Biomechanics principle of elbow joint for transhumeral prostheses: comparison of normal hand, body-powered, myoelectric & air splint prostheses

Changes in Sensorimotor Cortical Activation in Children Using Prostheses and Prosthetic Simulators

This study aimed to examine the neural responses of children using prostheses and prosthetic simulators to better elucidate the emulation abilities of the simulators. We utilized functional near-infrared spectroscopy (fNIRS) to evaluate the neural response in five children with a congenital upper limb reduction (ULR) using a body-powered prosthesis to complete a 60 s gross motor dexterity task. The ULR group was matched with five typically developing children (TD) using their non-preferred hand and a prosthetic simulator on the same hand. The ULR group had lower activation within the primary motor cortex (M1) and supplementary motor area (SMA) compared to the TD group, but nonsignificant differences in the primary somatosensory area (S1). Compared to using their non-preferred hand, the TD group exhibited significantly higher action in S1 when using the simulator, but nonsignificant differences in M1 and SMA. The non-significant differences in S1 activation between groups and the increased activation evoked by the simulator's use may suggest rapid changes in feedback prioritization during tool use. We suggest that prosthetic simulators may elicit increased reliance on proprioceptive and tactile feedback during motor tasks. This knowledge may help to develop future prosthesis rehabilitative training or the improvement of tool-based skills.

miR-744/eNOS/NO axis: A novel target to halt triple negative breast cancer progression

BACKGROUND

Nitric oxide (NO) may have a dual role in cancer. At low concentrations, endogenous NO promotes tumor growth and proliferation. However, at very high concentrations, it mediates cancer cell apoptosis and inhibits cancer growth. High levels of NO have been observed in blood of breast cancer (BC) patients, which increases tumor blood flow and promotes angiogenesis. To date, the regulation of NO-synthesizing enzyme, eNOS, by miRNAs has not been adequately investigated in BC. Therefore, the main aim of this study is to unravel the possible regulation of eNOS by miRNAs in BC and to examine their influence on NO production and BC progression.

METHODS

Expression profile of eNOS in Egyptian BC patients and MDA-MB-231 cell lines was investigated using qRT-PCR. In-silico analysis was performed to predict a putative upstream regulator of eNOS. miR-744-5p was selected and its expression was quantified in BC tissues using qRT-PCR. MDA-MB-231 cells were cultured and transfected with miR-744-5p using lipofection method. NO levels were determined using Griess Reagent. Cellular viability and colony-forming ability were assessed using MTT and colony-forming assays; respectively.

RESULTS

eNOS and miR-744-5p were significantly up-regulated in BC tissues compared to paired normal tissues. In-silico analysis revealed that miR-744-5p putatively binds to eNOS transcript with high binding scores. Transfection of MDA-MB-231 cells with miR-744-5p mimics resulted in a significant up-regulation of eNOS and consequently NO levels. In addition, miR-744-5p transfection led to an increase in cellular viability and colony-forming ability of the MDA-MB-231.

CONCLUSION

miR-744-5p acts as an upstream positive regulator of the NO synthesizing enzyme, eNOS which in turn elevates NO levels. Furthermore, miR-744-5p is a novel oncogenic miRNA in BC. Thus, targeting miR-744/eNOS/NO axis may act as a therapeutic tool in TNBC.

Evaluation of Force Sensing Resistors for the Measurement of Interface Pressures in Lower Limb Prosthetics

Understanding pressure distributions at the limb-socket interface is essential to the design and evaluation of prosthetic components for lower limb prosthesis users. Force sensing resistors (FSRs) are employed in prosthetics research to measure pressure at this interface due to their low cost, thin profile, and ease of use. While FSRs are known to be sensitive to many sources of error, few studies have systematically quantified these errors using test conditions relevant to lower limb prosthetics. The purpose of this study was to evaluate FSR accuracy for the measurement of lower limb prosthetics interface pressures. Two FSR models (Flexiforce A201 and Interlink 402) were subjected to a series of prosthetic-relevant tests. These tests included: (1) static compression, (2) cyclic compression, and (3) a combined static and cyclic compression protocol mimicking a variable activity (Walk-Sit-Stand) procedure. Flexiforce sensors outperformed Interlink sensors and were then subjected to two additional tests: (4) static curvature and (5) static shear stress. Results demonstrated that FSRs experienced significant errors all five tests. We concluded that: (1) if used carefully, FSRs can provide an estimate of prosthetic interface pressure, but these measurements should be interpreted within the expected range of possible measurement error given the setup; (2) FSRs should be calibrated in a setup that closely matches how they will be used for taking measurements; and (3) both Flexiforce and Interlink sensors can be used to estimate interface pressures, however in most cases Flexiforce sensors are likely to provide more accurate measurements.

Effects of realistic sheep elbow kinematics in inverse dynamic simulation

Looking for new opportunities in mechanical design, we are interested in studying the kinematic behaviour of biological joints. The real kinematic behaviour of the elbow of quadruped animals (which is submitted to high mechanical stresses in comparison with bipeds) remains unexplored. The sheep elbow joint was chosen because of its similarity with a revolute joint. The main objective of this study is to estimate the effects of elbow simplifications on the prediction of joint reaction forces in inverse dynamic simulations. Rigid motions between humerus and radius-ulna were registered during full flexion-extension gestures on five cadaveric specimens. The experiments were initially conducted with fresh specimens with ligaments and repeated after removal of all soft tissue, including cartilage. A digital image correlation system was used for tracking optical markers fixed on the bones. The geometry of the specimens was digitized using a 3D optical scanner. Then, the instantaneous helical axis of the joint was computed for each acquisition time. Finally, an OpenSim musculoskeletal model of the sheep forelimb was used to quantify effects of elbow joint approximations on the prediction of joint reaction forces. The motion analysis showed that only the medial-lateral translation is sufficiently large regarding the measuring uncertainty of the experiments. This translation assimilates the sheep elbow to a screw joint instead of a revolute joint. In comparison with fresh specimens, the experiments conducted with dry bone specimens (bones without soft tissue) provided different kinematic behaviour. From the results of our inverse dynamic simulations, it was noticed that the inclusion of the medial-lateral translation to the model made up with the mean flexion axis does not affect the predicted joint reaction forces. A geometrical difference between the axis of the best fitting cylinder and the mean flexion axis (derived from the motion analysis) of fresh specimens was highlighted. This geometrical difference impacts slightly the prediction of joint reactions.

Fixation of Anteromedial Coronoid Facet Fractures: A Biomechanical Evaluation of Plated Versus Screw Constructs

OBJECTIVE

To examine the stability of plate (locking and non-) versus screw constructs in the fixation of these fractures.

METHODS

An anteromedial coronoid facet fracture (OTA/AO type 21-B1, O'Driscoll type 2, subtype 3) was simulated in 24 synthetic ulna bones that were then assigned to 3 fracture fixation groups: non-locking plate, locking plate (LP), or screw fixation. Each construct was first cycled in tension (through a simulated medial collateral ligament) and then in compression. They were then loaded to failure (displacement >2 mm). Fracture fragment displacement was recorded with an optical tracking system.

RESULTS

During tension testing, a mean maximum fragment displacement of 12 ± 13 and 14 ± 9 μm was seen in the locking and non-locking constructs, respectively. There was no difference in fragment motion between the plated constructs. All screw-only fixed constructs failed during the tension protocol. During compression testing, the mean maximum fragment displacement for the screw-only construct (64 ± 79 μm) was significantly greater than locking (9 ± 5 μm) and non-locking constructs (10 ± 9 μm). During load to failure testing, the maximum load to failure in the screw-only group (316 ± 83 N) was significantly lower than locking (650.4 ± 107 N) and non-locking constructs (550 ± 76 N). There was no difference in load to failure between the plated groups.

CONCLUSION

Fixation of anteromedial coronoid fractures (type 2, subtype 3) is best achieved with a plating technique. Although LPs had greater stiffness, they did not offer any advantage over conventional non-LPs with respect to fracture fragment displacement in this study.

CLINICAL RELEVANCE

Isolated screw fixation showed inferior stability when compared with plate constructs for these fractures. This could result in loss of fracture reduction leading to instability and posttraumatic arthrosis.