Biomechanical Comparison of Open versus Percutaneous Techniques for Primary Mid-Substance Achilles Tendon Repair: A Meta-Analysis

poste

Playing Surface and Injury Risk: Artificial Turf Vs. Natural Grass

Artificial turf’s developmental history spans 6 generations and includes design improvements that transformed an injury-inducing 1st generation field into a modern 3rd generation natural grass substitute. Artificial turf has become a widely adopted playing surface with a $2.7 billion United States Dollar (USD) valuation in North America. Turf’s popularity is due to its increased functionality and decreased cost compared to natural grass that allows more sports to play on the surface for longer time periods with decreased maintenance costs. From a biomechanical perspective, artificial turf exhibits higher frictional coefficients than natural grass resulting in higher foot and ankle injury rates. Concussion rates on turf are decreased compared to natural grass due to lower G-max values on well-maintained artificial surfaces. Hip, knee, and overall injury rates are equivalent between the two surfaces except in specific populations including elite-level American football players that exhibit increased knee injury rates on artificial turf. Due to these tradeoffs, the authors suggest that athletic organizations with funding to support professional groundskeeping should consider investing in natural grass due to athlete preference and decreased injury risk. In contrast, organizations without sufficient funding for professional groundskeeping operations may consider investing in modern artificial turf due to its associated long-term benefits and decreased costs

Peristaltic Transport of a Rheological Fluid: Model for Movement of Food Bolus Through Esophagus

Fluid mechanical peristaltic transport through esophagus has been of concern in the paper. A mathematical model has been developed with an aim to study the peristaltic transport of a rheological fluid for arbitrary wave shapes and tube lengths. The Ostwald-de Waele power law of viscous fluid is considered here to depict the non-Newtonian behaviour of the fluid. The model is formulated and analyzed with the specific aim of exploring some important information concerning the movement of food bolus through the esophagus. The analysis has been carried out by using lubrication theory. The study is particularly suitable for cases where the Reynolds number is small. The esophagus is treated as a circular tube through which the transport of food bolus takes places by periodic contraction of the esophageal wall. Variation of different variables concerned with the transport phenomena such as pressure, flow velocity, particle trajectory and reflux are investigated for a single wave as well as for a train of periodic peristaltic waves. Locally variable pressure is seen to be highly sensitive to the flow index `n'. The study clearly shows that continuous fluid transport for Newtonian/rheological fluids by wave train propagation is much more effective than widely spaced single wave propagation in the case of peristaltic movement of food bolus in the esophagus.Comment: Accepted for publication in Applied Mathematics and Mechanics (AMM), Springe

Detrended Fluctuation Analysis of Systolic Blood Pressure Control Loop

We use detrended fluctuation analysis (DFA) to study the dynamics of blood pressure oscillations and its feedback control in rats by analyzing systolic pressure time series before and after a surgical procedure that interrupts its control loop. We found, for each situation, a crossover between two scaling regions characterized by exponents that reflect the nature of the feedback control and its range of operation. In addition, we found evidences of adaptation in the dynamics of blood pressure regulation a few days after surgical disruption of its main feedback circuit. Based on the paradigm of antagonistic, bipartite (vagal and sympathetic) action of the central nerve system, we propose a simple model for pressure homeostasis as the balance between two nonlinear opposing forces, successfully reproducing the crossover observed in the DFA of actual pressure signals

Network Physiology reveals relations between network topology and physiological function

The human organism is an integrated network where complex physiologic systems, each with its own regulatory mechanisms, continuously interact, and where failure of one system can trigger a breakdown of the entire network. Identifying and quantifying dynamical networks of diverse systems with different types of interactions is a challenge. Here, we develop a framework to probe interactions among diverse systems, and we identify a physiologic network. We find that each physiologic state is characterized by a specific network structure, demonstrating a robust interplay between network topology and function. Across physiologic states the network undergoes topological transitions associated with fast reorganization of physiologic interactions on time scales of a few minutes, indicating high network flexibility in response to perturbations. The proposed system-wide integrative approach may facilitate the development of a new field, Network Physiology.Comment: 12 pages, 9 figure

Abnormal shortened diastolic time length at increasing heart rates in patients with abnormal exercise-induced increase in pulmonary artery pressure

<p>Abstract</p> <p>Background</p> <p>The degree of pulmonary hypertension is not independently related to the severity of left ventricular systolic dysfunction but is frequently associated with diastolic filling abnormalities. The aim of this study was to assess diastolic times at increasing heart rates in normal and in patients with and without abnormal exercise-induced increase in pulmonary artery pressure (PASP). Methods. We enrolled 109 patients (78 males, age 62 ± 13 years) referred for exercise stress echocardiography and 16 controls. The PASP was derived from the tricuspid Doppler tracing. A cut-off value of PASP ≥ 50 mmHg at peak stress was considered as indicative of abnormal increase in PASP. Diastolic times and the diastolic/systolic time ratio were recorded by a precordial cutaneous force sensor based on a linear accelerometer.</p> <p>Results</p> <p>At baseline, PASP was 30 ± 5 mmHg in patients and 25 ± 4 in controls. At peak stress the PASP was normal in 95 patients (Group 1); 14 patients (Group 2) showed an abnormal increase in PASP (from 35 ± 4 to 62 ± 12 mmHg; P < 0.01). At 100 bpm, an abnormal (< 1) diastolic/systolic time ratio was found in 0/16 (0%) controls, in 12/93 (13%) Group 1 and 7/14 (50%) Group 2 patients (p < 0.05 between groups).</p> <p>Conclusion</p> <p>The first and second heart sound vibrations non-invasively monitored by a force sensor are useful for continuously assessing diastolic time during exercise. Exercise-induced abnormal PASP was associated with reduced diastolic time at heart rates beyond 100 beats per minute.</p

Phagocytosis of Cholesteryl Ester Is Amplified in Diabetic Mouse Macrophages and Is Largely Mediated by CD36 and SR-A

Type 2 diabetes (T2D) is associated with accelerated atherosclerosis, which accounts for approximately 75% of all diabetes-related deaths. Here we investigate the link between diabetes and macrophage cholesteryl ester accumulation. When diabetic (db/db) mice are given cholesteryl ester intraperitoneally (IP), peritoneal macrophages (PerMΦs) recovered from these animals showed a 58% increase in intracellular cholesteryl ester accumulation over PerMΦs from heterozygote control (db/+) mice. Notably, PerMΦ fluid-phase endocytosis and large particle phagocytosis was equivalent in db/+and db/db mice. However, IP administration of CD36 and SR-A blocking antibodies led to 37% and 25% reductions in cholesteryl ester accumulation in PerMΦ. Finally, in order to determine if these scavenger receptors (SRs) were part of the mechanism responsible for the increased accumulation of cholesteryl esters observed in the diabetic mouse macrophages, receptor expression was quantified by flow cytometry. Importantly, db/db PerMΦs showed a 43% increase in CD36 expression and an 80% increase in SR-A expression. Taken together, these data indicate that direct cholesteryl ester accumulation in mouse macrophages is mediated by CD36 and SR-A, and the magnitude of accumulation is increased in db/db macrophages due to increased scavenger receptor expression

Can Sustainable Withdrawal Rates be Enhanced by Trend Following?

We examine the consequences of alternative popular investment strategies for the decumulation of funds invested for retirement through a defined contribution pension scheme. We examine in detail the viability of specific ‘safe’ withdrawal rates including the ‘4%-rule’ of Bengen (1994). We find two powerful conclusions. First that smoothing the returns on individual assets by simple trend following techniques is a potent tool to enhance withdrawal rates. Second, we show that while diversification across asset classes does lead to higher withdrawal rates than simple equity/bond portfolios, “smoothing” returns in itself is far more powerful a tool for raising withdrawal rates. In fact, smoothing the popular equity/bond portfolios (such as the 60/40 portfolio) is in itself an excellent and simple solution to constructing a retirement portfolio. Alternatively, trend following enables portfolios to contain more risky assets, and the greater upside they offer, for the same level of overall risk compared to standard portfolios