An experimentally validated finite element method for augmented vertebral bodies

Background Finite element models of augmented vertebral bodies require a realistic modelling of the cement infiltrated region. Most methods published so far used idealized cement shapes or oversimplified material models for the augmented region. In this study, an improved, anatomy-specific, homogenized finite element method was developed and validated to predict the apparent as well as the local mechanical behavior of augmented vertebral bodies. Methods Forty-nine human vertebral body sections were prepared by removing the cortical endplates and scanned with high-resolution peripheral quantitative CT before and after injection of a standard and a low-modulus bone cement. Forty-one specimens were tested in compression to measure stiffness, strength and contact pressure distributions between specimens and loading-plates. From the remaining eight, fourteen cylindrical specimens were extracted from the augmented region and tested in compression to obtain material properties. Anatomy-specific finite element models were generated from the CT data. The models featured element-specific, density-fabric-based material properties, damage accumulation, real cement distributions and experimentally determined material properties for the augmented region. Apparent stiffness and strength as well as contact pressure distributions at the loading plates were compared between simulations and experiments. Findings The finite element models were able to predict apparent stiffness (R2 > 0.86) and apparent strength (R2 > 0.92) very well. Also, the numerically obtained pressure distributions were in reasonable quantitative (R2 > 0.48) and qualitative agreement with the experiments. Interpretation The proposed finite element models have proven to be an accurate tool for studying the apparent as well as the local mechanical behavior of augmented vertebral bodies.

Finite element analyses of human vertebral bodies embedded in polymethylmethalcrylate or loaded via the hyperelastic intervertebral disc models provide equivalent predictions of experimental strength

Quantitative computer tomography (QCT)-based finite element (FE) models of vertebral body provide better prediction of vertebral strength than dual energy X-ray absorptiometry. However, most models were validated against compression of vertebral bodies with endplates embedded in polymethylmethalcrylate (PMMA). Yet, loading being as important as bone density, the absence of intervertebral disc (IVD) affects the strength. Accordingly, the aim was to assess the strength predictions of the classic FE models (vertebral body embedded) against the in vitro and in silico strengths of vertebral bodies loaded via IVDs. High resolution peripheral QCT (HR-pQCT) were performed on 13 segments (T11/T12/L1). T11 and L1 were augmented with PMMA and the samples were tested under a 4° wedge compression until failure of T12. Specimen-specific model was generated for each T12 from the HR-pQCT data. Two FE sets were created: FE-PMMA refers to the classical vertebral body embedded model under axial compression; FE-IVD to their loading via hyperelastic IVD model under the wedge compression as conducted experimentally. Results showed that FE-PMMA models overestimated the experimental strength and their strength prediction was satisfactory considering the different experimental set-up. On the other hand, the FE-IVD models did not prove significantly better (Exp/FE-PMMA: R²=0.68; Exp/FE-IVD: R²=0.71, p=0.84). In conclusion, FE-PMMA correlates well with in vitro strength of human vertebral bodies loaded via real IVDs and FE-IVD with hyperelastic IVDs do not significantly improve this correlation. Therefore, it seems not worth adding the IVDs to vertebral body models until fully validated patient-specific IVD models become available.

Sporadic late-onset nemaline myopathy with MGUS: long-term follow-up after melphalan and SCT.

OBJECTIVE Sporadic late-onset nemaline myopathy (SLONM) is a rare, late-onset myopathy that progresses subacutely. If associated with a monoclonal gammopathy of unknown significance (MGUS), the outcome is unfavorable: the majority of these patients die within 1 to 5 years of respiratory failure. This study aims to qualitatively assess the long-term treatment effect of high-dose melphalan (HDM) followed by autologous stem cell transplantation (SCT) in a series of 8 patients with SLONM-MGUS. METHODS We performed a retrospective case series study (n = 8) on the long-term (1-8 years) treatment effect of HDM followed by autologous SCT (HDM-SCT) on survival, muscle strength, and functional capacities. RESULTS Seven patients showed a lasting moderate-good clinical response, 2 of them after the second HDM-SCT. All of them had a complete, a very good partial, or a partial hematologic response. One patient showed no clinical or hematologic response and died. CONCLUSIONS This case series shows the positive effect of HDM-SCT in this rare disorder. Factors that may portend an unfavorable outcome are a long disease course before the hematologic treatment and a poor hematologic response. Age at onset, level and type of M protein (κ vs λ), and severity of muscle weakness were not associated with a specific outcome. CLASSIFICATION OF EVIDENCE This study provides Class IV evidence that for patients with SLONM-MGUS, HDM-SCT increases the probability of survival and functional improvement.

Modelling Nd-isotopes with a coarse resolution ocean circulation model: Sensitivities to model parameters and source/sink distributions

The neodymium (Nd) isotopic composition (Nd) of seawater is a quasi-conservative tracer of water mass mixing and is assumed to hold great potential for paleoceanographic studies. Here we present a comprehensive approach for the simulation of the two neodymium isotopes 143Nd, and 144Nd using the Bern3D model, a low resolution ocean model. The high computational efficiency of the Bern3D model in conjunction with our comprehensive approach allows us to systematically and extensively explore the sensitivity of Nd concentrations and Nd to the parametrisation of sources and sinks. Previous studies have been restricted in doing so either by the chosen approach or by computational costs. Our study thus presents the most comprehensive survey of the marine Nd cycle to date. Our model simulates both Nd concentrations as well as Nd in good agreement with observations. Nd covaries with salinity, thus underlining its potential as a water mass proxy. Results confirm that the continental margins are required as a Nd source to simulate Nd concentrations and Nd consistent with observations. We estimate this source to be slightly smaller than reported in previous studies and find that above a certain magnitude its magnitude affects Nd only to a small extent. On the other hand, the parametrisation of the reversible scavenging considerably affects the ability of the model to simulate both, Nd concentrations and Nd. Furthermore, despite their small contribution, we find dust and rivers to be important components of the Nd cycle. In additional experiments, we systematically varied the diapycnal diffusivity as well as the Atlantic-to-Pacific freshwater flux to explore the sensitivity of Nd concentrations and its isotopic signature to the strength and geometry of the overturning circulation. These experiments reveal that Nd concentrations and Nd are comparatively little affected by variations in diapycnal diffusivity and the Atlantic-to-Pacific freshwater flux. In contrast, an adequate representation of Nd sources and sinks is crucial to simulate Nd concentrations and Nd consistent with observations. The good agreement of our results with observations paves the way for the evaluation of the paleoceanographic potential of Nd in further model studies.

Anxiety, ego depletion, and sports performance

In the present article, we analyzed the role of self-control strength and state anxiety in sports performance. We tested the hypothesis that self-control strength and state anxiety interact in predicting sports performance on the basis of two studies, each using a different sports task (Study 1: performance in a basketball free throw task, N = 64; Study 2: performance in a dart task, N = 79). The patterns of results were as expected in both studies: Participants with depleted self-control strength performed worse in the specific tasks as their anxiety increased, whereas there was no significant relation for participants with fully available self-control strength. Furthermore, different degrees of available self-control strength did not predict performance in participants who were low in state anxiety, but did in participants who were high in state anxiety. Thus increasing self-control strength could reduce the negative anxiety effects in sports and improve athletes' performance under pressure.

In vitro effects of 3 % hypertonic saline and 20 % mannitol on canine whole blood coagulation and platelet function.

BACKGROUND: Hyperosmolar therapy, using either mannitol or hypertonic saline (HTS), is considered the treatment of choice for intracranial hypertension. However, hyperosmolar agents may impair coagulation and platelet function, limiting their use in patients at risk for hemorrhage. Despite this, studies evaluating the effects of mannitol compared to other hyperosmolar agents in dogs are largely lacking. The aim of this study was to compare the in vitro effects on global hemostasis and platelet function of 20 % mannitol and 3 % HTS on canine blood. METHODS: Citrated whole blood from 15 healthy dogs was diluted with 0.9 % saline, 20 % mannitol and 3 % HTS in ratios of 1:16 and 1:8. Rotational thromboelastometry (ROTEM) was used to assess clotting time (CT), clot formation time (CFT) and maximal clot firmness (MCF) following extrinsic activation (Ex-tem) and after platelet inhibition (Fib-tem). A platelet function analyzer (PFA-100) was used to assess closure time (CtPFA). RESULTS: No significant differences were observed between untreated whole blood and samples diluted with saline. Samples diluted with both mannitol and HTS were hypocoagulable compared to untreated whole blood samples. At a dilution of 1:16, no significant differences were found between any measured parameter in samples diluted with saline compared to mannitol or HTS. At a 1:8 dilution, CtPFA was prolonged in samples diluted with mannitol and HTS compared to saline, and CtPFA was prolonged more with mannitol than HTS. Ex-tem CT was increased at a 1:8 dilution with mannitol compared to HTS. Ex-tem CFT was prolonged at a 1:8 dilution with both agents compared to saline, and was prolonged more with mannitol than HTS. Ex-tem MCF was reduced at a 1:8 dilution with both agents compared to saline. DISCUSSION AND CONCLUSIONS: Data in this study indicate that both mannitol and HTS affect canine platelet function and whole blood coagulation in vitro in a dose-dependent fashion. The most pronounced effects were observed after high dilutions with mannitol, which impaired platelet aggregation, clot formation time, clot strength, and fibrin formation significantly more than HTS. Further in vivo studies are necessary before recommendations can be made

Physical activity and liver diseases

Regular physical activity beneficially impacts the risk of onset and progression of several chronic diseases. However, research regarding the effects of exercising on chronic liver diseases is relatively recent. Most authors focused on non-alcoholic fatty liver disease (NAFLD), in which increasing clinical and experimental data indicate that skeletal muscle cross-talking to the adipose tissue and the liver regulates intrahepatic fat storage. In this setting physical activity is considered required in combination with calories restriction to allow an effective decrease of intrahepatic lipid component, and despite that evidence is not conclusive, some studies suggest that vigorous activity might be more beneficial than moderate activity to improve NAFLD/NASH. Evidence regarding the effects of exercise on the risk of hepatocellular carcinoma is scarce; some epidemiological studies indicate a lower risk in patients regularly and vigorously exercising. In compensated cirrhosis exercise acutely increases portal pressure, but in longer term it has been proved safe and probably beneficial. Decreased aerobic capacity (VO2) correlates with mortality in patients with decompensated cirrhosis, who are almost invariably sarcopenic. In these patients VO2 is improved by physical activity, which might also reduce the risk of hepatic encephalopathy through an increase in skeletal muscle mass. In solid organ transplantation recipients exercise is able to improve lean mass, muscle strength and as a consequence, aerobic capacity. Few data exist in liver transplant recipients, in whom exercise should be object of future studies given its high potential of providing long-term beneficial effects. Despite evidence is far from complete, physical activity should be seen as an important part of the management of patients with liver disease in order to improve their clinical outcome. This article is protected by copyright. All rights reserved.

Fraxinus excelsior in Europe: distribution, habitat, usage and threats

Common ash (Fraxinus excelsior L.) is a medium-sized deciduous tree with large compound leaves that develop relatively late in spring. It flowers before leaf-buds burst and trees can carry male, female, or hermaphrodite flowers, or different combinations of the flower types. It grows throughout the European temperate zone, but is absent from the driest Mediterranean areas because it does not tolerate extended summer drought, and from the northern boreal regions, with its seedlings in particular being vulnerable to late spring frost. Soils exert a strong control on common ash distribution locally. The species grows best on fertile soils where soil pH exceeds 5.5. It rarely forms pure stands, more often it is found in small groups in mixed stands. Ash trees produce high quality timber that combines light weight, strength, and flexibility. Before the mass use of steel, it was used for a wide range of purposes, from agricultural implements to construction of boat and car frames. Today

Index properties, shear strenghts and consolidation characteristics of ODP Hole 164-995A sediments

Geotechnical properties of sediment from Ocean Drilling Program Leg 164 are presented as: (1) normalized shipboard strength ratios from the Cape Fear Diapir, the Blake Ridge Diapir, and the Blake Ridge; and (2) Atterberg limit, vane shear strength, pocket-penetrometer strength, and constant-rate-of-strain consolidation results from Hole 995A, located on the Blake Ridge. This study was conducted to understand the stress history in a region characterized by high sedimentation rates and the presence of gas hydrates. Collectively, the results indicate that sediment from the Blake Ridge exhibits significant underconsolidated behavior, except near the seafloor. At least 10 m of additional overburden was removed by erosion or mass wasting at Hole 993A on the Cape Fear Diapir, compared to nearby sites.

Meteorological measurements from the Fourcade and Polar Club Glacier, Warszawa Icefield, King George Island, West Antarctica

The South Shetland Islands are located at the northern tip of the AP which is among the fastest warming regions on Earth. The islands are especially vulnerable to climate change due to their exposure to transient low-pressure systems and their maritime climate. Surface air temperature increases (2.5K in 50 years) are concurrent with retreating glacier fronts, an increase in melt areas, ice surface lowering and rapid break-up and disintegration of ice shelves. We have compiled a unique meteorological data set for the King George Island (KGI)/Isla 25 de Mayo, the largest of the South Shetland Islands. It comprises high-temporal resolution and spatially distributed observations of surface air temperature, wind directions and wind velocities, as well as glacier ice temperatures in profile with a fully equipped automatic weather station on the Warszawa Icefield, from November 2010 and ongoing. In combination with two long-term synoptic datasets (40 and 10 years, respectively) and NCEP/NCAR reanalysis data, we have looked at changes in the climatological drivers of the glacial melt processes, and the sensitivity of the inland ice cap with regard to winter melting periods and pressure anomalies. The analysis has revealed, a positive trend of 5K over four decades in minimum surface air temperatures for winter months, clearly exceeding the published annual mean statistics, associated to a decrease in mean monthly winter sea level pressure. This concurs with a positive trend in the Southern Annular Mode (SAM) index, which gives a measure for the strength and extension of the Antarctic vortex. We connect this trend with a higher frequency of low-pressure systems hitting the South Shetland Islands during austral winter, bringing warm and moist air masses from lower latitudes. Due to its exposure to the impact of transient synoptic weather systems, the ice cap of KGI is especially vulnerable to changes during winter glacial mass accumulation period. A revision of seasonal changes in adiabatic air temperature lapse rates and their dependency on exposure and elevation has shown a clear decoupling of atmospheric surface layers between coastal areas and the higher-elevation ice cap, showing the higher sensitivity to free atmospheric flow and synoptic changes. Observed surface air temperature lapse rates show a high variability during winter months (standard deviations up to ±1.0K/100 m), and a distinct spatial variability reflecting the impact of synoptic weather patterns. The observed advective conditions bringing warm, moist air with high temperatures and rain, lead to melt conditions on the ice cap, fixating surface air temperatures to the melting point. This paper assesses the impact of large-scale atmospheric circulation variability and climatic changes on the atmospheric surface layer and glacier mass accumulation of the upper ice cap during winter season for the Warszawa Icefield on KGI.

Penetration velocity and deceleration of penetrometer stations N1 to N97 during cruise Senckenberg_11_2008

In-situ geotechnical measurements of surface sediments were carried out along large subaqueous dunes in the Knudedyb tidal inlet channel in the Danish Wadden Sea using a small free-falling penetrometer. Vertical profiles showed a typical stratification pattern with a resolution of ~1 cm depicting a thin surface layer of low sediment strength and a stiffer substratum below (quasi-static bearing capacity equivalent: 1-3 kPa in the top layer, 20-140 kPa in the underlying sediment; thickness of the top layer ca. 5-8 cm). Observed variations in the thickness and strength of the surface layer during a tidal cycle were compared to mean current velocities (measured using an acoustic Doppler current profiler, ADCP), high-resolution bathymetry (based on multibeam echo sounding, MBES) and qualitative estimates of suspended sediment distributions in the water column (estimated from ADCP backscatter intensity). The results revealed an ebb dominance in sediment remobilization, and a general accretion of the bed towards low water. A loose top layer occurred throughout the tidal cycle, likely influenced by bedload transport and small events of suspended sediment resettlement (thickness: 6 +-2 cm). Furthermore, this layer showed a significant increase in thickness (e.g. from 8 cm to 16 cm) related to periods of overall deposition. These findings imply that dynamic penetrometers can conveniently serve to (1) quantify potentially mobile sediments by determining the thickness of a loose sediment surface layer, (2) unravel sediment strength development in potentially mobile sediments and (3) identify sediment accumulation. Such data are an important complement and add a new geotechnical perspective during investigations of sediment remobilization processes in highly dynamic coastal environments.

Mean sortable silt values from Holocene and glacial Scotia Sea sediments

The Antarctic Circumpolar Current is key to the mixing and ventilation of the world's oceans. This current flows from west to east between about 45° and 70° S connecting the Atlantic, Pacific and Indian oceans, and is driven by westerly winds and buoyancy forcing. High levels of productivity in the current regulate atmospheric CO2 concentrations. Reconstructions of the current during the last glacial period suggest that flow speeds were faster or similar to present, and it is uncertain whether the strength and position of the westerly winds changed. Here we reconstruct Antarctic Circumpolar Current bottom speeds through the constricting Drake Passage and Scotia Sea during the Last Glacial Maximum and Holocene based on the mean grain size of sortable silt from a suite of sediment cores. We find essentially no change in bottom flow speeds through the region, and, given that the momentum imparted by winds, and modulated by sea-ice cover, is balanced by the interaction of these flows with the seabed, this argues against substantial changes in wind stress. However, glacial flow speeds in the sea-ice zone south of 56° S were significantly slower than present, whereas flow in the north was faster, but not significantly so. We suggest that slower flow over the rough topography south of 56° S may have reduced diapycnal mixing in this region during the last glacial period, possibly reducing the diapycnal contribution to the Southern Ocean overturning circulation.

Neodymium isotopic data, radiocarbon dates and calibrated ages of sediment samples off the La Plata Estuary, southeastern South America

The continental margin off the La Plata Estuary (SE South America) is characterized by high fluvial sediment supply and strong ocean currents. High-resolution sediment-acoustic data combined with sedimentary facies analysis, AMS-14C ages, and neodymium isotopic data allowed us to reconstruct late Quaternary sedimentary dynamics in relation to the two major sediment sources, the La Plata Estuary and the Argentine margin. Sediments from these two provinces show completely different dispersal patterns. We show that the northward-trending La Plata paleo-valley was the sole transit path for the huge volumes of fluvial material during lower sea levels. In contrast, material from the Argentine margin sector was transported northwards by the strong current system. Despite the large sediment volumes supplied by both sources, wide parts of the shelf were characterized by either persistent non-deposition or local short-term depocenter formation. The location and formation history of these depocenters were primarily controlled by the interplay of sea level with current strength and local morphology. The high sediment supply was of secondary importance to the stratigraphic construction, though locally resulting in high sedimentation rates. Thus, the shelf system off the La Plata Estuary can be considered as a hydrodynamic-controlled end-member.

Age determinations, dinoflagellate cyst and subpolar foraminifera measurements from sediment core HH11-134-BC, from the west Spitsbergen slope

Three marine sediment cores distributed along the Norwegian (MD95-2011), Barents Sea (JM09-KA11-GC), and Svalbard (HH11-134-BC) continental margins have been investigated in order to reconstruct changes in the poleward flow of Atlantic waters (AW) and in the nature of upper surface water masses within the eastern Nordic Seas over the last 3000 yr. These reconstructions are based on a limited set of coccolith proxies: the abundance ratio between Emiliania huxleyi and Coccolithus pelagicus, an index of Atlantic vs. Polar/Arctic surface water masses; and Gephyrocapsa muellerae, a drifted coccolith species from the temperate North Atlantic, whose abundance changes are related to variations in the strength of the North Atlantic Current. The entire investigated area, from 66 to 77° N, was affected by an overall increase in AW flow from 3000 cal yr BP (before present) to the present. The long-term modulation of westerlies' strength and location, which are essentially driven by the dominant mode of the North Atlantic Oscillation (NAO), is thought to explain the observed dynamics of poleward AW flow. The same mechanism also reconciles the recorded opposite zonal shifts in the location of the Arctic front between the area off western Norway and the western Barents Sea-eastern Fram Strait region. The Little Ice Age (LIA) was governed by deteriorating conditions, with Arctic/Polar waters dominating in the surface off western Svalbard and western Barents Sea, possibly associated with both severe sea ice conditions and a strongly reduced AW strength. A sudden short pulse of resumed high WSC (West Spitsbergen Current) flow interrupted this cold spell in eastern Fram Strait from 330 to 410 cal yr BP. Our dataset not only confirms the high amplitude warming of surface waters at the turn of the 19th century off western Svalbard, it also shows that such a warming was primarily induced by an excess flow of AW which stands as unprecedented over the last 3000 yr.

Grain size composition and age of ODP Hole 167-1017E sediments

Siliciclastic sedimentation at Ocean Drilling Program Site 1017 on the southern slope of the Santa Lucia Bank, central California margin, responded closely to oceanographic and climatic change over the past ~130 ka. Variation in mean grain-size and sediment sorting within the ~25-m-thick succession from Hole 1017E show Milankovitch-band to submillenial-scale variation. Mean grain size of the "sortable silt" fraction (10-63 µm) ranges from 17.6 to 33.9 µm (average 24.8 µm) and is inversely correlated with the degree of sorting. Much of the sediment has a bimodal or trimodal grain-size distribution that is composed of distinct fine silt, coarse silt to fine sand, and clay-size components. The position of the mode and the sorting of each component changes through the succession, but the primary variation is in the presence or abundance of the coarse silt fraction that controls the overall mean grain size and sorting of the sample. The occurrence of the best-sorted, finest grained sediment at high stands of sea level (Holocene, marine isotope Substages 5c and 5e) reflect the linkage between global climate and the sedimentary record at Site 1017 and suggest that the efficiency of off-shelf transport is a key control of sedimentation on the Santa Lucia Slope. It is not clear what proportion of the variation in grain size and sorting may also be caused by variations in bottom current strength and in situ hydrodynamic sorting.