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Sumner B, McCamley J, Jacofsky DJ, Jacofsky MC. Comparison of Knee Kinematics and Kinetics during Stair Descent in Single- and Multi-Radius Total Knee Arthroplasty. J Knee Surg 2020; 33:1020-1028. [PMID: 31390673 DOI: 10.1055/s-0039-1692652] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Despite continuing advances, nearly 20% of patients remain dissatisfied with their total knee arthroplasty (TKA) outcomes. Single-radius (SR) and multiradius (MR) TKA designs are two commonly used knee replacement designs based on competing theories of the flexion/extension axis of the knee. Our aim was to characterize stair descent kinematics and kinetics in SR and MR TKA subjects. We hypothesized that 1 year after TKA, patients who received SR TKA will more closely replicate the knee kinematics and kinetics of healthy age-matched controls during stair descent, than will MR TKA patients. SR subjects (n = 12), MR subjects (n = 12), and age-matched controls (n = 12) descended four stairs affixed to force platforms, while 10 infrared cameras tracked markers attached to the body to collect kinematic and kinetic data. Both patient groups had improvements in stair descent kinetics and kinematics at the 1-year postoperative time point. However, SR TKA subjects were indistinguishable statistically from age-matched controls, while MR TKA subjects retained many differences from controls. Similar to previous reports for level walking, the SR knee design performs closer to healthy controls than MR knees during stair descent. This study demonstrates that patients who receive SR TKA have more improved kinematic normalization during stair descent postoperatively than those who received an MR TKA.
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Affiliation(s)
- Bonnie Sumner
- Department of Research, MORE Foundation, Phoenix, Arizona
| | - John McCamley
- Department of Research, MORE Foundation, Phoenix, Arizona
| | - David J Jacofsky
- Department of Adult Reconstruction, The CORE Institute, Phoenix, Arizona
| | - Marc C Jacofsky
- Department of Research, MORE Foundation, Phoenix, Arizona.,Department of Research and Development, The CORE Institute, Phoenix, Arizona
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Sumner B, McCamley JD, Jacofsky DJ, Jacofsky MC. Comparison of Knee Kinematics and Kinetics during Stair Ascent in Single-Radius and Multiradius Total Knee Arthroplasty. J Knee Surg 2019; 32:872-878. [PMID: 30227451 DOI: 10.1055/s-0038-1669952] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Traditionally total knee arthroplasty (TKA) design has been based on theories of the movement of the healthy knee joint. Currently, there are two competing theories on the flexion/extension axis of rotation of the knee with disparate radii of rotation, and thus differing movement patterns. The purpose of our study was to compare stair ascent kinematics and kinetics of single-radius (SR) and multiradius (MR) TKA subjects. We hypothesized that the knee kinematics and kinetics of SR TKA patients would more closely replicate healthy age matched controls during stair ascent than MR TKA patients, 1 year after TKA. Both patient groups had large improvements in biomechanical and clinical outcome measures following surgical intervention. However, the SR knee design performs closer to healthy controls than MR knees during stair ascent, supporting results that have been previously obtained for level walking. SR TKA subjects demonstrated reduced power production and sagittal moment compared with controls, albeit more than MR TKA subjects. This study demonstrates that patients who receive SR TKA have kinematics more closely aligned to normal patterns postoperatively than those who received an MR TKA. The power production and sagittal moment of the healthy controls most closely match previously published values of younger adults, SR TKA group most closely matches older adults, while the MR TKA group has lower power production and sagittal moments than either previously published age group. This strongly suggests that the biomechanical differences found in this study are evidence of functional deficiencies. Further research is needed to determine how these deficiencies progress with patient aging.
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Affiliation(s)
- Bonnie Sumner
- Department of Research, MORE Foundation, Phoenix, Arizona
| | | | - David J Jacofsky
- Department of Adult Reconstruction, The CORE Institute, Phoenix, Arizona
| | - Marc C Jacofsky
- Department of Research and Development, The CORE Institute, Phoenix, Arizona
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Sumner B. Primate morphology in Portland. Evol Anthropol 2016; 25:43. [PMID: 27061031 DOI: 10.1002/evan.21474] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Bonnie Sumner
- Dept. of Anatomical Sciences, Stony Brook University School of Medicine, Stony Brook, NY, 11794-8081
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Bartlett JL, Sumner B, Ellis RG, Kram R. Activity and functions of the human gluteal muscles in walking, running, sprinting, and climbing. Am J Phys Anthropol 2013; 153:124-31. [PMID: 24218079 DOI: 10.1002/ajpa.22419] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/18/2013] [Accepted: 10/22/2013] [Indexed: 11/06/2022]
Abstract
It has been suggested that the uniquely large gluteus maximus (GMAX) muscles were an important adaptation during hominin evolution based on numerous anatomical differences between humans and extant apes. GMAX electromyographic (EMG) signals have been quantified for numerous individual movements, but not across the range of locomotor gaits and speeds for the same subjects. Thus, comparing relative EMG amplitudes between these activities has not been possible. We assessed the EMG activity of the gluteal muscles during walking, running, sprinting, and climbing. To gain further insight into the function of the gluteal muscles during locomotion, we measured muscle activity during walking and running with external devices that increased or decreased the need to control either forward or backward trunk pitch. We hypothesized that 1) GMAX EMG activity would be greatest during sprinting and climbing and 2) GMAX EMG activity would be modulated in response to altered forward trunk pitch demands during running. We found that GMAX activity in running was greater than walking and similar to climbing. However, the activity during sprinting was much greater than during running. Further, only the inferior portion of the GMAX had a significant change with altered trunk pitch demands, suggesting that the hip extensors have a limited contribution to the control of trunk pitch movements during running. Overall, our data suggest that the large size of the GMAX reflects its multifaceted role during rapid and powerful movements rather than as a specific adaptation for a single submaximal task such as endurance running.
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Affiliation(s)
- Jamie L Bartlett
- Locomotion Laboratory, Department of Integrative Physiology, University of Colorado, Boulder, CO, 80309
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Sumner B, Mancuso C, Paradiso R. Performances evaluation of textile electrodes for EMG remote measurements. Annu Int Conf IEEE Eng Med Biol Soc 2013; 2013:6510-6513. [PMID: 24111233 DOI: 10.1109/embc.2013.6611046] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
This work focus on the evaluation of textile electrodes for EMG signals acquisition. Signals have been acquired simultaneously from textile electrode and from gold standard electrodes, by using the same acquisition system; tests were done across subjects and with multiple trials to enable a more complete analysis. This research activity was done in the frame of the European Project Interaction, aiming at the development of a system for a continuous daily-life monitoring of the functional performance of stroke survivors in their physical interaction with the environment.
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Abstract
Sex steroids exert potent effects on mood and mental state in the human. Our previous experimental findings in female rats suggest that these effects may be mediated, in part, by the action of estrogen on the 5-hydroxytryptamine2A receptor (5-HT(2A)R) and serotonin transporter (SERT) in brain. Here we review our recent findings on the effect of acute (approximately 32 h) testosterone manipulation on central 5-HT(2A)R and SERT in male rats. Castration decreased while testosterone or estrogen, but not 5alpha-dihydrotestosterone (5alpha-DHT), increased significantly the content of 5-HT(2A)R mRNA and SERT mRNA in the dorsal raphe nucleus (DR) and the density of 5-HT(2A)R and SERT binding sites in higher centers of the brain. The lack of effect of 5alpha-DHT, a potent androgen which cannot be converted to estrogen, suggests that the action of testosterone depends upon its conversion to estrogen by aromatase. This may also explain why estrogen, but not testosterone or 5alpha-DHT, increased the density of 5-HT(2A)R binding sites in the caudate-putamen, a brain region where aromatase is scarce. The estrogen induction of SERT mRNA is most prominent in the rostral DR and this together with the correlation between sensitivity of DR serotonin neurons to estrogen and neurotoxic amphetamine derivatives provides a potential topochemical handle with which to investigate testosterone/estrogen regulation of SERT gene expression. These findings are discussed in relation to the possible role of interactions between sex steroids and serotonin mechanisms in mood disorders, schizophrenia and Alzheimer's disease.
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Affiliation(s)
- G Fink
- MRC Brain Metabolism Unit, University Department of Neuroscience, Edinburgh, UK.
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Abstract
OBJECTIVES To determine the prevalence of Toxoplasma gondii in a population of domestic cats in Melbourne. DESIGN An ELISA assay was used to measure T gondii antibody titres in 103 cats from north-eastern Melbourne. Cats were obtained from outer suburban areas (less than 30 km from the Melbourne GPO) and from rural areas (more than 30 km from the Melbourne GPO). RESULTS Thirty-nine percent of cats were positive for T gondii IgG. Older cats tended to have higher antibody titres. There was no significant difference in the T gondii antibody titres between males and females, or between cats living in urban areas and cats from rural areas. CONCLUSIONS A significant proportion of cats from Melbourne have been exposed to Toxoplasma. This may have implications for the health of wildlife and humans.
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Affiliation(s)
- B Sumner
- Deakin University, School of Biological and Chemical Sciences, Victoria
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Sumner B, Dowd B, Pheley AM, Lurie N. Denial of health insurance due to preexisting conditions: how well does one high-risk pool work? Med Care Res Rev 1997; 54:357-71. [PMID: 9437172 DOI: 10.1177/107755879705400307] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
This study assesses whether Minnesota's high-risk insurance pool is successful at insuring those denied health insurance coverage because of preexisting medical conditions. Eight hundred and twenty-nine individuals who had been denied health insurance coverage were interviewed. At the time of the survey, 80 percent of the sample had obtained coverage, 22 percent through the state's high-risk insurance pool. Seventeen percent remained uninsured. Logistic regression was used to identify correlates of remaining uninsured. Younger age and less education were significantly associated with being uninsured versus enrolling in the high-risk pool. Younger age, less education, unemployment, being non-White, and having worse mental health were significantly associated with being uninsured versus having non-high-risk pool insurance. Despite the presence of a large high-risk pool in Minnesota, specific groups are identified as being at risk for remaining uninsured after being denied health insurance.
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Affiliation(s)
- B Sumner
- New York University, Lenox Hill Hospital, USA
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Abstract
This paper addresses how medical care financing issues may impact on the process and outcome of asthma care. Because asthma-specific data are scarce, an attempt has been made to extrapolate from an understanding of payment issues for chronic illness in general to the specific case of asthma. First, some broad features of the effect of payment systems on health care delivery are reviewed. How financing of care for the individual patient affects financial access to care is then examined. Next, financing of care at the provider level is discussed, and fee-for-service and prepaid systems are compared with respect to how individual patients with chronic illness may be treated differently. Financing at the health insurance plan level, particularly with regard to benefits and quality of care, then is explored. Finally, knowledge gaps are highlighted, as are some of the difficulties encountered in investigating this topic.
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Affiliation(s)
- B Sumner
- Department of Medicine, St. Paul-Ramsey Medical Center, MN 55101
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Sumner B. Nurturing the nurses of tomorrow. Nursing 1991; 4:32-3. [PMID: 2047009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
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