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Robinson A, Zheng B, von Kleeck BW, Tan J, Gayzik FS. Holistic shape variation of the rib cage in an adult population. Front Bioeng Biotechnol 2024; 12:1432911. [PMID: 39359263 PMCID: PMC11445027 DOI: 10.3389/fbioe.2024.1432911] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2024] [Accepted: 09/06/2024] [Indexed: 10/04/2024] Open
Abstract
Traumatic injuries to the thorax are a common occurrence, and given the disparity in outcomes, injury risk is non-uniformly distributed within the population. Rib cage geometry, in conjunction with well-established biomechanical characteristics, is thought to influence injury tolerance, but quantifiable descriptions of adult rib cage shape as a whole are lacking. Here, we develop an automated pipeline to extract whole rib cage measurements from a large population and produce distributions of these measurements to assess variability in rib cage shape. Ten measurements of whole rib cage shape were collected from 1,719 individuals aged 25-45 years old including angular, linear, areal, and volumetric measures. The resulting pipeline produced measurements with a mean percent difference to manually collected measurements of 1.7% ± 1.6%, and the whole process takes 30 s per scan. Each measurement followed a normal distribution with a maximum absolute skew value of 0.43 and a maximum absolute excess kurtosis value of 0.6. Significant differences were found between the sexes (p < 0.001) in all except angular measures. Multivariate regression revealed that demographic predictors explain 29%-68% of the variance in the data. The angular measurements had the three lowest R2 values and were also the only three to have little correlation with subject stature. Unlike other measures, rib cage height had a negative correlation with BMI. Stature was the dominant demographic factor in predicting rib cage height, coronal area, sagittal area, and volume. Subject weight was the dominant demographic factor for rib cage width, depth, axial area, and angular measurements. Age was minimally important in this cohort of adults from a narrow age range. Individuals of similar height and weight had average rib cage measurements near the regression predictions, but the range of values across all subjects encompassed a large portion of their respective distributions. Our findings characterize the variability in adult rib cage geometry, including the variation within narrow demographic criteria. In future work, these can be integrated into computer aided engineering workflows to assess the influence of whole rib cage shape on the biomechanics of the adult human thorax.
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Affiliation(s)
- Andrea Robinson
- Department of Biomedical Engineering, Wake Forest University School of Medicine, Winston-Salem, NC, United States
- Virginia Tech-Wake Forest Center for Injury Biomechanics, Wake Forest University School of Medicine, Winston-Salem, NC, United States
| | - Bowen Zheng
- Department of Biomedical Engineering, Columbia University, New York, NY, United States
| | - B Wade von Kleeck
- Department of Biomedical Engineering, Wake Forest University School of Medicine, Winston-Salem, NC, United States
- Virginia Tech-Wake Forest Center for Injury Biomechanics, Wake Forest University School of Medicine, Winston-Salem, NC, United States
| | - Josh Tan
- Department of Radiology - Imaging Informatics, Wake Forest University School of Medicine, Winston-Salem, NC, United States
| | - F Scott Gayzik
- Department of Biomedical Engineering, Wake Forest University School of Medicine, Winston-Salem, NC, United States
- Virginia Tech-Wake Forest Center for Injury Biomechanics, Wake Forest University School of Medicine, Winston-Salem, NC, United States
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Huang Y, Holcombe SA, Wang SC, Tang J. A deep learning-based pipeline for developing multi-rib shape generative model with populational percentiles or anthropometrics as predictors. Comput Med Imaging Graph 2024; 115:102388. [PMID: 38692200 DOI: 10.1016/j.compmedimag.2024.102388] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2023] [Revised: 04/06/2024] [Accepted: 04/18/2024] [Indexed: 05/03/2024]
Abstract
Rib cross-sectional shapes (characterized by the outer contour and cortical bone thickness) affect the rib mechanical response under impact loading, thereby influence the rib injury pattern and risk. A statistical description of the rib shapes or their correlations to anthropometrics is a prerequisite to the development of numerical human body models representing target demographics. Variational autoencoders (VAE) as anatomical shape generators remain to be explored in terms of utilizing the latent vectors to control or interpret the representativeness of the generated results. In this paper, we propose a pipeline for developing a multi-rib cross-sectional shape generative model from CT images, which consists of the achievement of rib cross-sectional shape data from CT images using an anatomical indexing system and regular grids, and a unified framework to fit shape distributions and associate shapes to anthropometrics for different rib categories. Specifically, we collected CT images including 3193 ribs, surface regular grid is generated for each rib based on anatomical coordinates, the rib cross-sectional shapes are characterized by nodal coordinates and cortical bone thickness. The tensor structure of shape data based on regular grids enable the implementation of CNNs in the conditional variational autoencoder (CVAE). The CVAE is trained against an auxiliary classifier to decouple the low-dimensional representations of the inter- and intra- variations and fit each intra-variation by a Gaussian distribution simultaneously. Random tree regressors are further leveraged to associate each continuous intra-class space with the corresponding anthropometrics of the subjects, i.e., age, height and weight. As a result, with the rib class labels and the latent vectors sampled from Gaussian distributions or predicted from anthropometrics as the inputs, the decoder can generate valid rib cross-sectional shapes of given class labels (male/female, 2nd to 11th ribs) for arbitrary populational percentiles or specific age, height and weight, which paves the road for future biomedical and biomechanical studies considering the diversity of rib shapes across the population.
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Affiliation(s)
- Yuan Huang
- Research Investigator in International Center for Automotive Medicine (ICAM), University of Michigan, USA.
| | - Sven A Holcombe
- Research Scientist in International Center for Automotive Medicine (ICAM), University of Michigan, USA
| | - Stewart C Wang
- University of Michigan of Surgery and Director of International Center for Automotive Medicine (ICAM), USA
| | - Jisi Tang
- Key Laboratory of Biorheological Science and Technology, Bioengineering College, Chongqing University, China.
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Huang N, He S, Chen S, Zhang G, Ruan L, Huang J. Incidence and risk factors for recurrent primary spontaneous pneumothorax after video-assisted thoracoscopic surgery: a systematic review and meta-analysis. J Thorac Dis 2024; 16:3696-3710. [PMID: 38983166 PMCID: PMC11228730 DOI: 10.21037/jtd-24-175] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2024] [Accepted: 04/30/2024] [Indexed: 07/11/2024]
Abstract
Background The incidence and risk factors for recurrent primary spontaneous pneumothorax (PSP) after video-assisted thoracoscopic surgery (VATS) remain controversial. A systematic review and meta-analysis were conducted to determine the incidence and risk factors for recurrence of PSP after VATS. Methods A systematic search of PubMed, Web of Science, Embase, and Cochrane Library databases was conducted to identify studies that reported the rate and risk factors for recurrence of PSP after VATS published up to December 2023. The pooled recurrence rate and odds ratio (OR) with 95% confidence interval (CI) were calculated using a random-effects model. In addition, risk factors were similarly included in the meta-analysis, and sources of heterogeneity were explored using meta-regression analysis. Results A total of 72 studies involving 23,531 patients were included in the meta-analysis of recurrence. The pooled recurrence rate of PSP after VATS was 10% (95% CI: 8-12%). Male sex (OR: 0.61; 95% CI: 0.41-0.92; P=0.02), younger age [mean difference (MD): -2.01; 95% CI: -2.57 to -1.45; P<0.001), lower weight (MD: -1.57; 95% CI: -3.03 to -0.11; P=0.04), lower body mass index (BMI) (MD: -0.73; 95% CI: -1.08 to 0.37; P<0.001), and history of contralateral pneumothorax (OR: 2.46; 95% CI: 1.56-3.87; P<0.001) were associated with recurrent PSP, whereas height, smoking history, affected side, stapling line reinforcement, and pleurodesis were not associated with recurrent PSP after VATS. Conclusions The recurrence rate of PSP after VATS remains high. Healthcare professionals should focus on factors, including sex, age, weight, BMI, and history of contralateral pneumothorax, that may influence recurrence.
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Affiliation(s)
- Ningbin Huang
- School of Nursing, Guangzhou Medical University, Guangzhou, China
- Organ Transplantation Department, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Shi He
- School of Nursing, Guangzhou Medical University, Guangzhou, China
- Organ Transplantation Department, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Siting Chen
- School of Nursing, Guangzhou Medical University, Guangzhou, China
| | - Guolong Zhang
- Bronchoscopy Room, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Liang Ruan
- Department of Nursing, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Jingjuan Huang
- Operating Room, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
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Mishra A, Shreevastava AK, Das RS. Technical and Anatomical Aspects of Retroperitoneoscopic Renal Surgery: A Summary of Tribulations and Resolutions Encountered at a Tertiary Care Institute of North India. Cureus 2024; 16:e59380. [PMID: 38817518 PMCID: PMC11139053 DOI: 10.7759/cureus.59380] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/29/2024] [Indexed: 06/01/2024] Open
Abstract
INTRODUCTION Kidneys are a retroperitoneal organ but the widely practiced laparoscopic approach to renal surgery is transperitoneal due to the advantages of greater working space at the cost of entering the peritoneal cavity, risk of injury to intraperitoneal organs, and the increased risk of postoperative bowel complications. The classic open approach to kidney procedures has been the flank approach without violating the peritoneal cavity instead of the retroperitoneal approach to renal surgery with the advantages of direct access to the renal hilum, especially the renal artery. Being a technically challenging procedure, the retroperitoneoscopic approach is less practiced and needs an experienced surgical team. Through this study, we have tried to unveil the myths and illustrate the exact position of ports, which is the decisive initial step in retroperitoneoscopic surgery. MATERIAL AND METHODS This retrospective study was conducted at a developing tertiary center in northern India with novice staff mainly to determine the technical and anatomical caveats pertaining to the retroperitoneoscopic approach for renal surgeries, the challenges faced, and their resolutions. The decision for the site of incision for primary or camera port was taken only after a proper anatomical study of the cadavers and ongoing retroperitoneal surgical experience while treating various patients suffering from renal diseases. The study comprised eight patients, during the period from June 2023 to March 2024. Various parameters, such as demographic variables, diagnosis, mean operative time, estimated blood loss, technical difficulties encountered and their resolution, complications, and reasons for conversion were studied. A total of 15 cadavers were dissected during the above time period to study finer anatomical details of port positioning and other details. RESULTS After an elaborate study of 15 cadavers and thereafter performing surgery on eight patients during the above time period, surgery was successfully performed on six patients, and two patients needed conversion to open procedure due to dense adhesions and non-progression while complications occurred in two patients (peritoneal rent and renal vein injury), which were managed laparoscopically. CONCLUSION Nonetheless, restrictions of surgical space make retroperitoneoscopic space a challenging procedure but with elaborate experience, which we gained through cadaveric study, and surgical results obtained during the initial few cases such as the exact site of the primary port and technical intricacies, and handling of complications if and when faced, we hope our study will certainly make retroperitoneal space more amicable to urologists.
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Affiliation(s)
- Amit Mishra
- Urology, All India Institute of Medical Sciences, Raebareli, IND
| | | | - Rajat S Das
- Anatomy, All India Institute of Medical Sciences, Raebareli, IND
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Amirav I, Rabin N, Levi S, Har-Even Cohn R, Lior Y, Shiran S, Sagi L, Fatal A, Zvirin A, Honen Y, Lavie M, Kimmel R. Non-ionizing measurement and quantification of bell-shaped chests in spinal muscular atrophy: a pilot study. Front Pediatr 2024; 12:1256445. [PMID: 38374878 PMCID: PMC10876057 DOI: 10.3389/fped.2024.1256445] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/10/2023] [Accepted: 01/22/2024] [Indexed: 02/21/2024] Open
Abstract
Background Spinal Muscular Atrophy (SMA) is manifested by deformation of the chest wall, including a bell-shaped chest. We determined the ability of a novel non-ionizing, non-volitional method to measure and quantify bell-shaped chests in SMA. Methods A 3D depth camera and a chest x-ray (CXR) were used to capture chest images in 14 SMA patients and 28 controls. Both methods measure the distance between two points, but measurements performed by 3D analysis allow for the consideration of the curve of a surface (geodesic measurements), whereas the CXR allows solely for the determination of the shortest path between two points, with no regard for the surface (Euclidean measurements). The ratio of the upper to lower chest distances was quantified to distinguish chest shape in imaging by both the 3D depth camera and the CXR, and the ratios were compared between healthy and SMA patients. Results The mean 3D Euclidean ratio of distances measured by 3D imaging was 1.00 in the control group and 0.92 in the SMA group (p = 0.01), the latter indicative of a bell-shaped chest. This result repeated itself in the ratio of geodesic measurements (0.99 vs. 0.89, respectively, p = 0.03). Conclusion The herein-described novel, noninvasive 3D method for measuring the upper and lower chest distances was shown to distinguish the bell-shaped chest configuration in patients with SMA from the chests of controls. This method bears several advantages over CXR and may be readily applicable in clinical settings that manage children with SMA.
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Affiliation(s)
- Israel Amirav
- Pediatric Pulmonology Unit, Dana-Dwek Children’s Hospital, Tel-Aviv Sourasky Medical Center, Tel Aviv, Israel
- Affiliated to the Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Neta Rabin
- Pediatric Pulmonology Unit, Dana-Dwek Children’s Hospital, Tel-Aviv Sourasky Medical Center, Tel Aviv, Israel
- Affiliated to the Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Sapir Levi
- Pediatric Pulmonology Unit, Dana-Dwek Children’s Hospital, Tel-Aviv Sourasky Medical Center, Tel Aviv, Israel
- Affiliated to the Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Ronly Har-Even Cohn
- Pediatric Pulmonology Unit, Dana-Dwek Children’s Hospital, Tel-Aviv Sourasky Medical Center, Tel Aviv, Israel
- Affiliated to the Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Yotam Lior
- Affiliated to the Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- Division of Anesthesia, Intensive Care, and Pain Management, Tel-Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - Shelly Shiran
- Affiliated to the Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- Radiology Department, Tel-Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - Liora Sagi
- Pediatric Pulmonology Unit, Dana-Dwek Children’s Hospital, Tel-Aviv Sourasky Medical Center, Tel Aviv, Israel
- Affiliated to the Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Aviva Fatal
- Pediatric Pulmonology Unit, Dana-Dwek Children’s Hospital, Tel-Aviv Sourasky Medical Center, Tel Aviv, Israel
- Affiliated to the Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Alon Zvirin
- Department of Computer Sciences, The Technion, Israel Institute of Technology, Haifa, Israel
| | - Yaron Honen
- Department of Computer Sciences, The Technion, Israel Institute of Technology, Haifa, Israel
| | - Moran Lavie
- Pediatric Pulmonology Unit, Dana-Dwek Children’s Hospital, Tel-Aviv Sourasky Medical Center, Tel Aviv, Israel
- Affiliated to the Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Ron Kimmel
- Department of Computer Sciences, The Technion, Israel Institute of Technology, Haifa, Israel
- Department of Electrical and Computer Engineering, The Technion, Israel Institute of Technology, Haifa, Israel
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Choi D, Lee KH, Kim OH, Kong JS, Kang CY, Choo YI. Risk factors affecting severe thoracic injuries in motor vehicle collisions based on age group and collision directions. Eur J Trauma Emerg Surg 2023; 49:2429-2437. [PMID: 37341757 DOI: 10.1007/s00068-023-02297-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Accepted: 05/29/2023] [Indexed: 06/22/2023]
Abstract
OBJECTIVE This study aimed to investigate the effect of age and collision direction on the severity of thoracic injuries based on a real-world crash database. METHODS This was a retrospective, observational study. We used the Korean In-Depth Accident Study (KIDAS) database, which was collected from crash injury patients who visited emergency medical centers between January 2011 and February 2022 in Korea. Among the 4520 patients enrolled in the database, we selected 1908 adult patients with abbreviated injury scale (AIS) scores between 0 and 6 in the thoracic region. We classified patients with an AIS score of 3 or higher into the severe injury group. RESULTS The incidence rate of severe thoracic injuries due to motor vehicle accidents was 16.4%. Between the severe and non-severe thoracic injury groups, there were significant differences in sex, age, collision direction, crash object, seatbelt use, and delta-V parameters. Among the age groups, over 55 years occupants had a higher risk in the thoracic regions than those under 54 years occupants. The risk of severe thoracic injury was highest in near-side collisions in all collision directions. Far-side and rear-end collisions showed a lower risk than frontal collisions. Occupants with unfastened seatbelts were at greater risk. CONCLUSIONS The risk of severe thoracic injury is high in near-side collisions among elderly occupants. However, the risk of injury for elderly occupants increases in a super-aging society. To reduce thoracic injury, safety features made for elderly occupants in near-side collisions are required.
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Affiliation(s)
- Dooruh Choi
- Center for Automotive Medical Science Institute, Wonju Severance Christian Hospital, Yonsei University Wonju College of Medicine, 20 Ilsan‑ro, Wonju, Gangwon‑do, 26426, South Korea
- Department of Emergency Medicine, Wonju Severance Christian Hospital, Yonsei University Wonju College of Medicine, 20 Ilsan‑ro, Wonju, Gangwon‑do, 26426, South Korea
| | - Kang Hyun Lee
- Center for Automotive Medical Science Institute, Wonju Severance Christian Hospital, Yonsei University Wonju College of Medicine, 20 Ilsan‑ro, Wonju, Gangwon‑do, 26426, South Korea.
- Department of Emergency Medicine, Wonju Severance Christian Hospital, Yonsei University Wonju College of Medicine, 20 Ilsan‑ro, Wonju, Gangwon‑do, 26426, South Korea.
| | - Oh Hyun Kim
- Center for Automotive Medical Science Institute, Wonju Severance Christian Hospital, Yonsei University Wonju College of Medicine, 20 Ilsan‑ro, Wonju, Gangwon‑do, 26426, South Korea
- Department of Emergency Medicine, Wonju Severance Christian Hospital, Yonsei University Wonju College of Medicine, 20 Ilsan‑ro, Wonju, Gangwon‑do, 26426, South Korea
| | - Joon Seok Kong
- Center for Automotive Medical Science Institute, Wonju Severance Christian Hospital, Yonsei University Wonju College of Medicine, 20 Ilsan‑ro, Wonju, Gangwon‑do, 26426, South Korea
- Department of Emergency Medicine, Wonju Severance Christian Hospital, Yonsei University Wonju College of Medicine, 20 Ilsan‑ro, Wonju, Gangwon‑do, 26426, South Korea
| | - Chan Young Kang
- Center for Automotive Medical Science Institute, Wonju Severance Christian Hospital, Yonsei University Wonju College of Medicine, 20 Ilsan‑ro, Wonju, Gangwon‑do, 26426, South Korea
- Department of Emergency Medicine, Wonju Severance Christian Hospital, Yonsei University Wonju College of Medicine, 20 Ilsan‑ro, Wonju, Gangwon‑do, 26426, South Korea
| | - Yeon Il Choo
- Center for Automotive Medical Science Institute, Wonju Severance Christian Hospital, Yonsei University Wonju College of Medicine, 20 Ilsan‑ro, Wonju, Gangwon‑do, 26426, South Korea
- Department of Emergency Medicine, Wonju Severance Christian Hospital, Yonsei University Wonju College of Medicine, 20 Ilsan‑ro, Wonju, Gangwon‑do, 26426, South Korea
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Sargent B, Bolanos D, Garcia V, Howell L. An Aggregate Sternal Force-Deflection Model. J Biomech Eng 2023; 145:111009. [PMID: 37565991 DOI: 10.1115/1.4063148] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2022] [Accepted: 08/03/2023] [Indexed: 08/12/2023]
Abstract
Understanding the force-deflection behavior of the sternum is an important element in designing devices for implants for chest wall deformity repair. Human growth and variability makes a single measure of the stiffness difficult to determine. This work takes empirical data from the literature to develop aggregate sternal force-deflection models. Statistical methods were used to determine possible groupings based on patient age and the effect of gender. It was found that three age groups could be used, representing childhood (4-10 years), adolescence (11-19 years), and adulthood (26-53 years). Gender was found to have a statistical p-value of 0.068, 0.0611, and 0.012, respectively, in the proposed age groups. Jittering of the data was used to account for human variability and assumptions made in data comparisons. The jittered results followed that of the initial dataset. Childhood force-deflection behavior follows a relatively constant stiffness, adolescence experiences a growth period of increasing stiffness, and adulthood stiffnesses again begin to stabilize around a relatively constant value.
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Affiliation(s)
- Brandon Sargent
- Department of Mechanical Engineering, Gonzaga University, Spokane, WA 99258
| | - Diana Bolanos
- Department of Mechanical Engineering, Brigham Young University, Provo, UT 84602
| | - Victor Garcia
- Cincinnati Children's Hospital Medical Center, Cincinnati, OH 45229
| | - Larry Howell
- Department of Mechanical Engineering, Brigham Young University, Provo, UT 84602
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Lynch SD, Taylor SL, Greene KA, Devane KS, Weaver AA. Characterizing thoracic morphology variation to develop representative 3D models for applications in chest trauma. Comput Biol Med 2023; 163:107211. [PMID: 37390760 DOI: 10.1016/j.compbiomed.2023.107211] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2023] [Revised: 05/31/2023] [Accepted: 06/25/2023] [Indexed: 07/02/2023]
Abstract
BACKGROUND Rib fracture(s) occurs in 85% of blunt chest trauma cases. Increasing evidence supports that surgical intervention, particularly for multiple fractures, may improve outcomes. Thoracic morphology diversity across ages and sexes is important to consider in the design and use of surgical intervention devices in chest trauma. However, research on non-average thoracic morphology is lacking. METHODS The rib cage was segmented from patient computed tomography (CT) scans to create 3D point clouds. These point clouds were uniformly oriented and chest height, width, and depth were measured. Size categorization was determined by grouping each dimension into small, medium, and large tertiles. From small and large size combinations, subgroups were extracted to develop thoracic 3D models of the rib cage and surrounding soft tissue. RESULTS The study population included 141 subjects (48% male) ranging from age 10-80 with ∼20 subjects/age decade. Mean chest volume increased with age by 26% from the age groups 10-20 to 60-70, with 11% of this increase occurring between the youngest groups of 10-20 and 20-30. Across all ages, chest dimensions were ∼10% smaller in females and chest volume was highly variable (SD: ±3936.5 cm3). Representative thoracic models of four males (ages 16, 24, 44, 48) and three females (ages 19, 50, 53) were developed to characterize morphology associated with combinations of small and large chest dimensions. CONCLUSIONS The seven models developed cover a broad range of non-average thoracic morphologies and can serve as a basis for informing device design, surgical planning, and injury risk assessments.
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Affiliation(s)
- S Delanie Lynch
- Virginia Tech-Wake Forest University School of Biomedical Engineering and Sciences, 575 N. Patterson Avenue Suite 530, Winston-Salem, North Carolina, 27101, USA
| | - Shannon L Taylor
- Virginia Tech-Wake Forest University School of Biomedical Engineering and Sciences, 575 N. Patterson Avenue Suite 530, Winston-Salem, North Carolina, 27101, USA
| | - Katelyn A Greene
- Virginia Tech-Wake Forest University School of Biomedical Engineering and Sciences, 575 N. Patterson Avenue Suite 530, Winston-Salem, North Carolina, 27101, USA
| | - Karan S Devane
- Virginia Tech-Wake Forest University School of Biomedical Engineering and Sciences, 575 N. Patterson Avenue Suite 530, Winston-Salem, North Carolina, 27101, USA
| | - Ashley A Weaver
- Virginia Tech-Wake Forest University School of Biomedical Engineering and Sciences, 575 N. Patterson Avenue Suite 530, Winston-Salem, North Carolina, 27101, USA.
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Ye J, Li H, Zhang M, Lin F, Liu J, Chen J, Peng Y, Xiao M. Oblique Axis Rib Stretch and Curved Planar Reformats in Patients for Rib Fracture Detection and Characterization: Feasibility and Clinical Application. Emerg Med Int 2023; 2023:4904844. [PMID: 37674861 PMCID: PMC10480015 DOI: 10.1155/2023/4904844] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Revised: 08/14/2023] [Accepted: 08/16/2023] [Indexed: 09/08/2023] Open
Abstract
Objective To assess the use of CT with oblique axis rib stretch (OARS) and curved planar reformats (CPRs) for rib fracture detection and characterization. Methods A total of 108 forensically diagnosed patients with rib fractures were evaluated retrospectively. OARS and CPRs were independently used during the diagnosis in two groups. In each group, the final diagnosis was made after a junior radiologist's initial diagnosis was reviewed by a senior radiologist. The images were evaluated for the presence and characterization of rib fractures. Results A total of 2,592 ribs were analyzed, and 326 fractured ribs and 345 fracture sites were diagnosed using reference standard. Two groups of radiologists identified 331 and 333 fracture sites using the OARS method, 291 and 288 fracture sites using the CPRs method, and 274 fracture sites in forensically diagnosed patients (CR: conventional reconstruction), respectively; and all missed diagnoses were nondisplaced rib fractures. The ROC Az value of OARS1,2 was 0.98, which is higher than CPRs1,2 0.91, and CR 0.90 (all p < 0.01). The Az value for detecting rib fractures using CPRs1,2 and CR has no statistical difference (p = 0.14 and 0.29). More misdiagnosed patients were found using CPRs1,2 (42 and 44 cases) than OARS1,2 (1 and 2 cases) and CR (2 cases). The displaced fracture detection ratio of all methods showed no difference. Conclusions Doctors using the OARS method could improve diagnostic performance for detecting rib fractures without the requirement of specialized software and workstation when compared with CPRs.
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Affiliation(s)
- Jingzhi Ye
- Department of Radiology, Zhuhai Hospital, Guangdong Provincial Hospital of Traditional Chinese Medicine, 53 Jingle Road, Zhuhai City, Guangdong Province, China
| | - Hongyi Li
- Department of Radiology, Zhuhai Hospital, Guangdong Provincial Hospital of Traditional Chinese Medicine, 53 Jingle Road, Zhuhai City, Guangdong Province, China
| | - Meng Zhang
- Department of Radiology, Zhuhai Hospital, Guangdong Provincial Hospital of Traditional Chinese Medicine, 53 Jingle Road, Zhuhai City, Guangdong Province, China
| | - Fenghuan Lin
- Department of Radiology, Zhuhai Hospital, Guangdong Provincial Hospital of Traditional Chinese Medicine, 53 Jingle Road, Zhuhai City, Guangdong Province, China
| | - Jingfeng Liu
- Department of Radiology, Zhuhai Hospital, Guangdong Provincial Hospital of Traditional Chinese Medicine, 53 Jingle Road, Zhuhai City, Guangdong Province, China
| | - Jun Chen
- Department of Radiology, Zhuhai Hospital, Guangdong Provincial Hospital of Traditional Chinese Medicine, 53 Jingle Road, Zhuhai City, Guangdong Province, China
| | - Ye Peng
- The Second People's Hospital of Xiangzhou District, 21 Nanquan Road, Zhuhai City, Guangdong Province, China
| | - Mengqiang Xiao
- Department of Radiology, Zhuhai Hospital, Guangdong Provincial Hospital of Traditional Chinese Medicine, 53 Jingle Road, Zhuhai City, Guangdong Province, China
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Tempo JA, Williams GM, Robertson IK, Rama DJ, Pascoe CEA, Cetti RJ. Assessing the Variability of the Twelfth Rib as a Landmark for Percutaneous Nephrolithotomy Using Computed Tomography. Res Rep Urol 2023; 15:355-363. [PMID: 37554929 PMCID: PMC10406120 DOI: 10.2147/rru.s409414] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2023] [Accepted: 07/01/2023] [Indexed: 08/10/2023] Open
Abstract
BACKGROUND The variability in length of the twelfth rib is mentioned in the literature but has never been formally studied. The highly variable rib length provides a challenge for urologists seeking a consistent landmark for Percutaneous Nephrolithotomy (PCNL). We set out to determine whether the twelfth rib is safe to use as a consistent landmark for surgery. METHODS Single centre, cross-sectional retrospective observational study and analysis of CT scans of 100 adults who had imaging between 23rd March and 12th April 2020. The distance from the mid-sagittal line to the twelfth rib tip in the axial plane was measured as was the distance from the twelfth rib tip to the kidney, spleen and liver. RESULTS Length from the mid-sagittal line to the right twelfth rib tip varied from 46 (percentile 95% CI 40 to 57) to 136mm (percentile 95% CI 133 to 138). On the left, the distances varied from 55 (percentile 95% CI 50 to 64) to 134mm (percentile 95% CI 131 to 135). Twenty-three percent of people had an organ lying between the tip of the twelfth rib and the kidney on the right and 11% on the left. CONCLUSION The twelfth rib is highly variable in length. Similar variability was recorded in the distance from the tip to intra-abdominal organs. Due to the frequency of organs lying between the tip of the rib and the kidney it should not be used as a landmark for accessing the kidney without prior knowledge of an individual patient's anatomy as seen on imaging.
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Affiliation(s)
- Jake A Tempo
- Department of Urology, Launceston General Hospital, Launceston, Tasmania, Australia
| | - Georgina M Williams
- Department of Urology, Launceston General Hospital, Launceston, Tasmania, Australia
| | - Iain K Robertson
- College of Health and Medicine, University of Tasmania, Hobart, Tasmania, Australia
- Clifford Craig Foundation, Launceston General Hospital, Launceston, Tasmania, Australia
| | - Darren J Rama
- Department of Urology, Launceston General Hospital, Launceston, Tasmania, Australia
| | - Claire E A Pascoe
- Department of Urology, Launceston General Hospital, Launceston, Tasmania, Australia
| | - Richard J Cetti
- Department of Urology, Launceston General Hospital, Launceston, Tasmania, Australia
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11
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Robinson A, von Kleeck BW, Gayzik FS. Development and preliminary validation of computationally efficient and detailed 50th percentile female human body models. ACCIDENT; ANALYSIS AND PREVENTION 2023; 190:107182. [PMID: 37390749 DOI: 10.1016/j.aap.2023.107182] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Revised: 05/15/2023] [Accepted: 06/17/2023] [Indexed: 07/02/2023]
Abstract
OBJECTIVE No vehicle testing standard (physical or computational) employs a mid-sized female human surrogate, despite discrepancies related to injury outcomes for female occupants amongst all vehicle users. We detail the design and preliminary validation of 50th percentile female (F50) computational human body models (HBMs) based on Global Human Body Models Consortium (GHBMC) models. METHOD Data for the target geometry was collected as part of the initial generation of GHBMC models. Imaging, surface data, and 15 anthropomorphic measures from a living female subject (60.8 kg and 1.61 m) served as the baseline for model development. Due to the role rib cage geometry plays in biomechanical loading, rib cage morphology from secondary retrospective data was leveraged to identify an average female rib cage based on gross anatomical features. A female rib cage was selected from an existing dataset closest to the mean depth, height, and width of the set, considering only those aged 20 - 50 years. The selected subject among this secondary set also exhibited a 7th rib angle and sternum angle within 5% of the mean measurements, and within the range of previously reported studies. The GHBMC 5th percentile, small female detailed (high biofidelity) and simplified (computationally efficient) models were morphed to match the F50 subject body surface, selected bones, and mean rib cage using established thin plate spline techniques. The models were validated vs. previously published literature studies with an emphasis on rib cage response. Model data was compared to 47 channels of experimental data across four biomechanical hub simulations, two sled test simulations (one of which included all female PMHS), and two robustness simulations to test stability. Model results were mass scaled to the average of the reported corridors. Objective evaluation was conducted using CORA. IRB approval was obtained for all prospective and retrospective data collected or used. The target rib cage was selected from retrospective image data used in prior studies (n = 339 chest CT scans). RESULTS The morphed HBMs closely matched the target geometry. The detailed and simplified models had masses and element counts of 61.2 kg and 61.8 kg, and 2.8 million and 0.3 million, respectively. The mass difference is due to a coarser mesh in the simplified model. The simplified model ran 23 times faster than the detailed model on the same hardware. Each model exhibited stability in robustness tests, and the average CORA scores were 0.80 and 0.72 in the detailed and simplified models, respectively. The models performed well in frontal impacts against PMHS corridors after mass scaling. CONCLUSIONS Numerous recent studies underscore poorer injury outcomes for female vehicle occupants compared to males. While such outcomes are multifactorial, the average female models introduced in this work offer a novel tool within a widely used family of HBMs to reduce the outcome gap in terms of injury for all drivers. HBMs can be deployed in safety studies or in future regulatory requirements faster and more economically than a resized or newly designed ATDs aimed at the same target population.
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Affiliation(s)
- Andrea Robinson
- Wake Forest University School of Medicine, Department of Biomedical Engineering, United States
| | - B Wade von Kleeck
- Wake Forest University School of Medicine, Department of Biomedical Engineering, United States
| | - F Scott Gayzik
- Wake Forest University School of Medicine, Department of Biomedical Engineering, United States.
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12
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Archer JE, Dong H, Berryman F, Pynsent P, Gardner A. The anatomical growth of the thoracic cage in adolescents with specific reference to axial growth comparing the right and left hemithorax. Clin Anat 2023; 36:2-10. [PMID: 36271772 DOI: 10.1002/ca.23971] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2022] [Revised: 10/19/2022] [Accepted: 10/21/2022] [Indexed: 12/14/2022]
Abstract
This study has demonstrated the changing volume of both the anterior and posterior thorax in normal adolescents (without spinal or thoracic deformity), differentiating for both sex and age, to further understand how the thorax grows, along with the differences in growth between the anterior and posterior thorax. The thorax was measured on axial CT slices at every vertebral level from T3 to T12 in a series of scans previous taken for routine clinical care. Measurements taken were the anteroposterior thoracic distance and the area of the anterior and posterior rib prominences on either side of the thorax. Data was analyzed per vertebral level, differentiating for age and sex. There were 486 CT scans analyzed (257 males and 229 females) between the ages of 8 and 18 years. The analysis identified that for the anterior thorax, there are three phases of growth with an initial slow increase in volume, followed by a stabilization of little growth, followed by another phase of a more rapid increase in volume. For the posterior thorax, there was a gradual increase in area with increasing age. This study demonstrates that the shape of the thorax is age and sex dependent, with males having both a greater width and depth of thorax compared to females. Of particular note is the difference in patterns of growth between the anterior and posterior thorax. This information will add to the understanding of normal growth, which will aid in the management of conditions where that growth is disturbed.
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Affiliation(s)
- James E Archer
- The Royal Orthopaedic Hospital NHS Foundation Trust, Bristol Road South, Birmingham, UK
| | - Huan Dong
- The Royal Orthopaedic Hospital NHS Foundation Trust, Bristol Road South, Birmingham, UK
| | - Fiona Berryman
- The Royal Orthopaedic Hospital NHS Foundation Trust, Bristol Road South, Birmingham, UK
| | - Paul Pynsent
- The Institute of Clinical Sciences, University of Birmingham, Birmingham, UK
| | - Adrian Gardner
- The Royal Orthopaedic Hospital NHS Foundation Trust, Bristol Road South, Birmingham, UK.,The Institute of Health and Life Sciences, Aston University, UK
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13
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Umale S, Khandelwal P, Humm JR, Yoganandan N. An investigation of elderly occupant injury risks based on anthropometric changes compared to young counterparts. TRAFFIC INJURY PREVENTION 2022; 23:S92-S98. [PMID: 36409229 DOI: 10.1080/15389588.2022.2135373] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/04/2022] [Revised: 10/09/2022] [Accepted: 10/09/2022] [Indexed: 06/16/2023]
Abstract
OBJECTIVE The objective of the study was to investigate the difference between elderly and young occupant injury risks using human body finite element modeling in frontal impacts. METHODS Two elderly male occupant models (representative age 70-80 years) were developed using the Global Human Body Consortium (GHBMC) 50th percentile as the baseline model. In the first elderly model (EM-1), material property changes were incorporated, and in the second elderly model (EM-2), material and anthropometric changes were incorporated. Material properties were based on literature. The baseline model was morphed to elderly anthropometry for EM-2. The three models were simulated in a frontal crash vehicle environment at 56 km/h. Responses from the two elderly and baseline models were compared with cadaver experimental data in thoracic, abdominal, and frontal impacts. Correlation and analysis scores were used for correlation with experimental data. The probabilities of head, neck, and thoracic injuries were assessed. RESULTS The elderly models showed a good correlation with experimental responses. The elderly EM-1 had higher risk of head and brain injuries compared to the elderly EM-2 and baseline GHBMC models. The elderly EM-2 demonstrated higher risk of neck, chest, and abdominal injuries than the elderly EM-1 and baseline models. CONCLUSIONS The study investigated injury risks of two elderly occupants and compared to a young occupant in frontal crashes. The change in the material properties alone (EM-1) suggested that elderly occupants may be vulnerable to a greater risk of head and thoracic injuries, whereas change in both anthropometric and material properties (EM-2) suggested that elderly occupants may be vulnerable to a greater risk of thoracic and neck injuries. The second elderly model results were in better agreement with field injury data from the literature; thus, both anthropometric and material properties should be considered when assessing the injury risks of elderly occupants. The elderly models developed in this study can be used to simulate different impact conditions and determine injury risks for this group of our population.
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Affiliation(s)
| | - Prashant Khandelwal
- Department of Neurosurgery, Medical College of Wisconsin, Milwaukee, Wisconsin
| | - John R Humm
- Department of Neurosurgery, Medical College of Wisconsin, Milwaukee, Wisconsin
| | - Narayan Yoganandan
- Department of Neurosurgery, Medical College of Wisconsin, Milwaukee, Wisconsin
- Department of Orthopaedic Surgery, Medical College of Wisconsin, Milwaukee, Wisconsin
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14
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Khalifé M, Vergari C, Ferrero E, Attali V, Heidsieck C, Assi A, Skalli W. The rib cage: a new element in the spinopelvic chain. EUROPEAN SPINE JOURNAL : OFFICIAL PUBLICATION OF THE EUROPEAN SPINE SOCIETY, THE EUROPEAN SPINAL DEFORMITY SOCIETY, AND THE EUROPEAN SECTION OF THE CERVICAL SPINE RESEARCH SOCIETY 2022; 31:1457-1467. [PMID: 35501578 DOI: 10.1007/s00586-022-07216-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/16/2021] [Revised: 03/03/2022] [Accepted: 04/06/2022] [Indexed: 10/18/2022]
Abstract
INTRODUCTION This study analyzes anatomical variations of the thoracic cage (TC) according to spinopelvic alignment, age and gender using stereoradiography in erect position. METHODS This retrospective multicentric study analyzed computed parameters collected from free-standing position bi-planar radiographs, among healthy subjects. Collected data were: age, gender, pelvic parameters (Pelvic Incidence, Pelvic Tilt (PT) and Sacral Slope), T1-T12 Kyphosis (TK), L1-S1 Lordosis (LL), curvilinear spinal length, global TC parameters (maximum thickness and width, rib cage volume, mean Spinal Penetration Index (SPI)), 1st-10th rib parameters (absolute and relative (to the corresponding vertebra) sagittal angles). RESULTS Totally, 256 subjects were included (140 females). Mean age was 34 (range: 8-83). Significant correlations were found between TK and TC thickness (0.3, p < 0.001) and with TC Volume (0.3, p = 0.04), as well as rib absolute sagittal angle for upper and middle ribs (0.2, p = 0.02). Conversely, a -0.3 correlation has been exhibited between SPI and TK. Similar correlations were found with LL. PT significantly correlated with TC thickness (0.4, p = 0.003), SPI (-0.3, p = 0.03), and all rib relative sagittal angles. Among global TC parameters, only thickness and SPI significantly changed after 20 years (respectively, 0.39 and -0.52, p < 0.001). Ribs relative sagittal angle showed negative correlation with age in skeletally mature subjects (p < 0.001). CONCLUSION This study demonstrates the correlation between TC anatomy and spinopelvic parameters, confirming its part of the spinopelvic chain of balance. Indeed, higher spinal curvatures were associated with lower SPI and higher TC thickness, TC volume and rib absolute sagittal angles.
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Affiliation(s)
- Marc Khalifé
- Orthopaedic Surgery Unit, Hôpital Européen Georges Pompidou, 20, rue Leblanc, 75015, Paris, France. .,Université Paris Cité, Paris, France. .,Arts Et Métiers Institute of Technology, Université Sorbonne Paris Nord, Villetaneuse, France. .,IBHGC - Institut de Biomécanique Humaine Georges Charpak, HESAM Université, 75013, Paris, France.
| | - Claudio Vergari
- Arts Et Métiers Institute of Technology, Université Sorbonne Paris Nord, Villetaneuse, France.,IBHGC - Institut de Biomécanique Humaine Georges Charpak, HESAM Université, 75013, Paris, France
| | - Emmanuelle Ferrero
- Orthopaedic Surgery Unit, Hôpital Européen Georges Pompidou, 20, rue Leblanc, 75015, Paris, France.,Université Paris Cité, Paris, France
| | - Valérie Attali
- INSERM, UMRS1158 Neurophysiologie Respiratoire Expérimentale Et Clinique, Sorbonne Université, Paris, France.,Service Des Pathologies du Sommeil (Département "R3S"), Assistance Publique Hôpitaux de Paris (APHP), Hôpitaux Universitaires Pitié Salpêtrière - Charles Foix, Paris, France
| | - Cécile Heidsieck
- Arts Et Métiers Institute of Technology, Université Sorbonne Paris Nord, Villetaneuse, France.,IBHGC - Institut de Biomécanique Humaine Georges Charpak, HESAM Université, 75013, Paris, France
| | - Ayman Assi
- Faculty of Medicine, Saint-Joseph University, Beirut, Lebanon
| | - Wafa Skalli
- Arts Et Métiers Institute of Technology, Université Sorbonne Paris Nord, Villetaneuse, France.,IBHGC - Institut de Biomécanique Humaine Georges Charpak, HESAM Université, 75013, Paris, France
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15
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Wei A, Wang J, Liu J, Jones MLH, Hu J. A parametric head geometry model accounting for variation among adolescent and young adult populations. COMPUTER METHODS AND PROGRAMS IN BIOMEDICINE 2022; 220:106805. [PMID: 35439654 DOI: 10.1016/j.cmpb.2022.106805] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/03/2021] [Revised: 03/24/2022] [Accepted: 04/07/2022] [Indexed: 06/14/2023]
Abstract
BACKGROUND AND OBJECTIVE Modeling the size and shape of human skull and scalp is essential for head injury assessment, design of helmets and head-borne equipment, and many other safety applications. Finite element (FE) head models are important tools to assess injury risks and design personal protective equipment. However, current FE head models are mainly developed based on the midsize male, failing to account for the significant morphological variation that exists in the skull and brain. The objective of this study was to develop a statistical head geometry model that accounts for size and shape variations among the adolescent and young adult population. METHODS To represent subject-specific geometry using a homologous mesh, threshold-based segmentation of head CT scans of 101 subjects between 14 and 25 years of age was performed, followed by landmarking, mesh morphing, and projection. Skull and scalp statistical geometry models were then developed as functions of age, sex, stature, BMI, head length, head breadth, and tragion-to-top of head using generalized Procrustes analysis (GPA), principal component analysis (PCA) and multivariate regression analysis. RESULTS The statistical geometry models account for a high percentage of morphological variations in scalp geometry (R2=0.63), outer skull geometry (R2=0.66), inner skull geometry (R2=0.55), and skull thickness (error < 1 mm) CONCLUSIONS: Skull and scalp statistical geometry models accounts for size and shape variations among the adolescent and young adult population were developed as functions of subject covariates. These models may serve as the geometric basis to develop individualized head FE models for injury assessment and design of head-borne equipment.
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Affiliation(s)
- Albert Wei
- University of Michigan Transportation Research Institute, Ann Arbor, MI, United States; Department of Industrial and Operations Engineering, University of Michigan, Ann Arbor, MI, United States
| | - Julie Wang
- University of Michigan Transportation Research Institute, Ann Arbor, MI, United States; Department of Computer Science Engineering, University of Michigan, Ann Arbor, MI, United States
| | - Jiacheng Liu
- University of Michigan Transportation Research Institute, Ann Arbor, MI, United States; Department of Industrial and Operations Engineering, University of Michigan, Ann Arbor, MI, United States
| | - Monica L H Jones
- University of Michigan Transportation Research Institute, Ann Arbor, MI, United States
| | - Jingwen Hu
- University of Michigan Transportation Research Institute, Ann Arbor, MI, United States; Department of Mechanical Engineering, University of Michigan, Ann Arbor, MI, United States.
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16
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Arlegi M, García‐Sagastibelza A, Veschambre‐Couture C, Gómez‐Olivencia A. Sexual dimorphism in the first rib of Homo sapiens. J Anat 2022; 240:959-971. [PMID: 34796481 PMCID: PMC9005670 DOI: 10.1111/joa.13594] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2021] [Revised: 11/04/2021] [Accepted: 11/05/2021] [Indexed: 11/28/2022] Open
Abstract
This work aimed to study sexual dimorphism in the first rib of modern humans, with a special focus on whether differences in shape are due to divergent allometric growth in males and females. Also, we compare the accuracy of sex classification using different approaches based on two methodologies, traditional morphometry based on linear measurements and geometric morphometric analysis based on 2D landmark coordinates. The sample studied here comprised 121 right and left first ribs from 65 female and male adult recent Euro-American Homo sapiens individuals. For traditional morphometrics, 12 metric variables were collected from each rib using a digital caliper, and for geometric morphometrics, six landmarks and 31 semilandmarks were captured from photographs using digital software. Both geometric morphometric and metric data were analyzed to calculate the index of sexual dimorphism, variation related to lateral asymmetry, variation in size and shape, and allometric trends between males and females. Finally, a linear discriminant analysis (LDA) was performed comparing both methodologies to test the best approach for sex classification. Results indicated that there are significant sex differences in the size and shape of the first ribs of recent Euro-American Homo sapiens. Regression analysis revealed different allometric patterns for males and females, and this could partially explain shape differences between sexes. Additionally, traditional morphometrics showed that all characteristics analyzed are significantly dimorphic, with the midshaft minimum craniocaudal diameter, the sternal end minimum diameter, and the neck minimum craniocaudal diameter displaying the most dimorphic scores. Similarly, geometric morphometrics results indicated that males have more curved and interno-exteriorly wider first ribs. Finally, analysis of sex classification using LDA yielded slightly better accuracy for traditional morphometry (83.8%) than the geometric morphometrics approach (81.3%) based on form Procrustes coordinates. This study demonstrates the usefulness of applying two different morphometric approaches to obtain more comprehensive results.
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Affiliation(s)
- Mikel Arlegi
- Institut Català de Paleoecologia Humana i Evolució Social (IPHES‐CERCA)TarragonaSpain
- Departament d’Història i Història de l’ArtUniversitat Rovira i VirgiliTarragonaSpain
| | - Andrea García‐Sagastibelza
- Facultad de Ciencia y TecnologíaDepartamento de GeologíaUniversidad del País Vasco‐Euskal Herriko Unibertsitatea (UPV/EHU)LeioaSpain
- UMR 5199 PACEAUniversité de Bordeaux. Allée Geoffroy Saint HilairePessacFrance
| | | | - Asier Gómez‐Olivencia
- Facultad de Ciencia y TecnologíaDepartamento de GeologíaUniversidad del País Vasco‐Euskal Herriko Unibertsitatea (UPV/EHU)LeioaSpain
- Centro UCM‐ISCIII de Investigación sobre Evolución y Comportamiento HumanosMadridSpain
- Sociedad de Ciencias AranzadiDonostia‐San SebastiánSpain
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17
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Suazo M, Herrero J, Fortuny G, Puigjaner D, López JM. Biomechanical response of human rib cage to cardiopulmonary resuscitation maneuvers: Effects of the compression location. INTERNATIONAL JOURNAL FOR NUMERICAL METHODS IN BIOMEDICAL ENGINEERING 2022; 38:e3585. [PMID: 35188706 PMCID: PMC9285513 DOI: 10.1002/cnm.3585] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Revised: 02/01/2022] [Accepted: 02/16/2022] [Indexed: 06/14/2023]
Abstract
The biomechanical response of a human rib cage to cardiopulmonary resuscitation maneuvers was investigated by means of finite element simulations. We analyzed the effect of the location where the force was applied on the achieved compression depths and stress levels experienced by the breastbone and ribs. For compression locations on the breastbone, a caudal shift of the application area toward the breastbone tip resulted in a 17% reduction of the force required to achieve a target 5 cm compression depth. We found that the use of compression regions located on the costal cartilages would involve higher risk of rib fractures.
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Affiliation(s)
- Mario Suazo
- Departament d’ Enginyeria Informàtica i MatemàtiquesUniversitat Rovira i VirgiliTarragonaCatalunyaSpain
- Departamento de Matemática AplicadaEscuela de Matemática y Ciencias de la Computación, UNAH–VSTegucigalpaHonduras
| | - Joan Herrero
- Departament d’ Enginyeria QuímicaUniversitat Rovira i VirgiliTarragonaCatalunyaSpain
| | - Gerard Fortuny
- Departament d’ Enginyeria Informàtica i MatemàtiquesUniversitat Rovira i VirgiliTarragonaCatalunyaSpain
| | - Dolors Puigjaner
- Departament d’ Enginyeria Informàtica i MatemàtiquesUniversitat Rovira i VirgiliTarragonaCatalunyaSpain
| | - Josep M. López
- Departament d’ Enginyeria Informàtica i MatemàtiquesUniversitat Rovira i VirgiliTarragonaCatalunyaSpain
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Over and beyond the Primate baubellum Surface: A “Jewel Bone” Shielded in Museums. APPLIED SCIENCES-BASEL 2022. [DOI: 10.3390/app12042096] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Computed Tomography (CT), mostly used in the medical field, has also recently been involved in Cultural Heritage studies, thanks to its efficiency and total non-invasiveness. Due to the large variety of sizes and compositions typical of Cultural Heritage objects, different X-ray sources, detectors, and setups are necessary to meet the different needs of various case studies. Here, we focus on the use of micro-CT to explore the morphology and shape of a small, neglected bone found inside the clitoris of non-human primates (the baubellum), which we obtained by accessing two prestigious primatological collections of the American Museum of Natural History (New York, NY, USA) and the National Museum of Natural History (Washington, DC, USA). Overcoming methodological limits imposed by the absence of homologous landmarks, we combined the use of the non-invasive 3D micro-CT and a recently released landmark-free shape analysis (the alpha-shape technique) to objectively describe and quantify the shape complexity of scanned primate baubella. Micro-CT provided high-resolution results, overcoming constraints linked to museum policy about non-disruptive sampling and preserving samples for future research. Finally, it proved appropriate as post-mortem sampling had no impact on protected wild primate populations.
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19
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Lim WH, Park CM. Validation for measurements of skeletal muscle areas using low-dose chest computed tomography. Sci Rep 2022; 12:463. [PMID: 35013501 PMCID: PMC8748601 DOI: 10.1038/s41598-021-04492-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2021] [Accepted: 12/23/2021] [Indexed: 11/21/2022] Open
Abstract
Various methods were suggested to measure skeletal muscle areas (SMAs) using chest low-dose computed tomography (chest LDCT) as a substitute for SMA at 3rd lumbar vertebra level (L3-SMA). In this study, four SMAs (L1-SMA, T12-erector spinae muscle areas, chest wall muscle area at carina level, pectoralis muscle area at aortic arch level) were segmented semi-automatically in 780 individuals taking concurrent chest and abdomen LDCT for healthcare screening. Four SMAs were compared to L3-SMA and annual changes were calculated from individuals with multiple examinations (n = 101). Skeletal muscle index (SMI; SMA/height2) cut-off for sarcopenia was determined by lower 5th percentile of young individuals (age ≤ 40 years). L1-SMA showed the greatest correlation to L3-SMA (men, R2 = 0.7920; women, R2 = 0.7396), and the smallest annual changes (0.3300 ± 4.7365%) among four SMAs. L1-SMI cut-offs for determining sarcopenia were 39.2cm2/m2 in men, and 27.5cm2/m2 in women. Forty-six men (9.5%) and ten women (3.4%) were found to have sarcopenia using L1-SMI cut-offs. In conclusion, L1-SMA could be a reasonable substitute for L3-SMA in chest LDCT. Suggested L1-SMI cut-offs for sarcopenia were 39.2cm2/m2 for men and 27.5cm2/m2 for women in Asian.
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Affiliation(s)
- Woo Hyeon Lim
- Department of Radiology, Namwon Medical Center, Namwon-si, Jeollabuk-do, Korea.,Department of Radiology, Seoul National University College of Medicine, 101 Daehak-ro, Chongno-gu, Seoul, 03080, Korea
| | - Chang Min Park
- Department of Radiology, Seoul National University College of Medicine, 101 Daehak-ro, Chongno-gu, Seoul, 03080, Korea. .,Institute of Radiation Medicine, Seoul National University Medical Research Center, Seoul, Korea. .,Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea. .,Institute of Medical and Biological Engineering, Medical Research Center, Seoul National University, Seoul, Korea.
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20
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Divya G, Kundal VK, Debnath PR, Addagatla RS, Garbhapu AK, Saha AK, Meena AK, Shah S, Sen A. Musculoskeletal and Esthetic Complications after Neonatal Thoracotomy: Revisited. J Indian Assoc Pediatr Surg 2022; 27:293-296. [PMID: 35733596 PMCID: PMC9208689 DOI: 10.4103/jiaps.jiaps_19_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2021] [Revised: 05/23/2021] [Accepted: 09/02/2021] [Indexed: 12/05/2022] Open
Abstract
AIM The aim is to study the complications of neonatal thoracotomy and its preventive measures. METHODS We retrospectively reviewed 53 neonates who underwent thoracotomy from January 2017 to December 2019 for a period of 3 years. Patient demographic data, primary disease for which they underwent thoracotomy, postoperative complications (immediate and delayed) during follow-up were documented. RESULTS During 3-year period, 53 neonates underwent thoracotomy for various surgical pathologies. The indications were esophageal atresia with tracheoesophageal fistula (n = 49), eventration of diaphragm (n = 3), congenital lobar emphysema of left upper lobe of lung (n = 1). Most of them were right posterolateral thoracotomies (n = 48, 90.56%) and left posterolateral thoracotomy was done in only 5 cases (9.43%). Associated anomalies were seen in 22 cases, such as cardiac (n = 19), renal (n = 4) and gastrointestinal (n = 5). Associated comorbidities seen in 14 cases; preterm (n = 4), low birth weight (n = 13), delayed presentation (n = 6). Early postoperative complications such as pneumonia (34%, n = 18) and wound infection (11.3%, n = 6) were noted. Delayed complications include musculoskeletal abnormalities (n = 19, 35.8%) and esthetic complications such as asymmetry of chest (5.6%). CONCLUSION Neonatal thoracotomy is associated with complications such as pneumonia, wound infections, and musculoskeletal abnormalities such as asymmetry of chest and scoliosis. These can be prevented by adequate postoperative pain relief, muscle-sparing thoracotomies, avoiding tight closures, and nerve injuries. Long-term follow-up is required because these complications may manifest later on also. Early detection and institution of physiotherapy may help.
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Affiliation(s)
- Gali Divya
- Department of Pediatric Surgery, Atal Bihari Vajpayee Institute of Medical Sciences, Dr. Ram Manohar Lohia Hospital, New Delhi, India
| | - Vijay Kumar Kundal
- Department of Pediatric Surgery, Atal Bihari Vajpayee Institute of Medical Sciences, Dr. Ram Manohar Lohia Hospital, New Delhi, India,Address for correspondence: Dr. Vijay Kumar Kundal, Room No. 409, Academic Block (PGI Building), ABVIMS and Dr. Ram Manohar Lohia Hospital, Baba Kharag Singh Marg, New Delhi - 110 001, India. E-mail:
| | - Pinaki Ranjan Debnath
- Department of Pediatric Surgery, Atal Bihari Vajpayee Institute of Medical Sciences, Dr. Ram Manohar Lohia Hospital, New Delhi, India
| | - Raja Sekhar Addagatla
- Department of Pediatric Surgery, Atal Bihari Vajpayee Institute of Medical Sciences, Dr. Ram Manohar Lohia Hospital, New Delhi, India
| | - Anil Kumar Garbhapu
- Department of Pediatric Surgery, Atal Bihari Vajpayee Institute of Medical Sciences, Dr. Ram Manohar Lohia Hospital, New Delhi, India
| | - Arnab Kumar Saha
- Department of Pediatric Surgery, Atal Bihari Vajpayee Institute of Medical Sciences, Dr. Ram Manohar Lohia Hospital, New Delhi, India
| | - Atul Kumar Meena
- Department of Pediatric Surgery, Atal Bihari Vajpayee Institute of Medical Sciences, Dr. Ram Manohar Lohia Hospital, New Delhi, India
| | - Shalu Shah
- Department of Pediatric Surgery, Atal Bihari Vajpayee Institute of Medical Sciences, Dr. Ram Manohar Lohia Hospital, New Delhi, India
| | - Amita Sen
- Department of Pediatric Surgery, Atal Bihari Vajpayee Institute of Medical Sciences, Dr. Ram Manohar Lohia Hospital, New Delhi, India
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The morphological changes of thorax in pediatric microtia patients after costal cartilage harvesting. Int J Pediatr Otorhinolaryngol 2021; 151:110965. [PMID: 34736014 DOI: 10.1016/j.ijporl.2021.110965] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/12/2021] [Revised: 09/11/2021] [Accepted: 10/25/2021] [Indexed: 10/20/2022]
Abstract
BACKGROUND The surgical treatment of microtia generally starts in childhood, and costal cartilage is the most widely used material for auricular reconstruction. However, multiple costal cartilage harvests lead to local cartilage defects, which may influence the growth of the hemithorax, that need close attention by doctors. In this study, morphological changes of the thorax were measured and analyzed in different follow-up groups. METHODS Twenty-eight adolescent microtia patients underwent auricular reconstruction using 6th-8th costal cartilage. Thoracic computed tomography (CT) with three-dimensional reconstruction was performed preoperatively and during follow-up. Comparison of the hemithorax on the operated and unoperated sides was performed by measuring several thoracic parameters using Mimics software (Materialise, Belgium). The data were further analyzed by a paired-samples t-test. RESULTS In the operated hemithorax, the costochondral junction midpoints moved medially (6th-8th), posteriorly (6th-7th) and descended less (6th-9th) with significant differences as P < 0.05 compared to the unoperated hemithorax. In addition, height differences indicated local depressions in the chest wall in the areas of cartilage defects (6th-9th, P < 0.05). Following local depression of the chest wall and migration of the ribs, the operated hemithorax also had a smaller area than the unoperated hemithorax (6th-9th, P < 0.05). The differences in the hemithorax were more significant in the midterm group (5-10 y) than in the other follow-up groups, while most parameters showed no significant differences in the long-term group (10-15 y). No significant differences were found in the modified Haller index. CONCLUSION Multiple costal cartilage harvests caused morphological changes and asymmetry of the thorax in adolescent patients. As indicated by thoracic CT, significant changes occurred in the local area of cartilage defects, which did not affect the overall thorax. In the long term, more than 10 years after harvesting, the differences in the hemithorax between the operated and unoperated sides decreased significantly. This study provides an important reference for thoracic changes when applying auricular reconstruction in the pediatric microtia patients.
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Yang CY, Pan YJ, Chou Y, Yang CJ, Kao CC, Huang KC, Chang JS, Chen HC, Kuo KH. Using Deep Neural Networks for Predicting Age and Sex in Healthy Adult Chest Radiographs. J Clin Med 2021; 10:jcm10194431. [PMID: 34640449 PMCID: PMC8509558 DOI: 10.3390/jcm10194431] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2021] [Revised: 09/20/2021] [Accepted: 09/22/2021] [Indexed: 11/18/2022] Open
Abstract
Background: The performance of chest radiography-based age and sex prediction has not been well validated. We used a deep learning model to predict the age and sex of healthy adults based on chest radiographs (CXRs). Methods: In this retrospective study, 66,643 CXRs of 47,060 healthy adults were used for model training and testing. In total, 47,060 individuals (mean age ± standard deviation, 38.7 ± 11.9 years; 22,144 males) were included. By using chronological ages as references, mean absolute error (MAE), root mean square error (RMSE), and Pearson’s correlation coefficient were used to assess the model performance. Summarized class activation maps were used to highlight the activated anatomical regions. The area under the curve (AUC) was used to examine the validity for sex prediction. Results: When model predictions were compared with the chronological ages, the MAE was 2.1 years, RMSE was 2.8 years, and Pearson’s correlation coefficient was 0.97 (p < 0.001). Cervical, thoracic spines, first ribs, aortic arch, heart, rib cage, and soft tissue of thorax and flank seemed to be the most crucial activated regions in the age prediction model. The sex prediction model demonstrated an AUC of >0.99. Conclusion: Deep learning can accurately estimate age and sex based on CXRs.
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Affiliation(s)
- Chung-Yi Yang
- School of Medicine, College of Medicine, I-Shou University, Kaohsiung 82445, Taiwan;
- Department of Medical Imaging, E-Da Hospital, Kaohsiung 82445, Taiwan
| | - Yi-Ju Pan
- Department of Psychiatry, Far Eastern Memorial Hospital, New Taipei City 22060, Taiwan;
- Institute of Public Health, School of Medicine, National Yang-Ming Chiao-Tung University, Taipei 11267, Taiwan
| | - Yen Chou
- Division of Medical Image, Far Eastern Memorial Hospital, New Taipei City 22060, Taiwan;
| | - Chia-Jung Yang
- Department of Radiology, Taitung MacKay Memorial Hospital, Taitung 95054, Taiwan;
| | - Ching-Chung Kao
- AI Lab, Quanta Computer Inc., Taoyuan City 33377, Taiwan; (C.-C.K.); (K.-C.H.); (J.-S.C.)
| | - Kuan-Chieh Huang
- AI Lab, Quanta Computer Inc., Taoyuan City 33377, Taiwan; (C.-C.K.); (K.-C.H.); (J.-S.C.)
| | - Jing-Shan Chang
- AI Lab, Quanta Computer Inc., Taoyuan City 33377, Taiwan; (C.-C.K.); (K.-C.H.); (J.-S.C.)
| | - Hung-Chieh Chen
- School of Medicine, National Yang-Ming Chiao-Tung University, Taipei 11267, Taiwan
- Department of Radiology, Taichung Veterans General Hospital, Taichung 40705, Taiwan
- Correspondence: (H.-C.C.); (K.-H.K.); Tel.: +886-4-23592525 (H.-C.C.); +886-(02)-7728-1264 (K.-H.K.); Fax: +886-4-2359-0296 (H.-C.C.); +886-(02)-8966-5567 (K.-H.K.)
| | - Kuei-Hong Kuo
- Division of Medical Image, Far Eastern Memorial Hospital, New Taipei City 22060, Taiwan;
- School of Medicine, National Yang-Ming Chiao-Tung University, Taipei 11267, Taiwan
- Correspondence: (H.-C.C.); (K.-H.K.); Tel.: +886-4-23592525 (H.-C.C.); +886-(02)-7728-1264 (K.-H.K.); Fax: +886-4-2359-0296 (H.-C.C.); +886-(02)-8966-5567 (K.-H.K.)
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Rojas CV, Olivares JI, Tutor PM, García AM, Sánchez MB. Sternal human variability and population affinity: Frequency of discrete traits and their relationship with sex and age. Anat Rec (Hoboken) 2021; 305:284-296. [PMID: 33943019 DOI: 10.1002/ar.24647] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2021] [Revised: 04/06/2021] [Accepted: 04/14/2021] [Indexed: 11/09/2022]
Abstract
Sternal morphological variations differ among populations and are influenced by the interaction between inheritance, development, and environment. There are currently no studies that include all variability from a morphogenesis approach following a homogeneous definition. The aims of this study were (a) to develop a standardized method for the anatomical study of the sternum; (b) to analyze the prevalence of the morphological variations and their relationship between sex and age; (c) to compare the results with other populations. The sterna of 155 skeletons from a Spanish population were studied. The age at the time of death was 17 to 97 years. We analyzed two metric and 22 sternal morphological variations described in the literature and designed an illustrated atlas. The atlas was validated using the intraclass correlation coefficient (ICC). A descriptive statistical analysis was conducted to measure the prevalence and relationship between sex and age. To analyze the interpopulation variability, we compared our results with those from other authors. The atlas with definitions and reference images improves the observation and detection of all morphological variations of the sternum (ICC = 0.90). The dependence between the morphological traits and sex was significant for the variations in the sternal angle, the number of esternebra, and the development of the xiphoid process. No significant differences were found between age group and morphological traits. The expression of the sternal morphological variation and sex are population-specific. The results will help standardize future studies and provide valuable information on the variability of the sternal morphological variation.
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Affiliation(s)
- Catherine Villoria Rojas
- Departamento de Medicina Legal, Psiquiatría y Anatomía Patológica, Universidad Complutense de Madrid, Madrid, Spain
| | - Javier Irurita Olivares
- Departamento de Medicina Legal, Toxicología y Antropología Física, Universidad de Granada, Granada, Spain
| | - Pilar Mata Tutor
- Departamento de Medicina Legal, Psiquiatría y Anatomía Patológica, Universidad Complutense de Madrid, Madrid, Spain
| | - Alexandra Muñoz García
- Departamento de Medicina Legal, Psiquiatría y Anatomía Patológica, Universidad Complutense de Madrid, Madrid, Spain
| | - María Benito Sánchez
- Departamento de Medicina Legal, Psiquiatría y Anatomía Patológica, Universidad Complutense de Madrid, Madrid, Spain
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Hung CS, Chen YC, Yang TF, Huang FH. Systematic review and meta-analysis on juvenile primary spontaneous pneumothorax: Conservative or surgical approach first? PLoS One 2021; 16:e0250929. [PMID: 33930078 PMCID: PMC8087103 DOI: 10.1371/journal.pone.0250929] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2021] [Accepted: 04/18/2021] [Indexed: 11/18/2022] Open
Abstract
Background Primary spontaneous pneumothorax (PSP) prevalence is typically higher in juvenile patients than in adults. We aimed to evaluate the optimal treatment for primary spontaneous pneumothorax and its efficacy and safety in juveniles. Materials and methods We searched PubMed, Embase, and Cochrane databases for eligible studies published from database inception to October 10, 2020, and conducted a systematic review and meta-analysis according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The primary and secondary outcomes were recurrence rate and hospital stay length, respectively. Odds ratios (OR) and mean differences were used for quantitatively analyzing binary and continuous outcomes, respectively. In total, nine retrospective studies with 1,452 juvenile patients (aged <21) were included for the quantitative analysis. The surgical approach led to a lower recurrence rate than did conservative approaches (OR: 1.95, 95% confidence interval: 1.15–3.32). Moreover, the recurrence rate was low in patients who underwent conservative treatment first and received surgery later. Conclusions Surgical approach for first-line management might have a greater effect on recurrence prevention than do conservative approaches. An upfront surgery might be an optimal choice for juvenile primary spontaneous pneumothorax.
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Affiliation(s)
- Chun-Shan Hung
- Department of Medical Education, Changhua Christian Hospital, Changhua City, Taiwan
| | - Yang-Ching Chen
- Department of Family Medicine, Taipei Medical University Hospital, Taipei City, Taiwan
- Department of Family Medicine, School of medicine, College of medicine, Taipei Medical University, Taipei City, Taiwan
| | - Ten-Fang Yang
- Department of Biological Science and Technology, National Chiao-Tung University, Hsinchu City, Taiwan
- Graduate Institute of Biomedical Informatics, Taipei Medical University and Hospital, Taipei City, Taiwan
| | - Fu-Huan Huang
- Department of Biological Science and Technology, National Chiao-Tung University, Hsinchu City, Taiwan
- Division of Pediatric Surgery, Department of Surgery, Taipei Medical University Hospital, Taipei City, Taiwan
- * E-mail:
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Yates KM, Agnew AM, Albert DL, Kemper AR, Untaroiu CD. Subject-specific rib finite element models with material data derived from coupon tests under bending loading. J Mech Behav Biomed Mater 2021; 116:104358. [PMID: 33610029 DOI: 10.1016/j.jmbbm.2021.104358] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2020] [Revised: 12/19/2020] [Accepted: 01/22/2021] [Indexed: 11/30/2022]
Abstract
Rib fractures are common thoracic injuries in motor vehicle crashes. Several human finite element (FE) human models have been created to numerically assess thoracic injury risks. However, the accurate prediction of rib biomechanical response has shown to be challenging due to human variation and modeling approaches. The main objective of this study was to better understand the role of modeling approaches on the biomechanical response of human ribs in anterior-posterior bending. Since the development of subject specific rib models is a time-consuming process, the second objective of this study was to develop an accurate morphing approach to quickly generate high quality subject specific rib meshes. The exterior geometries and cortical-trabecular boundaries of five human 6th-level ribs were extracted from CT-images. One rib mesh was developed in a parametric fashion and the other four ribs were developed with an in-house morphing algorithm. The morphing algorithm automatically defined landmarks on both the periosteal and endosteal boundaries of the cortical layer, which were used to morph the template nodes to target geometries. Three different cortical bone material models were defined based on the stress-strain data obtained from subject-specific tensile coupon tests for each rib. Full rib anterior-posterior bending tests were simulated based on data recorded in testing. The results showed similar trends to test data with some sensitivity relative to the material modeling approach. Additionally, the FE models were substantially more resistant to failure, highlighting the need for better techniques to model rib fracture. Overall, the results of this work can be used to improve the biofidelity of human rib finite element models.
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Wu Z, Hou P, Li W, Zhu T, Wang P, Yuan M, Sun J. Estimating rotation angle from asymmetric projection of chest. JOURNAL OF X-RAY SCIENCE AND TECHNOLOGY 2021; 29:1139-1147. [PMID: 34719433 DOI: 10.3233/xst-210990] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
BACKGROUND Manual or machine-based analysis of chest radiographs needs the images acquired with technical adequacy. Currently, the equidistance between the medial end of clavicles and the center of spinous processes serves as the only criterion to assess whether a frontal PA chest radiograph is taken with any rotation. However, this measurement is normally difficult to implement because there exists overlapping of anatomies within the region. Moreover, there is no way available to predict exact rotating angles even the distances were correctly measured from PA chest radiographs. OBJECTIVE To quantitatively assess positioning adequacy of PA chest examination, this study proposes and investigates a new method to estimate rotation angles from asymmetric projection of thoracic cage on radiographs. METHOD By looking into the process of radiographic projection, generalized expressions have been established to correlate rotating angles of thorax with projection difference of left and right sides of thoracic cage. A trunk phantom with different positioning angles is employed to acquire radiographs as standard reference to verify the theoretical expressions. RESULTS The angles estimated from asymmetric projections of thoracic cage yield good agreement with those actual rotated angles, and an approximate linear relationship exists between rotation angle and asymmetric projection of thoracic cage. Under the experimental projection settings, every degree of rotation corresponds to the width difference of two sides of thoracic cage around 13-14 pixels. CONCLUSION The proposed new method may be used to quantify rotating angles of chest and assess image quality for thoracic radiographic examination.
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Affiliation(s)
- Zhonghang Wu
- Department of Scientific Research, Shanghai University of Medicine and Health Sciences Affiliated Zhoupu Hospital, Shanghai, China
- Shanghai Key Laboratory of Molecular Imaging, Shanghai University of Medicine and Health Sciences, Shanghai, China
| | - Pengfei Hou
- School of Medical Instrument and Food Engineering, University of Shanghai for Science and Technology, Shanghai, China
| | - Wei Li
- School of Medical Imaging, Shanghai University of Medicine and Health Sciences, Shanghai, China
| | - Tianbao Zhu
- Shanghai Shanghe Intelligent Technology Co., Ltd., Shanghai, China
| | - Peipei Wang
- Department of Radiology, Shanghai University of Medicine and Health Sciences Affiliated Zhoupu Hospital, Shanghai, China
| | - Mingyuan Yuan
- Department of Radiology, Shanghai University of Medicine and Health Sciences Affiliated Zhoupu Hospital, Shanghai, China
| | - Jiuai Sun
- School of Medical Imaging, Shanghai University of Medicine and Health Sciences, Shanghai, China
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Lung and fissure shape is associated with age in healthy never-smoking adults aged 20-90 years. Sci Rep 2020; 10:16135. [PMID: 32999328 PMCID: PMC7528089 DOI: 10.1038/s41598-020-73117-w] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2020] [Accepted: 09/10/2020] [Indexed: 11/08/2022] Open
Abstract
Lung shape could hold prognostic information for age-related diseases that affect lung tissue mechanics. We sought to quantify mean lung shape, its modes of variation, and shape associations with lung size, age, sex, and Body Mass Index (BMI) in healthy subjects across a seven-decade age span. Volumetric computed tomography from 83 subjects (49 M/34 F, BMI [Formula: see text]) was used to derive two statistical shape models using a principal component analysis. One model included, and the other controlled for, lung volume. Volume made the strongest contribution to shape when it was included. Shape had a strong relationship with age but not sex when volume was controlled for, and BMI had only a small but significant association with shape. The first principal shape mode was associated with decrease in the antero-posterior dimension from base to apex. In older subjects this was rapid and obvious, whereas younger subjects had relatively more constant dimension. A shift of the fissures of both lungs in the basal direction was apparent for the older subjects, consistent with a change in tissue elasticity with age. This study suggests a quantifiable structure-function relationship for the healthy adult lung that can potentially be exploited as a normative description against which abnormal can be compared.
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28
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Late subadult ontogeny and adult aging of the human thorax reveals divergent growth trajectories between sexes. Sci Rep 2020; 10:10737. [PMID: 32612141 PMCID: PMC7329879 DOI: 10.1038/s41598-020-67664-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2019] [Accepted: 06/09/2020] [Indexed: 11/30/2022] Open
Abstract
Sexual dimorphism is an important feature of adult thorax morphology, but when and how sex-related differences in the ribcage arise during ontogeny is poorly known. Previous research proposed that sex-related size differences in the nasal region arise during puberty. Therefore, we explore whether ribcage sexual dimorphism also arises at that time and whether this sexual dimorphism is maintained until old age. We measured 526 (semi)landmarks on 80 CT-based human ribcage reconstructions, on individuals ranging from 7 to 65 year-old. The 3D coordinates were submitted to the Procrustes superimposition and analyzed. Our results show that the trajectories of thorax size and shape between sexes diverge at around 12 years of age, and continue slightly diverging until old age. The differential ontogenetic trends cause adult male ribcages to become deeper, shorter, and wider than female. Our results are consistent with the evidence from the cranial respiratory system, with the development of sexual dimorphism probably related to changes in body composition during puberty combined with changes in the reproductive system.
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Generic finite element models of human ribs, developed and validated for stiffness and strain prediction – To be used in rib fracture risk evaluation for the human population in vehicle crashes. J Mech Behav Biomed Mater 2020; 106:103742. [DOI: 10.1016/j.jmbbm.2020.103742] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2019] [Revised: 12/16/2019] [Accepted: 02/26/2020] [Indexed: 11/23/2022]
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30
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Scavacini AS, Davidson J, Wandalsen GF, Gonçalves DDMM, Lanza FC, Goulart AL, Solé D, Dos Santos AMN. Association between thoracic musculoskeletal abnormalities and lung function in preterm infants. THE CLINICAL RESPIRATORY JOURNAL 2020; 14:158-164. [PMID: 31773905 DOI: 10.1111/crj.13113] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/18/2019] [Revised: 11/22/2019] [Accepted: 11/23/2019] [Indexed: 11/28/2022]
Abstract
INTRODUCTION In view of the difficulties and risks of performing lung function tests in infants and the hypothesis that children with abnormal pulmonary test may exhibit thoracic musculoskeletal alterations. OBJECTIVES This study aimed to determine the frequency of abnormal lung function and their relationship. MATERIALS AND METHODS This was a cross-sectional study with children from 6 to 12 months of corrected age, born at a gestational age of <37 weeks and with a birthweight ≤1500 g, who were subjected to a lung function test and photogrammetry--an objective and non-invasive procedure. To verify the association between the thoracic musculoskeletal abnormalities and measure changes in lung function, univariate linear regression was used. The level of statistical significance was setted at P < 0.05. RESULTS Of the 38 infants, 12 (31.6%) exhibited abnormal lung function, including 9 (23.7%) with obstructive function and 3 (7.9%) with restrictive function. A significant association was noted between forced expiratory volume at 0.5 second <-2 z score and the acromion/xiphoid process/acromion angle (β = 4.935); forced vital capacity <-2 z score and the angle of the manubrium/left acromion/trapezium (β = 0.033) and forced expiratory volume at 0.5 second and forced vital capacity ratio <-2 z score and the inframammillary point/xiphoid process/inframammillary point angle (β = 0.043). CONCLUSION Preterm infants with very low birthweight presented a high frequency of abnormal lung function, particularly obstructive type and thoracic musculoskeletal abnormalities were associated with changes in lung function.
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Affiliation(s)
- Ana Sílvia Scavacini
- Neonatal Division of Medicine, Department of Pediatrics, Federal University of São Paulo, São Paulo, Brazil
| | - Josy Davidson
- Neonatal Division of Medicine, Department of Pediatrics, Federal University of São Paulo, São Paulo, Brazil
| | - Gustavo Falbo Wandalsen
- Division of Allergy, Clinical Immunology and Rheumatology, Department of Pediatrics, Federal University of São Paulo, São Paulo, Brazil
| | | | - Fernanda C Lanza
- Division of Allergy, Clinical Immunology and Rheumatology, Department of Pediatrics, Federal University of São Paulo, São Paulo, Brazil
| | - Ana Lucia Goulart
- Neonatal Division of Medicine, Department of Pediatrics, Federal University of São Paulo, São Paulo, Brazil
| | - Dirceu Solé
- Division of Allergy, Clinical Immunology and Rheumatology, Department of Pediatrics, Federal University of São Paulo, São Paulo, Brazil
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Beresheim AC, Pfeiffer S, Grynpas M. Ontogenetic changes to bone microstructure in an archaeologically derived sample of human ribs. J Anat 2019; 236:448-462. [PMID: 31729033 DOI: 10.1111/joa.13116] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/15/2019] [Indexed: 11/30/2022] Open
Abstract
There is considerable variation in the gross morphology and tissue properties among the bones of human infants, children, adolescents, and adults. Using 18 known-age individuals (nfemale = 8, nmale = 9, nunknown = 1; birth to 21 years old), from a well-documented cemetery collection, Spitalfields Christ Church, London, UK, this study explores growth-related changes in cortical and trabecular bone microstructure. Micro-CT scans of mid-shaft middle thoracic ribs are used for quantitative analysis. Results are then compared to previously quantified conventional histomorphometry of the same sample. Total area (Tt.Ar), cortical area (Ct.Ar), cortical thickness (Ct.Th), and the major (Maj.Dm) and minor (Min.Dm) diameters of the rib demonstrate positive correlations with age. Pore density (Po.Dn) increases, but age-related changes to cortical porosity (Ct.Po) appear to be non-linear. Trabecular thickness (Tb.th) and trabecular separation (Tb.Sp) increase with age, whereas trabecular bone pattern factor (Tb.Pf), structural model index (SMI), and connectivity density (Conn.D) decrease with age. Sex-based differences were not identified for any of the variables included in this study. Some samples display clear evidence of diagenetic alteration without corresponding changes in radiopacity, which compromises the reliability of bone mineral density (BMD) data in the study of past populations. Cortical porosity data are not correlated with two-dimensional measures of osteon population density (OPD). This suggests that unfilled resorption spaces contribute more significantly to cortical porosity than do the Haversian canals of secondary osteons. Continued research using complementary imaging techniques and a wide array of histological variables will increase our understanding of age- and sex-specific ontogenetic patterns within and among human populations.
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Affiliation(s)
- Amy C Beresheim
- Department of Anatomy, Des Moines University, Des Moines, IA, USA
| | - Susan Pfeiffer
- Department of Anthropology, University of Toronto, Toronto, ON, Canada.,Department of Anthropology, Center for the Advanced Study of Human Paleobiology, George Washington University, Washington, DC, USA.,Department of Archaeology, University of Cape Town, Cape Town, South Africa
| | - Marc Grynpas
- Lunenfeld-Tanenbaum Research Institute, Mount Sinai Hospital, Toronto, ON, Canada.,Department of Laboratory Medicine and Pathobiology and Institute for Biomaterials and Biomedical Engineering, University of Toronto, Toronto, ON, Canada
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Ando M. Effect of internal fixation of the sternum using bioabsorbable pins in small children. J Card Surg 2019; 34:983-987. [PMID: 31374584 DOI: 10.1111/jocs.14174] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2019] [Revised: 06/19/2019] [Accepted: 06/23/2019] [Indexed: 11/29/2022]
Abstract
OBJECTIVES A sternal pin can be used to internally fix the reapproximated sternum after midline sternotomy. This paper will evaluate the effectiveness of using a sternal pin in small children by means of a computer tomography scan. METHODS Propensity score matching was performed for patients undergoing a first-time median sternotomy from April 2012 to December 2014 with a follow-up computer tomography scan after 6 months. Seventeen matched patients were selected for both the control and the sternal pin groups. The angle of the sternal reflection at the joint surface was measured by computer tomography scan. In addition, the Haller index was measured at each thoracic vertebral level. RESULTS The angle of the sternal reflection was more variable in the control group compared with the sternal pin group: the standard deviation was 31.6° for the control group and 10.2° for the sternal pin group (P value = .0009). Seven out of 17 patients in the control group had a negative angle (excavated sternum) compared with 1 out of 17 in the sternal pin group (P = .0391). In the other patients, the angle was 23.9° ± 3.6° in the control group and 10.1 ± 2.8 in the sternal pin group (P = .0061). The Haller index was also more variable in the control group, and it was significantly different from the sternal pin group at the ninth vertebral level (P = .0409). CONCLUSIONS The study demonstrated that the use of a sternal pin was associated with decreased variation in the sternal angles and decreased incidence and severity of sternal protrusion and excavation in small children.
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Affiliation(s)
- Makoto Ando
- Department of Cardiovascular Surgery, Kanazawa Medical University, Kanazawa, Japan
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Holcombe SA, Kang YS, Derstine BA, Wang SC, Agnew AM. Regional maps of rib cortical bone thickness and cross-sectional geometry. J Anat 2019; 235:883-891. [PMID: 31225915 DOI: 10.1111/joa.13045] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/27/2019] [Indexed: 01/11/2023] Open
Abstract
Here we present detailed regional bone thickness and cross-sectional measurements from full adult ribs using high resolution CT scans processed with a cortical bone mapping technique. Sixth ribs from 33 subjects ranging from 24 to 99 years of age were used to produce average cortical bone thickness maps and to provide average ± 1SD corridors for expected cross-section properties (cross-sectional areas and inertial moments) as a function of rib length. Results obtained from CT data were validated at specific rib locations using direct measurements from cut sections. Individual thickness measurements from CT had an accuracy (mean error) and precision (SD error) of -0.013 ± 0.167 mm (R2 coefficient of determination of 0.84). CT-based measurement errors for rib cross-sectional geometry were -0.1 ± 13.1% (cortical bone cross-sectional area) and 4.7 ± 1.8% (total cross-sectional area). Rib cortical bone thickness maps show the expected regional variation across a typical rib's surface. The local mid-rib maxima in cortical thickness along the pleural rib aspect ranged from range 0.9 to 2.6 mm across the study population with an average map maximum of 1.4 mm. Along the cutaneous aspect, rib cortical bone thickness ranged from 0.7 to 1.9 mm with an average map thickness of 0.9 mm. Average cross-sectional properties show a steady reduction in total cortical bone area from 10% along the rib's length through to the sternal end, whereas overall cross-sectional area remains relatively constant along the majority of the rib's length before rising steeply towards the sternal end. On average, male ribs contained more cortical bone within a given cross-section than was seen for female ribs. Importantly, however, this difference was driven by male ribs having larger overall cross-sectional areas, rather than by sex differences in the bone thickness observed at specific local cortex sites. The cortical bone thickness results here can be used directly to improve the accuracy of current human body and rib models. Furthermore, the measurement corridors obtained from adult subjects across a wide age range can be used to validate future measurements from more widely available image sources such as clinical CT where gold standard reference measures (e.g. such as direct measurements obtained from cut sections) are otherwise unobtainable.
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Affiliation(s)
- Sven A Holcombe
- Morphomics Analysis Group, University of Michigan, Ann Arbor, MI, USA
| | - Yun-Seok Kang
- Injury Biomechanics Research Center, The Ohio State University, Columbus, OH, USA
| | - Brian A Derstine
- Morphomics Analysis Group, University of Michigan, Ann Arbor, MI, USA
| | - Stewart C Wang
- Morphomics Analysis Group, University of Michigan, Ann Arbor, MI, USA.,Department of Surgery, University of Michigan, Ann Arbor, MI, USA
| | - Amanda M Agnew
- Injury Biomechanics Research Center, The Ohio State University, Columbus, OH, USA
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Sternal fractures in children: An analysis of the National Trauma Data Bank. J Pediatr Surg 2019; 54:980-983. [PMID: 30770129 DOI: 10.1016/j.jpedsurg.2019.01.031] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2019] [Accepted: 01/27/2019] [Indexed: 11/20/2022]
Abstract
PURPOSE The purpose of this study was to describe the epidemiology and evaluate the clinical significance of traumatic sternal fractures. METHODS Patients age ≤18 years with sternal fractures in the National Trauma Database research datasets from 2007-2014 were identified. Patient demographics, injuries, procedures, and outcomes were analyzed using descriptive statistics and logistic regression. RESULTS Three thousand one hundred sixty patients with sternal fracture were identified. Ninety percent of injuries occurred in patients between 12 and 18 years old. Median injury severity score (ISS) was 17 [9,29]. Exploratory thoracotomy was performed in 1%. Thirty-nine percent were admitted to the intensive care unit (ICU). On multivariate regression, predictors of ICU stay >1 day were increasing ISS, lack of the use of protective devices, decreasing Glasgow Coma Score (GCS), tachycardia, and pulmonary contusion. Median hospital length of stay was 4 [2, 9] days. In-hospital mortality was 8%. Predictors of mortality were lower GCS, increasing ISS, decreasing oxygen saturation, hypotension, and cardiac arrest. Use of protective devices and seat belts did not affect mortality. CONCLUSION Sternal fractures in patients increase in incidence with age, and poor outcomes are impacted by associated injuries and complications. The presence of a sternal fracture should trigger a careful diagnostic evaluation. LEVEL OF EVIDENCE III STUDY TYPE: Treatment Study.
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García-Martínez D, Bastir M, Torres-Tamayo N, O'Higgins P, Torres-Sánchez I, García-Río F, Heuzé Y. Three-dimensional analysis of sexual dimorphism in ribcage kinematics of modern humans. AMERICAN JOURNAL OF PHYSICAL ANTHROPOLOGY 2019; 169:348-355. [PMID: 30934120 DOI: 10.1002/ajpa.23829] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/05/2018] [Revised: 03/13/2019] [Accepted: 03/17/2019] [Indexed: 11/10/2022]
Abstract
OBJECTIVES Sexual dimorphism is an important biological factor underlying morphological variation in the human skeleton. Previous research found sex-related differences in the static ribcage, with males having more horizontally oriented ribs and a wider lower ribcage than females. Furthermore, a recent study found sex-related differences in the kinematics of the human lungs, with cranio-caudal movements of the caudal part of the lungs accounting for most of the differences between sexes. However, these movements cannot be quantified in the skeletal ribcage, so we do not know if the differences observed in the lungs are also reflected in sex differences in the motion of the skeletal thorax. MATERIALS AND METHODS To address this issue, we quantified the morphological variation of 42 contemporary human ribcages (sex-balanced) in both maximal inspiration and expiration using 526 landmarks and semilandmarks. Thoracic centroid size differences between sexes were assessed using a t test, and shape differences were assessed using Procrustes shape coordinates, through mean comparisons and dummy regressions of shape on kinematic status. A principal components analysis was used to explore the full range of morphological variation. RESULTS Our results show significant size differences between males and females both in inspiration and expiration (p < .01) as well as significant shape differences, with males deforming more than females during inspiration, especially in the mediolateral dimension of the lower ribcage. Finally, dummy regressions of shape on kinematic status showed a small but statistically significant difference in vectors of breathing kinematics between males and females (14.78°; p < .01). DISCUSSION We support that sex-related differences in skeletal ribcage kinematics are discernible, even when soft tissues are not analyzed. We hypothesize that this differential breathing pattern is primarily a result of more pronounced diaphragmatic breathing in males, which might relate to differences in body composition, metabolism, and ultimately greater oxygen demand in males compared to females. Future research should further explore the links between ribcage morphological variation and basal metabolic rate.
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Affiliation(s)
- Daniel García-Martínez
- University of Bordeaux, CNRS, MCC, PACEA, Pessac, France.,Departamento de Paleobiología, Museo Nacional de Ciencias Naturales (CSIC), Madrid, Spain.,Centro de Estudios del Campo de Montiel (CECM), Ciudad Real, Castilla-La Mancha, Spain
| | - Markus Bastir
- Departamento de Paleobiología, Museo Nacional de Ciencias Naturales (CSIC), Madrid, Spain
| | - Nicole Torres-Tamayo
- Departamento de Paleobiología, Museo Nacional de Ciencias Naturales (CSIC), Madrid, Spain
| | - Paul O'Higgins
- Department of Archaeology and Hull York Medical School, the University of York, York, United Kingdom
| | | | - Francisco García-Río
- Hospital La Paz Institute for Health Research (IdiPAZ), Madrid, Spain.,Centro de Investigación Biomédica en Red en Enfermedades Respiratorias (CIBERES), Madrid, Spain
| | - Yann Heuzé
- Universite de Bordeaux, CNRS, MCC, De la Prehistoire a l'Actuel: Culture, Environnement et Anthropologie, (PACEA), Pessac, France
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Schoell SL, Beavers KM, Beavers DP, Lenchik L, Marsh AP, Rejeski WJ, Stitzel JD, Weaver AA. Prediction of lumbar vertebral body compressive strength of overweight and obese older adults using morphed subject-specific finite-element models to evaluate the effects of weight loss. Aging Clin Exp Res 2019; 31:491-501. [PMID: 30043314 DOI: 10.1007/s40520-018-1010-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2018] [Accepted: 07/13/2018] [Indexed: 12/23/2022]
Abstract
BACKGROUND Diet and exercise can promote weight loss in older adults; however, there is potential to increase fracture risk due to loss of bone mineral density (BMD) known to accompany weight loss. Weight loss effects on measures of bone quality and strength are currently unknown. AIMS The purpose of this study is to develop subject-specific finite-element (FE) models of the lumbar spine and study the effect of intentional weight loss on bone strength in a pilot data set. METHODS Computed tomography (CT) scans of the lumbar spine of 30 overweight and obese (mean BMI = 29.7 ± 3.9 kg/m2), older adults (mean age = 65.9 ± 4.6 years) undergoing an 18-month intentional weight loss intervention were obtained at baseline and post-intervention. Measures of volumetric BMD (vBMD) and variable cortical thickness were derived from each subject CT scan. Development of the subject-specific FE models of the lumbar spine involved model morphing techniques to accelerate the development of the models. vBMD-derived material properties and cortical thickness measures were directly mapped to baseline and post-intervention models. Bone strength was estimated through simulation of a quasi-static uniaxial compression test. RESULTS From baseline to 18-month post-weight loss intervention, there were statistically significant decreases in estimated bone strength (6.5% decrease; p < 0.05). Adjusting for baseline bone measures and gender revealed no statistically significant correlations between weight change and change in vBMD, cortical thickness, or bone strength. CONCLUSION Integration of CT-based measures and FE models with conventional areal BMD can improve the understanding of the effects of intentional weight loss on bone health.
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Affiliation(s)
- Samantha L Schoell
- Department of Biomedical Engineering, Medical Center Blvd, Wake Forest University School of Medicine, Winston-Salem, NC, USA
| | - Kristen M Beavers
- Department of Health and Exercise Science, Wake Forest University, Winston-Salem, NC, USA
| | - Daniel P Beavers
- Department of Biostatistical Sciences, Wake Forest University School of Medicine, Winston-Salem, NC, USA
| | - Leon Lenchik
- Department of Radiology, Wake Forest University School of Medicine, Winston-Salem, NC, USA
| | - Anthony P Marsh
- Department of Health and Exercise Science, Wake Forest University, Winston-Salem, NC, USA
| | - W Jack Rejeski
- Department of Health and Exercise Science, Wake Forest University, Winston-Salem, NC, USA
| | - Joel D Stitzel
- Department of Biomedical Engineering, Medical Center Blvd, Wake Forest University School of Medicine, Winston-Salem, NC, USA
| | - Ashley A Weaver
- Department of Biomedical Engineering, Medical Center Blvd, Wake Forest University School of Medicine, Winston-Salem, NC, USA.
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Nawayseh N, Sinan HA, Alteneiji S, Hamdan S. Effect of gender on the biodynamic responses to vibration induced by a whole-body vibration training machine. Proc Inst Mech Eng H 2019; 233:383-392. [PMID: 30887901 DOI: 10.1177/0954411919830122] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Whole-body vibration training machines are used by both male and female users. However, studies investigating the biodynamic responses to vibration during training have used either mixed-gender subjects or male subjects. No study has investigated the effect of gender on the biodynamic responses under vibration training conditions. The objective of this study is to investigate the effect of gender on the apparent mass and the vibration of the head of standing people during exposure to vibration. A total of 40 subjects (20 females and 20 males) were exposed to vertical vibration at six frequencies in the range 20-45 Hz and vibration acceleration in the range 10.8-20.9 m/s2 (peak). The subjects stood on a force platform mounted on the vibrating plate of the machine adopting an upright standing posture with their knees unlocked and their arms straight along their bodies. The vertical acceleration and force at the interface between the vibrating plate and the feet were measured and used to calculate the apparent mass. The accelerations of the head in the x-, y- and z-directions were also measured and used to calculate the transmissibility to the head. The apparent mass of males was found higher than that of females. The transmissibility to the head in all directions was found higher in females than males. The differences in the biodynamic responses between males and females were attributed to the differences in body properties and structure of the two genders. The results of this study imply the need for gender-specific vibration training programmes.
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Affiliation(s)
- Naser Nawayseh
- 1 Department of Mechanical Engineering, College of Engineering, University of Sharjah, Sharjah, United Arab Emirates
| | - Hawra Al Sinan
- 1 Department of Mechanical Engineering, College of Engineering, University of Sharjah, Sharjah, United Arab Emirates
| | - Shamma Alteneiji
- 1 Department of Mechanical Engineering, College of Engineering, University of Sharjah, Sharjah, United Arab Emirates
| | - Sadeque Hamdan
- 2 Sustainable Engineering Asset Management (SEAM) Research Group, University of Sharjah, Sharjah, United Arab Emirates
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Automatic rib cage unfolding with CT cylindrical projection reformat in polytraumatized patients for rib fracture detection and characterization: Feasibility and clinical application. Eur J Radiol 2019; 110:121-127. [DOI: 10.1016/j.ejrad.2018.11.011] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2018] [Revised: 11/10/2018] [Accepted: 11/12/2018] [Indexed: 11/23/2022]
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Canavese F, Dimeglio A, Bonnel F, Corradin M, Pereira B, Marcoul A, Charles YP. Thoracic cage volume and dimension assessment by optoelectronic molding in normal children and adolescents during growth. Surg Radiol Anat 2018; 41:287-296. [PMID: 30560403 DOI: 10.1007/s00276-018-2164-4] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2018] [Accepted: 12/08/2018] [Indexed: 11/29/2022]
Abstract
PURPOSE The thoracic spine, the chondral and osseous ribs, and the sternum together make up the thoracic cage. These elements are strictly correlated, although their growth is not synchronous. The purpose of this study is to provide a comprehensive data set of thoracic dimensions and non-invasive volumetric assessment in a large cohort of males and females from early childhood to young adult age. METHODS In all, 622 healthy individuals (406 girls, 216 boys) aged 6-18 years were consecutively enrolled between 2006 and 2016. All had to be healthy with no history of spinal deformity, or any lung, cardiovascular, systemic or neuromuscular disease. The optical ORTEN system for trunk surface data acquisition was used to calculate thoracic cage volume (V) and perimeter (Pe), anterior-posterior depth (AP) and transverse diameter (TD), AP/TD ratio, sternal length (St), and T1-T12 distance (Tle) in all patients. RESULTS The overall average age was 11.1 ± 2.5 years (4-18) for girls and 11.0 ± 3.1 years (4-18) for boys. Average growth parameters were: standing height 146.2 ± 14.6 cm (103-172) for girls and 146.4 ± 20.0 cm (94-192) for boys, sitting height 75.4 ± 8.6 cm (61-91) for girls and 75.5 ± 10.3 cm (60-99) for boys, weight 37.6 ± 10.4 kg (16-65) for girls and 38.3 ± 14.3 kg (13.7-104) for boys, BMI 16.7 ± 3.7 (18.5-26) for girls and 17.0 ± 3.3 (18.7-34.3) for boys. At age 6-8 years: V was 52.5% of its final size in girls and 44.9% in boys; Pe was 80.2% its final length in girls and 76.8% in boys; St reached 68% of its final size in girls and 66.9% in boys; Tle reached 73.3% of its final length in girls and 71.2% in boys. At skeletal maturity, thoracic cage volume in boys was 19.4% greater than in girls (p < 0.05). AP/TD ratio remained < 1 in all age groups and did not differ between genders (p > 0.05). CONCLUSION Growth of the thoracic cage is shown to be a gradual process that is more linear than previously reported. Only small increases in annual growth rates were observed during the pubertal growth spurt. The most important events characterizing thoracic cage development occurred during the first few years of postnatal growth. The circular cross-section of the very young child's thorax reached adult-like proportions together with its ovoid shape before age 6 years.
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Affiliation(s)
- Federico Canavese
- Service de Chirurgie Infantile, CHU Estaing Clermont-Ferrand, 1 Place Lucie et Raymond Aubrac, 63003, Clermont-Ferrand, France.
- Pediatric Surgery Department, University Hospital Estaing, 1 Place Lucie-et-Raymond-Aubrac, 63003, Clermont-Ferrand, France.
| | - Alain Dimeglio
- Faculté de Médicine, Université de Montpellier, 2 rue de l'école de Médecine, 34060, Montpellier, France
| | - François Bonnel
- Faculté de Médicine, Université de Montpellier, 2 rue de l'école de Médecine, 34060, Montpellier, France
| | - Marco Corradin
- Service de Chirurgie Infantile, CHU Estaing Clermont-Ferrand, 1 Place Lucie et Raymond Aubrac, 63003, Clermont-Ferrand, France
| | - Bruno Pereira
- Marcenac-Ducros, 1277 Avenue de Toulouse, 34070, Montpellier, France
| | - Amélie Marcoul
- Biostatistics Unit (DRCI), CHU Clermont-Ferrand, 58 Place Henri Dunant, 63003, Clermont-Ferrand, France
| | - Yann Philippe Charles
- Service de Chirurgie du Rachis, Hôpitaux Universitaires de Strasbourg, Fédération de Médecine Translationnelle (FMTS), 1 Place de l'hôpital, BP 426, 67091, Strasbourg Cedex, France
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Alpha shapes: determining 3D shape complexity across morphologically diverse structures. BMC Evol Biol 2018; 18:184. [PMID: 30518326 PMCID: PMC6282314 DOI: 10.1186/s12862-018-1305-z] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2017] [Accepted: 11/23/2018] [Indexed: 11/15/2022] Open
Abstract
Background Following recent advances in bioimaging, high-resolution 3D models of biological structures are now generated rapidly and at low-cost. To use this data to address evolutionary and ecological questions, an array of tools has been developed to conduct shape analysis and quantify topographic complexity. Here we focus particularly on shape techniques applied to irregular-shaped objects lacking clear homologous landmarks, and propose a new ‘alpha-shapes’ method for quantifying 3D shape complexity. Methods We apply alpha-shapes to quantify shape complexity in the mammalian baculum as an example of a morphologically disparate structure. Micro- computed-tomography (μCT) scans of bacula were conducted. Bacula were binarised and converted into point clouds. Following application of a scaling factor to account for absolute size differences, a suite of alpha-shapes was fitted per specimen. An alpha shape is formed from a subcomplex of the Delaunay triangulation of a given set of points, and ranges in refinement from a very coarse mesh (approximating convex hulls) to a very fine fit. ‘Optimal’ alpha was defined as the refinement necessary in order for alpha-shape volume to equal CT voxel volume, and was taken as a metric of overall ‘complexity’. Results Our results show that alpha-shapes can be used to quantify interspecific variation in shape ‘complexity’ within biological structures of disparate geometry. The ‘stepped’ nature of alpha curves is informative with regards to the contribution of specific morphological features to overall ‘complexity’. Alpha-shapes agrees with other measures of complexity (dissection index, Dirichlet normal energy) in identifying ursid bacula as having low shape complexity. However, alpha-shapes estimates mustelid bacula as being most complex, contrasting with other shape metrics. 3D fractal dimension is identified as an inappropriate metric of complexity when applied to bacula. Conclusions Alpha-shapes is used to calculate ‘optimal’ alpha refinement as a proxy for shape ‘complexity’ without identifying landmarks. The implementation of alpha-shapes is straightforward, and is automated to process large datasets quickly. We interpret alpha-shapes as being particularly sensitive to concavities in surface topology, potentially distinguishing it from other shape complexity metrics. Beyond genital shape, the alpha-shapes technique holds considerable promise for new applications across evolutionary, ecological and palaeoecological disciplines.
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Agnew AM, Murach MM, Dominguez VM, Sreedhar A, Misicka E, Harden A, Bolte JH, Kang YS, Stammen J, Moorhouse K. Sources of Variability in Structural Bending Response of Pediatric and Adult Human Ribs in Dynamic Frontal Impacts. STAPP CAR CRASH JOURNAL 2018; 62:119-192. [PMID: 30608995 DOI: 10.4271/2018-22-0004] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Despite safety advances, thoracic injuries in motor vehicle crashes remain a significant source of morbidity and mortality, and rib fractures are the most prevalent of thoracic injuries. The objective of this study was to explore sources of variation in rib structural properties in order to identify sources of differential risk of rib fracture between vehicle occupants. A hierarchical model was employed to quantify the effects of demographic differences and rib geometry on structural properties including stiffness, force, displacement, and energy at failure and yield. Three-hundred forty-seven mid-level ribs from 182 individual anatomical donors were dynamically (~2 m/s) tested to failure in a simplified bending scenario mimicking a frontal thoracic impact. Individuals ranged in age from 4 - 108 years (mean 53 ± 23 years) and included 59 females and 123 males of diverse body sizes. Age, sex, body size, aBMD, whole rib geometry and cross-sectional geometry were explored as predictors of rib structural properties. Measures of cross-sectional rib size (Tt.Ar), bone quantity (Ct.Ar), and bone distribution (Z) generally explained more variation than any other predictors, and were further improved when normalized by rib length (e.g., robustness and WBSI). Cortical thickness (Ct.Th) was not found to be a useful predictor. Rib level predictors performed better than individual level predictors. These findings moderately explain differential risk for rib fracture and with additional exploration of the rib's role in thoracic response, may be able contribute to ATD and HBM development and alterations in addition to improvements to thoracic injury criteria and scaling methods.
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Affiliation(s)
- Amanda M Agnew
- Injury Biomechanics Research Center, The Ohio State University
| | | | | | | | - Elina Misicka
- Injury Biomechanics Research Center, The Ohio State University
| | - Angela Harden
- Injury Biomechanics Research Center, The Ohio State University
| | - John H Bolte
- Injury Biomechanics Research Center, The Ohio State University
| | - Yun-Seok Kang
- Injury Biomechanics Research Center, The Ohio State University
| | - Jason Stammen
- National Highway Traffic Safety Administration, Vehicle Research and Test Center
| | - Kevin Moorhouse
- National Highway Traffic Safety Administration, Vehicle Research and Test Center
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Torres-Tamayo N, García-Martínez D, Nalla S, Barash A, Williams SA, Blanco-Pérez E, Mata Escolano F, Sanchis-Gimeno JA, Bastir M. The torso integration hypothesis revisited in Homo sapiens: Contributions to the understanding of hominin body shape evolution. AMERICAN JOURNAL OF PHYSICAL ANTHROPOLOGY 2018; 167:777-790. [PMID: 30259957 DOI: 10.1002/ajpa.23705] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/23/2018] [Revised: 08/04/2018] [Accepted: 08/09/2018] [Indexed: 01/08/2023]
Abstract
OBJECTIVES Lower thoracic widths and curvatures track upper pelvic widths and iliac blades curvatures in hominins and other primates (torso integration hypothesis). However, recent studies suggest that sexual dimorphism could challenge this assumption in Homo sapiens. We test the torso integration hypothesis in two modern human populations, both considering and excluding the effect of sexual dimorphism. We further assess covariation patterns between different thoracic and pelvic levels, and we explore the allometric effects on torso shape variation. MATERIAL AND METHODS A sex-balanced sample of 50 anatomically connected torsos (25 Mediterraneans, 25 Sub-Saharan Africans) was segmented from computed tomography scans. We compared the maximum medio-lateral width at seventh-ninth rib levels with pelvic bi-iliac breadth in males and females within both populations. We measured 1,030 (semi)landmarks on 3D torso models, and torso shape variation, mean size and shape comparisons, thoraco-pelvic covariation and allometric effects were quantified through 3D geometric morphometrics. RESULTS Females show narrow thoraces and wide pelves and males show wide thoraces and narrow pelves, although this trend is more evident in Mediterraneans than in Sub-Saharans. Equal thoracic and pelvic widths, depths and curvatures were found in absence of sexual dimorphism. The highest strength of covariation was found between the lowest rib levels and the ilia, and allometric analyses showed that smaller torsos were wider than larger torsos. CONCLUSIONS This is the first study testing statistically the torso integration hypothesis in anatomically connected torsos. We propose a new and more complex torso integration model in H. sapiens with sexual dimorphism leading to different thoracic and pelvic widths and curvatures. These findings have important implications in hominin body shape reconstructions.
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Affiliation(s)
| | | | - Shahed Nalla
- Department of Human Anatomy and Physiology, Faculty of Health Sciences, University of Johannesburg, Johannesburg, South Africa.,Evolutionary Studies Institute and Centre for Excellence in PalaeoSciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Alon Barash
- Faculty of Medicine, Bar-Ilan University, Ramat Gan, Israel
| | - Scott A Williams
- Evolutionary Studies Institute and Centre for Excellence in PalaeoSciences, University of the Witwatersrand, Johannesburg, South Africa.,Center for the Study of Human Origins, Department of Anthropology, New York University, New York, New York.,New York Consortium in Evolutionary Primatology, New York, New York
| | | | - Federico Mata Escolano
- CT and MRI Unit, ERESA, Department of Radiology, General University Hospital, Valencia, Spain
| | - Juan Alberto Sanchis-Gimeno
- Department of Radiology, Hospital de La Ribera, Valencia, Spain.,Department of Anatomy and Human Embryology, Faculty of Medicine, University of Valencia, Valencia, Spain
| | - Markus Bastir
- Paleoanthropology Group, Museo Nacional de Ciencias Naturales, Madrid, Spain
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Abstract
Men Are from Mars, Women Are from Venus. John Gray used this provocative title for his book to describe the fundamental psychological differences between the sexes. Many other controlled studies and brain scans demonstrate that men and women are physically and mentally different. The purpose of this physiology masterclass is to illustrate how sex-related differences are present in respiratory function and their possible clinical implications. An overview of sex-related differences in respiratory function and their possible clinical implicationshttp://ow.ly/106m30jqOSW
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Affiliation(s)
- Antonella LoMauro
- Dipartimento di Elettronica, Informazione e Bioingegneria, Politecnico di Milano, Milan, Italy
| | - Andrea Aliverti
- Dipartimento di Elettronica, Informazione e Bioingegneria, Politecnico di Milano, Milan, Italy
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Schoell SL, Weaver AA, Beavers DP, Lenchik L, Marsh AP, Rejeski WJ, Stitzel JD, Beavers KM. Development of Subject-Specific Proximal Femur Finite Element Models Of Older Adults with Obesity to Evaluate the Effects of Weight Loss on Bone Strength. ACTA ACUST UNITED AC 2018; 6. [PMID: 29683141 PMCID: PMC5909834 DOI: 10.4172/2329-9509.1000213] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
Study background Recommendation of intentional weight loss in older adults remains controversial, due in part to the loss of bone mineral density (BMD) known to accompany weight loss. While finite element (FE) models have been used to assess bone strength, these methods have not been used to study the effects of weight loss. The purpose of this study is to develop subject-specific FE models of the proximal femur and study the effect of intentional weight loss on bone strength. Methods Computed tomography (CT) scans of the proximal femur of 25 overweight and obese (mean BMI=29.7 ± 4.0 kg/m2), older adults (mean age=65.6 ± 4.1 years) undergoing an 18-month intentional weight loss intervention were obtained at baseline and post-intervention. Measures of volumetric BMD (vBMD) and variable cortical thickness were derived from each subject CT scan and directly mapped to baseline and post-intervention models. Subject-specific FE models were developed using morphing techniques. Bone strength was estimated through simulation of a single-limb stance and sideways fall configuration. Results After weight loss intervention, there were significant decreases from baseline to 18 months in vBMD (total hip: -0.024 ± 0.013 g/cm3; femoral neck: -0.012 ± 0.014 g/cm3), cortical thickness (total hip: -0.044 ± 0.032 mm; femoral neck: -0.026 ± 0.039 mm), and estimated strength (stance: -0.15 ± 0.12 kN; fall: -0.04 ± 0.06 kN). Adjusting for baseline bone measures, body mass, and gender, correlations were found between weight change and change in total hip and femoral neck cortical thickness (all p<0.05). For every 1 kilogram of body mass lost cortical thickness in the total hip and femoral neck decreased by 0.003 mm and 0.004 mm, respectively. No significant correlations were present for the vBMD or strength data. Conclusion The developed subject-specific FE models could be used to better understand the effects of intentional weight loss on bone health.
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Affiliation(s)
- S L Schoell
- Department of Biomedical Engineering, Wake Forest School of Medicine, USA
| | - A A Weaver
- Department of Biomedical Engineering, Wake Forest School of Medicine, USA
| | - D P Beavers
- Department of Biostatistical Sciences, Wake Forest School of Medicine, USA
| | - Leon Lenchik
- Department of Radiology, Wake Forest School of Medicine, USA
| | - A P Marsh
- Department of Health and Exercise Science, Wake Forest University, USA
| | - W J Rejeski
- Department of Health and Exercise Science, Wake Forest University, USA
| | - J D Stitzel
- Department of Biomedical Engineering, Wake Forest School of Medicine, USA
| | - K M Beavers
- Department of Health and Exercise Science, Wake Forest University, USA
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Lim SJ, Kim JY, Lee SJ, Lee GD, Cho YJ, Jeong YY, Jeon KN, Lee JD, Kim JR, Kim HC. Altered Thoracic Cage Dimensions in Patients with Chronic Obstructive Pulmonary Disease. Tuberc Respir Dis (Seoul) 2018. [PMID: 29527844 PMCID: PMC5874141 DOI: 10.4046/trd.2017.0095] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Background Chronic obstructive pulmonary disease (COPD) may cause changes in the shape of the thoracic cage by increasing lung volume and hyperinflation. This study investigated changes in thoracic cage dimensions and related factors in patients with COPD. Methods We enrolled 85 patients with COPD (76 males, 9 females; mean age, 70.6±7.1 years) and 30 normal controls. Thoracic cage dimensions were measured using chest computed tomography at levels 3, 6, and 9 of the thoracic spine. We measured the maximal transverse diameter, mid-sagittal anteroposterior (AP) diameter, and maximal AP diameter of the right and left hemithorax. Results The average AP diameter was significantly greater in patients with COPD compared with normal controls (13.1±2.8 cm vs. 12.2±1.13 cm, respectively; p=0.001). The ratio of AP/transverse diameter of the thoracic cage was also significantly greater in patients with COPD compared with normal controls (0.66±0.061 vs. 0.61±0.86; p=0.002). In COPD patients, the AP diameter of the thoracic cage was positively correlated with body mass index (BMI) and 6-minute walk test distance (r=0.395, p<0.001 and r=0.238, p=0.028) and negatively correlated with increasing age (r=−0.231, p=0.034). Multiple regression analysis revealed independent correlation only between BMI and increased ratio of AP/transverse diameter of the thoracic cage (p<0.001). Conclusion Patients with COPD exhibited an increased AP diameter of the thoracic cage compared with normal controls. BMI was associated with increased AP diameter in these patients.
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Affiliation(s)
- Su Jin Lim
- Department of Internal Medicine, Masan Medical Center, Masan, Korea
| | - Ju Young Kim
- Department of Internal Medicine, Gyeongsang National University Changwon Hospital, Gyeongsang National University School of Medicine, Changwon, Korea
| | - Seung Jun Lee
- Department of Internal Medicine, Gyeongsang National University Hospital, Gyeongsang National University School of Medicine, Jinju, Korea
| | - Gi Dong Lee
- Department of Internal Medicine, Gyeongsang National University Changwon Hospital, Gyeongsang National University School of Medicine, Changwon, Korea
| | - Yu Ji Cho
- Department of Internal Medicine, Gyeongsang National University Hospital, Gyeongsang National University School of Medicine, Jinju, Korea
| | - Yi Yeong Jeong
- Department of Internal Medicine, Gyeongsang National University Hospital, Gyeongsang National University School of Medicine, Jinju, Korea
| | - Kyung Nyeo Jeon
- Department of Diagnostic Radiology, Gyeongsang National University Changwon Hospital, Gyeongsang National University School of Medicine, Changwon, Korea
| | - Jong Deog Lee
- Department of Internal Medicine, Gyeongsang National University Hospital, Gyeongsang National University School of Medicine, Jinju, Korea
| | - Jang Rak Kim
- Department of Preventive Medicine, Gyeongsang National University School of Medicine, Jinju, Korea
| | - Ho Cheol Kim
- Department of Internal Medicine, Gyeongsang National University Changwon Hospital, Gyeongsang National University School of Medicine, Changwon, Korea.
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Weaver C, Baker A, Davis M, Miller A, Stitzel JD. Finite Element Based Pelvic Injury Metric Creation and Validation in Lateral Impact for a Human Body Model. J Biomech Eng 2018; 140:2673563. [PMID: 29560493 DOI: 10.1115/1.4039393] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2017] [Indexed: 11/08/2022]
Abstract
Pelvic fractures are serious injuries resulting in high mortality and morbidity. The objective of this study is to develop and validate local pelvic anatomical, cross-section-based injury risk metrics for a finite element (FE) model of the human body. Cross-sectional instrumentation was implemented in the pelvic region of the Global Human Body Models Consortium (GHBMC M50-O) 50th percentile detailed male FE model (v4.3). In total, 25 lateral impact FE simulations were performed using input data from cadaveric lateral impact tests performed by Bouquet et al. The experimental force-time data was scaled using five normalization techniques, which were evaluated using log rank, Wilcoxon rank sum, and correlation and analysis (CORA) testing. Survival analyses with Weibull distribution were performed on the experimental peak force (scaled and unscaled) and the simulation test data to generate injury risk curves (IRCs) for total pelvic injury. Additionally, IRCs were developed for regional injury using cross-sectional forces from the simulation results and injuries documented in the experimental autopsies. These regional IRCs were also evaluated using the receiver operator characteristic (ROC) curve analysis. Based on the results of the all the evaluation methods, the Equal Stress Equal Velocity (ESEV) and ESEV using effective mass (ESEV-EM) scaling techniques performed best. The simulation IRC shows slight under prediction of injury in comparison to these scaled experimental data curves. However, this difference was determined to not be statistically significant. Additionally, the ROC curve analysis showed moderate predictive power for all regional IRCs.
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Affiliation(s)
- Caitlin Weaver
- Wake Forest University School of Medicine, Virginia Tech-Wake Forest University Center for Injury Biomechanics, 575 N. Patterson Ave., Ste. 120, Winston-Salem, NC 27101, US Army Research Laboratory Soldier Protection Sciences Branch, RDRL-WMP-B, Aberdeen Proving Ground, MD 21005
| | - Alexander Baker
- Wake Forest University School of Medicine, Virginia Tech-Wake Forest University Center for Injury Biomechanics, 575 N. Patterson Ave., Ste. 120, Winston-Salem, NC 27101
| | - Matthew Davis
- Wake Forest University School of Medicine, Virginia Tech-Wake Forest University Center for Injury Biomechanics, 575 N. Patterson Ave., Ste. 120, Winston-Salem, NC 27101
| | - Anna Miller
- Washington University, Department of Orthopaedic Surgery, 660 S. Euclid Ave., Box 8233, St. Louis, MO 63110
| | - Joel D Stitzel
- Wake Forest University School of Medicine, Virginia Tech-Wake Forest University Center for Injury Biomechanics, 575 N. Patterson Ave., Ste. 120, Winston-Salem, NC 27101
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García-Martínez D, Nalla S, Ferreira MT, Guichón RA, D'Angelo Del Campo MD, Bastir M. Eco-geographic adaptations in the human ribcage throughout a 3D geometric morphometric approach. AMERICAN JOURNAL OF PHYSICAL ANTHROPOLOGY 2018; 166:323-336. [PMID: 29417988 DOI: 10.1002/ajpa.23433] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/29/2017] [Revised: 01/22/2018] [Accepted: 01/23/2018] [Indexed: 11/11/2022]
Abstract
OBJECTIVES According to eco-geographic rules, humans from high latitude areas present larger and wider trunks than their low-latitude areas counterparts. This issue has been traditionally addressed on the pelvis but information on the thorax is largely lacking. We test whether ribcages are larger in individuals inhabiting high latitudes than in those from low latitudes and explored the correlation of rib size with latitude. We also test whether a common morphological pattern is exhibited in the thorax of different cold-adapted populations, contributing to their hypothetical widening of the trunk. MATERIALS AND METHODS We used 3D geometric morphometrics to quantify rib morphology of three hypothetically cold-adapted populations, viz. Greenland (11 individuals), Alaskan Inuit (8 individuals) and people from Tierra del Fuego (8 individuals), in a comparative framework with European (Spain, Portugal and Austria; 24 individuals) and African populations (South African and sub-Saharan African; 20 individuals). RESULTS Populations inhabiting high latitudes present longer ribs than individuals inhabiting areas closer to the equator, but a correlation (p < 0.05) between costal size and latitude is only found in ribs 7-11. Regarding shape, the only cold adapted population that was different from the non-cold-adapted populations were the Greenland Inuit, who presented ribs with less curvature and torsion. CONCLUSIONS Size results from the lower ribcage are consistent with the hypothesis of larger trunks in cold-adapted populations. The fact that only Greenland Inuit present a differential morphological pattern, linked to a widening of their ribcage, could be caused by differences in latitude. However, other factors such as genetic drift or specific cultural adaptations cannot be excluded and should be tested in future studies.
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Affiliation(s)
| | - Shahed Nalla
- Department of Human Anatomy and Physiology, Faculty of Health Sciences, University of Johannesburg, Johannesburg, South Africa.,Evolutionary Studies Institute (ESI) and Center of Excellence in Palaeosciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Maria Teresa Ferreira
- Laboratory of Forensic Anthropology, Centre for Functional Ecology, Department of Life Sciences, University of Coimbra, Coimbra, Portugal
| | - Ricardo A Guichón
- Núcleo de Estudios Interdisciplinarios de Poblaciones Humanas de Patagonia Austral, Laboratorio de Ecología Evolutiva Humana, Facultad de Ciencias Sociales, Universidad del Centro de la Provincia de Buenos Aires, Argentina (CONICET)
| | - Manuel D D'Angelo Del Campo
- Núcleo de Estudios Interdisciplinarios de Poblaciones Humanas de Patagonia Austral, Laboratorio de Ecología Evolutiva Humana, Facultad de Ciencias Sociales, Universidad del Centro de la Provincia de Buenos Aires, Argentina (CONICET).,Laboratorio de Poblaciones de Pasado, Departamento de Biología, Facultad de Ciencias, Universidad Autónoma de Madrid, Madrid, España
| | - Markus Bastir
- Paleoanthropology Group, Museo Nacional de Ciencias Naturales, Madrid, Spain
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Torres‐Tamayo N, García‐Martínez D, Lois Zlolniski S, Torres‐Sánchez I, García‐Río F, Bastir M. 3D analysis of sexual dimorphism in size, shape and breathing kinematics of human lungs. J Anat 2018; 232:227-237. [PMID: 29148039 PMCID: PMC5770305 DOI: 10.1111/joa.12743] [Citation(s) in RCA: 47] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/29/2017] [Indexed: 11/30/2022] Open
Abstract
Sexual dimorphism in the human respiratory system has been previously reported at the skeletal (cranial and thoracic) level, but also at the pulmonary level. Regarding lungs, foregoing studies have yielded sex-related differences in pulmonary size as well as lung shape details, but different methodological approaches have led to discrepant results on differences in respiratory patterns between males and females. The purpose of this study is to analyse sexual dimorphism in human lungs during forced respiration using 3D geometric morphometrics. Eighty computed tomographies (19 males and 21 females) were taken in maximal forced inspiration (FI) and expiration (FE), and 415 (semi)landmarks were digitized on 80 virtual lung models for the 3D quantification of pulmonary size, shape and kinematic differences. We found that males showed larger lungs than females (P < 0.05), and significantly greater size and shape differences between FI and FE. Morphologically, males have pyramidal lung geometry, with greater lower lung width when comparing with the apices, in contrast to the prismatic lung shape and similar widths at upper and lower lungs of females. Multivariate regression analyses confirmed the effect of sex on lung size (36.26%; P < 0.05) and on lung shape (7.23%; P < 0.05), and yielded two kinematic vectors with a small but statistically significant angle between them (13.22°; P < 0.05) that confirms sex-related differences in the respiratory patterns. Our 3D approach shows sexual dimorphism in human lungs likely due to a greater diaphragmatic action in males and a predominant intercostal muscle action in females during breathing. These size and shape differences would lead to different respiratory patterns between sexes, whose physiological implications need to be studied in future research.
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Affiliation(s)
- Nicole Torres‐Tamayo
- Paleoanthropology GroupMuseo Nacional de Ciencias Naturales (CSIC)MadridSpain
- Biology DepartmentFaculty of SciencesAutonoma University of MadridMadridSpain
| | - Daniel García‐Martínez
- Paleoanthropology GroupMuseo Nacional de Ciencias Naturales (CSIC)MadridSpain
- Biology DepartmentFaculty of SciencesAutonoma University of MadridMadridSpain
| | | | | | - Francisco García‐Río
- Hospital Universitario La PazInstitute of Biomedical Research (Idipaz)MadridSpain
| | - Markus Bastir
- Paleoanthropology GroupMuseo Nacional de Ciencias Naturales (CSIC)MadridSpain
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Chung MH, Gil BM, Kwon SS, Park HI, Song SW, Jung NY, Yoo WJ. Computed tomographic thoracic morphologic indices in normal subjects and patients with chronic obstructive pulmonary disease: Comparison with spiral CT densitometry and pulmonary function tests. Eur J Radiol 2018; 100:147-153. [PMID: 29496074 DOI: 10.1016/j.ejrad.2018.01.014] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2017] [Revised: 11/27/2017] [Accepted: 01/11/2018] [Indexed: 11/18/2022]
Abstract
OBJECTIVES To determine what computed tomographic (CT) dimensions can predict obstructive lung disease on routine chest CT scans by comparing morphological and densitometric CT findings with pulmonary function test (PFT) in normal subjects and patients with chronic obstructive pulmonary disease (COPD). MATERIALS AND METHODS Consecutive patients (n = 646; 260 females and 386 males; mean age 54.9 years, ranged 20-90 years) who received chest CT scans with densitometry during a 3-month period were retrospectively analyzed in single center. PFT was undertaken in 235 patients (152 males, 83 females) at same times of CT scanning. The patients were grouped by age (<30 years, 31-45 years, 46-60 years, and >61 years). CT parameters including tracheal, azygoesophageal, thoracic vertical, anterior-posterior (AP), transverse diameters, transverse cardiac diameter, diameters of main, right, and left pulmonary arteries, and CT densitometric values including lung volume and density (-900 to -1000 Hounsfield Units, HU), low attenuation value cluster (default threshold: -950 HU) were compared with PFT values. Spearman correlation coefficients was used to evaluate the relationship between the CT indices and PFT. RESULTS Ninety of 235 patients with PFT were smokers (76 males, 14 females). Obstructive PFT was detected in 65 patients (27.7%: 46 males, 19 females). Male smokers with obstructive PFT displayed significantly larger thoracic anterior-posterior (mean: normal, 172.3 cm versus COPD, 185.9 cm, p = 0.0001) and smaller transverse diameters (mean: normal, 247.0 cm vs. COPD, 235.8 cm, p = 0.01), and increased right pulmonary artery diameter (mean: normal, 20.3 cm v s. COPD, 22.1 cm, p < 0.001), and increased left pulmonary artery diameter (mean: normal, 19.7 cm vs. COPD, 20.6 cm, p < 0.025). The lung parenchyma density (-1000 to -900 HU) and greater concentration of largest cluster on densitometry were significantly different between normal and obstructive PFT pattern in male smoker. Residual volume and total lung capacity are positively correlated with lung volume and lung density (-1000 to -800) of densitometry. CONCLUSIONS CT findings of the overexpansion of the lungs, such as increases in the vertical diameter of the lung and decreases in the transverse diameter of the heart, can be significant as indirect findings of early chronic obstructive diseases. However, despite the significant CT findings in male smokers, particularly those in their 40s, most lung function parameters were not decidedly abnormal.
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Affiliation(s)
- Myung Hee Chung
- Department of Radiology, Bucheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, 327 Sosa-ro, Bucheon-si, Gyeonggi-do 14647, Republic of Korea.
| | - Bo Mi Gil
- Department of Radiology, Bucheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, 327 Sosa-ro, Bucheon-si, Gyeonggi-do 14647, Republic of Korea
| | - Soon Seog Kwon
- Division of Allergy and Pulmonary, Department of Internal Medicine, Bucheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, 327 Sosa-ro, Bucheon-si, Gyeonggi-do 14647, Republic of Korea
| | - Hae-Il Park
- Department of Laboratory Medicine, Bucheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, 327 Sosa-ro, Bucheon-si, Gyeonggi-do 14647, Republic of Korea
| | - Sun Wha Song
- Departement of Radiology, Uijeongbu St. Mary's Hospital, College of Medicine, The Catholic University of Korea, 271, Cheonbo-ro, Uijeongbu-si, Gyeonggi-do, 11765, Republic of Korea
| | - Na Young Jung
- Department of Radiology, Bucheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, 327 Sosa-ro, Bucheon-si, Gyeonggi-do 14647, Republic of Korea
| | - Won Jong Yoo
- Departement of Radiology, Bucheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, 327 Sosa-ro, Bucheon-si, Gyeonggi-do 14647, Republic of Korea
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Peters JR, Campbell RM, Balasubramanian S. Characterization of the age-dependent shape of the pediatric thoracic spine and vertebrae using generalized procrustes analysis. J Biomech 2017; 63:32-40. [DOI: 10.1016/j.jbiomech.2017.07.030] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2017] [Revised: 07/18/2017] [Accepted: 07/22/2017] [Indexed: 11/25/2022]
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