation during early phase of tetanic summation.     

Mechanical properties of the patellar tendon in adults and children

It is not currently known how the mechanical properties of human tendons change with maturation in the two sexes. To address this, the stiffness and Young's modulus of the patellar tendon were measured in men, women, boys and girls (each group, n=10). Patellar tendon force (F_pt) was calculated from the measured joint moment during a ramped voluntary isometric knee extension contraction, the antagonist knee extensor muscle co-activation quantified from its electromyographical activity, and the patellar tendon moment arm measured from magnetic resonance images. Tendon elongation was imaged using the sagittal-plane ultrasound scans throughout the contraction. Tendon cross-sectional area was measured at rest from ultrasound scans in the transverse plane. Maximal F_pt and tendon elongation were (mean±SE) 5453±307 N and 5±0.5 mm for men, 3877±307 N and 4.9±0.6 mm for women, 2017±170 N and 6.2±0.5 mm for boys and 2169±182 N and 5.9±0.7 mm for girls. In all groups, tendon stiffness and Young's modulus were examined at the level that corresponded to the maximal 30% of the weakest participant's F_pt and stress, respectively; these were 925–1321 N and 11.5–16.5 MPa, respectively. Stiffness was 94% greater in men than boys and 84% greater in women than girls (p<0.01), with no differences between men and women, or boys and girls (men 1076±87 N/mm; women 1030±139 N/mm; boys 555±71 N/mm and girls 561.5±57.4 N/mm). Young's modulus was 99% greater in men than boys (p<0.01), and 66% greater in women than girls (p<0.05). There were no differences in modulus between men and women, or boys and girls (men 597±49 MPa; women 549±70 MPa; boys 255±42 MPa and girls 302±33 MPa). These findings indicate that the mechanical stiffness of tendon increases with maturation due to an increased Young's modulus and, in females due to a greater increase in tendon cross-sectional area than tendon length.     

Ultrasonographic imaging of the reproductive tract and surgical recovery of oocytes in Cebus apella (capuchin monkeys)

Two-dimensional real-time and Doppler ultrasonography are valuable non-invasive methods to assess reproductive anatomy and physiology. In adult, postpubertal female Cebus apella (capuchin monkeys), the objectives were to determine (1) uterine and ovarian dimensions, ovarian follicular dynamics, day of ovulation, and arterial blood flow of uterus and utero-ovarian ligament during the follicular phase of the menstrual cycle and (2) the number of oocytes aspirated from antral follicles at laparotomy. Based on two-dimensional, transabdominal B-mode ultrasonography, mean (± S.E.M.) length, height, width, and volume of the uterus were 17.9 ± 0.4, 12.4 ± 0.3, 13.6 ± 0.3 mm, and 1.55 ± 0.08 mL, respectively, and of the ovary were 13.4 ± 0.2, 8.2 ± 0.1, 7.7 ± 0.1 mm, and 4.5 ± 0.2 mL. Ovarian follicles were monitored for 6 days before ovulation, which occurred on day 9.3 ± 0.5 (range, days 7–11; day 1 = start of menses), with 10 of 12 ovulations in the right ovary. Diameter and volume of the preovulatory follicle were 10.1 ± 0.2 mm and 0.55 ± 0.03 mL (on the estimated day of ovulation) and of the CL were 8.1 ± 0.4 mm and 0.3 ± 0.05 mL. Resistivity and pulsatility indices were 0.86 ± 0.02 and 2.15 ± 0.11 for uterine arteries, and were 0.69 ± 0.04 and 1.63 ± 0.15 for the utero-ovarian ligament (UOL) artery; just prior to ovulation, both indices peaked (P < 0.05) in the uterine artery ipsilateral to the side of ovulation, but both reached a nadir (P < 0.05) in the UOL artery. In the absence of ovarian stimulation, 31 oocytes (diameter, 137 ± 10 μm) were aspirated (average of 2 oocytes/(female attempt)) on days 5, 7, and 9. In conclusion, transabdominal ultrasonography facilitated assessment of reproductive anatomy and physiology in C. apella adult females. Resistance and pulsatility indices of uterine and UOL arteries changed near the time of ovulation. Dominant follicles were easiest to aspirate at 8–9 mm in diameter (∼day 9), with intact cumulus-oocyte complexes recovered from ovarian follicles 2–9 mm in diameter.     

Objective assessment of the cryoprotective effects of dimethylformamide for freezing goat semen

The aim of this work was to assess the cryoprotective effects of dimethylformamide (DMF) for freezing goat semen, using an objective analysis by computer-assisted sperm analysis (CASA). Twenty-one ejaculates (seven per animal) were collected from three stud bucks with the aid of an artificial vagina and immediately evaluated for gross and microscopic characteristics. The semen was diluted in two steps with a Tris–egg yolk extender containing 6% glycerol or 6% DMF, frozen in 0.50-mL straws, and stored in liquid nitrogen. Samples were accessed for sperm morphology, sperm membrane structural and functional integrity, and by CASA, immediately after thawing. There were differences (P < 0.05) between glycerol and DMF with regard to subjective progressive motility (23.9 ± 2.2% vs. 16.6 ± 2.0%), objective progressive motility (3.5 ± 0.4% vs. 1.8 ± 0.3%), linearity (53.9 ± 1.6% vs. 48.1 ± 1.4%) and amplitude of lateral head (2.3 ± 0.1 vs. 2.9 ± 0.1 mm), which confirmed the efficiency of glycerol. In conclusion, dimethylformamide could be used as an alternative cryoprotectant for goat semen freezing. However it was showed that no benefits were derived by using dimethylformamide to replace glycerol at an equal 6% concentration.     

Tolerance of the skull to blunt ballistic temporo-parietal impact

Less-lethal ballistic projectiles are used by police personnel to temporarily incapacitate suspects. While the frequency of these impacts to the head is low, they account for more serious injuries than impacts to any other body region. As a result, there is an urgent need to assess the tolerance of the head to such impacts. The focus of this study was to investigate the tolerance of the temporo-parietal skull to blunt ballistic impact and establish injury criteria for risk assessment. Seven unembalmed isolated cadaver heads were subjected to fourteen impacts. Specimens were instrumented with a nine-accelerometer array as well as strain gages surrounding the impact site. Impacts were performed with a 38 mm instrumented projectile at velocities ranging from 18 to 37 m/s. CT images and autopsies were performed to document resulting fractures. Peak fracture force for the seven resulting fractures was 5633±2095 N. Peak deformation for fracture-producing impacts was 7.8±3.2 mm. The blunt criterion (BC), peak force and principal strain were determined to be the best predictors of depressed comminuted fractures. Temporo-parietal tolerance levels were consistent with previous studies. An initial force tolerance level of 2346 N is established for the temporo-parietal region for blunt ballistic impact with a 38 mm diameter impactor.     

Voluntary activation of the trapezius muscle in cases with neck/shoulder pain compared to healthy controls

Subjects reporting neck/shoulder pain have been shown to generate less force during maximal voluntary isometric contractions (MVC) of the shoulder muscles compared to healthy controls. This has been suggested to be caused by a pain-related decrease in voluntary activation (VA) rather than lack of muscle mass. The aim of the present study was to investigate VA of the trapezius muscle during MVCs in subjects with and without neck/shoulder pain by use of the twitch interpolation technique.Ten cases suffering from pain and ten age and gender matched, healthy controls were included in the study. Upper trapezius muscle thickness was measured using ultrasonography and pain intensity was measured on a 100 mm visual analog scale (VAS). VA was calculated from five maximal muscle activation attempts. Superimposed stimuli were delivered to the accessory nerve at peak force and during a 2% MVC following the maximal contraction.Presented as mean ± SD for cases and controls, respectively: VAS; 16.0 ± 14.4 mm and 2.1 ± 4.1 mm (P = 0.004), MVC; 545 ± 161 N and 664 ± 195 N (P = 0.016), upper trapezius muscle thickness; 10.9 ± 1.9 mm and 10.4 ± 1.5 mm (P = 0.20), VA; 93.6 ± 14.2% and 96.3 ± 6.0% (P = 0.29).In spite of significantly eight-fold higher pain intensity and ∼20% lower MVC for cases compared to controls, no difference was found in VA. Possible explanations for the reduction in MVC could be differences in co-activation of antagonists and synergists as well as muscle quality.     

The influence of starvation on fast-start performance of Spinibarbus sinensis

Juvenile Spinibarbus sinensis (n = 48, body length, 5.86 ± 0.10 cm, 25 °C) were fasted for 0, 0.5, 1, 2, 4 and 6 weeks. The fast-start performances of the experimental fish were assessed using high-speed video photography and the locomotive kinematics analysis. The morphological parameters including tail height (H₂), tail length (L₂), lateral body area (S₁), median fin area (S₂), dorsal cross section area (S₃) and tail cross section area (S₄) were also measured using TpsDig and the Photoshop. The results showed that 6 week starvation resulted in significant decreases in the escape distance (d), maximum linear velocity (V_max) and maximum linear acceleration (a_max) of center of mass in Stage 1 and Stage 2 of fast-start process (P < 0.05), however there were two relatively sTable phases in the V_max and d, during the week 1–2 (V_max = 0.67 ± 0.06 mm/ms; d = 8.86 ± 0.73 mm) and week 4–6 (V_max = 0.31 ± 0.04 mm/ms; d = 3.70 ± 0.56 mm). When compared with the control group (0 week starvation group), only the 6 week starvation group showed the significantly different response time (t) with average t = 9.20 ± 0.37 ms in week 1–4. There were no significant difference in mass center turning angles at first stage (T_a1) , second stage (T_a2) and the sum of two stages (T_a(1+2)) was also not different (P > 0.05). The fish did not show any directional preference for left or right during escape turning, and all of the related parameters also remained unchanged among treatment group (P > 0.05). The areas of dorsal body cross-section decreased more acutely (P < 0.05) than caudal body cross-section (45.4% vs 38.0%) during the entire starvation period while no significant differences were observed in both the tail height and tail length among all treatment groups (P > 0.05). The results indicated that fast-start performance of juvenile S. sinensis is affected by the starvation; metabolic energy related traits such as the maximum linear velocity and the maximum linear acceleration decreased significantly after starvation; whereas traits with no direct link to metabolic energy such as the response time and turning angle remained unchanged during starvation. The lack of starvation induced change in the maneuverability of the fish suggests that fast-start ability related to escape strategy is relatively well conservative in juvenile S. sinensis.     

Descriptive analysis of kinematics and kinetics of catchers throwing to second base from their knees

In order to decrease the amount of time that it takes the catcher to throw the ball, a catcher may chose to throw from the knees. Upper extremity kinematics may play a significant role in the kinetics about the elbow observed in catchers throwing from the knees. If relationships between kinematics and kinetics exist then the development of training and coaching instruction may help in reduced upper extremity injury risk. Twenty-two baseball and softball catchers (14.36 ± 3.86 years; 165.11 ± 17.54 cm; 65.67 ± 20.60 kg) volunteered. The catchers exhibited a less trunk rotation (5.6 ± 16.2°), greater elbow flexion (87.9 ± 21.4°) and decreased humeral elevation (71.1 ± 12.3°) at the event of maximum shoulder external rotation as compared to what has previously reported in catchers. These variables are important, as they have previously been established as potential injury risk factors in pitchers, however it is not yet clear the role these variables play in catchers’ risk of injury. A positive relationship between elbow varus torque during the deceleration phase and elbow flexion at MIR was observed (r = 0.609; p = 0.003). Throwing from the knees reduces a catcher’s ability to utilize the proximal kinetic chain and this may help to explain why their kinematics and kinetics differ from what has previously been presented in the literature.     

Differences in preovulatory follicle dynamics and timing of preovulatory LH surge affect fertility of maiden sheep reared in semi-arid extensive conditions

In the current study follicular dynamics, pituitary function, ovulatory response and luteal activity of 30 maiden Barbarine sheep were analyzed according to oestrus occurrence and lambing outcome after oestrus synchronisation with cloprostenol. Animals were retrospectively classified in three groups named as O? (n = 7, ewes not displaying oestrus), O+L? (n = 7, ewes showing oestrus but failing to lamb) and O+L+ (n = 16; ewes showing oestrus and lambing thereafter). All the sheep ovulated and daily transrectal ultrasonographies revealed that preovulatory follicles were present at cloprostenol injection in all the animals. In sheep O+L+ and O+L?, 50% and 57% of the ovulatory follicles were the largest follicles at cloprostenol treatment (mean size of 4.1 ± 0.26 mm and 4.3 ± 0.74 mm, respectively). In O? ewes, the same percentage was higher (86%, P < 0.05 when compared to group O+L+; mean size of 4.0 ± 0.46 mm). The number of large follicles and the final diameter of the ovulatory follicles at oestrous tended thereafter to be higher in group O+L+ (1.4 ± 0.1 and 6.4 ± 0.2) than in groups O+L? (1 ± 0.2 and 5.7 ± 0.36) and O? (0.9 ± 0.2 and 5.9 ± 0.5, respectively). Conversely, the number of medium follicles at oestrus detection was higher in the group O+L? (2.1 ± 0.3, P < 0.05) than in the other two groups (1 ± 0.2 and 1 ± 0.3 for O+L+ and O? respectively). Timing of preovulatory LH surge was earlier for ewes O? (24.0 ± 4.75, P < 0.05) than for sheep O+L+ and O+L? (37.9 ± 2.45 h and 38.0 ± 4.75 h, respectively) and 94% of O+L+ ewes had a LH surge between 16 h and 64 h after cloprostenol injection compared to 57% in O+L? and O? groups (P < 0.05). Thus, maiden Barbarine sheep failing to display oestrus or conceive showed alterations in their follicular dynamics and, thereafter, pituitary function and ovulatory response.     

Respiratory motion of adrenal gland metastases: Analyses using four-dimensional computed tomography images

PurposeTo evaluate the respiratory motion of adrenal gland metastases in three-dimensional directions using four-dimensional computed tomography (4DCT) images.MethodsFrom January 2013 to May 2016, 12 patients with adrenal gland metastases were included in this study. They all underwent 4DCT scans to assess respiratory motion of adrenal gland metastases in free breathing state. The 4DCT images were sorted into 10 image series according to the respiratory phase from the end inspiration to the end expiration, and then transferred to FocalSim workstation. All gross tumor volumes (GTVs) of adrenal gland metastases were drawn by a single physician and confirmed by a second. Relative coordinates of adrenal gland metastases were automatically generated to calculate adrenal gland metastases motion in different axial directions.ResultsThe average respiratory motion of adrenal gland metastases in left-right (LR), cranial-caudal (CC), anterior-posterior (AP), 3-dimensional (3D) vector directions was 3.4 ± 2.2 mm, 9.5 ± 5.5 mm, 3.8 ± 2.0 mm and 11.3 ± 5.3 mm, respectively. The ratios were 58.6% ± 11.4% and 63.2% ± 12.5% when the volumes of GTV_In0% and GTV _In100% were compared with volume of IGTV_10phase. The volume ratio of IGTV_10phase to GTV_3D was 1.73 ± 0.48.ConclusionsAdrenal gland metastasis is a respiration-induced moving target, and an internal target volume boundary should be provided when designing the treatment plan. The CC motion of adrenal gland metastasis is predominant and >5 mm, thus motion management strategies are recommended for patients undergoing external radiotherapy for adrenal gland metastasis.