Video rasterstereography of the spine and pelvis in eight erect positions: A reliability study.

INTRODUCTION: To investigate the reliability and variability of Video Rasterstereography (VR) measurements of the spine and pelvis, for eight proposed standing postures, in order to help define an optimal standing position for erect pelvis radiography. METHODS: Surface topography data were collected using the formetic 4D dynamic modelling (Diers) system. 61 healthy participants were recruited; each participant performed eight different standing positions. Four positions were performed with the feet shoulder width apart and parallel, and four positions were performed with the feet shoulder width apart and internally rotated. For the upper extremity, each of the (two sets of) four positions were performed with different arm positions (arms by the sides, arms crossed over the chest, arms 30° flexed and touching the medial end of the clavicle, arms 30° flexed with the hands holding a support). Three sets of surface topography were collected in the eight positions (n = 24). The variability was assessed by calculating standard error of the measurement (SEm) and the coefficient of variation (CV). Reliability was assessed using intra-class correlation coefficients (ICC ± 95% CI). RESULTS: No significant differences in the SEm were found between the three paired measurements for all standing positions (P > 0.05). ICC values demonstrated excellent reliability for all measurements across the eight standing positions (range 0.879-1.00 [95% CI 0.813-1.00]). CONCLUSION: Evaluating eight standing positions radiographically would be unethical as it would involve repeat radiation exposures. Using the formetic 4D dynamic modelling (Diers) system, provides an alternative and has shown that there was only a minimal, non-statistically significant, differences between the eight different standing positions. IMPLICATION FOR PRACTICE: Different standing positions were proposed for erect pelvis radiography.

Hemorrhage risk with transjugular intrahepatic portosystemic shunt (TIPS) insertion at the main portal vein bifurcation with stent grafts.

PURPOSE: The purpose of this study was to assess the incidence of major hemorrhage after transjugular intrahepatic portosystemic shunt (TIPS) insertion using a stent graft at the main portal vein bifurcation. PATIENTS AND METHODS: TIPS insertion using stent grafts was performed in 215 patients due to non-variceal hemorrhage indications. There were 137 men and 78 women, with a mean age of 57 years±10.6 (SD) (range: 19-90 years). Based on retrospective review of portal venograms, TIPS inserted within 5mm from the portal vein bifurcation were considered "bifurcation TIPS", while those inserted 2cm or greater from the bifurcation were considered intrahepatic. Suspicion for acute major periprocedural hemorrhage were categorized as low, moderate, and high, based on the number of signs of hemorrhage. RESULTS: Of 215 TIPS inserted for purposes other than hemorrhage, the TIPS was inserted at the portal bifurcation in 41 patients (29 men, 12 women; mean age, 55.9±11.7 (SD); range: 26-79 years) and intrahepatic in 62 patients (37 men, 25 women; mean age, 57.6±10.6 (SD), range: 34-82 years), whereas 112 were indeterminate in location. No active extravasations were identified on post-TIPS portal venograms. Suspicion for acute major hemorrhage was moderate or high in 3/41 (7%) of patients in the TIPS bifurcation group compared to 5/62 (8%) in the intrahepatic TIPS group (P>0.99). There were no significant differences in 30-day mortality rates (1/41 [2%] and 3/62 [5%] respectively; P> 0.99). No deaths or interventions were attributed to acute hemorrhage. CONCLUSION: TIPS insertion at the portal bifurcation with stent grafts did not incur an elevated risk of hemorrhagic complications.

Reproducibility of kinematic measures of the thoracic spine, lumbar spine and pelvis during fast running.

This study evaluated the reproducibility of the angular rotations of the thoracic spine, lumbar spine, pelvis and lower extremity during running. In addition, the study compared kinematic reproducibility between two methods for calculating kinematic trajectories: a six degrees of freedom (6DOF) approach and a global optimisation (GO) approach. With the first approach segments were treated independently, however with GO approach joint constraints were imposed to stop translation of adjacent segments. A total of 12 athletes were tested on two separate days whilst running over ground at a speed of 5.6ms(-1). The results demonstrated good between-day reproducibility for most kinematic parameters in the frontal and transverse planes with typical angular errors of 1.4-3°. Acceptable repeatability was also found in the sagittal plane. However, in this plane, although kinematic waveform shape was preserved between testing session, there were sometimes shifts in curve offset which lead to slightly higher angular errors, typically ranging from 1.9° to 3.5°. In general, the results demonstrated similar levels of reproducibility for both computational approaches (6DOF and, GO) and therefore suggest that GO may not lead to improved kinematic reproducibility during running.

An investigation into plantar pressure measurement protocols for footwear research.

Many researchers investigate how footwear design affects plantar pressure (PP) and ask participants to walk in unfamiliar footwear as part of their studies. However, there are no clear guidelines for the required period of time or number of steps a healthy participant requires to acclimatise to unfamiliar footwear. Nor are there clear guidelines for how many steps should be collected to produce data that is representative of gait in each particular shoe being tested. There were therefore two aims to this study: (1) to investigate the number of steps required to produce an average step that is representative of normal gait; (2) to investigate the number of steps required for a participant to acclimatise to a range of footwear types. PP data were collected in 20 healthy participants whilst they walked for 400 m in a range of footwear. The results showed that the number of steps required for both acclimatisation and to ensure data quality are dependent on shoe type and the foot region being investigated. It is recommended that 30 steps from one foot are collected during data collection and an acclimatisation period of at least 166 steps is given for each shoe condition. The former recommendation is not met by most studies in the literature.

Effect of rocker shoe design features on forefoot plantar pressures in people with and without diabetes.

BACKGROUND: There is no consensus on the precise rocker shoe outsole design that will optimally reduce plantar pressure in people with diabetes. This study aimed to understand how peak plantar pressure is influenced by systematically varying three design features which characterise a curved rocker shoe: apex angle, apex position and rocker angle. METHODS: A total of 12 different rocker shoe designs, spanning a range of each of the three design features, were tested in 24 people with diabetes and 24 healthy participants. Each subject also wore a flexible control shoe. Peak plantar pressure, in four anatomical regions, was recorded for each of the 13 shoes during walking at a controlled speed. FINDINGS: There were a number of significant main effects for each of the three design features, however, the precise effect of each feature varied between the different regions. The results demonstrated maximum pressure reduction in the 2nd-4th metatarsal regions (39%) but that lower rocker angles (<20°) and anterior apex positions (>60% shoe length) should be avoided for this region. The effect of apex angle was most pronounced in the 1st metatarsophalangeal region with a clear decrease in pressure as the apex angle was increased to 100°. INTERPRETATION: We suggest that an outsole design with a 95° apex angle, apex position at 60% of shoe length and 20° rocker angle may achieve an optimal balance for offloading different regions of the forefoot. However, future studies incorporating additional design feature combinations, on high risk patients, are required to make definitive recommendations.

Effects of twenty percent corn wet distillers grains plus solubles in steam-flaked and dry-rolled corn-based finishing diets on heifer performance, carcass characteristics, and manure characteristics.

Two hundred sixty-four crossbred heifers (initial BW = 354 kg ± 0.5) were used to determine effects of corn processing method and wet distillers grains plus solubles (WDGS) inclusion in finishing diets on animal performance, carcass characteristics, and manure characteristics. The study was conducted as a randomized complete block with a 2 × 2 factorial arrangement of treatments. Dietary treatments included steam-flaked corn (SFC)- and dry-rolled corn (DRC)-based finishing diets containing 0 or 20% WDGS (0SFC, 20SFC, 0DRC, and 20DRC, respectively). Heifers averaged 154 d on feed and were marketed in 3 groups. There were no interactions between corn processing method and WDGS detected (P ≥ 0.29) for any performance or carcass response variables. Heifers fed diets containing WDGS tended to have greater final BW (P = 0.10) and increased G:F (P = 0.08) compared with heifers fed diets without WDGS. Heifers fed SFC-based diets consumed 7% less feed (P < 0.01) and were 9% more efficient (P < 0.01) than heifers fed DRC-based diets. Carcass characteristics were not affected by corn processing method or WDGS inclusion (P ≥ 0.16). Intakes of OM, N, P, and K were greater (P ≤ 0.05) for heifers fed DRC-based diets than those fed SFC-based diets, which resulted in greater net accumulation of the nutrients in the manure (P ≤ 0.04). Heifers fed diets containing WDGS had greater (P < 0.01) intakes of N, P, and K than heifers fed diets without WDGS. As a result, a greater net accumulation of P and K (P ≤ 0.03) and N (P = 0.10) were present in the manure from cattle fed diets containing WDGS compared with those fed diets without WDGS. There was no interaction (P ≥ 0.16) between corn processing and WDGS on N volatilization losses. Nitrogen volatilization losses from manure (expressed as a percentage of intake and g·heifer(-1)·d(-1)) were greater (P < 0.01) for heifers fed SFC-based diets than heifers fed DRC-based diets. Feeding DRC-based finishing diets to heifers resulted in increased manure production and nutrient excretion and decreased N volatilization. Both corn processing method and WDGS inclusion affected animal performance and manure characteristics.

Model-based parameter recovery from uncalibrated optical images.

We propose a novel method for quantitative interpretation of uncalibrated optical images which is derived explicitly from an analysis of the image formation model. Parameters characterising the tissue are recovered from images acquired using filters optimised to minimise the error. Preliminary results are shown for the skin, where the technique was successfully applied to aid the diagnosis and interpretation of non-melanocytic skin cancers and acne; and for the more challenging ocular fundus, for mapping of the pigment xanthophyll.

Monte Carlo modelling of the spectral reflectance of the human eye.

The interpretation of in vivo spectral reflectance measurements of the ocular fundus requires an accurate model of radiation transport within the eye. As well as considering the scattering and absorption processes, it is also necessary to account for appropriate histological variation. This variation results in experimentally measured spectra which vary, both with position in the eye, and between individuals. In this paper the results of a Monte Carlo simulation are presented. Three histological variables are considered: the RPE melanin concentration, the choriodal haemoglobin concentration and the choroidal melanin concentration. By considering these three variables, it is possible to generate model spectra which agree well with in vivo experimental measurements of the nasal fundus. The model has implications for the problem of extracting histological parameters from spectral reflectance measurements. These implications are discussed and a novel approach to interpretation of images of the ocular fundus suggested.

High-performance liquid chromatography and inductively coupled plasma mass spectrometry (HPLC-ICP-MS) for the analysis of xenobiotic metabolites in rat urine: application to the metabolites of 4-bromoaniline.

The use of HPLC-ICP-MS for the profiling and quantification of the metabolites of 4-bromoaniline following reversed-phase gradient chromatography is demonstrated. In the 0-8 h post dose sample, which contained the highest concentrations of compound-related material, it was possible to detect at least 16 metabolites of the compound. The methodology described offers the possibility of obtaining metabolite profiles and quantification for drugs and other xenobiotics in biological fluids and excreta without the requirement for radiolabelled tracers.

Mass spectrometric analysis of 2-deoxyribonucleoside and 2'-deoxyribonucleotide adducts with aldehydes derived from lipid peroxidation.

An important emerging issue in chemical carcinogenesis is the role that products of endogenous metabolism play in formation of covalently modified DNA. One example is the formation of alpha, beta-unsaturated aldehydes as a result of endogenous and drug-stimulated lipid peroxidation. Malondialdehyde (MDA), crotonaldehyde (CR), 2-hexenal (HX), and 4-hydroxy-2-nonenal (HNE) react covalently with 2'-deoxyguanosine (dG) and 2'-deoxyadenosine (dA) residues on DNA to form promutagenic cyclic adducts that may be important in the etiology of cancer in humans and animals. The accurate quantification of such adducts provides a powerful tool in molecular epidemiology for assessing carcinogenic risks from various lifestyle choices (e.g. diet, drug use) in humans. 32P-Postlabeling is recognized as one of the most sensitive methods available for detection of DNA adducts in human tissues, but without adequate validation such methodology can yield inaccurate quantitative measurements. We have used LC separations in conjunction with electrospray ionization MS and tandem MS (triple quadrupole and hybrid quadrupole-orthogonal acceleration time of flight analyzers) to characterize MDA-, CR-, HX- and HNE-modified dG and nucleotide (3'- and 5'-monophosphate; 3',5'-bisphosphate) adducts. These data have been used to validate 32P-postlabeling methods for quantification of low level MDA-dG adducts formed in DNA of human and animal tissues. Availability of reliable methods for quantification of endogenous DNA damage in humans and animals is essential for determining unknown etiologies of cancer and for the assessment of cancer risks in humans.

Nitrogen dioxide, the oxides of nitrogen, and infants' health symptoms. ALSPAC Study Team. Avon Longitudinal Study of Pregnancy and Childhood.

In this cross-sectional postal study, the authors measured nitrogen dioxide levels inside infants' bedrooms and outside their homes. During the 2-wk monitoring period, the authors investigated the association between nitrogen dioxide levels and 20 infant symptoms. The subjects were 1,200 women who had infants aged 3-12 mo. Median levels of indoor and outdoor nitrogen dioxide were 6.8 and 12.6 ppb, respectively. Environmental factors that were associated significantly with indoor levels were gas cooking, cigarette smoking, reported traffic levels, and presence of a kerosene heater; use of a cooker hood was associated negatively with indoor nitrogen dioxide levels. There was no evidence for any short-term significant association between prevalence of respiratory symptoms and nitrogen dioxide levels. Diarrhea, the only symptom associated significantly and positively with indoor nitrogen dioxide levels, had unadjusted and adjusted odds ratios of 1.48 (95% confidence interval: 1.13, 1.95) and 1.38 (1.11, 1.70), respectively. This association is discussed in terms of a proposed mechanism with nitric oxide. No association between a gas cooker in the home and diarrhea was found. The association between diarrhea and nitrogen dioxide level might have been a chance finding; the authors investigated 20 symptoms, and at least 1 was expected to be significant at the .05 level. The finding, however, was similar to that reported in a previous study in which a gas cooker was a proxy for nitrogen dioxide exposure.

Magnetic fields from domestic appliances in the UK.

In a survey of 50 UK homes the 50 Hz fundamental and harmonic magnetic fields generated by 806 domestic appliances found in the homes, and used regularly by mothers, were measured. Measurements were made in the direction of most likely access, and from the surface of the appliances. Mothers completed a questionnaire on the use of appliances and were monitored for 24 h so that acquired exposure could be compared with the measured ambient fields in the home. Appliances were measured at standard distances and an algorithm was used to calculate fields at 100 and 50 cm to remove room background contributions. A few appliances generated fields in excess of 0.2 microT at 1 m: microwave cookers 0.37 +/- 0.14 microT; washing machines 0.27 +/- 0.14 microT; dishwashers 0.23 +/- 0.13 microT; some electric showers 0.11 +/- 0.25 microT and can openers 0.20 +/- 0.21 microT. Of continuously operating devices, only central heating pumps (0.51 +/- 0.47 microT), central heating boilers (0.27 +/- 0.26 microT) and fish-tank air pumps (0.32 +/- 0.09 microT) produced significant fields at 0.5 m. There were no obvious ways to group different types of appliances as high- or low-strength sources. Mothers spent on average about 4.5 h per day in the kitchen, where the strongest sources of magnetic field were located.

Quantification of heterocyclic amine carcinogens in cooked meats using isotope dilution liquid chromatography/atmospheric pressure chemical ionization tandem mass spectrometry.

Heterocyclic aromatic amines (HAAs) are formed in cooked meats through pyrolysis reactions of different amino acids in the presence or absence of creatine/creatinine and sugars. HAAs are mutagens, colon/mammary gland carcinogens in rodents, and are suspected in the etiology of human cancers. In this study, cooked meats containing incurred HAAs as well as control (microwave) meat, were spiked with four labeled HAA internal standards (MeIQx, IQ, AAC and PhIP) and extracted using a liquid/liquid cleanup procedure. Isotope dilution measurements were made using on-line liquid chromatography atmosphere pressure chemical ionization tandem mass spectrometry with multiple reaction monitoring to provide the sensitivity and specificity needed for trace analysis in these complex matrices. The procedure was validated using control meat spiked with the four native HAAs at 0-50 ppb. The levels of HAAs found in cooked meats ranged from non-detectable (limit of detection 0.1-1.0 ppb) in microwave-cooked hamburger to 226 ppb PhIP and 104 ppb AAC in well-done grilled chicken. This methodology has the potential to provide accurate data on the consumption of HAAs in the diet for use in human cancer risk assessment.

Gas and liquid chromatography coupled to tandem mass spectrometry for the multiresidue analysis of beta-agonists in biological matrices.

beta-Agonists are substances used in veterinary and human medicine for the treatment of pulmonary disorders. They have found a use as growth promoters to improve meat-to-fat ratios in cattle but they are not authorized for use in the European Union. Due to their presence in trace levels (usually less than 1 microgram/kg), to the diversity of the illegally used compounds and to the complexity of the biological matrices analysed, the detection of these residues requires a very sensitive and specific method of determination. This work describes the strategy of analysis we developed for five beta-agonists in urine and liver. The combination of improved solid- or liquid-phase extraction methods and LC or GC-MS-MS (in the multiple reaction monitoring mode) has shown to provide a system suitable for the control of these substances. The efficiency of extraction and the sensitivity and selectivity allow this multiresidue detection down to, and below, the UK regulatory level of 0.5 microgram/kg. Moreover, the use of LC removes the need for the derivatisation step (cyclic methylboronate derivatives) which is required prior to GC-MS-MS analysis.