Effects of intramuscular fat infiltration, scarring, and spasticity on the risk for sitting-acquired deep tissue injury in spinal cord injury patients

Sitting-acquired deep tissue injury (DTI) is a severe form of pressure ulcer (PU) often affecting patients with spinal cord injury (SCI) who also tend to suffer from intramuscular fat infiltration, soft tissue scarring (due to previous PU), and/or muscle spasticity in their buttocks. We previously used finite element (FE) modeling to evaluate whether abnormal bodyweight is a risk factor for sitting-acquired DTI. Here we hypothesize that fat infiltration, scarring, or spasms increase internal loads in the gluteus muscles in the vicinity of the ischial tuberosities during sitting, which consequently put SCI patients with these conditions at a higher risk for DTI. Our objective was to determine changes in gluteal strains and stresses and tissue volumes exposed to elevated strains/stresses associated with these factors. Thirty-five FE models of coronal slices through the seated buttocks, simulating these conditions at different severities, were developed. We calculated peak strains and stresses in glutei and percentage volumes of muscle tissue exposed to above-critical strains/stresses (compression strain≥50%, compression/von Mises stress≥2?kPa, and strain energy density≥0.5?kPa). Progressive intramuscular fat infiltration increased all the aforementioned outcome measures. Increase in size of scar patterns that were contained in both muscle and fat tissues similarly elevated the outcome measures. Spasms increased muscle stresses and volumetric exposures to stress, but tissue volumes at risk were ～1-2% and increases due to spasticity were slight. We conclude that the above potential risk factors can be listed according to the following order of importance: (i) fat infiltration, (ii) scars contained in both muscle and fat tissues, and (iii) spasms. This information should be considered when prioritizing prevention means and resources for patients with SCI.     

Accumulation of loading damage and unloading reperfusion injury — Modeling of the propagation of deep tissue ulcers

Deep tissue injury (DTI) occurs in deep muscles around bony prominences due to excessive and prolonged mechanical loading acting on the skin surface. The condition is clinically challenging because it can escape being noticed till the damage propagates all the way to the skin. In this study, a semi-3D finite element model of a human buttock was used to simulate the process of ulcer evolution based on our recent damage accumulation and repair theory for DTI. The theory included not only the loading damage, but also further reperfusion and inflammatory injuries upon unloading. The results showed that depending on the model parameters and loading conditions, a deep tissue ulcer may initiate around a bony prominence and expand to affect the entire tissue thickness. The damage evolution can be affected by the tissue healing rate, the loading–unloading pattern and the cushion stiffness. The results may help clinical workers appreciate the importance of proper patient turning and the appropriate choice of cushion.     

Finite element models of the thigh-buttock complex for assessing static sitting discomfort and pressure sore risk: a literature review

Being seated for long periods, while part of many leisure or occupational activities, can lead to discomfort, pain and sometimes health issues. The impact of prolonged sitting on the body has been widely studied in the literature, with a large number of human-body finite element models developed to simulate sitting and assess seat-induced discomfort or to investigate the biomechanical factors involved. Here, we review the finite element models developed to investigate sitting discomfort or risk of pressure sores. Our study examines finite element models from twenty-seven papers, seventeen dedicated to assessing seating discomfort and ten dedicated to investigating pressure ulcers caused by prolonged sitting. The models’ mesh composition and material properties are found to differ widely. These models share a lack of validation and generally make little allowance for anthropometric diversity.     

Theoretical and experimental determination of SAR patterns for spherical tissue models in a rectangular resonant cavity

Specific absorption rates (SARs) were determined theoretically and experimentally for several spherical models of tissue exposed to electrical fields of TE101 mode in a rectangular cavity of 57.3 MHz resonant frequency. The approximate theoretical SAR can be calculated according to the Mie theory by superposition of four plane waves representing the fields excited in the cavity. The theoretical and thermographically determined SAR patterns in spheres with radii of 5, 7.5, and 10 cm and with conductivities of 0.1, 1, and 10 S/m were compared. For a sphere with radius less than 7.5 cm and conductivity less than 1 S/m, the SAR was quite uniform. When conductivity was increased to 10 S/m, the SAR patterns showed higher absorption in the periphery of the largest sphere (10-cm radius). These characteristics are important in evaluating the scaling technique of exposing a model of a human to very-high-frequency fields to obtain power absorption data in humans exposed to high-frequency or very-low-frequency fields.     

Development and evaluation of a new growth medium for Helicobacter pylori

The present study was aimed at modifying the original formulation of Commercial Eugon agar (CEA) to develop a new H. pylori growth medium. Initial studies were carried out to determine the number of H. pylori colonies recovered on in-house H. pylori agar (IHPA), IHPA without l -cysteine and sodium sulfite (IHPA-NC), IHPA without l -cysteine (IHPA-C), IHPA without sodium sulfite (IHPA-N) and CEA as the control. Significant differences ( P <0.001) in the number of colonies recovered were observed between IHPA-N, IHPA-NC and IHPA-C. Incorporation of sodium sulfite decreased the number of colonies recovered, indicating that sodium sulfite was inhibitory to H. pylori growth. Removal of l -cysteine reduced the number of colonies recovered, suggesting that l -cysteine is necessary for the growth of H. pylori . In the subsequent study, incorporation of K₂HPO₄ further increased the number of colonies recovered compared with IHPA-N ( P <0.001), and 0.25% (w/v) of K₂HPO₄ yielded the highest numbers of colonies ( P ≤0.04). Finally, thirty other H. pylori clinical isolates were evaluated for their growth in the IHPAP-N, a new medium consisting of 1.5% (w/v) pepticase, 0.5% (w/v) peptone, 0.4% (w/v) sodium chloride, 0.03% (w/v) l -cysteine, 0.55% (w/v) dextrose, 0.25% (w/v) K₂HPO₄ and 1.5% (w/v) agar. The number of colonies recovered in IHPAP-N was significantly ( P <0.005) higher than that of CEA. IHPAP-N with 0.25% K₂HPO₄ and without sodium sulfite were adequate solid media for the growth of H. pylori .     

Effects of sitting postures on risks for deep tissue injury in the residuum of a transtibial prosthetic-user: a biomechanical case study

Transtibial amputation prosthetic-users are at risk of developing deep tissue injury (DTI) while donning their prosthesis for prolonged periods; however, no study addresses the mechanical loading of the residuum during sitting with a prosthesis. We combined MRI-based 3D finite element modelling of a residuum with an injury threshold and a muscle damage law to study risks for DTI in one sitting subject in two postures: 30°-knee-flexion vs. 90°-knee-flexion. We recorded skin-socket pressures, used as model boundary conditions. During the 90°-knee-flexion simulations, major internal muscle injuries were predicted (>1000 mm³). In contrast, the 30°-knee-flexion simulations only produced minor injury ( < 14 mm³). Predicted injury rates at 90°-knee-flexion were over one order of magnitude higher than those at 30°-knee-flexion. We concluded that in this particular subject, prolonged 90°-knee-flexion sitting theoretically endangers muscle viability in the residuum. By expanding the studies to large subject groups, this research approach can support development of guidelines for DTI prevention in prosthetic-users.     

Development and design of a novel loading device for the investigation of bone adaptation around immediately loaded dental implants using the reindeer antler as implant bed

The assessment of the behavior of immediately loaded dental implants using biomechanical methods is of particular importance. The primary goal of this investigation is to optimize the function of the implants to serve for immediate loading. Animal experiments on reindeer antlers as a novel animal model will serve for investigation of the bone remodeling processes in the implant bed. The main interest is directed towards the time and loading-dependant behavior of the antler tissue around the implants. The aim and scope of this work was to design an autonomous loading device that has the ability to load an inserted implant in the antler with predefined occlusal forces for predetermined time protocols. The mechanical part of the device can be attached to the antler and is capable of cyclically loading the implant with forces of up to 100 N. For the calibration and testing of the loading device a biomechanical measuring system has been used. The calibration curve shows a logarithmic relationship between force and motor current and is used to control the force on the implant. A first test on a cast reindeer antler was performed successfully.     

基于响应面分析的高抗原活性猪水肿病大肠杆菌疫苗培养基的研制及效果评价

【背景】猪水肿病大肠杆菌引发的疾病造成了很大的危害,但现有培养基存在培养密度低的问题。【目的】研制出高抗原活性猪水肿病大肠杆菌疫苗培养基。【方法】以常用的市售猪水肿培养基为对照,通过单因素试验、爬坡试验(Plackett-Burman, PB)、响应面(Box-Behnken, BB)试验对猪水肿培养基进行响应面优化,得到猪水肿培养基最优配方。以响应面试验得到的培养基培养猪水肿病大肠杆菌,评价不同培养时间点菌株的抗原活性,制作灭活疫苗,进行动物免疫保护试验。【结果】对研制的培养基进行扩大培养验证,发现扩大培养得到的菌株活菌数可达5×10⁹ CFU/mL以上,约为对照组的2倍。制备的灭活疫苗效价可达1:140 000,并在9 h时抗原蛋白效价达到最高。【结论】本研究研制出的疫苗培养基显著提高了猪大肠杆菌菌体密度,并可提高菌体抗原活性,为猪水肿病灭活疫苗的制备提供了技术指引。     

基于响应面法的高抗原活性禽多杀性巴氏杆菌疫苗培养基的研制与效果评价

【背景】禽多杀性巴氏杆菌(Pasteurella multocida)引发的禽霍乱疫情造成了巨大的危害,而现有培养基存在培养菌密度较低的问题。【目的】研制高抗原活性的禽多杀性巴氏杆菌疫苗培养基。【方法】通过单因素试验、Plackett-Burman试验和响应面分析方法对禽多杀性巴氏杆菌培养基的成分进行调整,并对不同发酵阶段的菌体进行免疫原性测定。最后使用该培养基培养细菌后制备疫苗并通过动物攻毒试验评价其保护效果。【结果】使用研制的培养基培养禽多杀性巴氏杆菌,活菌密度能够在6 h达到约1.84×1010 CFU/mL,增菌效果是对照培养基的2.6倍;免疫原性测定结果显示在生长平台期菌体的抗原活性最高;攻毒试验表明制备的疫苗能够很好地抵抗禽多杀性巴氏杆菌的侵袭。【结论】研制出了高抗原活性的禽多杀性巴氏杆菌疫苗培养基,为疫苗的生产奠定了基础。     

A repeated sampling bone chamber methodology for the evaluation of tissue differentiation and bone adaptation around titanium implants under controlled mechanical conditions

A repeated sampling bone chamber methodology was developed for the study of the influence of the mechanical environment on skeletal tissue differentiation and bone adaptation around titanium implants. Via perforations, bone grows into the implanted outer bone chamber, containing an inner bone chamber with a central test implant. An actuator—easily mounted on the outer bone chamber—allows a controlled mechanical stimulation of the test implant. After each experiment, the inner bone chamber—with its content—can be harvested and analysed. A new inner bone chamber with a central implant can be inserted consecutively in the outer bone chamber and a new experiment can start. Pilot studies led to a reliable surgical protocol and showed the applicability of the methodology, offering the possibility to study skeletal tissue differentiation and adaptation around implants under well-controlled mechanical conditions, and this protected from external loading. Repeated sampling of the bone chamber allows conducting several experiments within the same animal at the same site, thereby excluding subject- and site-dependent variability and reducing the amount of experimental animals.     

Optimisation of NMR dynamic models II. A new methodology for the dual optimisation of the model-free parameters and the Brownian rotational diffusion tensor

Finding the dynamics of an entire macromolecule is a complex problem as the model-free parameter values are intricately linked to the Brownian rotational diffusion of the molecule, mathematically through the autocorrelation function of the motion and statistically through model selection. The solution to this problem was formulated using set theory as an element of the universal set —the union of all model-free spaces (d’Auvergne EJ and Gooley PR (2007) Mol BioSyst 3(7), 483–494). The current procedure commonly used to find the universal solution is to initially estimate the diffusion tensor parameters, to optimise the model-free parameters of numerous models, and then to choose the best model via model selection. The global model is then optimised and the procedure repeated until convergence. In this paper a new methodology is presented which takes a different approach to this diffusion seeded model-free paradigm. Rather than starting with the diffusion tensor this iterative protocol begins by optimising the model-free parameters in the absence of any global model parameters, selecting between all the model-free models, and finally optimising the diffusion tensor. The new model-free optimisation protocol will be validated using synthetic data from Schurr JM et al. (1994) J Magn Reson B 105(3), 211–224 and the relaxation data of the bacteriorhodopsin (1–36)BR fragment from Orekhov VY (1999) J Biomol NMR 14(4), 345–356. To demonstrate the importance of this new procedure the NMR relaxation data of the Olfactory Marker Protein (OMP) of Gitti R et al. (2005) Biochem 44(28), 9673–9679 is reanalysed. The result is that the dynamics for certain secondary structural elements is very different from those originally reported. Electronic supplementary material The online version of this article (doi:) contains supplementary material, which is available to authorized users.     

Mathematical and numerical models for transfer of low-density lipoproteins through the arterial walls: a new methodology for the model set up with applications to the study of disturbed lumenal flow

In this work we introduce and discuss several mathematical models, based on partial differential equations, devised to study the coupled transport of macromolecules as low-density lipoproteins in the blood stream and in the arterial walls. These models are accurate provided that a suitable set of physical parameters characterizing the physical properties of the molecules and of the wall layers are available. Here we turn our attention on this aspect, and propose a new methodology to compute the physical parameters needed for the model set up, starting from available in vivo measurements. Then, we focus on the study of the accumulation of low-density lipoproteins in vascular districts featuring a highly disturbed flow. Our results demonstrate that mathematical models whose set up procedure benefits from an experimental feedback provide reliable information not only qualitatively, but also quantitatively. Their application to geometrically perturbed vascular districts (as for example a severe stenosis) shows that geometrical parameters such as curvature and variations of the lumenal section strongly influence the accumulation of low-density lipoproteins within the wall. For instance, in a stenotic segment with 75% area constriction, the LDL concentration at the lumenal side of the wall is about 10% higher than for the undisturbed segment.     

Finite Element Analysis as a Tool for Parametric Prosthetic Foot Design and Evaluation. Technique Development in the Solid Ankle Cushioned Heel (SACH) Foot

In this study, we developed an approach for prosthetic foot design incorporating motion analysis, mechanical testing and computer analysis. Using computer modeling and finite element analysis, a three-dimensional (3D), numerical foot model of the solid ankle cushioned heel (SACH) foot was constructed and analyzed based upon loading conditions obtained from the gait analysis of an amputee and validated experimentally using mechanical testing. The model was then used to address effects of viscoelastic heel performance numerically. This is just one example of the type of parametric analysis and design enabled by this approach. More importantly, by incorporating the unique gait characteristics of the amputee, these parametric analyses may lead to prosthetic feet more appropriately representing a particular user's needs, comfort and activity level.     

De Novo Assembly and Species-Specific Marker Development as a Useful Tool for the Identification of Scutellaria L. Species

Scutellaria L. (family Lamiaceae) includes approximately 470 species found in most parts of the world and is commonly known as skullcaps. Scutellaria L. is a medicinal herb used as a folk remedy in Korea and East Asia, but it is difficult to identify and classify various subspecies by morphological methods. Since Scutellaria L. has not been studied genetically, to expand the knowledge of species in the genus Scutellaria L., de novo whole-genome assembly was performed in Scutellaria indica var. tsusimensis (H. Hara) Ohwi using the Illumina sequencing platform. We aimed to develop a molecular method that could be used to classify S. indica var. tsusimensis (H. Hara) Ohwi, S. indica L. and three other Scutellaria L. species. The assembly results for S. indica var. tsusimensis (H. Hara) Ohwi revealed a genome size of 318,741,328 bp and a scaffold N50 of 78,430. The assembly contained 92.08% of the conserved BUSCO core gene set and was estimated to cover 94.65% of the genome. The obtained genes were compared with previously registered Scutellaria nucleotide sequences and similar regions using the NCBI BLAST service, and a total of 279 similar nucleotide sequences were detected. By selecting the 279 similar nucleotide sequences and nine chloroplast DNA barcode genes, primers were prepared so that the size of the PCR product was 100 to 1000 bp. As a result, a species-specific primer set capable of distinguishing five species of Scutellaria L. was developed.     

Palifermin for the protection and regeneration of epithelial tissues following injury: new findings in basic research and pre‐clinical models

Keratinocyte growth factor (KGF) is a paracrine‐acting epithelial mitogen produced by cells of mesenchymal origin, that plays an important role in protecting and repairing epithelial tissues. Pre‐clinical data initially demonstrated that a recombinant truncated KGF (palifermin) could reduce gastrointestinal injury and mortality resulting from a variety of toxic exposures. Furthermore, the use of palifermin in patients with hematological malignancies reduced the incidence and duration of severe oral mucositis experienced after intensive chemoradiotherapy. Based upon these findings, as well as the observation that KGF receptors are expressed in many, if not all, epithelial tissues, pre‐clinical studies have been conducted to determine the efficacy of palifermin in protecting different epithelial tissues from toxic injury in an attempt to model various clinical situations in which it might prove to be of benefit in limiting tissue damage. In this article, we review these studies to provide the pre‐clinical background for clinical trials that are described in the accompanying article and the rationale for additional clinical applications of palifermin.     

Cascading tripartite binomial classification plans to monitor European red mite (Acari,Tetranychidae) through a season; development and evaluation of a new methodology for pest monitoring

A monitoring protocol that schedules future sample bouts based on the outcome of density classification and expected population growth has been developed and applied to monitoring European red mite (Panonychus ulmi Koch) through a growing season. The monitoring protocol is based on concatenating through time tripartite sequential classification sampling plans that use binomial counts in lieu of complete enumeration. Binomial counts are scored positive when the number of organisms (mites) on a sample unit (leaves) exceeds a tally number. At each sample occasion the monitoring procedure leads to one of three possible decisions; intervene when the density is high, sample at the next sample occasion (after one week) when the density is intermediate, and sample at the second next sample occasion (after two weeks) when the density is low. Evaluation of the monitoring protocol under field conditions showed that the protocol with constituent tally 0 binomial count sampling plans was quite successful in timing intervention at the moment when population densities were about to exceed an established threshold that dictated intervention. The performance of this monitoring protocol and another protocol in which constituent sampling plans used binomial counts with a tally number of 4 were compared using simulation. Sampling plans that used a tally number of 4 were more precise than plans that used a tally number of 0. However, the overall performance of the monitoring protocol based on tally 0 sampling plans did not greatly differ from the monitoring protocol based on tally 4 sampling plans. Simulated performance of the tally 0 protocol was corroborated by field evaluation. The monitoring protocol based on tripartite classification required 30 to 45 percent fewer sample bouts than a protocol based on conventional sequential classification at weekly intervals. The monitoring protocol based on tripartite classification was also better able to schedule intervention when needed compared to a protocol based on conventional classification at two week intervals. Using the tally 0 protocol and current thresholds forP. ulmi, cumulative mite density was kept below 300 mite-days per leaf, which is well below levels regarded damaging. A tally 0 protocol with raised thresholds, developed on the basis of this finding, gave the best simulated performance of all protocols evaluated.