Next-Generation Sequencing of Coccidioides immitis Isolated during Cluster Investigation

Next-generation sequencing enables use of whole-genome sequence typing (WGST) as a viable and discriminatory tool for genotyping and molecular epidemiologic analysis. We used WGST to confirm the linkage of a cluster of Coccidioides immitis isolates from 3 patients who received organ transplants from a single donor who later had positive test results for coccidioidomycosis. Isolates from the 3 patients were nearly genetically identical (a total of 3 single-nucleotide polymorphisms identified among them), thereby demonstrating direct descent of the 3 isolates from an original isolate. We used WGST to demonstrate the genotypic relatedness of C. immitis isolates that were also epidemiologically linked. Thus, WGST offers unique benefits to public health for investigation of clusters considered to be linked to a single source

Sensitization in Transplantation: Assessment of Risk (STAR) 2017 Working Group Meeting Report

Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/144684/1/ajt14752_am.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/144684/2/ajt14752.pd

Low-profile prosthetic foot stiffness category and size, and shoes affect axial and torsional stiffness and hysteresis

IntroductionPassive-elastic prosthetic feet are manufactured with numerical stiffness categories and prescribed based on the user's body mass and activity level, but mechanical properties, such as stiffness values and hysteresis are not typically reported. Since the mechanical properties of passive-elastic prosthetic feet and footwear can affect walking biomechanics of people with transtibial or transfemoral amputation, characterizing these properties can provide objective metrics for comparison and aid prosthetic foot prescription and designMethodsWe characterized axial and torsional stiffness values, and hysteresis of 33 categories and sizes of a commercially available passive-elastic prosthetic foot model [Össur low-profile (LP) Vari-flex] with and without a shoe. We assumed a greater numerical stiffness category would result in greater axial and torsional stiffness values but would not affect hysteresis. We hypothesized that a greater prosthetic foot length would not affect axial stiffness values or hysteresis but would result in greater torsional stiffness values. We also hypothesized that including a shoe would result in decreased axial and torsional stiffness values and greater hysteresis.ResultsProsthetic stiffness was better described by curvilinear than linear equations such that stiffness values increased with greater loads. In general, a greater numerical stiffness category resulted in increased heel, midfoot, and forefoot axial stiffness values, increased plantarflexion and dorsiflexion torsional stiffness values, and decreased heel, midfoot, and forefoot hysteresis. Moreover, for a given category, a longer prosthetic foot size resulted in decreased heel, midfoot, and forefoot axial stiffness values, increased plantarflexion and dorsiflexion torsional stiffness values, and decreased heel and midfoot hysteresis. In addition, adding a shoe to the prosthetic foot resulted in decreased heel and midfoot axial stiffness values, decreased plantarflexion torsional stiffness values, and increased heel, midfoot, and forefoot hysteresis.DiscussionOur results suggest that manufacturers should adjust the design of each category to ensure the mechanical properties are consistent across different sizes and highlight the need for prosthetists and researchers to consider the effects of shoes in combination with prostheses. Our results can be used to objectively compare the LP Vari-flex prosthetic foot to other prosthetic feet to inform their prescription, design, and use for people with a transtibial or transfemoral amputation

Datasheet5_Low-profile prosthetic foot stiffness category and size, and shoes affect axial and torsional stiffness and hysteresis.docx

IntroductionPassive-elastic prosthetic feet are manufactured with numerical stiffness categories and prescribed based on the user's body mass and activity level, but mechanical properties, such as stiffness values and hysteresis are not typically reported. Since the mechanical properties of passive-elastic prosthetic feet and footwear can affect walking biomechanics of people with transtibial or transfemoral amputation, characterizing these properties can provide objective metrics for comparison and aid prosthetic foot prescription and designMethodsWe characterized axial and torsional stiffness values, and hysteresis of 33 categories and sizes of a commercially available passive-elastic prosthetic foot model [Össur low-profile (LP) Vari-flex] with and without a shoe. We assumed a greater numerical stiffness category would result in greater axial and torsional stiffness values but would not affect hysteresis. We hypothesized that a greater prosthetic foot length would not affect axial stiffness values or hysteresis but would result in greater torsional stiffness values. We also hypothesized that including a shoe would result in decreased axial and torsional stiffness values and greater hysteresis.ResultsProsthetic stiffness was better described by curvilinear than linear equations such that stiffness values increased with greater loads. In general, a greater numerical stiffness category resulted in increased heel, midfoot, and forefoot axial stiffness values, increased plantarflexion and dorsiflexion torsional stiffness values, and decreased heel, midfoot, and forefoot hysteresis. Moreover, for a given category, a longer prosthetic foot size resulted in decreased heel, midfoot, and forefoot axial stiffness values, increased plantarflexion and dorsiflexion torsional stiffness values, and decreased heel and midfoot hysteresis. In addition, adding a shoe to the prosthetic foot resulted in decreased heel and midfoot axial stiffness values, decreased plantarflexion torsional stiffness values, and increased heel, midfoot, and forefoot hysteresis.DiscussionOur results suggest that manufacturers should adjust the design of each category to ensure the mechanical properties are consistent across different sizes and highlight the need for prosthetists and researchers to consider the effects of shoes in combination with prostheses. Our results can be used to objectively compare the LP Vari-flex prosthetic foot to other prosthetic feet to inform their prescription, design, and use for people with a transtibial or transfemoral amputation.</p

Datasheet1_Low-profile prosthetic foot stiffness category and size, and shoes affect axial and torsional stiffness and hysteresis.pdf

IntroductionPassive-elastic prosthetic feet are manufactured with numerical stiffness categories and prescribed based on the user's body mass and activity level, but mechanical properties, such as stiffness values and hysteresis are not typically reported. Since the mechanical properties of passive-elastic prosthetic feet and footwear can affect walking biomechanics of people with transtibial or transfemoral amputation, characterizing these properties can provide objective metrics for comparison and aid prosthetic foot prescription and designMethodsWe characterized axial and torsional stiffness values, and hysteresis of 33 categories and sizes of a commercially available passive-elastic prosthetic foot model [Össur low-profile (LP) Vari-flex] with and without a shoe. We assumed a greater numerical stiffness category would result in greater axial and torsional stiffness values but would not affect hysteresis. We hypothesized that a greater prosthetic foot length would not affect axial stiffness values or hysteresis but would result in greater torsional stiffness values. We also hypothesized that including a shoe would result in decreased axial and torsional stiffness values and greater hysteresis.ResultsProsthetic stiffness was better described by curvilinear than linear equations such that stiffness values increased with greater loads. In general, a greater numerical stiffness category resulted in increased heel, midfoot, and forefoot axial stiffness values, increased plantarflexion and dorsiflexion torsional stiffness values, and decreased heel, midfoot, and forefoot hysteresis. Moreover, for a given category, a longer prosthetic foot size resulted in decreased heel, midfoot, and forefoot axial stiffness values, increased plantarflexion and dorsiflexion torsional stiffness values, and decreased heel and midfoot hysteresis. In addition, adding a shoe to the prosthetic foot resulted in decreased heel and midfoot axial stiffness values, decreased plantarflexion torsional stiffness values, and increased heel, midfoot, and forefoot hysteresis.DiscussionOur results suggest that manufacturers should adjust the design of each category to ensure the mechanical properties are consistent across different sizes and highlight the need for prosthetists and researchers to consider the effects of shoes in combination with prostheses. Our results can be used to objectively compare the LP Vari-flex prosthetic foot to other prosthetic feet to inform their prescription, design, and use for people with a transtibial or transfemoral amputation.</p

Datasheet3_Low-profile prosthetic foot stiffness category and size, and shoes affect axial and torsional stiffness and hysteresis.docx

IntroductionPassive-elastic prosthetic feet are manufactured with numerical stiffness categories and prescribed based on the user's body mass and activity level, but mechanical properties, such as stiffness values and hysteresis are not typically reported. Since the mechanical properties of passive-elastic prosthetic feet and footwear can affect walking biomechanics of people with transtibial or transfemoral amputation, characterizing these properties can provide objective metrics for comparison and aid prosthetic foot prescription and designMethodsWe characterized axial and torsional stiffness values, and hysteresis of 33 categories and sizes of a commercially available passive-elastic prosthetic foot model [Össur low-profile (LP) Vari-flex] with and without a shoe. We assumed a greater numerical stiffness category would result in greater axial and torsional stiffness values but would not affect hysteresis. We hypothesized that a greater prosthetic foot length would not affect axial stiffness values or hysteresis but would result in greater torsional stiffness values. We also hypothesized that including a shoe would result in decreased axial and torsional stiffness values and greater hysteresis.ResultsProsthetic stiffness was better described by curvilinear than linear equations such that stiffness values increased with greater loads. In general, a greater numerical stiffness category resulted in increased heel, midfoot, and forefoot axial stiffness values, increased plantarflexion and dorsiflexion torsional stiffness values, and decreased heel, midfoot, and forefoot hysteresis. Moreover, for a given category, a longer prosthetic foot size resulted in decreased heel, midfoot, and forefoot axial stiffness values, increased plantarflexion and dorsiflexion torsional stiffness values, and decreased heel and midfoot hysteresis. In addition, adding a shoe to the prosthetic foot resulted in decreased heel and midfoot axial stiffness values, decreased plantarflexion torsional stiffness values, and increased heel, midfoot, and forefoot hysteresis.DiscussionOur results suggest that manufacturers should adjust the design of each category to ensure the mechanical properties are consistent across different sizes and highlight the need for prosthetists and researchers to consider the effects of shoes in combination with prostheses. Our results can be used to objectively compare the LP Vari-flex prosthetic foot to other prosthetic feet to inform their prescription, design, and use for people with a transtibial or transfemoral amputation.</p

Datasheet7_Low-profile prosthetic foot stiffness category and size, and shoes affect axial and torsional stiffness and hysteresis.docx

IntroductionPassive-elastic prosthetic feet are manufactured with numerical stiffness categories and prescribed based on the user's body mass and activity level, but mechanical properties, such as stiffness values and hysteresis are not typically reported. Since the mechanical properties of passive-elastic prosthetic feet and footwear can affect walking biomechanics of people with transtibial or transfemoral amputation, characterizing these properties can provide objective metrics for comparison and aid prosthetic foot prescription and designMethodsWe characterized axial and torsional stiffness values, and hysteresis of 33 categories and sizes of a commercially available passive-elastic prosthetic foot model [Össur low-profile (LP) Vari-flex] with and without a shoe. We assumed a greater numerical stiffness category would result in greater axial and torsional stiffness values but would not affect hysteresis. We hypothesized that a greater prosthetic foot length would not affect axial stiffness values or hysteresis but would result in greater torsional stiffness values. We also hypothesized that including a shoe would result in decreased axial and torsional stiffness values and greater hysteresis.ResultsProsthetic stiffness was better described by curvilinear than linear equations such that stiffness values increased with greater loads. In general, a greater numerical stiffness category resulted in increased heel, midfoot, and forefoot axial stiffness values, increased plantarflexion and dorsiflexion torsional stiffness values, and decreased heel, midfoot, and forefoot hysteresis. Moreover, for a given category, a longer prosthetic foot size resulted in decreased heel, midfoot, and forefoot axial stiffness values, increased plantarflexion and dorsiflexion torsional stiffness values, and decreased heel and midfoot hysteresis. In addition, adding a shoe to the prosthetic foot resulted in decreased heel and midfoot axial stiffness values, decreased plantarflexion torsional stiffness values, and increased heel, midfoot, and forefoot hysteresis.DiscussionOur results suggest that manufacturers should adjust the design of each category to ensure the mechanical properties are consistent across different sizes and highlight the need for prosthetists and researchers to consider the effects of shoes in combination with prostheses. Our results can be used to objectively compare the LP Vari-flex prosthetic foot to other prosthetic feet to inform their prescription, design, and use for people with a transtibial or transfemoral amputation.</p

Datasheet2_Low-profile prosthetic foot stiffness category and size, and shoes affect axial and torsional stiffness and hysteresis.csv

IntroductionPassive-elastic prosthetic feet are manufactured with numerical stiffness categories and prescribed based on the user's body mass and activity level, but mechanical properties, such as stiffness values and hysteresis are not typically reported. Since the mechanical properties of passive-elastic prosthetic feet and footwear can affect walking biomechanics of people with transtibial or transfemoral amputation, characterizing these properties can provide objective metrics for comparison and aid prosthetic foot prescription and designMethodsWe characterized axial and torsional stiffness values, and hysteresis of 33 categories and sizes of a commercially available passive-elastic prosthetic foot model [Össur low-profile (LP) Vari-flex] with and without a shoe. We assumed a greater numerical stiffness category would result in greater axial and torsional stiffness values but would not affect hysteresis. We hypothesized that a greater prosthetic foot length would not affect axial stiffness values or hysteresis but would result in greater torsional stiffness values. We also hypothesized that including a shoe would result in decreased axial and torsional stiffness values and greater hysteresis.ResultsProsthetic stiffness was better described by curvilinear than linear equations such that stiffness values increased with greater loads. In general, a greater numerical stiffness category resulted in increased heel, midfoot, and forefoot axial stiffness values, increased plantarflexion and dorsiflexion torsional stiffness values, and decreased heel, midfoot, and forefoot hysteresis. Moreover, for a given category, a longer prosthetic foot size resulted in decreased heel, midfoot, and forefoot axial stiffness values, increased plantarflexion and dorsiflexion torsional stiffness values, and decreased heel and midfoot hysteresis. In addition, adding a shoe to the prosthetic foot resulted in decreased heel and midfoot axial stiffness values, decreased plantarflexion torsional stiffness values, and increased heel, midfoot, and forefoot hysteresis.DiscussionOur results suggest that manufacturers should adjust the design of each category to ensure the mechanical properties are consistent across different sizes and highlight the need for prosthetists and researchers to consider the effects of shoes in combination with prostheses. Our results can be used to objectively compare the LP Vari-flex prosthetic foot to other prosthetic feet to inform their prescription, design, and use for people with a transtibial or transfemoral amputation.</p