Can measures of limb loading and dynamic stability during the squat maneuver provide an index of early functional recovery following unilateral total hip arthroplasty?

Objective: To investigate limb loading and dynamic stability during squatting in the early functional recovery of total hip arthroplasty (THA) patients. Design: Cohort study Setting: Inpatient rehabilitation clinic. Participants: A random sample of 61 THA patients (34♂/27♀; 62±9 yrs, 77±14 kg, 174±9 cm) was assessed twice, 13.2±3.8 days (PRE) and 26.6±3.3 days post-surgery (POST), and compared with a healthy reference group (REF) (22♂/16♀; 47±12yrs; 78±20kg; 175±10cm). Interventions: THA patients received two weeks of standard in-patient rehabilitation. Main Outcome Measure(s): Inter-limb vertical force distribution and dynamic stability during the squat maneuver, as defined by the root mean square (RMS) of the center of pressure in antero-posterior and medio-lateral directions, of operated (OP) and non-operated (NON)limbs. Self-reported function was assessed via FFb-H-OA 2.0 questionnaire. Results: At PRE, unloading of the OP limb was 15.8% greater (P<.001, d=1.070) and antero-posterior and medio-lateral center of pressure RMS were 30-34% higher in THA than REF P<.05). Unloading was reduced by 12.8% towards a more equal distribution from PRE to POST (P<.001, d=0.874). Although medio-lateral stability improved between PRE and POST (OP: 14.8%, P=.024, d=0.397; NON: 13.1%, P=.015, d=0.321), antero-posterior stability was not significantly different. Self-reported physical function improved by 15.8% (P<.001, d=0.965). Conclusion(s): THA patients unload the OP limb and are dynamically more unstable during squatting in the early rehabilitation phase following total hip replacement than healthy adults. Although loading symmetry and medio-lateral stability improved to the level of healthy adults with rehabilitation, antero-posterior stability remained impaired. Measures of dynamic stability and load symmetry during squatting provide quantitative information that can be used to clinically monitor early functional recovery from THA.

The N170 observed ‘in the wild’: robust event-related potentials to faces in cluttered dynamic visual scenes

As a social species in a constantly changing environment, humans rely heavily on the informational richness and communicative capacity of the face. Thus, understanding how the brain processes information about faces in real-time is of paramount importance. The N170 is a high temporal resolution electrophysiological index of the brain's early response to visual stimuli that is reliably elicited in carefully controlled laboratory-based studies. Although the N170 has often been reported to be of greatest amplitude to faces, there has been debate regarding whether this effect might be an artifact of certain aspects of the controlled experimental stimulation schedules and materials. To investigate whether the N170 can be identified in more realistic conditions with highly variable and cluttered visual images and accompanying auditory stimuli we recorded EEG 'in the wild', while participants watched pop videos. Scene-cuts to faces generated a clear N170 response, and this was larger than the N170 to transitions where the videos cut to non-face stimuli. Within participants, wild-type face N170 amplitudes were moderately correlated to those observed in a typical laboratory experiment. Thus, we demonstrate that the face N170 is a robust and ecologically valid phenomenon and not an artifact arising as an unintended consequence of some property of the more typical laboratory paradigm.

Amplitude of accommodation in type 1 diabetes

Purpose People with diabetes have accelerated age-related biometric ocular changes compared with people without diabetes. We determined the effect of Type 1 diabetes on amplitude of accommodation. Method There were 43 participants (33 ± 8 years) with type 1 diabetes and 32 (34 ± 8 years) age-balanced participants without diabetes. There was no significant difference in the mean equivalent refractive error and visual acuity between the two groups. Amplitude of accommodation was measured using two techniques: objective — by determining the accommodative response to a stimulus in a COAS-HD wavefront aberrometer (Wavefront Sciences), and subjective — with a Badal hand optometer (Rodenstock). The influences of age and diabetes duration (in years) on amplitude of accommodation were analyzed using multiple regression analysis. Results Across both groups, objective amplitude was less than subjective amplitude by 1.4 ± 1.2 D. People with diabetes had lower objective (2.7 ± 1.6 D) and subjective (4.0 ± 1.7 D) amplitudes than people without diabetes (objective 4.1 ± 2.1 D, subjective 5.6 ± 2.1 D). For objective amplitude and the whole group, the duration of diabetes contributed 57% of the variation as did age. For the objective amplitude and only the diabetes group this was 78%. For subjective amplitude, the corresponding proportions were 68% and 103%. Conclusions Both objective and subjective techniques showed lowered amplitude of accommodation in participants with type 1 diabetes when compared with age-matched controls. The loss correlated strongly with duration of diabetes. The results suggest that individuals with diabetes will experience presbyopia earlier in life than people without diabetes, possibly due to metabolic changes in the lens.

Effect of diabetes on amplitude of accommodation

Purpose: To determine the effect of Type 1 diabetes (DM1) on amplitude of accommodation. Method: There were 43 participants (33 ± 8 years) with DM1 and 32 (34 ± 8 years) age-balanced controls. Amplitude was measured objectively with a COAS wavefront aberrometer and subjectively with a Badal hand optometer. Results: Across both groups, objective amplitude was less than subjective amplitude by 1.4 ± 1.2 D. People with diabetes had lower objective (2.7±1.6 D) and subjective (4.0±1.7 D) amplitudes than people without diabetes (objective 4.1±2.1 D, subjective 5.6±2.1 D). For the DM1 group, the objective and subjective multivariate linear regressions were 7.1 – 0.097Age – 0.076DiabDur (R2 0.51) and 9.1 –0.103Age – 0.106DiabDur (R2 0.63), respectively. Conclusion: Objective and subjective techniques showed lowered amplitude of accommodation in DM1 participants compared with age-matched controls. Loss was affected strongly by duration of diabetes. People with diabetes will experience presbyopia earlier in life than people without diabetes.

The effect of repeated loading and freeze-thaw cycling on immature bovine thoracic motion segment stiffness

There is growing interest in the biomechanics of ‘fusionless’ implant constructs used for deformity correction in the thoracic spine, however, there are questions over the comparability of in vitro biomechanical studies from different research groups due to the various methods used for specimen preparation, testing and data collection. The aim of this study was to identify the effect of two key factors on the stiffness of immature bovine thoracic spine motion segments: (i) repeated cyclic loading and (ii) multiple freeze-thaw cycles, to aid in the planning and interpretation of in vitro studies. Two groups of thoracic spine motion segments from 6-8 week old calves were tested in flexion/extension, right/left lateral bending, and right/left axial rotation under moment control. Group (A) were tested with continuous repeated cyclic loading for 500 cycles with data recorded at cycles 3, 5, 10, 25, 50, 100, 200, 300, 400 and 500. Group (B) were tested after each of five freeze-thaw sequences, with data collected from the 10th load cycle in each sequence. Group A: Flexion/extension stiffness reduced significantly over the 500 load cycles (-22%; P=0.001), but there was no significant change between the 5th and 200th load cycles. Lateral bending stiffness decreased significantly (-18%; P=0.009) over the 500 load cycles, but there was no significant change in axial rotation stiffness (P=0.137). Group B: There was no significant difference between mean stiffness over the five freeze-thaw sequences in flexion/extension (P=0.813) and a near significant reduction in mean stiffness in axial rotation (-6%; P=0.07). However, there was a statistically significant increase in stiffness in lateral bending (+30%; P=0.007). Comparison of in vitro testing results for immature thoracic bovine spine segments between studies can be performed with up to 200 load cycles without significant changes in stiffness. However, when testing protocols require greater than 200 cycles, or when repeated freeze-thaw cycles are involved, it is important to account for the effect of cumulative load and freeze-thaw cycles on spine segment stiffness.

Dynamic simulation of CFRP strengthened steel column under impact loading

Carbon fibre reinforced polymer (CFRP) strengthening of metallic structures under static loading has shown great potential in the recent years. However, steel structures are often experienced natural (e.g. earthquake, wind) as well as man-made (e.g. vehicular impact, blast) dynamic loading. Therefore, there is a growing interest among the researchers to investigate the capability of CFRP strengthened members under such dynamic conditions. This study focuses on the finite element (FE) numerical modelling and simulation of CFRP strengthened steel column under transverse impact loading to predict the behaviour and failure modes. Impact simulation process and the CFRP strengthened steel column are validated with the existing experimental results in literature. The validated FE model of CFRP strengthened steel column is then further used to investigate the effects of transverse impact loading on its structural performance. The results are presented in terms of transvers e impact force, lateral and axial displacement, and deformed shape to evaluate the effectiveness of CFRP strengthening technique. Comparisons between the bare steel and CFRP strengthened steel columns clearly indicate the performance enhancement of strengthened column under transverse impact loading.

A fast semi-implicit difference method for a nonlinear two-sided space-fractional diffusion equation with variable diffusivity coefficients

In this paper, we derive a new nonlinear two-sided space-fractional diffusion equation with variable coefficients from the fractional Fick’s law. A semi-implicit difference method (SIDM) for this equation is proposed. The stability and convergence of the SIDM are discussed. For the implementation, we develop a fast accurate iterative method for the SIDM by decomposing the dense coefficient matrix into a combination of Toeplitz-like matrices. This fast iterative method significantly reduces the storage requirement of O(n2)O(n2) and computational cost of O(n3)O(n3) down to n and O(nlogn)O(nlogn), where n is the number of grid points. The method retains the same accuracy as the underlying SIDM solved with Gaussian elimination. Finally, some numerical results are shown to verify the accuracy and efficiency of the new method.

Biomechanics of transfemoral amputees fitted with osseointegrated fixation: Loading data for evidence-based practice

This presentation will provide an overview of the load applied on the residuum of transfemoral amputees fitted with an osseointegrated fixation during (A) rehabilitation, including static and dynamic load bearing exercises (e.g., rowing, adduction, abduction, squat, cycling, walking with aids), and (B) activities of daily living including standardized activities (e.g., level walking in straight line and around a circle, ascending and descending slopes and stairs) and activities in real world environments.

Review of direct measurement of inner prosthesis loading in transfemoral amputation: Potential benefits for evidence-based practice

The understanding of the load applied on the residuum through the prosthesis of individuals with transfemoral amputation (TFA) is essential to address a number of concerns that could strongly reduce their quality of life (e.g., residuum skin lesion, prosthesis fitting, alignment). This inner prosthesis loading could be estimated using a typical gait laboratory relying on inverse dynamics equations. Alternative, technological advances proposed over the last decade enabled direct measurement of this kinetic information in a broad variety of situations that could potentially be more relevant in clinical settings. The purposes of this presentation are (A) to review the literature about recent developments in measure and analyses of inner prosthesis loading of TFA, and (B) to extract information that could potentially contribute to a better evidence-based practice.

Variable phenotype in 16p duplication within a family

Background More individuals are now being identified with very rare genetic syndromes. We present a family with an inherited duplication of 16p11.2 to 16q12.1 in ring formation. Three of the four children, (aged 15 months to 10 years), mother, uncle, and grandmother are affected. Our aim was to provide preliminary evidence of possible phenotypic patterns of learning and behaviour associated with this chromosome anomaly. Method Psychometric assessments were undertaken with all four children. The mother and uncle also agreed to participate in the study. Measures of development (Bayley or Mullen), intellectual ability (WISC-IV or WAIS-III), academic achievement (WIAT-II), adaptive behaviour (Vinelands), and other relevant aspects of functioning (e.g., Children’s Memory Scale) were administered. Results. The first-born child is the only one who is unaffected. Her intellectual ability was assessed as being within the superior range. The second child experienced early difficulties with speech and motor skills. Although his intelligence is average, he has learning difficulties and significant auditory memory problems. The third child’s speech and motor milestones were markedly delayed. He has a complex medical history that includes a vitamin B12 deficiency. On the Mullen Scales at age 4 his scores ranged from average to very low. The development of the youngest child (aged 15 months), who also had a B12 deficiency but was treated early, was assessed as being within typical limits. Conclusions There is considerable developmental variability among the three children with this inherited 16p duplication. We discuss the intriguing similarities and differences, considering common features that may reflect phenotypic patterns and speculating about possible explanations for the variable presentations.