Evaluating the Appropriateness of Podcasts to Improve the Knowledge and Awareness of Selected Health Topics Among Undergraduate General Nursing Students: Protocol for an International Feasibility Study

BACKGROUND

Podcasts have proven to be a successful alternative source of educational material for students. Given the ability to listen to podcasts 24/7 and while on the go, this technology has the potential to provide informative and educational material to a large number of people at any given time. Podcasts are usually freely available on commonly used mobile devices, such as smartphones, laptops, and tablets.

OBJECTIVE

This paper describes the impact of health-related podcasts as an intervention tool to support the knowledge and awareness of nursing students on a given topic.

METHODS

Pre- and postpodcast questionnaires will gather data regarding the participants' knowledge and awareness of two topics-gestational diabetes and mental health. This intervention will be tested on general nursing undergraduate students. The total number of students (N=2395) from the participating universities are broken down as follows: (1) University College Cork (n=850) and the University of Galway (n=450) in Ireland, (2) Mzuzu University in Malawi (n=719), and (3) University of Fort Hare in South Africa (n=376).

RESULTS

The study received ethical approval from the University College Cork Ethics Committee (2022-027A1). The approval obtained from University College Cork sufficed as ethics coverage for the University of Galway in Ireland. Ethics approval was also received from the Mzuzu University Research Ethics Committee (ID MZUNIREC/DOR/23/28) and the Inter-Faculty Research Ethics Committee of the University of Fort Hare (ID CIL002-21). Data collection is currently underway and will continue until the end of February 2024. The quantitative and qualitative data are expected to be analyzed in March 2024.

CONCLUSIONS

Results from this study will allow for an investigation into the impact of podcasts in different settings: a high-income country (Ireland), an upper-middle-income country (South Africa), and a low-to-middle-income country (Malawi). The data gathered from this feasibility study will provide more clarity on the potential utility of podcasts as an intervention tool. We will gather data regarding listener demographics (eg, country of residence, age, gender, and year of study).

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID)

DERR1-10.2196/50735.

PRECISION ALS-an integrated pan European patient data platform for ALS

Amyotrophic Lateral Sclerosis (ALS) is an incurable neurodegenerative condition. Despite significant advances in pre-clinical models that enhance understanding of disease pathobiology, translation of candidate drugs to effective human therapies has been disappointing. There is increasing recognition of the need for a precision medicine approach toward drug development, as many failures in translation can be attributed in part to disease heterogeneity in humans. PRECISION-ALS is an academic industry collaboration between clinicians, Computer Scientists, Information engineers, technologists, data scientists and industry partners that will address the key clinical, computational, data science and technology associated research questions to generate a sustainable precision medicine based approach toward new drug development. Using extant and prospectively collected population based clinical data across nine European sites, PRECISION-ALS provides a General Data Protection Regulation (GDPR) compliant framework that seamlessly collects, processes and analyses research-quality multimodal and multi-sourced clinical, patient and caregiver journey, digitally acquired data through remote monitoring, imaging, neuro-electric-signaling, genomic and biomarker datasets using machine learning and artificial intelligence. PRECISION-ALS represents a first-in-kind modular transferable pan-European ICT framework for ALS that can be easily adapted to other regions that face similar precision medicine related challenges in multimodal data collection and analysis.

Genome-wide association study reveals candidate markers related to field fertility and semen quality traits in Holstein-Friesian bulls

In vitro assessment of bull semen quality is routinely used in bull semen processing centres in order to ensure that semen destined to be used in the field has passed minimum standards. Despite these stringent quality control checks, individual bulls that pass the quality control checks can still vary in field fertility by up to 25%. A genome-wide association study was undertaken to determine genetic markers associated with prefreeze and post-thaw bull sperm quality traits as well as field fertility. Genome-wide association analysis was performed using a single nucleotide polymorphism (SNP) regression mixed linear model in WOMBAT. Genes within a 250 Kb span of a suggestive (P ≤ 1 × 10^-5) SNP were considered as candidate genes. One SNP was associated with adjusted pregnancy rate, and 21 SNPs were associated across the seven semen quality traits (P ≤ 1 × 10^-5). Functional candidate genes include SIPA1L2 which was associated with adjusted pregnancy rate. This encodes a Rap GTPase-activating protein involved in Rap1 signalling pathway and was previously found to play a role in the process of sperm differentiation. Gene ontology (GO) analysis also identified significantly enriched biological processes involved protein tyrosine kinase activity including genes such as DYRK1A, TEC and TXK that were associated with sperm motility prior to freezing. Another candidate gene associated with post-thaw sperm motility was FHDC1 which coordinates actin filament and microtubule dynamics. The induced 11 GO terms in the ejaculates rejected after freezing trait were related to ATPase, phosphatase and hydrolase activity. These results reveal novel specific genomic regions and candidate genes associated with economically important phenotypes such as field fertility and semen quality traits.

Comprehensive functional analysis reveals that acrosome integrity and viability are key variables distinguishing artificial insemination bulls of varying fertility

In vitro methods of assessing bull semen quality in artificial insemination (AI) centers are unable to consistently detect individuals of lower fertility, and attempts to reliably predict bull fertility are still ongoing. This highlights the need to identify robust biomarkers that can be readily measured in a practical setting and used to improve current predictions of bull fertility. In this study, we comprehensively analyzed a range of functional, morphological, and intracellular attributes in cryopreserved spermatozoa from a selected cohort of Holstein Friesian AI bulls classified as having either high or low fertility (n = 10 of each fertility phenotype; difference of 11.4% in adjusted pregnancy rate between groups). Here, spermatozoa were assessed for motility and kinematic parameters, morphology, acrosome integrity, plasma membrane lipid packing, viability (or membrane integrity), superoxide production, and DNA integrity. In addition, spermatozoa were used for in vitro fertilization to evaluate their capacity for fertilization and successful embryo development. The information collected from these assessments was then used to phenotypically profile the 2 groups of bulls of divergent fertility status as well as to develop a model to predict bull fertility. According to the results, acrosome integrity and viability were the only sperm attributes that were significantly different between high- and low-fertility bulls. Interestingly, although spermatozoa from low-fertility bulls, on average, had reduced viability and acrosome integrity, this response varied considerably from bull to bull. Principal component analysis revealed a sperm phenotypic profile that represented a high proportion of ejaculates from low-fertility bulls. This was constructed based on the collective influence of several sperm attributes, including the presence of cytoplasmic droplets and superoxide production. Finally, using the combined results as a basis for modeling, we developed a linear model that was able to explain 47% of the variation in bull field fertility in addition to a logistic predictive model that had a 90% chance of distinguishing between fertility groups. Taken together, we conclude that viability and acrosome integrity could serve as fertility biomarkers in the field and, when used alongside other sperm attributes, may be useful in detecting low-fertility bulls. However, the variable nature of low-fertility bulls suggests that additional, in-depth characterization of spermatozoa at a molecular level is required to further understand the etiology of low fertility in dairy bulls.

Influence of bull age, ejaculate number, and season of collection on semen production and sperm motility parameters in Holstein Friesian bulls in a commercial artificial insemination centre

In the current era of genomic selection, there is an increased demand to collect semen from genomically selected sires at a young age. The objective of this study was to assess the effect of bull age, ejaculate number, and season of collection on semen production (ejaculate volume, sperm concentration, and total sperm number; TSN) and sperm motility (prefreeze and post-thaw total and gross motility) parameters in Holstein Friesian bulls in a commercial artificial insemination (AI) center. The study involved the interrogation of a large dataset collected over a 4-yr period, (n = 8,983 ejaculates; n = 176 Holstein Friesian bulls aged between 9 mo and 8 yr). Bulls aged less than 1 yr had the poorest semen production and sperm motility values for all parameters assessed compared with bulls older than 1 yr (P < 0.01). First ejaculates had greater semen production and greater prefreeze motility values than second consecutive ejaculates (P < 0.01), but despite this, there was no difference in post-thaw motility. When subsequent ejaculates were collected from bulls aged less than 1 yr, semen production and sperm motility did not differ compared with mature bulls. Semen collected in winter was poorest in terms of sperm concentration and TSN, but best in terms of post-thaw motility (P < 0.01). In conclusion, second ejaculates can be collected, particularly from bulls aged less than 1 yr, without a significant decrease in post-thaw sperm motility, thus may be a useful strategy to increase semen availability from young genomically selected AI bulls in high demand.

Comparison of plant- and egg yolk-based semen diluents on in vitro sperm kinematics and in vivo fertility of frozen-thawed bull semen

Diluents using components of plant origin have been developed as an alternative to animal based extenders for the dilution of bull semen, however, it is unclear if use of these diluents results in in vivo fertility rates similar to those that occur with use of traditional egg yolk-based diluents. The aim of this study was to assess the effect of semen diluent on 60-day non-return rate (NRR) following artificial insemination (AI) with frozen-thawed bull semen. The effect of semen dilution in one of three different commercial diluents (BullXcell - egg yolk-based, OptiXcell - plant-based or AndroMed - plant-based) on post-thaw total and progressive motility as well as kinematic parameters (Experiment 1) and field fertility (Experiment 2, n = 1,480 inseminations) was assessed. Semen stored in OptiXcell had greater post-thaw total and progressive motility than AndroMed (P < 0.05) but did not differ from BullXcell. Semen stored in BullXcell had a greater beat cross frequency and straight line velocity compared to semen stored in AndroMed (P < 0.05) but did not differ when compared with use of OptiXcell; while values for these variables when using OptiXcell and AndroMed did not differ from each other (P > 0.05). There was no difference in any other sperm kinematic parameters (P > 0.05). There was no effect of diluent on 60-day NRR (71.5%, 67.8% and 70.6% for BullXcell, OptiXcell and AndroMed, respectively). In conclusion, while diluent significantly affected post-thaw sperm motility and kinematics, no effect on 60-day NRR was observed. Given that OptiXcell and AndroMed are animal protein-free media these diluents may be a suitable alternative to BullXcell for the storage of frozen-thawed bull semen.

Simultaneous 68Ga DOTATATE Positron Emission Tomography/Magnetic Resonance Imaging in Meningioma Target Contouring: Feasibility and Impact Upon Interobserver Variability Versus Positron Emission Tomography/Computed Tomography and Computed Tomography/Magnetic Resonance Imaging

AIMS

The increasing use of highly conformal radiation techniques to treat meningioma confers a greater need for accurate targeting. Several groups have shown that positron emission tomography/computed tomography (PET/CT) information alters meningioma targets contoured by single observers, but whether this translates into improved accuracy has not been defined. As magnetic resonance imaging (MRI) is the cornerstone of meningioma target contouring, simultaneous PET/MRI may be superior to PET/CT. We assessed whether ⁶⁸Ga DOTATATE PET imaging (from PET/CT and PET/MRI) reduced interobserver variability (IOV) in meningioma target volume contouring.

MATERIALS AND METHODS

Ten patients with meningioma underwent simultaneous ⁶⁸Ga DOTATATE PET/MRI followed by PET/CT. They were selected as it was anticipated that target volume definition in their cases would be particularly challenging. Three radiation oncologists contoured target volumes according to an agreed protocol: gross tumour volume (GTV) and clinical target volume (CTV) on CT/MRI alone, CT/MRI+PET(CT) and CT/MRI+PET(MRI). GTV/CTV Kouwenhoven conformity levels (KCL), regions of contour variation and qualitative differences between PET(CT) and PET(MRI) were evaluated.

RESULTS

There was substantial IOV in contouring. GTV mean KCL: CT/MRI 0.34, CT/MRI+PET(CT) 0.38, CT/MRI+PET(MRI) 0.39 (P = 0.06). CTV mean KCL: CT/MRI 0.31, CT/MRI+PET(CT) 0.35, CT/MRI+PET(MRI) 0.35 (P = 0.04 for all groups; P > 0.05 for individual pairs). One observer consistently contoured largest and one smallest. Observers rarely decreased volumes in relation to PET. Most IOV occurred in bone followed by dural tail, postoperative bed and venous sinuses. Tumour edges were qualitatively clearer on PET(MRI) versus PET(CT), but this did not affect contouring.

CONCLUSION

IOV in contouring challenging meningioma cases was large and only slightly improved with the addition of ⁶⁸Ga DOTATATE PET. Simultaneous PET/MRI for meningioma contouring is feasible, but did not improve IOV versus PET/CT. Whether volumes can be safely reduced according to PET requires evaluation.

A comparison of semen diluents on the in vitro and in vivo fertility of liquid bull semen

The aim of this study was to assess the effect of semen diluent on calving rate (CR) following artificial insemination with liquid bull semen stored for up to 3 d postcollection. In experiment 1, the effect of storing liquid semen maintained at a constant ambient temperature in 1 of 7 different diluents [Caprogen (homemade), OptiXcell, BioXcell, BullXcell, INRA96, NutriXcell, or AndroMed (all commercially available)] on total and progressive motility was assessed on d 0, 1, 2, and 3 postcollection. In experiment 2, the field fertility of liquid semen diluted in Caprogen, BioXcell, or INRA96 and inseminated on d 1, 2, or 3 postcollection was assessed in comparison to frozen-thawed semen (total of n = 19,126 inseminations). In experiment 3, the effect of storage temperature fluctuations (4 and 18°C) on total and progressive motility following dilution in Caprogen, BioXcell, and INRA96 was assessed on d 0, 1, 2, and 3 postcollection. In experiment 1, semen stored in Caprogen, BioXcell, and INRA96 resulted in the highest total and progressive motility on d 1, 2, and 3 of storage compared with OptiXcell, BullXcell, NutriXcell, and AndroMed. In experiment 2, an effect of diluent on CR was found as semen diluted in BioXcell had a lower CR on d 1, 2, and 3 of storage (46.3, 35.4, and 34.0%, respectively) in comparison with Caprogen (55.8, 52.0, and 51.9%, respectively), INRA96 (55.0, 55.1, and 52.2%, respectively), and frozen-thawed semen (59.7%). Effects were found of parity, cow fertility sub-index, as well as the number of days in milk on CR. In experiment 3, when the storage temperature of diluted semen fluctuated between 4 and 18°C, to mimic what occurs in the field (nighttime vs. daytime), BioXcell had the lowest total and progressive motility in comparison to Caprogen and INRA96. In conclusion, diluent significantly affected sperm motility when stored for up to 3 d. Semen diluted in INRA96 resulted in a similar CR to semen diluted in Caprogen and to frozen-thawed semen, whereas that diluted in BioXcell resulted in a decreased CR. Consistent with this finding, semen diluted in BioXcell was less tolerant of temperature fluctuations than that stored in Caprogen or INRA96. Given that it can be used directly off the shelf, INRA96 may be a suitable alternative to Caprogen for the storage of liquid bull semen.

A comparison of the psychological burden of PET/MRI and PET/CT scans and association to initial state anxiety and previous imaging experiences

OBJECTIVE

To investigate the level of psychological burden experienced by patients undergoing positron emission tomography (PET)/MRI scanning compared with PET/CT.

METHODS

100 adult patients referred for PET/CT and underwent PET/MRI scanning were eligible. Initial state, psychological burden of PET/CT and PET/MRI, scan satisfaction and preference were assessed using a purpose-designed questionnaire, comprising 61 five-point Likert scale questions and a three-point tick box question indicating preference between PET/CT and PET/MRI. State anxiety was assessed using the state portion of the State Trait Anxiety Inventory. Wilcoxon signed-rank tests compared psychological burden experienced by participants following PET/CT and PET/MRI scan.

RESULTS

A greater level of psychological burden was experienced by patients during PET/MRI than PET/CT p ≤ 0.001, consistent with patients' preference for PET/CT over PET/MRI (p = 0.013). There was a significant relationship between PET/CT psychological burden and initial state (r = 0.386, p ≤ 0.001). No significant relationship was identified between Initial state and psychological burden of PET MRI (r = -0.089; p = 217). There was a significant relationship between psychological burden of PET/CT and PET/MRI (r = 0.354; p = 0.001).

CONCLUSION

Patients' experience increased psychological burden during PET/MRI compared with PET/CT. Previous scanning experiences and patients' interactions prior to and during PET/MRI improved patient satisfaction. Interventions could be implemented to improve imaging outcome.

ADVANCES IN KNOWLEDGE

This study provides evidence for the increased psychological burden of PET/MRI compared with PET/CT, and that people prefer the PET/CT procedure. We have shown that the patients who expressed a preference for PET/MRI demonstrated significantly lower psychological burden for that procedure than those that preferred PET/CT, which indicates that the benefit of reduced psychological burden could be facilitated by an appropriate intervention.

Dural prostate metastasis resembling a chronic subdural haematoma

Subdural hematoma (SDH) is a common neurosurgical pathology, characteristically recognised on plain CT and can be treated with simple and effective surgical intervention. In contrast, dural metastatic adenocarcinoma of the prostate with SDH and malignant extension into the subdural membranes is extremely rare. We describe the case of a 62-year old Caucasian male, provide a brief review of the literature, and explore the potential role of neoangiogenesis and disseminated intravascular coagulopathy in SDH development.

232 SPECIES-RELATED DIFFERENCES IN BLASTOCYST QUALITY ARE ASSOCIATED WITH DIFFERENCES IN RELATIVE mRNA EXPRESSION

We have previously reported a species-related qualitative difference (in terms of ultrastructural morphology and cryotolerance) between bovine and ovine blastocysts produced under identical conditions of in vitro culture in synthetic oviduct fluid (SOF1, Rizos et al. 2002 Mol. Reprod. Dev. 62, 320–327). The overall objective of this study was to see if these differences were reflected at the transcript level. From each of five IVF replicates, groups of 10 bovine and 10 ovine blastocysts were used. The objective of Experiment 1 was to compare the relative transcript abundance of eight candidate genes between ovine and bovine blastocysts cultured in SOF1. Following real-time quantitative RT-PCR, transcript levels for MnSOD, survivin, and Glut-5 were significantly higher in ovine than in bovine blastocysts (ANOVA, P < 0.05), while transcripts for Cx31, IFN-tau and SOX were significantly more abundant in bovine blastocysts (P < 0.01). For the two remaining transcripts, E-cad and Na/K, there was no difference. The objective of Experiment 2 was to examine the possibility of modifying the pattern of expression in both types of blastocysts by changing the culture medium. Culture took place in SOF1 or SOF2 (Holm et al. 1999 Theriogenology 52, 683–700). Culture of bovine embryos in SOF2 resulted in a significant increase in the level of expression of MnSOD and Glut-5 (P < 0.05) compared to culture in SOF1. For all the other transcripts except survivin, there was a significant decrease in the relative abundance. Culture of ovine embryos in either SOF1 or SOF2 did not have a major influence on transcript abundance; of the eight transcripts examined, the relative abundance of only one, SOX, was significantly altered. Based on the above, the objective of Experiment 3 (3 replicates) was to determine whether the changed pattern of expression in bovine blastocysts produced in SOF2 was associated with an improvement in cryotolerance. Bovine blastocysts produced in both culture media were vitrified and warmed, and survival was assessed by re-expansion and hatching. Blastocysts produced in SOF2 had significantly higher survival rates at 24, 48, and 72 h and significantly higher hatching rates following vitrification and warming than those produced in SOF1 (P < 0.001). In conclusion, we have demonstrated that the apparent differences between ovine and bovine embryos in their adaptability to culture conditions, manifested in differences in embryo morphology and cryotolerance, are related to differences in mRNA relative abundance. This work was supported by Science Foundation Ireland under Grant No. 02/IN1/B78 and by Ministerio de Ciencia y Tecnologia from Spain under Grant No. AGL2003-05783.

Species-related differences in blastocyst quality are associated with differences in relative mRNA transcription

The objective of this study was to compare the relative transcript abundance of several important candidate genes between ovine and bovine blastocysts. Blastocysts were produced by in vitro maturation, fertilization, and subsequent culture in one of two formulations of synthetic oviduct fluid medium (SOF1 and SOF2). From each IVF replicate groups of 10 bovine and 10 ovine blastocysts from each of the two media were used for analysis of mRNA relative abundance. Transcript levels for mitochondrial Mn-superoxide dismutase (MnSOD), survivin, and glucose transport 5 (Glut-5) were significantly higher in ovine blastocysts than bovine (P < 0.05), while transcripts for Connexin 31 (Cx31), interferon tau (IFN-tau), and sarcosine oxidase (SOX) were significantly more abundant in bovine blastocysts (P < 0.01). For the two remaining transcripts, E-cadherin (E-cad) and Na/K ATPase (Na/K), there was no difference. Culture of bovine embryos in SOF2 resulted in a significant increase in the level of expression of MnSOD and Glut-5 (P < 0.05) compared to those bovine embryos cultured in SOF1. For all the other transcripts, except survivin, there was a significant decrease in the relative abundance. Culture of sheep embryos in either SOF1 or SOF2 did not have a major influence on transcript abundance; of the eight transcripts examined, the relative abundance of only one, SOX, was significantly altered. Bovine blastocysts produced in SOF2 had significantly higher survival rates at 24, 48, and 72 hr and significantly higher hatching rates following vitrification and warming than those cultured in SOF1 (P < 0.001). In conclusion, we have quantified for the first time the mRNA expression of a set of important developmental genes in sheep blastocysts and we have demonstrated that these differences between species in their adaptability to culture conditions, manifested in differences in embryo morphology and cryotolerance, are related to differences in mRNA relative abundance. The results also highlight the usefulness of transcript analysis as a marker of embryo quality.

State health department and university evaluation of North Carolina's Maternal Outreach Worker Program

INTRODUCTION

The Maternal Outreach Worker (MOW) Program is a social support intervention using lay helpers to provide support, health education, and outreach to Medicaid eligible women at risk for poor pregnancy and parenting outcomes. State Health Department and University collaborators designed a two-pronged evaluation comprised of programwide and interview study components to assess the impact of the program on pregnancy outcomes, health behaviors, and infant health status.

METHODS

Programwide evaluation data are based on 1992-1995 N.C. birth files for the original 24 participating counties and include 1,726 MOW participant births and 12,988 comparison births whose records were linked to birth files and met the study criteria. For the interview study 373 MOW participants and 332 comparison women were personally interviewed three times: during pregnancy, one month postpartum, and one year after delivery.

RESULTS

Risk factors associated with poor pregnancy and parenting outcomes were greater among MOW participants than comparisons in both the programwide and intensive study components. Caucasian MOW participants had slightly higher rates of adequate prenatal care. African Americans were found to have less adequate prenatal care. Fewer than expected LBW and VLBW births were observed for African-American MOW participants. MOW Program participation did not affect the utilization of health and social services for infants. African Americans, regardless of whether they received MOW services, fared better than Caucasians in terms of having their pregnancy needs fulfilled.

CONCLUSIONS

Findings show the need to further explore appropriate measures of maternity support program outcomes and indicate inconsistent program benefit among subpopulations.

An evaluation of consumer perspectives of childbirth and parenting education

As part of a study of childbirth and parenting education in the Australian Capital Territory (O'Meara, 1993a; 1993b) an evaluation of clients' views of the service was undertaken. The evaluation sought to identify indicators of effectiveness and needs. Two independent groups (current and past users, n = 207) were surveyed using an original questionnaire based on predisposing, reinforcing and enabling factors for human behaviour (Green's PRECEDE model). The data were compared and analysed using the related t-test for indicative differences in perceptions of the two groups. Indicative differences that were statistically significant were compared on variables representing users' age, parity and preferred mode of childbirth education (public or private). No evidence was found of significant differences in attitudes, beliefs and values before and after birth attributable to childbirth education. However, the health skills, confidence and emotional preparation for the birth, and the extent of participation in the learning process did not fully measure up to users' expectations. Consumers expect professionalism in the provision of services, with course content specifically tailored to their learning needs, taking into account age and previous experience of childbirth. A comprehensive curriculum is suggested covering all stages of the childbirth process from prepregnancy to parenting.

Monoclonal antibody solution hybridization assay for detection of human immunodeficiency virus nucleic acids

In this report we describe a novel, nonisotopic hybridization assay for the measurement of viral RNA in biological samples. The assay involved a solution-phase reaction between a biotinylated DNA probe and RNA target sequences. Labeled hybrids were detected in an immunoreaction by using a solid-phase anti-biotin antibody and an enzyme-labeled monoclonal antibody specific for DNA-RNA hybrids. This monoclonal antibody solution hybridization assay was compared with an antigen-capture immunoassay for the detection of human immunodeficiency virus in 436 cell culture samples from 60 seropositive patients. The sensitivity and specificity of the hybridization assay were 93.5 and 94.6%, respectively. Detection of human immunodeficiency virus solely by hybridization in the initial sample but not subsequent samples from seven cultures may reflect detection of virus that was present in the patients' lymphocytes but did not replicate in vitro. Since the assay method is adapatable to the detection of either RNA or DNA, it could provide a means for the detection of a wide range of viral nucleic acids.

Pressure distribution in the wrist joint

We performed a study to determine pressure distribution properties of the normal radio-carpal joint. A system was developed for measurement of the contact pressure within the wrist joint surfaces. The transducer was based on Fuji pressure-sensitive paper, which was inserted into the joint space through a dorsal capsular incision. The hand was then positioned using a jig that permitted free axial loading of the joint. Each of five specimens was tested in 36 positions combining flexion/extension with radio/ulnar deviation and supination/pronation. The transducers were analyzed for contact area, scapho-lunate contact area ratio, pressure, and centroid locations using a microcomputer-based video-imaging system. The scaphoid and lunate contact areas on the radius and triangular fibrocartilage were separate and distinct in all wrist positions. Together these contact areas accounted for a relatively small fraction of the total joint surface area (average contact area/total joint area = 0.206, SD = 0.0495). For an applied 103 Newton compressive load, the high pressure averaged 3.17 MPa (SD = 0.83 MPa). Overall, the scaphoid contact area was 1.47 times that of the lunate, although variations occurred with position, as in flexion, in which the scaphoid/lunate area ratio was 0.83. The high-pressure centroids of both scaphoid and lunate contact areas shifted palmarly from 20 degrees of flexion to 20 degrees of extension and then dorsally with further extension. The scaphoid-lunate intercentroid distance averaged 14.91 mm with a range of 10-20 mm.

Load transfer characteristics of the wrist. Part II. Perilunate instability

An experimental model with a static positioning frame, pressure-sensitive film (Fuji), and a microcomputer-based video digitizing system, previously developed by the two senior authors, was used in this study to examine the effects of increasing perilunate instability on the load transfer characteristics of the wrist. These effects included a significant dorsal ulnar shift of the scaphoid centroid with increasing perilunate instability together with a less dramatic palmar ulnar shift of the lunate centroid. Overall, the scaphoid contact area was found to decrease as the stage of perilunate instability increased, even in ulnar deviation and/or extension, which in the normal wrist was found to be the positions that had the greatest scaphoid contact area. Average pressures in the high pressure zones were found to significantly increase in wrists with a stage III instability compared with normal wrists. An increase in the intercentroid (scaphoid/lunate) distance was most evident with the wrist in 20 degrees extension, neutral radioulnar deviation, and 90 degrees supination.

Load transfer characteristics of the wrist. Part I. The normal joint

A static positioning frame allows the positioning of unembalmed human upper extremities in any combination of wrist flexion/extension, radio/ulnar deviation, and pronation/supination. Pressure-sensitive film (Fuji) was used to study the contact areas, scaphoid-lunate area ratios, average high pressures, centroid positions, and intercentroid distances of five wrist joints under a uniform load of 103 Newtons (N) in 36 different positions. The contact areas accounted for only 20.6% of the available joint surface. They shift from a primarily palmar location to a primarily dorsal location when the wrist changes from flexion to extension. Overall the scaphoid contact area was 1.47 times that of the lunate and was generally greatest with the wrist in ulnar deviation. The scapho-lunate contact area ratio increased as wrist position changed from radial to ulnar deviation and/or from flexion to extension. For the constant load of 103 Newtons the high pressure averaged 3.17 megapascals (MPa). The scaphoid and lunate high pressure centroids shifted palmar when wrist position changed from 20 degrees of flexion to 20 degrees of extension and then shifted dorsal with further extension of the wrist. The intercentroid distance averaged 14.91 mm and ranged from 10 to 20 mm.

Hand injuries from shrimp boat winches

Shrimp boat winch injury to the upper extremity was identified in three patients. The injury occurred when the individual's hand became entrapped in the cable and the upper extremity was drawn into the winch mechanism. This resulted in midshaft fractures of one or both bones of the forearm and amputation of a portion of the fourth and fifth fingers. This injury emphasizes the importance of safeguards on the cable system. However, in the absence of safety regulations in the shrimping industry, more of these injuries can be expected.