Head excursions of rearward-facing child restraint systems in rear impacts.

OBJECTIVE: The aim of the current study was to quantify the head excursions of pediatric anthropomorphic test devices (ATDs) seated in rearward-facing child restraint system (CRS) models during rear impact sled tests and compare to roof heights of vehicles in the current fleet to assess the possibility of head contact against the vehicle roof. METHODS: Head excursions of ATDs seated in rearward-facing CRS models were analyzed from high-speed video data from 14 rear impact sled tests across two different series. Tests were conducted in rigidized vehicle seats from recent model year vehicles. Rearward-facing infant and convertible CRS models were tested with a variety of pediatric ATDs aged 12 months to 6 years in a variety of installation conditions (e.g., lower anchors or seat belt, anti-rotation features, etc). Maximum ATD head excursions in plane of the seatback were compared to previously measured roof heights of 87 different vehicles. RESULTS: The roof heights in all sedan seating positions (n = 58) and SUV/CUV/minivan seating positions (n = 60) were greater than the largest maximum ATD head excursions in plane of the seatback (792 mm). Head contact was possible in two of the pickup trucks which had roof heights of 730 and 775 mm. In all, 98% of vehicle seating positions measured in this study would accommodate all of the maximum ATD head excursions in plane of the seatback without contact. CONCLUSIONS: The risk of head contact against the vehicle interior roof appears low as maximum ATD head excursions in plane of the seatback were typically not great enough to reach the rooflines of the vehicles in the sample. Head contact appears possible in pickup trucks, where the window/roofline is directly behind the head restraint.

Biophotonic tools for probing extracellular matrix mechanics.

The complex, hierarchical and heterogeneous biomechanics of the extracellular matrix (ECM) are central to the health of multicellular organisms. Characterising the distribution, dynamics and above all else origins of ECM biomechanics are challenges that have captivated researchers for decades. Recently, a suite of biophotonics techniques have emerged as powerful new tools to investigate ECM biomechanics. In this mini-review, we discuss how the non-destructive, sub-micron resolution imaging capabilities of Raman spectroscopy and nonlinear microscopy are being used to interrogate the biomechanics of thick, living tissues. These high speed, label-free techniques are implemented during mechanical testing, providing unprecedented insight into the compositional and structural response of the ECM to changes in the mechanical environment.

Micro-mechanical damage of needle puncture on bovine annulus fibrosus fibrils studied using polarization-resolved Second Harmonic Generation(P-SHG) microscopy.

Needle injection has been widely used in spinal therapeutic or diagnostic processes, such as discography. The use of needles has been suspected in causing mild disc degeneration which can lead to long-term back pain. However, the localised microscopic damage caused by needles has not been well studied. The local progressive damage on a microscopic level caused by needle punctures on the surface of bovine annulus fibrosus was investigated. Four different sizes of needle were used for the puncture and twenty-nine bovine intervertebral discs were studied. Polarization-resolved second harmonic generation and fluorescent microscopy were used to study the local microscopic structural changes in collagen and cell nuclei due to needle damage. Repeated 70 cyclic loadings at ±5% of axial strain were applied after the needle puncture in order to assess progressive damage caused by the needle. Puncture damage on annulus fibrosus were observed either collagen fibre bundles being pushed aside, being cut through or combination of both with part being lift or pushed in. The progressive damage was found less relevant to the needle size and more progressive damage was only observed using the larger needle. Two distinct populations of collagen, in which one was relatively more organised than the other population, were observed especially after the puncture from skewed distribution of polarization-SHG analysis. Cell shape was found rounder near the puncture site where collagen fibres were damaged.

Nontraumatic Acute Hyperextension Myelopathy Associated With Weightlifting.

ABSTRACT: We describe the clinical course of a 56-yr-old woman without a significant medical history presenting with nontraumatic paraplegia found to have an infarction of the conus medullaris after intensive lumbar hyperextension exercises. This condition, known as surfer's myelopathy, has been described in multiple case reports that attributed a similar mechanism and presentation. We present a case of surfer's myelopathy associated with weightlifting, which has not been previously reported. We conclude that this diagnosis should be considered in patients who present after spine hyperextension activity with nontraumatic paraplegia. Furthermore, we support the nomenclature change to "acute hyperextension myelopathy," better reflecting the underlying pathophysiology.

Scoring reading parameters: An inter-rater reliability study using the MNREAD chart.

PURPOSE: First, to evaluate inter-rater reliability when human raters estimate the reading performance of visually impaired individuals using the MNREAD acuity chart. Second, to evaluate the agreement between computer-based scoring algorithms and compare them with human rating. METHODS: Reading performance was measured for 101 individuals with low vision, using the Portuguese version of the MNREAD test. Seven raters estimated the maximum reading speed (MRS) and critical print size (CPS) of each individual MNREAD curve. MRS and CPS were also calculated automatically for each curve using two different algorithms: the original standard deviation method (SDev) and a non-linear mixed effects (NLME) modeling. Intra-class correlation coefficients (ICC) were used to estimate absolute agreement between raters and/or algorithms. RESULTS: Absolute agreement between raters was 'excellent' for MRS (ICC = 0.97; 95%CI [0.96, 0.98]) and 'moderate' to 'good' for CPS (ICC = 0.77; 95%CI [0.69, 0.83]). For CPS, inter-rater reliability was poorer among less experienced raters (ICC = 0.70; 95%CI [0.57, 0.80]) when compared to experienced ones (ICC = 0.82; 95%CI [0.76, 0.88]). Absolute agreement between the two algorithms was 'excellent' for MRS (ICC = 0.96; 95%CI [0.91, 0.98]). For CPS, the best possible agreement was found for CPS defined as the print size sustaining 80% of MRS (ICC = 0.77; 95%CI [0.68, 0.84]). Absolute agreement between raters and automated methods was 'excellent' for MRS (ICC = 0.96; 95% CI [0.88, 0.98] for SDev; ICC = 0.97; 95% CI [0.95, 0.98] for NLME). For CPS, absolute agreement between raters and SDev ranged from 'poor' to 'good' (ICC = 0.66; 95% CI [0.3, 0.80]), while agreement between raters and NLME was 'good' (ICC = 0.83; 95% CI [0.76, 0.88]). CONCLUSION: For MRS, inter-rater reliability is excellent, even considering the possibility of noisy and/or incomplete data collected in low-vision individuals. For CPS, inter-rater reliability is lower. This may be problematic, for instance in the context of multisite investigations or follow-up examinations. The NLME method showed better agreement with the raters than the SDev method for both reading parameters. Setting up consensual guidelines to deal with ambiguous curves may help improve reliability. While the exact definition of CPS should be chosen on a case-by-case basis depending on the clinician or researcher's motivations, evidence suggests that estimating CPS as the smallest print size sustaining about 80% of MRS would increase inter-rater reliability.

Extending the MNREAD sentence corpus: Computer-generated sentences for measuring visual performance in reading.

The MNREAD chart consists of standardized sentences printed at 19 sizes in 0.1 logMAR steps. There are 95 sentences distributed across the five English versions of the chart. However, there is a demand for a much larger number of sentences: for clinical research requiring repeated measures, and for new vision tests that use multiple trials at each print size. This paper describes a new sentence generator that has produced over nine million sentences that fit the MNREAD constraints, and demonstrates that reading performance with these new sentences is comparable to that obtained with the original MNREAD sentences. We measured reading performance with the original MNREAD sentences, two sets of our new sentences, and sentences with shuffled word order. Reading-speed versus print-size curves were obtained for each sentence set from 14 readers with normal vision at two levels of blur (intended to simulate acuity loss in low vision) and with unblurred text. We found no significant differences between the new and original sentences in reading acuity and critical print size across all levels of blur. Maximum reading speed was 7% slower with the new sentences than with the original sentences. Shuffled sentences yielded slower maximum reading speeds and larger reading acuities than the other sentences. Overall, measures of reading performance with the new sentences are similar to those obtained with the original MNREAD sentences. Our sentence generator substantially expands the reading materials for clinical research on reading vision using the MNREAD test, and opens up new possibilities for measuring how text parameters affect reading.

Characterization of the pathogenicity of strains of Pseudomonas syringae towards cherry and plum.

Bacterial canker is a major disease of Prunus avium (cherry), Prunus domestica (plum) and other stone fruits. It is caused by pathovars within the Pseudomonas syringae species complex including P. syringae pv. morsprunorum (Psm) race 1 (R1), Psm race 2 (R2) and P. syringae pv. syringae (Pss). Psm R1 and Psm R2 were originally designated as the same pathovar; however, phylogenetic analysis revealed them to be distantly related, falling into phylogroups 3 and 1, respectively. This study characterized the pathogenicity of 18 newly genome-sequenced P. syringae strains on cherry and plum, in the field and laboratory. The field experiment confirmed that the cherry cultivar Merton Glory exhibited a broad resistance to all clades. Psm R1 contained strains with differential specificity on cherry and plum. The ability of tractable laboratory-based assays to reproduce assessments on whole trees was examined. Good correlations were achieved with assays using cut shoots or leaves, although only the cut shoot assay was able to reliably discriminate cultivar differences seen in the field. Measuring bacterial multiplication in detached leaves differentiated pathogens from nonpathogens and was therefore suitable for routine testing. In cherry leaves, symptom appearance discriminated Psm races from nonpathogens, which triggered a hypersensitive reaction. Pathogenic strains of Pss rapidly induced disease lesions in all tissues and exhibited a more necrotrophic lifestyle than hemibiotrophic Psm. This in-depth study of pathogenic interactions, identification of host resistance and optimization of laboratory assays provides a framework for future genetic dissection of host-pathogen interactions in the canker disease.

Can faecal calprotectin predict relapse in inflammatory bowel disease: a mini review.

Crohn's disease and ulcerative colitis are chronic inflammatory disorders affecting the gastrointestinal tract. Faecal calprotectin is a protein complex of the S-100 family of calcium-binding proteins present in inflammatory cells that can be measured in stool samples, which act as a biomarker for bowel inflammation. Elevated faecal calprotectin has been shown to reflect the presence of ongoing mucosal inflammation, which improves with mucosal healing. The aim of this review was to evaluate the available evidence on the ability of faecal calprotectin to predict a relapse in inflammatory bowel disease. Multiple retrospective studies have shown that patients who relapse have significantly higher levels of calprotectin in their stool compared with non-relapsers, especially in ulcerative colitis. Elevated faecal calprotectin postoperatively in Crohn's disease was also shown to be indicative of a relapse. However, the association of a raised faecal calprotectin and relapse is not universal and may be explained by the different patterns of mucosal inflammatory activity that exist. In conclusion, we put forward our hypothesis that changes such as a rise in faecal calprotectin levels may be more predictive of a relapse than absolute values.

Prospects for vaccination against pathogenic African trypanosomes.

African trypanosomes cause human and animal African trypanosomiases, which are chronic, debilitating and often fatal diseases of people and livestock in sub-Saharan Africa. The extracellular protozoan parasites are exemplars of antigenic variation. They direct host-protective B-cell and T-cell immune responses towards hypervariable components of their variable surface glycoprotein coat and evade immune elimination by generating new surface coat antigenic variants at a rate that supersedes immune destruction. This results in recurring waves of parasitemia, tissue invasion and escalating immunopathology in trypanosomiasis-susceptible hosts. Here, we discuss the possibility that host control of African trypanosomes might be improved by immunization with conserved VSG peptides and invariant surface glycoproteins. Infection-induced T-cell recall responses to these typically poorly expressed or nonimmunogenic parasite components induce tissue phagocytes to produce microbicidal materials that kill trypanosomes. Preliminary data that support this immune-enhancing vaccine strategy are discussed, as are host and parasite interactions that might downregulate the protective responses. These include infection-induced immunosuppression and increasing virulence of infecting parasites over time.

Baseline MNREAD Measures for Normally Sighted Subjects From Childhood to Old Age.

PURPOSE: The continuous-text reading-acuity test MNREAD is designed to measure the reading performance of people with normal and low vision. This test is used to estimate maximum reading speed (MRS), critical print size (CPS), reading acuity (RA), and the reading accessibility index (ACC). Here we report the age dependence of these measures for normally sighted individuals, providing baseline data for MNREAD testing. METHODS: We analyzed MNREAD data from 645 normally sighted participants ranging in age from 8 to 81 years. The data were collected in several studies conducted by different testers and at different sites in our research program, enabling evaluation of robustness of the test. RESULTS: Maximum reading speed and reading accessibility index showed a trilinear dependence on age: first increasing from 8 to 16 years (MRS: 140-200 words per minute [wpm]; ACC: 0.7-1.0); then stabilizing in the range of 16 to 40 years (MRS: 200 ± 25 wpm; ACC: 1.0 ± 0.14); and decreasing to 175 wpm and 0.88 by 81 years. Critical print size was constant from 8 to 23 years (0.08 logMAR), increased slowly until 68 years (0.21 logMAR), and then more rapidly until 81 years (0.34 logMAR). logMAR reading acuity improved from -0.1 at 8 years to -0.18 at 16 years, then gradually worsened to -0.05 at 81 years. CONCLUSIONS: We found a weak dependence of the MNREAD parameters on age in normal vision. In broad terms, MNREAD performance exhibits differences between three age groups: children 8 to 16 years, young adults 16 to 40 years, and middle-aged to older adults >40 years.

Transcriptome analysis of Streptococcus gordonii Challis DL1 indicates a role for the biofilm-associated fruRBA operon in response to Candida albicans.

Multiple levels of interkingdom signaling have been implicated in maintaining the ecological balance between Candida albicans and commensal streptococci to assure a state of oral health. To better understand the molecular mechanisms involved in the initial streptococcal response to the presence of C. albicans that can initiate oral surface colonization and biofilm formation, hypha-forming cells were incubated with Streptococcus gordonii cells for 30 min to assess the streptococcal transcriptome response. A genome-wide microarray analysis and quantitative polymerase chain reaction validation of S. gordonii transcripts identified a number of genes, the majority of which were involved in metabolic functions that were differentially expressed in the presence of hyphae. The fruR, fruB, and fruA genes encoding the transcriptional regulator, fructose-1-phosphate kinase, and fructose-specific permease, respectively, of the phosphoenolpyruvate-dependent fructose phosphotransferase system, were consistently upregulated. An S. gordonii mutant in which these genes were deleted by allelic replacement formed an architecturally distinct, less robust biofilm with C. albicans than did parental strain cells. Complementing the mutant with plasmid borne fruR, fruB, and fruA genes caused phenotype reversion, indicating that the genes in this operon played a role in dual-species biofilm formation. This genome-wide analysis of the S. gordonii transcriptional response to C. albicans has identified several genes that have potential roles in interkingdom signaling and responses.

Continuous Processing of Multi-Walled Carbon Nanotube-Studded Carbon Fiber Tapes for Enhanced Through-Thickness Thermal Diffusivity Composites.

Carbon fiber reinforced polymer (CFRP) composites offer advantages over traditional metallic structures, particularly specific strength and stiffness, but at much reduced thermal conductivity. Moreover, fiber-to-fiber heat conduction in the composite transverse directions is significantly lower. When these structures contain electronics (heat generators), shortfalls in heat transport can be problematic. Here we report the achievement of a continuous, reel-to-reel process for growing short multiwalled carbon nanotubes (MWCNT) on the surfaces of spread-tow carbon fiber tapes. These tapes were subsequently prepregged with an epoxy matrix, and laid up into multi-ply laminate panels, cured and tested for through-thickness thermal diffusivity. The results showed up to a 57% increase in through thickness thermal diffusivity compared to the baseline composite with no MWCNT.

The micromechanics of the superficial zone of articular cartilage.

OBJECTIVE: To investigate the relationships between the unique mechanical and structural properties of the superficial zone of articular cartilage on the microscopic scale. DESIGN: Fresh unstained equine metacarpophalangeal cartilage samples were mounted on tensile and compressive loading rigs on the stage of a multiphoton microscope. Sequential image stacks were acquired under incremental loads together with simultaneous measurements of the applied stress and strain. Second harmonic generation was used to visualise the collagen fibre network, while two photon fluorescence was used to visualise elastin fibres and cells. The changes visualised by each modality were tracked between successive loads. RESULTS: The deformation of the cartilage matrix was heterogeneous on the microscopic length scale. This was evident from local strain maps, which showed shearing between different regions of collagen under tensile strain, corrugations in the articular surface at higher tensile strains and a non-uniform distribution of compressive strain in the axial direction. Chondrocytes elongated and rotated under tensile strain and were compressed in the axial direction under compressive load. The magnitude of deformation varied between cells, indicating differences in either load transmission through the matrix or the mechanical properties of individual cells. Under tensile loading the reorganisation of the elastin network differed from a homogeneous elastic response, indicating that it forms a functional structure. CONCLUSIONS: This study highlights the complexity of superficial zone mechanics and demonstrates that the response of the collagen matrix, elastin fibres and chondrocytes are all heterogeneous on the microscopic scale.

Thiopurine withdrawal during sustained clinical remission in inflammatory bowel disease: relapse and recapture rates, with predictive factors in 237 patients.

BACKGROUND: Thiopurines (azathioprine and mercaptopurine) remain integral to most medical strategies for maintaining remission in Crohn's disease (CD) and ulcerative colitis (UC). Indefinite use of these drugs is tempered by long-term risks. While clinical relapse is noted frequently following drug withdrawal, there are few published data on predictive factors. AIM: To investigate the success of planned thiopurine withdrawal in patients in sustained clinical remission to identify rates and predictors of relapse. METHODS: This was a multicentre retrospective cohort study from 11 centres across the UK. Patients included had a definitive diagnosis of IBD, continuous thiopurine use ≥3 years and withdrawal when in sustained clinical remission. All patients had a minimum of 12 months follow-up post drug withdrawal. Primary and secondary end points were relapse at 12 and 24 months respectively. RESULTS: 237 patients were included in the study (129 CD; 108 UC). Median duration of thiopurine use prior to withdrawal was 6.0 years (interquartile range 4.4-8.4). At follow-up, moderate/severe relapse was observed in 23% CD and 12% UC patients at 12 months, 39% CD and 26% UC at 24 months. Relapse rate at 12 months was significantly higher in CD than UC (P = 0.035). Elevated CRP at withdrawal was associated with higher relapse rates at 12 months for CD (P = 0.005), while an elevated white cell count was predictive at 12 months for UC (P = 0.007). CONCLUSION: Thiopurine withdrawal in the context of sustained remission is associated with a 1-year moderate-to-severe relapse rate of 23% in Crohn's disease and 12% in ulcerative colitis.

Micromechanical response of articular cartilage to tensile load measured using nonlinear microscopy.

Articular cartilage (AC) is a highly anisotropic biomaterial, and its complex mechanical properties have been a topic of intense investigation for over 60 years. Recent advances in the field of nonlinear optics allow the individual constituents of AC to be imaged in living tissue without the need for exogenous contrast agents. Combining mechanical testing with nonlinear microscopy provides a wealth of information about microscopic responses to load. This work investigates the inhomogeneous distribution of strain in loaded AC by tracking the movement and morphological changes of individual chondrocytes using point pattern matching and Bayesian modeling. This information can be used to inform models of mechanotransduction and pathogenesis, and is readily extendable to various other connective tissues.

Multispectral imaging: a review of its technical aspects and applications in anatomic pathology.

The field of anatomic pathology has changed significantly over the last decades and, as a result of the technological developments in molecular pathology and genetics, has had increasing pressures put on it to become quantitative and to provide more information about protein expression on a cellular level in tissue sections. Multispectral imaging (MSI) has a long history as an advanced imaging modality and has been used for over a decade now in pathology to improve quantitative accuracy, enable the analysis of multicolor immunohistochemistry, and drastically reduce the impact of contrast-robbing tissue autofluorescence common in formalin-fixed, paraffin-embedded tissues. When combined with advanced software for the automated segmentation of different tissue morphologies (eg, tumor vs stroma) and cellular and subcellular segmentation, MSI can enable the per-cell quantitation of many markers simultaneously. This article covers the role that MSI has played in anatomic pathology in the analysis of formalin-fixed, paraffin-embedded tissue sections, discusses the technological aspects of why MSI has been adopted, and provides a review of the literature of the application of MSI in anatomic pathology.

Molecular analysis of 16S rRNA genes identifies potentially periodontal pathogenic bacteria and archaea in the plaque of partially erupted third molars.

PURPOSE: Small subunit rRNA sequencing and phylogenetic analysis were used to identify cultivable and uncultivable microorganisms present in the dental plaque of symptomatic and asymptomatic partially erupted third molars to determine the prevalence of putative periodontal pathogens in pericoronal sites. MATERIALS AND METHODS: Template DNA prepared from subgingival plaque collected from partially erupted symptomatic and asymptomatic mandibular third molars and healthy incisors was used in polymerase chain reaction with broad-range oligonucleotide primers to amplify 16S rRNA bacterial and archaeal genes. Amplicons were cloned, sequenced, and compared with known nucleotide sequences in online databases to identify the microorganisms present. RESULTS: Two thousand three hundred two clones from the plaque of 12 patients carried bacterial sequences from 63 genera belonging to 11 phyla, including members of the uncultivable TM7, SR1, and Chloroflexi, and difficult-to-cultivate Synergistetes and Spirochaetes. Dialister invisus, Filifactor alocis, Fusobacterium nucleatum, Porphyromonas endodontalis, Prevotella denticola, Tannerella forsythia, and Treponema denticola, which have been associated with periodontal disease, were found in significantly greater abundance in pericoronal compared with incisor sites. Dialister invisus and F nucleatum were found in greater abundance in sites exhibiting clinical symptoms. The archaeal species, Methanobrevibacter oralis, which has been associated with severe periodontitis, was found in 3 symptomatic patients. CONCLUSIONS: These findings have provided new insights into the complex microbiota of pericoronitis. Several bacterial and archaeal species implicated in periodontal disease were recovered in greater incidence and abundance from the plaque of partially erupted third molars compared with incisors, supporting the hypothesis that the pericoronal region may provide a favored niche for periodontal pathogens in otherwise healthy mouths.