Anatomically-based skeletal coordinate systems for use with impact biomechanics data intended for anthropomorphic test device development

Post-mortem human subjects (PMHS) are frequently used to characterize biomechanical response and injury tolerance of humans to various types of loading by means of instrumentation installed directly on the skeleton. Data extracted from such tests are often used to develop and validate anthropomorphic test devices (ATDs), which function as human surrogates in tests for injury assessment. Given that the location and orientation of installed instrumentation differs between subjects, nominally similar measurements made on different PMHS must be transformed to standardized, skeletal-based local coordinate systems (LCS) before appropriate data comparisons can be made. Standardized PMHS LCS that correspond to ATD instrumentation locations and orientations have not previously been published. This paper introduces anatomically-defined PMHS LCS for body regions in which kinematic measurements are made using ATDs. These LCS include the head, sternum, single vertebrae, pelvis, femurs (distal and proximal), and tibiae (distal and proximal) based upon skeletal landmarks extracted from whole body CT scans. The proposed LCS provide a means to standardize the reporting of PMHS data, and facilitate both the comparison of PMHS impact data across institutions and the application of PMHS data to the development and validation of ATDs.     

Using,risking, and consent: Why risking harm to bystanders is morally different from risking harm to research subjects

Subjects in studies on humans are used as a means of conducting the research and achieving whatever good would justify putting them at risk. Accordingly, consent must normally be obtained before subjects are exposed to any substantial risks to their welfare. Bystanders are also often put at risk, but they are not used as a means. Accordingly—or so I argue—consent is more often unnecessary before bystanders are exposed to similar substantial risks to their welfare.     

The extrapituitary prolactin promoter polymorphism is associated with rheumatoid arthritis and anti-CCP antibodies in Mexican population

Prolactin (PRL) is a hormone–cytokine that has been involved in autoimmunity due to its immunoregulatory and lymphoproliferative effects. It is produced by various extrapituitary sites including immune cells, under control of a superdistal promoter that contains a single nucleotide polymorphism − 1149 G/T previously associated with rheumatoid arthritis (RA) susceptibility in European population. The aim of this study was to investigate the association of the extrapituitary PRL − 1149 G/T promoter polymorphism with clinical parameters, clinical activity and disability indices in RA patients from Western Mexico and to analyze the PRL mRNA expression according to the PRL − 1149 G/T promoter polymorphism in total leucocytes from RA patients and controls. We conducted a case–control study that included 258 RA patients and 333 control subjects (CS). The DNA samples were genotyped using the PCR–RFLP method and the PRL mRNA expression was determined by quantitative real time PCR. PRL serum levels and antibodies to cyclic citrullinated peptides (anti-CCP) were measured with ELISA. We found significant differences in the genotype (p = 0.022) and allelic (p = 0.046) distribution of the polymorphism between RA patients and control subjects. According to the dominant genetic model, there is an association between the T allele (GT + TT genotypes) and decreased RA susceptibility in comparison to the G allele carriers (GG genotype) (OR 0.64, 95% CI 0.45–0.92; p = 0.011). The T allele carriers (GT + TT genotypes) had lower titers of anti-CCP antibodies in comparison to the G allele carriers (GG genotype) (median, 66 U/mL vs. 125 U/mL; p = 0.03). Furthermore, the GG homozygotes had higher PRL mRNA expression in comparison to the GT heterozygotes, and this latter with respect to the TT homozygotes, in both groups (RA: 1 > 0.72 > 0.19; CS: 1 > 0.54 > 0.28). However, PRL serum levels were similar in both groups. Our results suggest that the PRL − 1149 T allele is a genetic marker for decreased RA susceptibility and is associated with lower titers of anti-CCP antibodies in Mexican population. We also suggest influence of genotype upon PRL mRNA expression.     

健康体检人群甲状腺结节多普勒超声检查结果及影响因素分析

目的:研究健康体检人群甲状腺结节多普勒超声检查结果及影响因素。方法:将从2018年1月~2019年12月,于医院接受体检的健康体检人员5270例纳入研究,对所有受试者均进行多普勒超声检查,分析超声检查结果和体检人群基线资料的关系,分析甲状腺结节多普勒超声特征。采用单因素以及多因素Logistic回归分析健康体检人群甲状腺结节的影响因素。结果:在5270例健康体检人群中,甲状腺结节检出率为51.86%(2733/5270),女性甲状腺结节检出率为52.83%(2355/4458),高于男性的46.55%(378/812),且随着年龄的不断增长,健康体检人群甲状腺结节检出率呈逐渐升高趋势(均P<0.05)。甲状腺结节患者的多普勒超声检查特征以低回声以及结节直径<2 cm为主(均P<0.05),但是结节数目以及病变部位比较无明显差异(均P>0.05)。经单因素分析发现:吸烟、甲状腺疾病家族史、高血压及糖尿病的健康体检人员甲状腺结节检出率高于不吸烟、无甲状腺疾病家族史、无高血压及无糖尿病的健康体检人员(均P<0.05),而不同民族、受教育年限、体质量指数(BMI)、是否饮酒的健康体检人员甲状腺结节检出率比较无统计学差异(均P>0.05)。经多因素Logistic回归分析发现:女性、年龄、吸烟、甲状腺疾病家族史、高血压及糖尿病均是健康体检人群甲状腺结节发生的独立危险因素(均OR>1,P<0.05)。结论:甲状腺结节多普勒超声检查特征以低回声以及结节直径≤2 cm为主,其影响因素包括年龄、性别、吸烟、甲状腺疾病家族史、高血压及糖尿病,值得临床重点关注。     

高原移居者红细胞滤过指数的变化及其机理

目的：探讨不同海拔和同一海拔高底氧环境不同血色素范围对高原健康人红细胞流变特性的影响及其可能发生的机制。方法：检测不同海拔高度（2260m、3300m、4080m）对320健康人EFI、SOD、和MDA的影响。结果：随海拔高度的升高,高原健康人EFI和MDA含量明显升高,而红细胞SOD活性明显降低;EFI与MDA呈正相关,而与红细胞SOD活性呈负相关。同一海拔低氧环境Hb增高者,EFI和MDA升高,而红细胞SOD活性降低;随海拔升高,EFI和MDA含量明显升高,而红细胞SOD活性明显降低。结论：不同海拔红细胞流变学和氧自由基代谢差异性的形成,低氧环境起核心作用;而随海拔高度升高和同一海拔低氧环境自由基代谢异常加重者是导致高原健康人红细胞流变学异常的中心环节。     

Specific memory effects of Ginkgo biloba extract EGb 761 in middle-aged healthy volunteers

Introduction

Recent reviews showed that Ginkgo biloba extract EGb 761¹ is effective to enhance performance in patients with cognitive impairment (e.g., dementia). The aim of this study was to investigate the effects of EGb 761 on memory and the specificity of such effects on distinct memory functions in middle-aged healthy volunteers.

Methods

A total of 188 healthy subjects aged 45-56 years were randomised to receive EGb 761 (240 mg once daily) or placebo for 6 weeks. Outcome measures were the change in memory performance in a demanding standardised free recall paradigm (list of appointments) and a less demanding standardised recognition test (driving-route). Based on previous findings we predicted superiority of EGb 761 in recall testing. Specificity in effects was assessed by separating immediate vs. delayed and quantitative vs. qualitative free recall measures.

Results

After 6 weeks, EGb 761-treated subjects improved significantly in quantity of recall, i.e., the number of correctly recalled appointments (drug-placebo differences: p = 0.038 for immediate and p = 0.008 for delayed recall). Effects on qualitative recall performance (ratio of false to correct items) were similar (drug-placebo differences: p = 0.092 for immediate and p = 0.010 for delayed recall). No superiority of Ginkgo was evident in another everyday memory test which asked for recognition of a driving route (drug-placebo differences: p > 0.10). The incidence of adverse events was low and not significantly different between treatment groups.

Discussion

EGb 761 (240 mg once daily) improves free recall of appointments in middle-aged healthy volunteers, which requires high demands on self-initiated retrieval of learned material. This function is known to be sensitive to normal aging, i.e., reduced in healthy middle-aged subjects. No effects are seen in a less demanding everyday memory task which does not tap this critical function. This ties in with previous studies which found specific patterns of benefit from EGb 761 in demanding cognitive tasks.     

Asymptomatic Helicobacter pylori infection increases asymmetric dimethylarginine levels in healthy subjects

BACKGROUND: Chronic infections have been demonstrated to be early factors of atherosclerosis and cardiovascular diseases, and their relevance increases when they are caused by agents with extremely broad spectrum of disease outcome such as Helicobacter pylori. The consequent endothelial impairment leads to a reduced bioavailability of nitric oxide. Increasing evidences have pointed out that the endogenous inhibitor of nitric oxide synthase, asymmetric dimethylarginine, defined as a risk factor for cardiovascular disease, may increase in infections and plays an important role impairing the vascular functions of the endothelium. Starting from these findings, we aim to investigate whether H. pylori may affect asymmetric dimethylarginine levels. MATERIALS AND METHODS: The study was carried out on a group of 186 subjects (age 46.2 +/- 14.9 years). We evaluated asymmetric dimethylarginine, symmetric dimethylarginine, L-arginine, presence of H. pylori by 13C-urea breath test, and the main parameters of glyco and lipo metabolic balance. RESULTS: Increased levels of asymmetric dimethylarginine were found in H. pylori-positive subjects with respect to H. pylori-negative subjects (0.46 x/ / 1.13 versus 0.42 x/ / 1.23 mol/l, p < .001, respectively). No differences were detected in L-arginine levels between the two groups. Multiple regression analysis performed in H. pylori-positive subjects and H. pylori-negative subjects showed profound differences in the variables related to asymmetric dimethylarginine (R2 = 66.9%, p < .01 versus 34.3%, p < .01, respectively) and symmetric dimethylarginine (R2 = 39.2%, p < .01 versus 20.6%, p = .09, respectively) levels. CONCLUSIONS: Our data clearly demonstrate that H. pylori infection increases asymmetric dimethylarginine levels. Moreover, this infection causes a profound metabolic modification that alters the role of the known determinants of asymmetric dimethylarginine levels. We conclude that H. pylori infection must be taken into account as a cause of increased asymmetric dimethylarginine levels and that the eradication of H. pylori may therefore lead to a decrease in asymmetric dimethylarginine levels, which is a further reason for the reduction of the risk for cardiovascular disease in this large portion of population.     

The Raynaud's Treatment Study: Biofeedback Protocols and Acquisition of Temperature Biofeedback Skills

The Raynaud's Treatment Study (RTS) compared temperature biofeedback training and a behavioral control procedure (frontalis EMG biofeedback) with nifedipine-XL and a medication placebo for treatment of primary Raynaud's phenomenon (RP) in a large (N = 313) multicenter trial. The present study describes the RTS biofeedback protocols and presents data on the acquisition of digital skin temperature and frontalis EMG responses in the RTS. The findings point to substantial problems with acquisition of physiological self-regulation skills in the RTS. Only 34.6% of the Temperature Biofeedback group (N = 81) and 55.4% of the EMG Biofeedback group (N = 74) successfully learned the desired physiological response. In contrast, 67.4% of a Normal Temperature Biofeedback group (N = 46) learned hand warming. Multivariate analysis found that coping strategies, anxiety, gender, and clinic site predicted acquisition of hand-warming skills whereas variables related to RP disease severity did not. Physiological data showed vasoconstriction in response to the onset of biofeedback and also found that performance in the initial sessions was critical for successful acquisition. These findings indicate that attention to the emotional and cognitive aspects of biofeedback training, and a degree of success in the initial biofeedback sessions, are important for acquisition.     

Prediction of normal values for lactate threshold estimated by gas exchange in men and women

Lactate threshold (LT) is an index of exercise capacity and can be estimated from the gas exchange consequences of a metabolic acidosis (LT_GE). In recent years, it has emerged as a diagnostic tool in the evaluation of subjects with exercise limitation. The purpose of this study was to develop LT_GE prediction equations on a relatively large sample of adults and to cross-validate each equation. A total of 204 healthy, sedentary, nonsmoking subjects (103 men and 101 women), aged 20–70 years, underwent graded exercise testing on a cycle ergometer. The V-slope technique was used to detect LT_GE as the oxygen uptake (V˙O₂) at the breakpoint of the carbon dioxide output versus V˙O₂ relationship. Multiple linear regression was used to develop 12 equations with combinations of the following predictor variables: age, height, body mass, and fat-free mass. Eight of the equations are gender-specific and four are generalized with gender as a dummy variable. The equations were cross-validated using the predicted residual sum of squares (PRESS) method. The results demonstrate that the equations had relatively high multiple correlations (0.577–0.863) and low standard errors of the estimate (0.123–0.228 1 · min⁻¹). The PRESS method demonstrated that the equations are generalizable, i.e., can be used in future studies without a significant loss of accuracy. Since we tested only healthy, sedentary subjects, our equations can be used to predict the lower limit of normal for a given subject. Using individual data for healthy and diseased subjects from the literature, we found that our gender-specific equations rarely miscategorized subjects unless they were obese and mass was a predictor variable. We conclude that our equations provide accurate predictions of normal values for LT_GE and that they are generalizable to other subject populations. Accepted: 13 February 1997     

Daily copper supplement effects on copper balance in trained subjects during prolonged restriction of muscular activity

The aim of this study was to assess the effect of a daily intake of copper supplements on negative copper balance during prolonged exposure to hypokinesia (decreased number of kilometers per day). During hypokinesia (HK), negative copper balance is shown by increased, not by decreased, serum copper concentration, as it happens in other situations. Studies were done during a 30-d prehypokinetic period and a 364-d hypokinetic period. Forty male trained volunteers aged 22–26 yr with a peak oxygen uptake of 66.4 mL/min/kg and with an average of 13.7 km/d running distance were chosen as subjects. They were equally divided into four groups: unsupplemented ambulatory control subjects (UACS), unsupplemented hypokinetic subjects (UHKS), supplemented hypokinetic subjects (SHKS), and supplemented ambulatory control subjects (SACS). The SACS and SHKS groups took 0.09 mg copper carbonate/kg body weight daily. The SHKS and UHKS groups were maintained under an average running distance of 1.7 km/d, whereas the SACS and UACS groups did not experience any modifications in their normal training routines. During the 30-d prehypokinetic period and the 346-d hypokinetic period, urinary excretion of copper, calcium, and magnesium and serum concentrations of copper, calcium, and magnesium were measured. Copper loss in feces and copper balance was also determined. In both UHKS and SHKS groups, urinary excretion of copper, calcium, and magnesium and concentrations of copper, magnesium, and calcium in serum increased significantly when compared with the SACS and UACS groups. Loss of copper in feces was also increased significantly in the SHKS and UHKS groups when compared with the UACS and SACS groups. Throughout the study, the copper balance was negative in the SHKS and UHKS groups, whereas in the SACS and UACS groups, the copper balance was positive. It was concluded that a daily intake of copper supplements cannot be used to prevent copper deficiency shown by increased copper concentration. Copper supplements also failed to prevent negative copper balance and copper losses in feces and urine in endurancetrained subjects during prolonged exposure to HK.