The ultrasound appearance of the patellar tendon attachment to the tibia in young athletes is conditional on gender and pubertal stage

This cross-sectional study investigated the imaging appearance of the previous termpatellarnext term tendon attachment to the tibia in young male and female tennis players of different ages and pubertal status. Forty-four competitive young players, who had been playing tennis at least for 2 years, were recruited from a tennis school and local tennis clubs. All subjects had bilateral ultrasound imaging of the previous termpatellarnext term tendon attachment to the tibia. Standard anthropometric measurements, pubertal status and injury history were recorded. Ultrasound appearance of the previous termpatellarnext term tendon attachment was categorised into three stages: cartilage attachment, insertional cartilage and mature attachment. Cartilage attachment was more prevalent in boys (32%) and extended further into puberty (until Tanner stage 4) compared to girls (6% and Tanner stage 1). Tendons with Osgood–Schlatter Disease symptoms (n = 3) did not have a cartilage attachment. Imaging appearance commonly seen in young active athletes, consistent with a clinical diagnosis of OSD, was more common in boys and in the pre- and peri-pubertal stages.

Analysis of dynamic strains in tibia during human locomotion based on flexible multibody approach integrated with magnetic resonance imaging technique

Bone is known to adapt to the prevalent strain environment while the variation in strains, e.g., due to mechanical loading, modulates bone remodeling, and modeling. Dynamic strains rather than static strains provide the primary stimulus of bone functional adaptation. The finite element method can be generally used for estimating bone strains, but it may be limited to the static analysis of bone strains since the dynamic analysis requires expensive computation. Direct in vivo strain measurement, in turn, is an invasive procedure, limited to certain superficial bone sites, and requires surgical implementation of strain gauges and thus involves risks (e.g., infection). Therefore, to overcome difficulties associated with the finite element method and the in vivo strain measurements, the flexible multibody simulation approach has been recently introduced as a feasible method to estimate dynamic bone strains during physical activity. The purpose of the present study is to further strengthen the idea of using the flexible multibody approach for the analysis of dynamic bone strains. Besides discussing the background theory, magnetic resonance imaging is integrated into the flexible multibody approach framework so that the actual bone geometry could be better accounted for and the accuracy of prediction improved.

Cross-sectional geometry of weight-bearing tibia in female athletes subjected to different exercise loadings

Summary The association of long-termsport-specific exercise loading with cross-sectional geometry of the weight-bearing tibia was evaluated among 204 female athletes representing five different exercise loadings and 50 referents. All exercises involving ground impacts (e.g., endurance running, ball games, jumping) were associated with thicker cortex at the distal and diaphyseal sites of the tibia and also with large diaphyseal cross-section, whereas the high-magnitude (powerlifting) and non-impact (swimming) exercises were not. Introduction Bones adapt to the specific loading to which they are habitually subjected. In this cross-sectional study, the association of long-term sport-specific exercise loading with the geometry of the weight-bearing tibia was evaluated among premenopausal female athletes representing 11 different sports.

Methods A total of 204 athletes were divided into five exercise loading groups, and the respective peripheral quantitative computed tomographic data were compared to data obtained from 50 physically active, non-athletic referents. Analysis of covariance was used to estimate the between-group differences.

Results At the distal tibia, the high-impact, odd-impact, and repetitive low-impact exercise loading groups had ~30% to 50% (p<0.05) greater cortical area (CoA) than the referents. At the tibial shaft, these three impact groups had ~15% to 20% (p<0.05) greater total area (ToA) and ~15% to 30% (p<0.05) greater CoA. By contrast, both the high-magnitude and repetitive non-impact groups had similar ToA and CoA values to the reference group at both tibial sites.

Conclusions High-impact, odd-impact, and repetitive lowimpact exercise loadings were associated with thicker cortex at the distal tibia. At the tibial shaft, impact loading was not only associated with thicker cortex, but also a larger cross-sectional area. High-magnitude exercise loading did not show such associations at either site but was comparable to repetitive non-impact loading and reference data. Collectively, the relevance of high strain rate together with moderate-to-high strain magnitude as major determinants of osteogenic loading of the weight-bearing tibia is implicated.

Direction-specific diaphyseal geometry and mineral mass distribution of tibia and fibula: A pQCT study of female athletes representing different exercise loading types

Bones adapt to prevalent loading, which comprises mainly forces caused by muscle contractions. Therefore, we hypothesized that similar associations would be observed between neuromuscular performance and rigidity of bones located in the same body segment. These associations were assessed among 221 premenopausal women representing athletes in high-impact, odd-impact, highmagnitude, repetitive low-impact, and repetitive nonimpact sports and physically active referents aged 17–40 years. The whole group mean age and body mass were 23 (5) and 63 (9) kg, respectively. Bone cross sections at the tibial and fibular mid-diaphysis were assessed with peripheral quantitative computed tomography (pQCT). Density-weighted polar section modulus (SSI) and minimal and maximal crosssectional moments of inertia (Imin, Imax) were analyzed. Bone morphology was described as the Imax/Imin ratio. Neuromuscular performance was assessed by maximal power during countermovement jump (CMJ). Tibial SSI was 31% higher in the high-impact, 19% in the odd-impact, and 30% in the repetitive low-impact groups compared with the reference group (P\0.005). Only the high-impact group differed from the referents in fibular SSI (17%, P\0.005). Tibial morphology differed between groups (P = 0.001), but fibular morphology did not (P = 0.247). The bone-bygroup interaction was highly significant (P\0.001). After controlling for height, weight, and age, the CMJ peak power correlated moderately with tibial SSI (r = 0.31, P\0.001) but not with fibular SSI (r = 0.069, P = 0.313). In conclusion, observed differences in the association between neuromuscular performance and tibial and fibular traits suggest
that the tibia and fibula experience different loading

Peanut allergens alter intestinal barrier permeability and tight junction localisation in Caco-2 cell cultures

Allergen absorption by epithelia may play an important role in downstream immune responses. Transport mechanisms that can bypass Peyer's patches include transcellular and paracellular transport. The capacity of an allergen to cross via these means can modulate downstream processing of the allergen by the immune system. The aim of this study was to investigate allergen-epithelial interactions of peanut allergens with the human intestinal epithelium.

Monotonicity preserving approximation of multivariate scattered data

This paper describes a new method of monotone interpolation and smoothing of multivariate scattered data. It is based on the assumption that the function to be approximated is Lipschitz continuous. The method provides the optimal approximation in the worst case scenario and tight error bounds. Smoothing of noisy data subject to monotonicity constraints is converted into a quadratic programming problem. Estimation of the unknown Lipschitz constant from the data by sample splitting and cross-validation is described. Extension of the method for locally Lipschitz functions is presented.

Elastic modulus and hardness of cortical and trabecular bovine bone measured by nanoindentation

The elastic modulus and hardness of several microstructure components of dry bovine vertebrae and tibia have been investigated in the longitude and transverse directions using nanoindentation. The elastic modulus for the osteons and the interstitial lamellae in the longitude direction were found to be (24.7±2.5) GPa and (30.1±2.4) GPa. As it's difficult to distinguish osteons from interstitial lamellae in the transverse direction, the average elastic modulus for cortical bovine bone in the transverse direction was (19.8±1.6) GPa. The elastic modulus for trabecular bone in the longitude and transverse direction were (20±2) GPa and (14.7±1.9) GPa respectively. The hardness also varied among the microstructure components in the range of 0.41–0.89 GPa. Analyses of variance show that the values are significantly different.

Are unilateral and bilateral patellar tendinopathy distinguished by differences in anthropometry, body composition, or muscle strength in elite female basketball players?

Background: Overuse injury to the patellar tendon (patellar tendinopathy) is a major reason for interrupted training and competition for elite athletes. In both sexes, the prevalence of unilateral and bilateral tendinopathy has been shown to differ. It has been proposed that bilateral pathology may have a different aetiology from unilateral pathology. Investigation of risk factors that may be unique to unilateral and bilateral patellar tendinopathy in female athletes may reveal insights into the aetiology of this condition.
Objectives: To examine whether anthropometry, body composition, or muscle strength distinguished elite female basketball players with unilateral or bilateral patellar tendinopathy.
Methods: Body composition, anthropometry, and muscle strength were compared in elite female basketball players with unilateral (n = 8), bilateral (n = 7), or no (n = 24) patellar tendinopathy. Body composition was analysed using a dual energy x ray absorptiometer. Anthropometric measures were assessed using standard techniques. Knee extensor strength was measured at 180°/s using an isokinetic dynamometer. z scores were calculated for the unilateral and bilateral groups (using the no tendinopathy group as controls). z scores were tested against zero.
Results: The tibia length to stature ratio was approximately 1.3 (1.3) SDs above zero in both the affected and non-affected legs in the unilateral group (p<0.05). The waist to hip ratio was 0.66 (0.78) SD above zero in the unilateral group (p<0.05). In the unilateral group, leg lean to total lean ratio was 0.42 (0.55) SD above zero (p<0.07), the trunk lean to total lean ratio was 0.63 (0.68) SD below zero (p<0.05), and leg fat relative to total fat was 0.47 (0.65) SD below zero (p<0.09). In the unilateral group, the leg with pathology was 0.78 (1.03) SD weaker during eccentric contractions (p<0.07).
Conclusions: Unilateral patellar tendinopathy has identifiable risk factors whereas bilateral patellar tendinopathy may not. This suggests that the aetiology of these conditions may be different. However, interpretation must respect the limitation of small subject numbers.

Championing telemedicine in New Zealand : the case of utilizing video conferencing in psychiatry and dermatology

This research explores the factors that could influence telemedicine success in two hospitals involved in a rural setting in New Zealand. Findings from the cases revealed that telemedicine utilising the video conferencing technology (TMVC) was adopted based on its cost-benefit to the hospitals. This is necessary but considering the impact of other factors, specifically the compatibility factor could have made the adoption decision more effective earlier on. The administration manager was the primary instigator of TMVC in psychiatry in one of the hospitals, whereas in the other hospital it was the dermatologist. Therefore, this research emphasises the importance of the tight coupling between the roles of both the management and the clinical champions for TMVC to succeed in New Zealand. However, the research results suggest the limited use of the technology in the cases.