Motion Analysis Strategy Appropriate for 3D Kinematic Assessment of Children and Adults with Osteogenesis Imperfecta

Human motion analysis provides a quantitative means of assessing whole body and segmental motion of subjects with musculoskeletal pathologies. This chapter describes a low cost motion analysis appropriate for complete three-dimensional (3D) assessment of upper and lower extremity kinematics. The system has been designed to support lower cost outreach efforts that require accuracy and resolution on the order of classical fixed lot systems such as Vicon. The focus of this work addresses the assessment needs typically seen in adults and children with osteogenesis imperfect (OI) experiencing ambulatory and upper extremity challenges

Effects of the private-label invasion in food industries

Using supermarket scanner data, we test a variety of hypotheses from trade journals about the invasion of private-label food products. According to conventional industry wisdom, name-brand firms defended their brands against new private-label products by lowering their prices, engaging in additional promotional activities, and increasingly differentiating their products. Our empirical evidence is inconsistent with these beliefs.private label; entry; price; promotional activity; differentiation; supermarket

PTF11kx: A Type Ia Supernova with Hydrogen Emission Persisting After 3.5 Years

The optical transient PTF11kx exhibited both the characteristic spectral features of Type Ia supernovae (SNe Ia) and the signature of ejecta interacting with circumstellar material (CSM) containing hydrogen, indicating the presence of a nondegenerate companion. We present an optical spectrum at $1342$ days after peak from Keck Observatory, in which the broad component of H$\alpha$ emission persists with a similar profile as in early-time observations. We also present $Spitzer$ IRAC detections obtained $1237$ and $1818$ days after peak, and an upper limit from $HST$ ultraviolet imaging at $2133$ days. We interpret our late-time observations in context with published results - and reinterpret the early-time observations - in order to constrain the CSM's physical parameters and compare to theoretical predictions for recurrent nova systems. We find that the CSM's radial extent may be several times the distance between the star and the CSM's inner edge, and that the CSM column density may be two orders of magnitude lower than previous estimates. We show that the H$\alpha$ luminosity decline is similar to other SNe with CSM interaction, and demonstrate how our infrared photometry is evidence for newly formed, collisionally heated dust. We create a model for PTF11kx's late-time CSM interaction and find that X-ray reprocessing by photoionization and recombination cannot reproduce the observed H$\alpha$ luminosity, suggesting that the X-rays are thermalized and that H$\alpha$ radiates from collisional excitation. Finally, we discuss the implications of our results regarding the progenitor scenario and the geometric properties of the CSM for the PTF11kx system.Comment: 15 pages, 8 figures, 3 tables; submitted to Ap

Bioresorbable Polylactide Interbody Implants in an Ovine Anterior Cervical Discectomy and Fusion Model: Three-Year Results

Study Design. In vivo study of anterior discectomy and fusion using a bioresorbable 70:30 poly(l-lactide-co-d,l-lactide) interbody implant in an ovine model. Objective. To evaluate the efficacy of the polylactide implant to function as an interbody fusion device, and to assess the tissue reaction to the material during the resorption process. Summary of Background Data. The use of polylactide as a cervical interbody implant has several potential advantages when compared with traditional materials. Having an elastic modulus very similar to bone minimizes the potential for stress shielding, and as the material resorbs additional loading is transferred to the developing fusion mass. Although preclinical and clinical studies have demonstrated the suitability of polylactide implants for lumbar interbody fusion, detailed information on cervical anterior cervical discectomy and fusion (ACDF) with polylactide devices is desirable. Methods. Single level ACDF was performed in 8 skeletally mature ewes. Bioresorbable 70:30 poly (l-lactide-co-d,l-lactide) interbody implants packed with autograft were used with single-level metallic plates. Radiographs were made every 3 months up to 1 year, and yearly thereafter. The animals were killed at 6 months (3 animals), 12 months (3 animals), and 36 months (2 animals). In addition to the serial plain radiographs, the specimens were evaluated by nondestructive biomechanical testing and undecalcified histologic analysis. Results. The bioresorbable polylactide implants were effective in achieving interbody fusion. The 6-month animals appeared fused radiographically and biomechanically, whereas histologic sections demonstrated partial fusion (in 3 of 3 animals). Radiographic fusion was confirmed histologically and biomechanically at 12 months (3 of 3 animals) and 36 months (2 of 2 animals). A mild chronic inflammatory response to the resorbing polylactide implant was observed at both 6 months and 12 months. At 36 months, the operative levels were solidly fused and the implants were completely resorbed. No adverse tissue response was observed in any animal at any time period. Conclusion. Interbody fusion was achieved using bioresorbable polylactide implants, with no evidence of implant collapse, extrusion, or adverse tissue response to the material. The use of polylactide as a cervical interbody device appears both safe and effective based on these ACDF animal model results

Production, Outflow, Velocity, and Radial Distribution of H2O and OH in the Coma of Comet C/1995 O1 (Hale-Bopp) from Wide-field Imaging of OH

Observations of OH are a useful proxy of the water production rate (Q H2O) and outflow velocity (VH2O) in comets. From wide-field images taken on 1997 March 28 and April 8 that capture the entire scale length of the OH coma of comet C/1995 O1 (Hale-Bopp), we obtain Q OH from the model-independent method of aperture summation and Q H2O from the OH photochemical branching ratio, BROH. Using an adaptive ring summation algorithm, we extract the radial brightness distribution of OH 0-0 band emission out to cometocentric distances of up to 10 to the sixth power km, both as azimuthal averages and in quadrants covering different position angles relative to the comet-Sun line. These profiles are fitted using both fixed and variable velocity two-component spherical expansion models to estimate VOH with increasing distance from the nucleus. The OH coma of Hale-Bopp was more spatially extended than those of previous comets, and this extension is best matched by a variable acceleration of H 2O and OH that acted across the entire coma, but was strongest within 1-2 × 104 km from the nucleus. Our models indicate that VOH at the edge of our detectable field of view (10 to the sixth power km) was ∼2-3 times greater in Hale-Bopp than for 1P/Halley class comet at 1 AU, which is consistent with the results of more sophisticated gas-kinetic models, extrapolation from previous observations of OH in comets with QH2O \u3e 10 to the twenty-ninth power s superscript -1, and direct radio measurements of the outer coma Hale-Bopp OH velocity. The likely source of this acceleration is thermalization of the excess energy of dissociation of H2O and OH over an extended collisional coma. When the coma is broken down by quadrants in position angle, we find an azimuthal asymmetry in the radial distribution that is characterized by an increase in the spatial extent of OH in the region between the orbit-trailing and anti-Sunward directions. Model fits specific to this area and comparison with radio OH measurements suggest greater acceleration here, with VOH ∼ 1.5 times greater at a 10 to the sixth power km cometocentric distance than elsewhere in the coma. We discuss several mechanisms that may have acted within the coma to produce the observed effect

Bone Properties by Nanoindentation in Mild and Severe \u3cem\u3eOsteogenesis Imperfecta\u3c/em\u3e

Background Osteogenesis imperfecta is a heterogeneous genetic disorder characterized by bone fragility. Previous research suggests that impaired collagen network and abnormal mineralization affect bone tissue properties, however, little data is yet available to describe bone material properties in individuals with this disorder. Bone material properties have not been characterized in individuals with the most common form of osteogenesis imperfecta, type I. Methods Bone tissue elastic modulus and hardness were measured by nanoindentation in eleven osteotomy specimens that were harvested from children with osteogenesis imperfecta during routine surgeries. These properties were compared between osteogenesis imperfecta types I (mild, n = 6) and III (severe, n = 5), as well as between interstitial and osteonal microstructural regions using linear mixed model analysis. Findings Disease severity type had a small but statistically significant effect on modulus (7%, P = 0.02) and hardness (8%, P \u3c 0.01). Individuals with osteogenesis imperfecta type I had higher modulus and hardness than did those with type III. Overall, mean modulus and hardness values were 13% greater in interstitial lamellar bone regions than in osteonal regions (P \u3c 0.001). Interpretation The current study presents the first dataset describing bone material properties in individuals with the most common form of osteogenesis imperfecta, i.e., type I. Results indicate that intrinsic bone tissue properties are affected by phenotype. Knowledge of the material properties of bones in osteogenesis imperfecta will contribute to the ability to develop models to assist in predicting fracture risk

Five-Year Clinical Outcomes of a Randomized Trial of Anterior Cruciate Ligament Treatment Strategies: An Evidence-Based Practice Paper

REFERENCE/CITATION: Frobell RB, Roos HP, Roos EM, Roemer FW, Ranstam J, Lohmander LS. Treatment for acute anterior cruciate ligament tear: five year outcome of randomised trial. BMJ. 2013;346:F232. CLINICAL QUESTION: Does early anterior cruciate ligament (ACL) reconstruction with rehabilitation lead to better patient-reported outcomes and a lower incidence of osteoarthritis at 5 years postinjury compared with delayed ACL reconstruction with rehabilitation? STUDY SELECTION: This randomized controlled trial with extended follow-up at 5 years postrandomization was conducted in 2 Swedish orthopaedic departments. DATA EXTRACTION: The authors studied a total of 121 moderately active adults (age = 18–35 years) with an acute ACL rupture in a knee with no other history of trauma. Excluded were patients with a collateral ligament rupture, full-thickness cartilage defect, or extensive meniscal fixation. One patient assigned to the early ACL-reconstruction group did not attend the 5-year follow-up visit. Patients were randomly assigned to (1) an early ACL reconstruction plus structured rehabilitation group (n = 62, surgery within 10 weeks of injury) or (2) optional-delayed ACL reconstruction plus structured rehabilitation group (n = 59). The primary outcome measure was change in the average of 4 out of 5 subscales of the Knee Injury and Osteoarthritis Outcome Score (KOOS). The authors also assessed crude KOOS (combined 4 subscales), KOOS subscale scores, general physical and mental health (Short-Form 36), activity level (Tegner Activity Scale), mechanical knee stability (Lachman and pivot shift tests), meniscal surgery status, and presence of knee osteoarthritis on radiographs. MAIN RESULTS: Among patients randomized to the optional-delayed ACL-reconstruction group, 30 (51%) opted for an ACL reconstruction. The treatment groups had comparable 5-year patient-reported outcomes and changes in patient-reported outcomes (eg, knee pain, knee symptoms, activities of daily living, sport and recreational levels, knee-related quality of life, general physical health, and general mental health). Patients in the optional-delayed ACL-reconstruction group had greater mechanical knee instability than patients who received early ACL reconstruction; however, this was primarily among the patients opting for conservative management alone. In the overall sample, 61 knees (51%) required meniscal surgery over 5 years, regardless of treatment group. At 5 years, radiographs were available for 113 patients (93%). Overall, 29 patients (26%) had knee osteoarthritis at 5 years. Specifically, 13 patients (12%) developed tibiofemoral radiographic osteoarthritis (9 patients [16%] in the early ACL-reconstruction group, 4 [7%] in the optional-delayed ACL-reconstruction group) and 22 (19%) developed patellofemoral osteoarthritis (14 patients [24%] in the early ACL-reconstruction group, 8 [15%] in the optional-delayed ACL-reconstruction group). Patients with patellar tendon grafts (n = 40) had a greater incidence of ipsilateral patellofemoral osteoarthritis than patients with hamstrings tendon grafts (n = 51), but the 2 groups had similar incidences of ipsilateral tibiofemoral osteoarthritis. Six knees (5%) had both tibiofemoral and patellofemoral osteoarthritis. CONCLUSIONS: Early ACL reconstruction plus rehabilitation did not provide better results at 5 years compared with optional-delayed ACL reconstruction plus rehabilitation. Furthermore, the authors found no radiographic differences among patients with early ACL reconstruction, delayed ACL reconstruction, or no ACL reconstruction (rehabilitation alone)

Hybrid Lattice-Boltzmann-Potential Flow Simulations of Turbulent Flow around Submerged Structures

We report on the development and validation of a 3D hybrid Lattice Boltzmann Model (LBM), with Large Eddy Simulation (LES), to simulate the interactions of incompressible turbulent flows with ocean structures. The LBM is based on a perturbation method, in which the velocity and pressure are expressed as the sum of an inviscid flow and a viscous perturbation. The far- to near-field flow is assumed to be inviscid and represented by potential flow theory, which can be efficiently modeled with a Boundary Element Method (BEM). The near-field perturbation flow around structures is modeled by the Navier–Stokes (NS) equations, based on a Lattice Boltzmann Method (LBM) with a Large Eddy Simulation (LES) of the turbulence. In the paper, we present the hybrid model formulation, in which a modified LBM collision operator is introduced to simulate the viscous perturbation flow, resulting in a novel perturbation LBM (pLBM) approach. The pLBM is then extended for the simulation of turbulence using the LES and a wall model to represent the viscous/turbulent sub-layer near solid boundaries. The hybrid model is first validated by simulating turbulent flows over a flat plate, for moderate to large Reynolds number values, Re ∈ [3.7×104;1.2×106]; the plate friction coefficient and near-field turbulence properties computed with the model are found to agree well with both experiments and direct NS simulations. We then simulate the flow past a NACA-0012 foil using a regular LBM-LES and the new hybrid pLBM-LES models with the wall model, for Re = 1.44 x 106. A good agreement is found for the computed lift and drag forces, and pressure distribution on the foil, with experiments and results of other numerical methods. Results obtained with the pLBM model are either nearly identical or slightly improved, relative to those of the standard LBM, but are obtained in a significantly smaller computational domain and hence at a much reduced computational cost, thus demonstrating the benefits of the new hybrid approach