Accuracy of Cutaneous Landmarks Compared to Ultrasound to Locate the Calcaneal Footprint of the CFL

The purpose was to determine the accuracy of the techniques of Lopes et al. and Michels et al., compared to ultrasound, to locate the center of the calcaneal footprint of the CFL in healthy volunteers. The authors recruited 17 healthy adult volunteers at 1 center with no current ankle pathologies and no previous surgical antecedents on either ankle. The authors recorded the age, sex, height, BMI, and ankle side for each volunteer. Measurements were made on both ankles of the 17 volunteers to increase the sample size and ensure less dispersion of data, independently by 2 surgeons: 1 senior surgeon with 15 years' experience and 1 junior with 3 years' experience. The location of the center of the calcaneal footprint of the CFL was determined by each surgeon using 3 methods: (1) the cutaneous technique of Lopes et al., (2) the cutaneous technique of Michels et al., and (3) ultrasound imaging. The 17 volunteers (34 feet) had a mean age of 26.3 ± 8.7 and a BMI of 21.7 ± 2.9. The Michels point was significantly closer (4.6 ± 3.7 mm) than the Lopes point (11.1 ± 5.4 mm) to the true center of the calcaneal footprint of the CFL determined by ultrasound, notably in the vertical direction. The Michels point was located significantly closer to the true center of the calcaneal footprint of the CFL and demonstrated less dispersion than the Lopes point, indicated by significantly lower absolute mean deviation from the true center of the calcaneal footprint of the CFL, and that ultrasound is therefore preferred to locate the footprint the CFL.

Qualitative and Quantitative Anatomy of the Deep Radioulnar Ligaments' Insertion on Ulna: Cadaveric, Histologic, and MRI Study

PURPOSE

To qualitatively and quantitatively analyze the anatomic features of the insertion of deep radioulnar ligaments (RULs) and provide an anatomic basis for further studies.

METHODS

The anatomic features of deep RUL insertion were observed macroscopically in 26 cadaveric wrists, after which the size of the deep RUL footprint and distance from the center of the footprint to the ulnar-sided margin of articular cartilage of the ulnar head were each measured. Five specimens were analyzed histologically to examine the attachment of the RUL on the ulna. In addition, we evaluated 21 asymptomatic wrists from healthy volunteers using 3.0 T magnetic resonance imaging.

RESULTS

The insertion of the deep RUL was located mainly on the radial aspect of the ulnar fovea from the foveal center to the articular cartilage. The footprint of the deep RUL appeared in 3 different shapes. The maximal width, length, and area of the footprint of the deep RUL were 3.7 (95% confidence interval [CI], 3.3-4.0) mm, 8.4 (95% CI, 7.9-8.9) mm, and 26.3 (95% CI, 23.4-29.1) mm2, respectively. Histologic analyses showed the attachment of the deep RUL on the radial wall of the fovea exhibited a direct insertion with typical 4-layer structures. The deep RUL fibers formed an acute angle with the distal component of the triangular fibrocartilage complex.

CONCLUSIONS

The deep RUL was inserted on the radial side of the ulnar fovea and not the foveal center; it had direct insertion on the radial wall continuous with articular cartilage, and the fibers in the direct insertion formed an acute angle with the distal component of the triangular fibrocartilage complex.

CLINICAL RELEVANCE

Understanding the quantitative anatomy of the deep RUL insertion may help guide surgeons to perform an anatomic foveal repair of the triangular fibrocartilage complex in its native footprint.

The feasibility study of stress position device simulating standing weight-bearing applied in computed tomography examination

BACKGROUND

In order to simulate weight-bearing Computed Tomography (CT) examination, this study designed a simple stress position device. By analyzing the relevant data of stress position footprints and weight-bearing position footprints, the feasibility of the stress position device to simulate standing weight-bearing was verified.

METHODS

This study randomly selected 25 volunteers for standing weight-bearing and stress position footprints collection, and measured the relevant indicators of stress position footprints and standing weight-bearing position footprints. Two foot and ankle surgeons conducted two measurements respectively on the footprints. Intra-observer and inter-observer reliability were calculated using intra-class correlation coefficients (ICC). Pearson correlation coefficient, ICC, scatter plot analysis, and paired t-test were used to analyze the stress and weight-bearing position data.

RESULTS

The intra-observer and inter-observer measurement values were reliable. There was a certain degree of correlation between the stress position footprints and weight-bearing position footprints in terms of Pearson correlation coefficient, ICC, and scatter plot analysis. Paired t-tests showed significant differences in Clarke angle (t 2.636, p .012), C-S index (t 10.568, p .000), arch indx (t 2.176, p .035), and arch lower angle (t 6.246, p .000).

CONCLUSION

The stress position device can generate a certain degree of stress, and after further optimization and improvement of the stress position device, it is feasible to apply it to weight-bearing CT examination in clinical settings.

Characteristics of net ecosystem exchange and source distribution of Xilinhot grassland, China

To understand carbon sequestration capacity of grasslands, the changes of CO2 flux in Xilinhot grasslands and the influence of environmental factors were analyzed by using the eddy data of Xilinhot National Climate Observatory in 2018-2021, and the distribution of flux source areas was analyzed. The results showed that the southwest wind prevailed in the study area throughout the year, the source area in the growing season was larger than that in the non-growing season, and the source area under stable atmospheric conditions was larger than that under unstable conditions. The maximum length of source region with a contribution rate of 90% was close to 400 m, which was consistent with the length estimated by the classical law. The net ecosystem exchange (NEE) of Xilinhot grasslands had obvious diurnal and seasonal dynamics, which was manifested as a carbon sink in the daytime and a carbon source at night during the growing season and weak carbon source in the non-growing season. From 2018 to 2021, the annual total NEE were -15.59, -46.28, -41.94, and -78.14 g C·m-2·a-1, respectively, with an average value of -45.49 g C·m-2·a-1, indicating that Xilinhot grassland had strong carbon sequestration capacity. Vapor pressure deficit and photosynthetically active radiation helped grasslands absorb atmospheric CO2. At night, when temperature was above 0 ℃, the increases in air and soil temperature promoted vegetation respiration to release CO2.

Unveiling the Nexus Profile of Embodied Water-Energy-Carbon-Value Flows of the Yellow River Basin in China

Unveiling the nexus profile of the water-energy-carbon (WEC) and value flows embodied in regional trade is essential for enhancing the co-benefits between economic development and environment conservation. However, minimal research explores the WEC and value-added nexus efficiency of the Yellow Basin River (YRB) with a comprehensive framework. Thus, this study built a nexus framework based on a multiregional input-output model (MRIO) to analyze embodied WEC and value-added flows in the nine provinces of the YRB and all 31 provinces of China, primarily in 2017 compared to 2012 and 2015. Three dimensions (space, sectors, and environmental and economic factors) depict the WEC and value-added nexus patterns. The results from these three dimensions uncovered that the YRB benefits from regional trade but suffers environmental losses, and the development imbalance among the provinces of the basin is exacerbated. The proposed integrated framework can be generalized to water-energy extended nexus analysis in other regions to portray a more complex human-environment system nexus pattern. The new knowledge of how embodied WEC interacts with concomitant economic activities within and beyond the YRB can benefit multiresource-integrated management in the YRB and coordinated regional development in China.

Fast One-Step Fabrication of Highly Regular Microscrolls with Controllable Surface Morphology

Although rolling origami technology has provided convenient access to three-dimensional (3D) microstructure systems, the high yield and scalable construction of complex rolling structures with well-defined geometry without impeding functionality has remained challenging. The straightforward, one-step fabrication that uses external mechanical stress to scroll micrometer thick, flexible planar films with centimeter lateral dimensions into tubular or spiral geometry within a few seconds is demonstrated. The method allows controlling the scrolls' diameter, number of windings and nanostructured surface morphology, and is applicable to a wide range of functional materials. The obtained 3D structures are highly promising for various applications including sensors, actuators, microrobotics, as well as energy storage and electronic devices.

Relationship between Joint and Ligament Structures of the Subtalar Joint and Degeneration of the Subtalar Articular Facet

This study aimed to clarify the relationship between the joint and ligament structures of the subtalar joint and degeneration of the subtalar articular facet. We examined 50 feet from 25 Japanese cadavers. The number of articular facets, joint congruence, and intersecting angles were measured for the joint structure of the subtalar joint, and the footprint areas of the ligament attachments of the cervical ligament, interosseous talocalcaneal ligament (ITCL), and anterior capsular ligament were measured for the ligament structure. Additionally, subtalar joint facets were classified into Degeneration (+) and (-) groups according to degeneration of the talus and calcaneus. No significant relationship was identified between the joint structure of the subtalar joint and degeneration of the subtalar articular facet. In contrast, footprint area of the ITCL was significantly higher in the Degeneration (+) group than in the Degeneration (-) group for the subtalar joint facet. These results suggest that the joint structure of the subtalar joint may not affect degeneration of the subtalar articular facet. Degeneration of the subtalar articular facet may be related to the size of the ITCL.

Methane dynamics from a mixed plantation of north China: Observation using closed-path eddy covariance method

Although an important greenhouse gas, methane flux in hilly forest ecosystems remains unclear. By using closed-path eddy covariance systems, methane flux was measured continuously from 2017 to 2019 in a mixed plantation in the Xiaolangdi area of the Yellow River in North China. The methane flux footprint and its diurnal and monthly variations were analysed, and its characteristics on rainy days are discussed. The results showed that: (a) the observation data were reliable with good spatial representation (b) The methane flux in the mixed plantation ecosystem had obvious diurnal and seasonal variations: the monthly average diurnal variation of the methane flux had a single-peak; the methane flux value was source in the daytime and sink at night. The daily mean maximum value of methane flux in growing season was lower than that in non-growing season with the maximum value appearing in March, and the minimum value in October. (c) The forest is an atmospheric CH₄ source with the annual emission in 2017 of (3.31 g C·m^-2·year ^-1) >2019 (2.94 g C·m^-2·year^-1) >2018 (2.81 g C·m^-2·year ^-1), and the main influencing factor was precipitation. Rainfall affected CH₄ flux with a lag period of approximately three days. Rainfall also changed the balance of CH₄ flux between sink or source according to precipitation intensity and frequency.

Functional and radiologic results of the crimson duvet procedure in rotator cuff treatment: a randomized controlled clinical trial

BACKGROUND

Rotator cuff tears are one of the more frequent pathologies of the shoulder. Arthroscopic techniques and biologic augmentation have been developed to improve the rate and quality of healing. The crimson duvet procedure (CDP) theoretically provides mesenchymal stem cells through microfracture treatment of the footprint. The aim of this research was to evaluate the effect of CDP in patients who had undergone arthroscopic surgery for complete rotator cuff repair.

METHODS

A prospective randomized clinical trial was performed in a total of 123 patients, consisting of 59 women and 64 men, with a mean age of 58 years. We included patients with a clinical and radiologic diagnosis of a complete rotator cuff tear. All patients were treated with arthroscopic rotator cuff repair. In group 1, the surface of the footprint was débrided; in group 2, the footprint underwent microfracture. The primary outcome was the nonhealing rate, which was detected by magnetic resonance imaging (MRI) or ultrasonography, and the secondary outcome was the functional result. A Sugaya classification of I to III was considered to indicate healing. For clinical evaluation, the American Shoulder and Elbow Surgeons Standardized Shoulder Assessment Form (ASES) and Constant scores were evaluated, along with the range of motion. The functional evaluation was performed preoperatively and at 6 months and 1 year postoperatively. The radiologic (MRI or ultrasonography) evaluation was performed at 6 months. Neither the patients nor the radiologists and physical therapists who performed the postoperative evaluations were informed of the random selection.

RESULTS

We observed a healing rate of 85.11% in the control group and 93.7% in the CDP group, which was not significant (P = .19). However, a significant improvement in function was observed in all patients. The ASES score improved from 68.9 (SD 13.8) preoperatively to 92.2 at 6 months and to 96.4 (SD 6.2) at 12 months (P < .05), but no difference was observed between the groups. A similar level of improvement was observed in the Constant score.

CONCLUSION

The arthroscopic repair of complete rotator cuff tears presents good and excellent clinical results in most patients. Nevertheless, nonhealing occurs at a rate that depends mainly on the age of the patient and the size of the tear. The addition of CDP did not improve the functional results or the healing rate.

Spatio-temporal changes pattern in the hotspot's footprint: a case study of confirmed, recovered and deceased cases of Covid-19 in India

Hotspot detection and the analysis for the hotspot's footprint recently gained more attention due to the pandemic caused by the coronavirus. Different countries face the effect of the virus differently. In India, very little research has been done to find the virus transmission. The paper's main objective is to find changing pattern of the footprint of the hotspot. The confirmed, recovered, and deceased cases of the Covid-19 from April 2020 to Jan 2021 is chosen for the analysis. The study found a sudden change in the hotspot district and a similar change in the footprint from August. Change pattern of the hotspot's footprint will show that October is the most dangerous month for the first wave of the Corona. This type of study is helpful for the health department to understand the behavior of the virus during the pandemic. To find the presence of the clustering pattern in the dataset, we use Global Moran’s I. A value of Global Moran’s I greater than zero shows the clustering in the data set. Dataset is temporal, and for each type of case, the value Global Moran’s I > 0, shows the presence of clustering. Local Moran’s I find the location of cluster i.e., the hotspot. The dataset is granulated at the district level. A district with a high Local Moran’s I surrounded by a high Local Moran’s I value is considered the hotspot. Monte Carlo simulation with 999 simulations is taken to find the statistical significance. So, for the 99% significance level, the p-value is taken as 0.001. A hotspot that satisfies the p-value threshold is considered the statistically significant hotspot. The footprint of the hotspot is found from the coverage of the hotspot. Finally, a change vector is defined that finds the pattern of change in the time series of the hotspot’s footprint.

Comparison of Two Diagnostic Assays for Anti-Laminin 332 Mucous Membrane Pemphigoid

Anti-laminin 332 mucous membrane pemphigoid (MMP) is an autoimmune blistering disease characterized by predominant mucosal lesions and autoantibodies against laminin 332. The exact diagnosis of anti-laminin 332 MMP is important since nearly 30% of patients develop solid cancers. This study compared two independently developed diagnostic indirect immunofluorescence (IF) tests based on recombinant laminin 332 expressed in HEK239 cells (biochip mosaic assay) and the migration trails of cultured keratinocytes rich in laminin 332 (footprint assay). The sera of 54 anti-laminin 332 MMP, 35 non-anti-laminin 332 MMP, and 30 pemphigus vulgaris patients as well as 20 healthy blood donors were analyzed blindly and independently. Fifty-two of 54 and 54/54 anti-laminin 332 MMP sera were positive in the biochip mosaic and the footprint assay, respectively. In the 35 non-anti-laminin 332 MMP sera, 3 were positive in both tests and 4 others showed weak reactivity in the footprint assay. In conclusion, both assays are easy to perform, highly sensitive, and specific, which will further facilitate the diagnosis of anti-laminin 332 MMP.

Planetary Boundaries for Forests and Their National Exceedance

Achieving forest sustainability is a declared sustainable development goal (SDG 15). Measuring the safe operating space─planetary boundaries─of global forests is essential to determine global forest pressure and manage forests sustainably. Here, we quantify the forestry planetary boundary (FPB) and national forestry boundaries. Results show that, in 2015, the FPB was 7.1 billion m³ of forest stock increments. Global timber harvests account for 58.7% of the FPB. Timber harvests of 47 nations, mostly in Africa and Asia, have exceeded their national forestry boundaries. Their boundary-exceeding timber harvest is mainly driven by the final demand of developed nations (e.g., the United States and Japan) and emerging economies (e.g., India and China) through global supply chains. This study highlights the importance of the FPB in global forest management and trade-related policymaking. The findings can guide global and national forest harvesting activities and help promote international cooperation to mitigate global deforestation.

Relationship of Body Mass Index and Footprint Morphology to the Actual Height of the Medial Longitudinal Arch of the Foot

The medial longitudinal arch height of the foot is linked to individual characteristics such as sex and body mass index, and these characteristics have been shown to be associated with conditions such as flat feet. In this cross-sectional descriptive study, we examined the medial longitudinal arch morphology in an adult population to determine if there are differences related to sex and body mass index, and values were obtained for the foot posture index. Normalized anthropometric measurements and arch indices were calculated from footprints. Groups, defined by sex and body mass index, were compared, and the correlations between body mass index and the variables were determined. In the population studied (266 women and 177 men), significant differences between men and women for the foot posture index and normalized arch measurements were found. Analysis of the variables related to body mass index indicated there were significant differences in arch indices. Significant differences and positive correlations were also found between the arch index and body mass index for the left and right feet among the men and women studied. The results obtained allow us to reflect on and analyze whether the medial longitudinal arch morphology classification methods used in the clinical and research setting are adequate or whether the influence of factors such as body mass index can generate confusion.

Spatial-Temporal Footprints Assessment and Driving Mechanism of China Household Diet Based on CHNS

Food consumption is closely associated with resource consumption and environmental sustainability. An unreasonable dietary pattern would cause great pressure or damage to resources and the environment. It is particularly important to reduce the negative impact of household food consumption on resources and the environment while simultaneously ensuring people’s nutrient intake and health. This study applied the China Health and Nutrition Survey (CHNS) database to quantitatively study the spatial-temporal analysis of multiple footprints of household food consumption at multiple scales and explored the driving mechanism of the multiple footprints. The results showed that, except land footprint (LF), the other four types of footprints all decreased at varying degrees; the water footprint (WF), carbon footprint (CF), nitrogen footprint (NF) and energy footprint (EF) decreased by 18.24%, 17.82%, 12.03% and 20.36%, respectively, from 2000 to 2011; multiple footprints of food consumption of household in Guizhou was the highest among the 12 provinces involved in the study; this shows that resource consumption (water, energy and land resource) and environmental influences (CO₂ emissions and nitrogen emissions) brought by food consumption of per household in Guizhou are much greater than in other provinces, which has a negative influence on sustainable development; by analyzing the driving factors of multiple footprints, it is shown that nutrient intake, household attributes, educational level and health conditions were significantly correlated to multiple footprints. Among them, nutrient intake has greater impact on the multiple footprints of Chinese household food consumption. By comparing multiple footprints of different dietary patterns, it was found that the current Chinese dietary pattern would cause excessive resource consumption, which would bring more pressure on resources and the environment. Adjusting household living habits would possibly reverse the unsustainable situation, such as reducing the consumption of animal-derived foods and adjusting the dietary pattern of households with a higher educational level and income status. Chinese Dietary Guidelines 2016 has better sustainability; the promotion of this dietary pattern across the country would help China to relieve the pressure on resources and environment from the consumer side, promoting the realization of sustainable development.

A Modular Setup to Run a Large Line of Behavioral Testing in Mice in a Single Space

Elucidating the complex neural mechanisms that underlie cognition is contingent upon our ability to measure behavioral outputs reliably in animal models. While the development of open-source software has made behavioral science more accessible, behavioral research remains underappreciated and underutilized. One reason is the large real estate necessitated by traditional behavioral setups. Space must be specifically allocated for a controlled testing environment, accommodate the large footprint of mazes used in behavioral research, and allow a contiguous computerized area for data acquisition. Additionally, to achieve the distinct and sometimes incompatible environmental conditions required by different tasks, a suite of testing rooms may be necessary. Because space is a limited resource, this makes behavioral testing impractical for some labs or leads to implementation of suboptimal solutions that compromise the ergonomics of the working space, prevent the adequate control of environmental parameters around the testing setup, and jeopardize experimental reproducibility. Here, we describe a modular, space-saving, self-sufficient, functional, customizable, and cost-efficient setup to allow a large line of behavioral tests in mice within a single, compact room (<8 m² ). Because it is modular by design, this setup requires no compromises on ergonomics, environmental control, or complexity of the visual landscape. It is inherently effective at streamlining behavioral experiments by eliminating the need to redefine tracking parameters, and makes swapping between configurations fast (∼1 min) and effortless. Presently, this design allows one to run eight major behavioral tasks, permitting a detailed and comprehensive analysis of mouse behavior within the footprint of a small office. © 2020 Wiley Periodicals LLC. Basic Protocol 1: Constructing the support table Support Protocol 1: Constructing the open-field maze Support Protocol 2: Constructing IR-permissive inserts for light-dark assays Support Protocol 3: Constructing the three-chamber maze Support Protocol 4: Constructing the Y maze Support Protocol 5: Constructing the elevated plus maze Support Protocol 6: Constructing the Barnes maze Basic Protocol 2: Setting up the behavior room: flange and pulley systems Basic Protocol 3: Setting up the behavior room: environmental and storage systems Basic Protocol 4: Assembling and switching between configurations.

Spatially Explicit Global Hotspots Driving China's Mercury Related Health Impacts

Over 100 nations signed the Minamata Convention on Mercury to control the adverse effects of mercury (Hg) emissions on human beings. A spatially explicit analysis is needed to identify the specific sources and distribution of Hg-related health impacts. This study maps China's Hg-related health impacts and global supply chain drivers (i.e., global final consumers and primary suppliers) at a high spatial resolution. Here we show significant spatial heterogeneity in hotspots of China's Hg-related health impacts. Approximately 1% of the land area holds only 40% of the Chinese population but nearly 70% of the fatal heart attack deaths in China. Moreover, approximately 3% of the land area holds nearly 60% of the population but 70% of the intelligence quotient (IQ) decrements. The distribution of hotspots of China's Hg-related health impacts and global supply chain drivers are influenced by various factors including population, economy, transportation, resources, and dietary intake habits. These spatially explicit hotspots can support more effective policies in various stages of the global supply chains and more effective international cooperation to reduce Hg-related health impacts. This can facilitate the successful implementation of the Minamata Convention on Mercury.

Ulnar footprints of the distal radioulnar ligaments: a detailed topographical study in 21 cadaveric wrists

Understanding of the exact topography of the distal radioulnar ligaments insertions remains limited. An anatomical study was performed in 21 fresh frozen cadaveric wrists, where the superficial and deep ligaments were sequentially transected sharply at their ulnar insertions. The relationships between the distal radioulnar ligament footprints relative to the bony landmarks of the ulnar styloid were digitized. Our study demonstrated that in the coronal plane, the superficial distal radioulnar ligaments inserted at an average of 87% of the styloid height proximally to the styloid tip distally. The deep distal radioulnar ligaments inserted at an average of 81% of the styloid height distally to the fovea proximally. The superficial footprint had an area of 10.6 mm² on the ulnar styloid. The deep distal radioulnar ligaments attachment was asymmetric and generally had two separate footprints. This study adds important topographical knowledge about the footprint of the distal radioulnar ligaments and may contribute to understanding the consequences of ulnar styloid fractures and distal radioulnar ligaments lesions.

Performance Comparison of Spiral-Wound and Plate-and-Frame Forward Osmosis Membrane Module

We compared two representative forward osmosis (FO) modules—spiral-wound (SW) and plate-and-frame (PF)—to provide practical information for the selection of FO element for a large-scale FO process. The FO operating performance of commercially available SW FO and PF FO was explored under different membrane area and flow rate conditions. The performance trend as a function of the membrane was obtained by adjusting the number of serially connected elements. Although SW FO and PF FO elements exhibited comparable feed pressure drops, SW FO demonstrated a significantly higher draw channel pressure drop than PF FO. Furthermore, the significant draw pressure drop in SW FO increased the draw inlet pressure, consequently limiting the number of serially connected elements. For example, the maximum number of serially connected elements for the normal operation was three elements for SW FO (45.9 m²) but nine elements for PF FO (63 m²) when the flow rate of 10 LMP was applied for feed and draw streams. Additionally, a footprint analysis indicated that SW FO module exhibited a slightly larger footprint than PF FO. Under investigated conditions, PF FO exhibited relatively better performance than SW FO. Therefore, this pilot-scale FO study highlighted the need to reduce the flow resistance of SW FO draw channel to take advantage of the high packing density of the SW element.

Variable Lower Limb Alignment of Clinical Measures With Digital Photographs and the Footscan Pressure System

OBJECTIVE

This study examines the effect of the lower limb misalignment and its possible compensatory effect on plantar pressure in a normal population. The aim of this paper is to present a structured method for the analysis of posture and its changes using a standardized digital photography technique and plantar pressure measuring device.

DESIGN

Cohort.

SETTING

Laboratory.

PARTICIPANTS

A total of 200 adult volunteers between 18 and 22 years of age who had no current symptoms of pain and foot or ankle pathology participated in the study.

MAIN OUTCOME MEASURES

The gold standard measure of lower limb alignment with weight-bearing status is the mechanical axis and their angles using Image J software. Structural and functional measurements of the same foot were taken using a plantar pressure measuring device. In this study, 5 alignment (thigh, knee, leg, ankle, and foot) characteristics were measured on the lower limb using the 2 techniques, and, additionally, the foot contact area, peak pressure, foot axis, rearfoot angle, and subtalar joint flexibility score were analyzed in 10 different regions of the foot.

RESULTS

This study has shown a reasonable correlation between digitalized measurements and plantar pressures values. Quadriceps angle affected midfoot impulse, foot axis angle, subtalar joint minimum angle, and rearfoot angle positively. Subtalar joint flexibility scores were analyzed in 10 different regions of the foot. There was a positive correlation between rearfoot angle and quadriceps angle (P = .009, r = .261). Results of both methods show that they endorse each other.

CONCLUSIONS

The posture of the standing feet may have influence on lower limb alignment. Currently, there are no studies carried out by using digital photogrammetry and foot scan. The authors claim that patient-friendly digital photogrammetry would have a positive contribution to the monitoring of patients, even including new ones in the treatment programs, reducing any possible loss in the personal and national economy.

It's in the loop: shared sub-surface foot kinematics in birds and other dinosaurs shed light on a new dimension of fossil track diversity

The feet of ground-dwelling birds retain many features of their dinosaurian ancestry. Experiments with living species offer insights into the complex interplay among anatomy, kinematics and substrate during the formation of Mesozoic footprints. However, a key aspect of the track-making process, sub-surface foot movement, is hindered by substrate opacity. Here, we use biplanar X-rays to image guineafowl walking through radiolucent substrates of different consistency (solid, dry granular, firm to semi-liquid muds). Despite substantial kinematic variation, the foot consistently moves in a looping pattern below ground. As the foot sinks and then withdraws, the claws of the three main toes create entry and exit paths in different locations. Sampling these paths at incremental horizons captures two-dimensional features just as fossil tracks do, allowing depth-based zones to be characterized by the presence and relative position of digit impressions. Examination of deep, penetrative tracks from the Early Jurassic confirms that bipeds had an equivalent looping response to soft substrates approximately 200 Ma. Our integration of extant and extinct evidence demonstrates the influence of substrate properties on sinking depth and sub-surface foot motion, both of which are significant sources of track variation in the fossil record of dinosaurs.

Surgical anatomy of the pectoralis major tendon insertion revisited: relationship to nearby structures and the pectoral eminence for defining the anatomic footprint

Background

Intraoperative identification of the normal pectoralis major (PM) footprint can be challenging to identify in the acute and chronic settings. The purpose of this study was to revisit the anatomic footprint of the PM tendon and to determine which nearby landmarks can be used to re-create the normal insertion site during anatomic repair or reconstruction.

Methods

Twenty-one fresh-frozen human cadaveric shoulder specimens were used to define the PM tendon width (ie, superior-to-inferior) and to determine the relationship between the superior aspect of the PM insertion and that of the latissimus dorsi (LD) and anterior deltoid (AD) tendons. An attempt was made to identify potential useful bony landmarks that can be used during anatomic repair or reconstruction of the PM tendon.

Results

The mean PM tendon width was 68.8 ± 4.4 mm. The superior margin of the LD insertion was 9.4 ± 5.9 mm above and the AD was 48.4 ± 7.1 mm below the superior margin of the PM tendon insertion, respectively. In 17 of 21 specimens (81%), the superior insertion of the PM tendon attached onto a bony prominence, named the pectoral eminence.

Conclusions

The LD and AD tendon insertions represent reliable soft tissue landmarks for identifying the superior extent of the PM tendon along its bony footprint. The pectoral eminence can also be used as an additional reference point in the majority of cases to facilitate anatomic restoration of the pectoralis tendon during repair and reconstruction. Surgeons should be familiar with the proximity of nearby neurovascular structures when performing PM repairs.

Regional environmental assessment of dairy farms

A comprehensive, yet in depth, assessment is needed of the environmental impacts of dairy farms at regional and national scales to better track improvements made by the industry. With Pennsylvania as an example, a method using process-level simulation and cradle-to-farm gate life cycle assessment was developed and used to assess important environmental footprints of dairy farms within a state. Representative dairy farms of various sizes and management practices throughout 7 regions of the state were simulated with the Integrated Farm System Model. Environmental footprints varied widely among farms, with this variation influenced primarily by soil characteristics and climate and secondarily by farm management. Therefore, prescriptive mitigation strategies for individual farms are more effective than uniform enforcement of specific strategies across the state. Footprints for the whole state were determined by totaling values among farms and regions based on the amounts of milk produced by each. Pennsylvania dairy farms were determined to emit 4,555 with an uncertainty of ±415 Gg of CO₂ equivalent of greenhouse gas with an intensity of 0.99 ± 0.09 kg of CO₂ equivalent/kg of fat- and protein-corrected milk (FPCM) produced. Fossil energy consumption was 12,324 ± 1,946 TJ or 2.69 ± 0.42 MJ/kg of FPCM. Blue (nonprecipitation) water consumption was 64.1 ± 13.5 Tg with an intensity of 14.0 ± 3.0 kg/kg of FPCM. A total of all forms of reactive N loss was 43.2 ± 5.0 Gg with an intensity of 9.4 ± 1.1 g/kg of FPCM. These metrics were equivalent to 1.6% of the greenhouse gas emissions, 0.4% of fossil energy use, and 0.8% of fresh water consumption reported for the state. Thus, greenhouse gas emissions, fossil energy use, and blue water use associated with dairy farm production are relatively small compared with total estimates for the state. Perhaps the greatest environmental concern is that of ammonia emission, where dairy farms accounted for about half the estimated emissions of the state. This method can be applied to assessments of the dairy industry at larger regional and national scales.

Evaluation of the paediatric foot using footprints and foot posture index: A cross-sectional study

AIM

Footprints have long been used as proxy measures of foot morphology, yet there is little consensus regarding footprints versus measures of foot posture, which address foot anatomy directly. Foot posture in children can be a confusing clinical presentation, with previous studies both supporting and refuting the relationship between childhood obesity and flat feet. The aim of this study was to determine the relationship between footprints and foot posture in children.

METHODS

A total of 316 school children (153 boys, 163 girls) from Spain, aged 6-9 years, were assessed for both footprint (Clarke's angle (CA)), by Tecniwork Pedrograph Plate, and foot posture (foot posture index (FPI)) measures, with participants barefoot, in a relaxed standing position, on a 50-cm elevated platform.

RESULTS

A negative correlation was found between FPI and footprints (CA) (rho = -0.505 left, P < 0.001) and by gender (rho = -0.457 for the left foot in girls, P < 0.001; rho = -0.548 for the left foot in boys, P < 0.001). The children with pes cavus according to the CA (73.3%) had normal feet according to FPI, and the children with severe pes planus according to the CA (78.98%) had pronated feet according to the FPI. A χ² test showed these results to be statistically significant (P > 0.001).

CONCLUSIONS

An inverse relationship between CA and FPI was identified, that is, the greater the FPI, the smaller the CA, but not all pronated foot are planus feet and not all cavus feet are supinated feet. Footprints may overestimate and misguide paediatric foot posture concerns.

Interspecies comparison of sea star adhesive proteins

Sea stars use adhesive secretions to attach their numerous tube feet strongly and temporarily to diverse surfaces. After detachment of the tube feet, the adhesive material stays bound to the substrate as so-called 'footprints'. In the common sea star species Asterias rubens, the adhesive material has been studied extensively and the first sea star footprint protein (Sfp1) has been characterized. We identified Sfp1-like sequences in 17 additional sea star species, representing different taxa and tube foot morphologies, and analysed the evolutionary conservation of this protein. In A. rubens, we confirmed the expression of 34 footprint proteins in the tube foot adhesive epidermis, with 22 being exclusively expressed in secretory cells of the adhesive epidermis and 12 showing an additional expression in the stem epidermis. The sequences were used for BLAST searches in seven asteroid transcriptomes providing a first insight in the conservation of footprint proteins among sea stars. Our results highlighted a high conservation of the large proteins making up the structural core of the footprints, whereas smaller, potential surface-binding proteins might be more variable among sea star species. This article is part of the theme issue 'Transdisciplinary approaches to the study of adhesion and adhesives in biological systems'.

China's Land Uses in the Multi-Region Input-Output Framework

The finite resource of land is subject to competing pressures from food demand, urbanization, and ecosystem service provision. Linking the land resource use to the whole production chain and final consumption of various products and services offers a new perspective to understand and manage land uses. This study conducted a systematic analysis of land uses at the provincial level in China using the multi-region input–output model in 2012. Land use patterns related to the sectoral production and consumption in different provinces were examined. The results indicated that the land use transfers between different provinces in China have formed a highly interacting network. Products and services involved in the inter-provincial trades in China contained 2.3 million km² land uses, which constituted approximately 40% of the total national land uses that were finally consumed in China. Agriculture was the most direct land use intensive sector, and industry was the most indirect land use intensive sector. Land resource-scarce provinces with low per capita land availability have outsourced parts of their land uses by net importing lands from other provinces. The results have important policy implications towards sustainable land uses in China.

Error Budget for Geolocation of Spectroradiometer Point Observations from an Unmanned Aircraft System

We investigate footprint geolocation uncertainties of a spectroradiometer mounted on an unmanned aircraft system (UAS). Two microelectromechanical systems-based inertial measurement units (IMUs) and global navigation satellite system (GNSS) receivers were used to determine the footprint location and extent of the spectroradiometer. Errors originating from the on-board GNSS/IMU sensors were propagated through an aerial data georeferencing model, taking into account a range of values for the spectroradiometer field of view (FOV), integration time, UAS flight speed, above ground level (AGL) flying height, and IMU grade. The spectroradiometer under nominal operating conditions (8∘ FOV, 10 m AGL height, 0.6 s integration time, and 3 m/s flying speed) resulted in footprint extent of 140 cm across-track and 320 cm along-track, and a geolocation uncertainty of 11 cm. Flying height and orientation measurement accuracy had the largest influence on the geolocation uncertainty, whereas the FOV, integration time, and flying speed had the biggest impact on the size of the footprint. Furthermore, with an increase in flying height, the rate of increase in geolocation uncertainty was found highest for a low-grade IMU. To increase the footprint geolocation accuracy, we recommend reducing flying height while increasing the FOV which compensates the footprint area loss and increases the signal strength. The disadvantage of a lower flying height and a larger FOV is a higher sensitivity of the footprint size to changing distance from the target. To assist in matching the footprint size to uncertainty ratio with an appropriate spatial scale, we list the expected ratio for a range of IMU grades, FOVs and AGL heights.

Bottom trawl fishing footprints on the world's continental shelves

We conducted a systematic, high-resolution analysis of bottom trawl fishing footprints for 24 regions on continental shelves and slopes of five continents and New Zealand. The proportion of seabed trawled varied >200-fold among regions (from 0.4 to 80.7% of area to a depth of 1,000 m). Within 18 regions, more than two-thirds of seabed area remained untrawled during study periods of 2–6 years. Relationships between metrics of total trawling activity and footprint were strong and positive, providing a method to estimate trawling footprints for regions where high-resolution data are not available. Trawling footprints were generally smaller in regions where fisheries met targets for exploitation rates, implying collateral environmental benefits of effective fisheries management.

Bottom trawlers land around 19 million tons of fish and invertebrates annually, almost one-quarter of wild marine landings. The extent of bottom trawling footprint (seabed area trawled at least once in a specified region and time period) is often contested but poorly described. We quantify footprints using high-resolution satellite vessel monitoring system (VMS) and logbook data on 24 continental shelves and slopes to 1,000-m depth over at least 2 years. Trawling footprint varied markedly among regions: from <10% of seabed area in Australian and New Zealand waters, the Aleutian Islands, East Bering Sea, South Chile, and Gulf of Alaska to >50% in some European seas. Overall, 14% of the 7.8 million-km² study area was trawled, and 86% was not trawled. Trawling activity was aggregated; the most intensively trawled areas accounting for 90% of activity comprised 77% of footprint on average. Regional swept area ratio (SAR; ratio of total swept area trawled annually to total area of region, a metric of trawling intensity) and footprint area were related, providing an approach to estimate regional trawling footprints when high-resolution spatial data are unavailable. If SAR was ≤0.1, as in 8 of 24 regions, there was >95% probability that >90% of seabed was not trawled. If SAR was 7.9, equal to the highest SAR recorded, there was >95% probability that >70% of seabed was trawled. Footprints were smaller and SAR was ≤0.25 in regions where fishing rates consistently met international sustainability benchmarks for fish stocks, implying collateral environmental benefits from sustainable fishing.

Assembly, maturation, and degradation of the supraspinatus enthesis

The development of the rotator cuff enthesis is still poorly understood. The processes in the early and late developmental steps are gradually elucidated, but it is still unclear how cell activities are coordinated during development and maturation of the structured enthesis. This review summarizes current knowledge about development and age-related degradation of the supraspinatus enthesis. Healing and repair of an injured and degenerated supraspinatus enthesis also remain a challenge, as the original graded transitional tissue of the fibrocartilaginous insertion is not re-created after the tendon is surgically reattached to bone. Instead, mechanically inferior and disorganized tissue forms at the healing site because of scar tissue formation. Consequently, the enthesis never reaches mechanical properties comparable to those of the native enthesis. So far, no novel biologic healing approach has been successful in enhancing healing of the injured enthesis. The results revealed in this review imply the need for further research to pave the way for better treatment of patients with rotator cuff disorder.

Consumption-Based Conservation Targeting: Linking Biodiversity Loss to Upstream Demand through a Global Wildlife Footprint

Although most conservation efforts address the direct, local causes of biodiversity loss, effective long-term conservation will require complementary efforts to reduce the upstream economic pressures, such as demands for food and forest products, which ultimately drive these downstream losses. Here, we present a wildlife footprint analysis that links global losses of wild birds to consumer purchases across 57 economic sectors in 129 regions. The United States, India, China, and Brazil have the largest regional wildlife footprints, while per-person footprints are highest in Mongolia, Australia, Botswana, and the United Arab Emirates. A US$100 purchase of bovine meat or rice products occupies approximately 0.1 km2 of wild bird ranges, displacing 1-2 individual birds, for 1 year. Globally significant importer regions, including Japan, the United Kingdom, Germany, Italy, and France, have large footprints that drive wildlife losses elsewhere in the world and represent important targets for consumption-focused conservation attention.

Topographical Anatomy of the Distal Ulna Attachment of the Radioulnar Ligament

PURPOSE

The deep component of the distal radioulnar ligament provides translational stability and rotational guidance to the forearm. However, controversy exists regarding the importance of this structure as well as the nature of its attachment to the distal ulna. We aimed to evaluate the topographic anatomy of the distal ulna attachment of both the superficial and the deep components of the radioulnar ligament and to assess the relationship between its internal and its external morphometry.

METHODS

Thirteen human distal ulnae attached by ulnar part of the distal radioulnar ligament were scanned using micro-computed tomography and reconstructed in 3 dimensions. In addition, the distal radioulnar ligaments were examined under polarized light microscopy to determine the histological characteristics of collagen contained within the ligaments.

RESULTS

The deep limbs have broad marginal insertions at the fovea, whereas the superficial limbs have a circular and condensed insertion to the ulnar styloid. The center of the deep limb was separated from the base of the ulnar styloid by a mean of 2.0 ± 0.76 mm, and this distance was positively correlated with the width of the ulnar styloid. The mean distance between the center of the ulnar head and the center of the fovea was 2.4 ± 0.58 mm. The proportion of collagen type I was lower in the deep limb than in the superficial limb.

CONCLUSIONS

This new observation of the footprint of the radioulnar ligament in the distal ulna indicates that the deep limb may serve as an internal capsular ligament of the distal radioulnar joint, whereas the superficial limb as the external ligament.

CLINICAL RELEVANCE

Knowledge of the topographic anatomy of the radioulnar ligament's attachment to the distal ulna may provide a better understanding of distal radioulnar ligament-related pathologies.

Financial and environmental costs of reusable and single-use anaesthetic equipment

BACKGROUND.

An innovative approach to choosing hospital equipment is to consider the environmental costs in addition to other costs and benefits.

METHODS.

We used life cycle assessment to model the environmental and financial costs of different scenarios of replacing reusable anaesthetic equipment with single-use variants. The primary environmental costs were CO 2 emissions (in CO 2 equivalents) and water use (in litres). We compared energy source mixes between Australia, the UK/Europe, and the USA.

RESULTS.

For an Australian hospital with six operating rooms, the annual financial cost of converting from single-use equipment to reusable anaesthetic equipment would be an AUD$32 033 (£19 220), 46% decrease. In Australia, converting from single-use to reusable equipment would result in an increase of CO 2 emissions from 5095 (95% CI: 4614-5658) to 5575 kg CO 2 eq (95% CI: 5542-5608), a 480 kg CO 2 eq (9%) increase. Using the UK/European power mix, converting from single-use (5575 kg CO 2 eq) to reusable anaesthetic equipment (802 kg CO 2 eq) would result in an 84% reduction (4873 kg CO 2 eq) in CO 2 emissions, whilst in the USA converting to reusables would have led to a 2427 kg CO 2 eq (48%) reduction. In Australia, converting from single-use to reusable equipment would more than double water use from 34.4 to 90.6 kilolitres.

CONCLUSIONS.

For an Australian hospital with six operating rooms, converting from single-use to reusable anaesthetic equipment saved more than AUD$30 000 (£18 000) per annum, but increased the CO 2 emissions by almost 10%. The CO 2 offset is highly dependent on the power source mix, while water consumption is greater for reusable equipment.

Modeling the Footprint and Equivalent Radiance Transfer Path Length for Tower-Based Hemispherical Observations of Chlorophyll Fluorescence

The measurement of solar-induced chlorophyll fluorescence (SIF) is a new tool for estimating gross primary production (GPP). Continuous tower-based spectral observations together with flux measurements are an efficient way of linking the SIF to the GPP. Compared to conical observations, hemispherical observations made with cosine-corrected foreoptic have a much larger field of view and can better match the footprint of the tower-based flux measurements. However, estimating the equivalent radiation transfer path length (ERTPL) for hemispherical observations is more complex than for conical observations and this is a key problem that needs to be addressed before accurate retrieval of SIF can be made. In this paper, we first modeled the footprint of hemispherical spectral measurements and found that, under convective conditions with light winds, 90% of the total radiation came from an FOV of width 72°, which in turn covered 75.68% of the source area of the flux measurements. In contrast, conical spectral observations covered only 1.93% of the flux footprint. Secondly, using theoretical considerations, we modeled the ERTPL of the hemispherical spectral observations made with cosine-corrected foreoptic and found that the ERTPL was approximately equal to twice the sensor height above the canopy. Finally, the modeled ERTPL was evaluated using a simulated dataset. The ERTPL calculated using the simulated data was about 1.89 times the sensor’s height above the target surface, which was quite close to the results for the modeled ERTPL. Furthermore, the SIF retrieved from atmospherically corrected spectra using the modeled ERTPL fitted well with the reference values, giving a relative root mean square error of 18.22%. These results show that the modeled ERTPL was reasonable and that this method is applicable to tower-based hemispherical observations of SIF.

Genetic regulatory signatures underlying islet gene expression and type 2 diabetes. Proc Natl Acad Sci U S A. 2017;114:2301-2306. [PMID: 28193859 DOI: 10.1073/pnas.1621192114]

Genome-wide association studies (GWAS) have identified >100 independent SNPs that modulate the risk of type 2 diabetes (T2D) and related traits. However, the pathogenic mechanisms of most of these SNPs remain elusive. Here, we examined genomic, epigenomic, and transcriptomic profiles in human pancreatic islets to understand the links between genetic variation, chromatin landscape, and gene expression in the context of T2D. We first integrated genome and transcriptome variation across 112 islet samples to produce dense cis-expression quantitative trait loci (cis-eQTL) maps. Additional integration with chromatin-state maps for islets and other diverse tissue types revealed that cis-eQTLs for islet-specific genes are specifically and significantly enriched in islet stretch enhancers. High-resolution chromatin accessibility profiling using assay for transposase-accessible chromatin sequencing (ATAC-seq) in two islet samples enabled us to identify specific transcription factor (TF) footprints embedded in active regulatory elements, which are highly enriched for islet cis-eQTL. Aggregate allelic bias signatures in TF footprints enabled us de novo to reconstruct TF binding affinities genetically, which support the high-quality nature of the TF footprint predictions. Interestingly, we found that T2D GWAS loci were strikingly and specifically enriched in islet Regulatory Factor X (RFX) footprints. Remarkably, within and across independent loci, T2D risk alleles that overlap with RFX footprints uniformly disrupt the RFX motifs at high-information content positions. Together, these results suggest that common regulatory variations have shaped islet TF footprints and the transcriptome and that a confluent RFX regulatory grammar plays a significant role in the genetic component of T2D predisposition.

Examination of the Correlation Between Foot Morphology Measurements Using Pedography and Radiographic Measurements

Pedography provides excellent visualization of the footprint. However, the correlation between the footprint images and radiographic measures has not been thoroughly evaluated. Therefore, the objectives of our study were to examine the correlation between the pedography-based measures of foot morphology and radiographic measurements and to propose reference values for the diagnosis of flatfoot using footprint imaging. The plantar footprints of 100 right feet were photographed using a pedography standing platform. The sole and arch areas were measured to calculate the footprint index (FPI). The lateral talar-first metatarsal angle (LTM) and calcaneal pitch angle (CP) were measured on standing lateral radiographs, and the talonavicular coverage angle was measured on frontal radiographs. The Pearson moment correlation between the FPI and radiography-based measures was calculated. The area under the receiver operating characteristic curve was calculated using an LTM of <-4° as the identifying criterion of flatfoot. The sensitivity and specificity of FPI were calculated for LTM values <-4°. The FPI correlated with the LTM (y = -17.964 ± 52.644x, R = 0.588) and CP (y = 9.2304 ± 27.739x, R = 0.659) but not with the talonavicular coverage angle (y = 26.01 ± 15.78x, R = 0.207). The area under the receiver operating characteristic curve was 0.753, with a cutoff FPI of 0.208, yielding a sensitivity of 0.462 and specificity of 0.934 for flatfoot identification. Pedography could provide an easy screening tool for flatfoot, with an FPI cutoff of 0.208, yielding a specificity of 93.4%.

On the energy balance closure and net radiation in complex terrain

In complex, sloping terrain, horizontal measurements of net radiation are not reflective of the radiative energy available for the conductive and convective heat exchange of the underlying surface. Using data from a grassland site on a mountain slope characterised by spatial heterogeneity in inclination and aspect, we tested the hypothesis that a correction of the horizontal net radiation measurements which accounts for the individual footprint contributions of the various surfaces to the measured sensible and latent heat eddy covariance fluxes will yield more realistic slope-parallel net radiation estimates compared to a correction based on the average inclination and aspect of the footprint. Our main result is that both approaches led to clear, but very similar improvements in the phase between available energy and the sum of the latent and sensible heat fluxes. As a consequence the variance in the sum of latent and sensible heat flux explained by available radiation improved by >10 %, while energy balance closure improved only slightly. This is shown to be mainly due to the average inclination and aspect corresponding largely with the inclination and aspect of the main flux source area in combination with a limited sensitivity of the slope correction to small angular differences in, particularly, inclination and aspect. We conclude with a discussion of limitations of the present approach and future research directions.

Potential Impact of Dietary Choices on Phosphorus Recycling and Global Phosphorus Footprints: The Case of the Average Australian City

Changes in human diets, population increases, farming practices, and globalized food chains have led to dramatic increases in the demand for phosphorus fertilizers. Long-term food security and water quality are, however, threatened by such increased phosphorus consumption, because the world's main source, phosphate rock, is an increasingly scarce resource. At the same time, losses of phosphorus from farms and cities have caused widespread water pollution. As one of the major factors contributing to increased phosphorus demand, dietary choices can play a key role in changing our resource consumption pathway. Importantly, the effects of dietary choices on phosphorus management are twofold: First, dietary choices affect a person or region's "phosphorus footprint" - the magnitude of mined phosphate required to meet food demand. Second, dietary choices affect the magnitude of phosphorus content in human excreta and hence the recycling- and pollution-potential of phosphorus in sanitation systems. When considering options and impacts of interventions at the city scale (e.g., potential for recycling), dietary changes may be undervalued as a solution toward phosphorus sustainability. For example, in an average Australian city, a vegetable-based diet could marginally increase phosphorus in human excreta (an 8% increase). However, such a shift could simultaneously dramatically decrease the mined phosphate required to meet the city resident's annual food demand by 72%. Taking a multi-scalar perspective is therefore key to fully exploring dietary choices as one of the tools for sustainable phosphorus management.

Anatomic and Biomechanical Comparison of Traditional Bankart Repair With Bone Tunnels and Bankart Repair Utilizing Suture Anchors

Background:

Traditional Bankart repair using bone tunnels has a reported failure rate between 0% and 5% in long-term studies. Arthroscopic Bankart repair using suture anchors has become more popular; however, reported failure rates have been cited between 4% and 18%. There have been no satisfactory explanations for the differences in these outcomes.

Hypothesis:

Bone tunnels will provide increased coverage of the native labral footprint and demonstrate greater load to failure and stiffness and decreased cyclic displacement in biomechanical testing.

Study Design:

Controlled laboratory study.

Methods:

Twenty-two fresh-frozen cadaveric shoulders were used. For footprint analysis, the labral footprint area was marked and measured using a Microscribe technique in 6 specimens. A 3-suture anchor repair was performed, and the area of the uncovered footprint was measured. This was repeated with traditional bone tunnel repair. For the biomechanical analysis, 8 paired specimens were randomly assigned to bone tunnel or suture anchor repair with the contralateral specimen assigned to the other technique. Each specimen underwent cyclic loading (5-25 N, 1 Hz, 100 cycles) and load to failure (15 mm/min). Displacement was measured using a digitized video recording system.

Results:

Bankart repair with bone tunnels provided significantly more coverage of the native labral footprint than repair with suture anchors (100% vs 27%, P < .001). Repair with bone tunnels (21.9 ± 8.7 N/mm) showed significantly greater stiffness than suture anchor repair (17.1 ± 3.5 N/mm, P = .032). Mean load to failure and gap formation after cyclic loading were not statistically different between bone tunnel (259 ± 76.8 N, 0.209 ± 0.064 mm) and suture anchor repairs (221.5 ± 59.0 N [P = .071], 0.161 ± 0.51 mm [P = .100]).

Conclusion:

Bankart repair with bone tunnels completely covered the footprint anatomy while suture anchor repair covered less than 30% of the native footprint. Repair using bone tunnels resulted in significantly greater stiffness than repair with suture anchors. Load to failure and gap formation were not significantly different.

Preliminary investigation of a biological augmentation of rotator cuff repairs using a collagen implant: a 2-year MRI follow-up

BACKGROUND

the inability to restore the normal tendon footprint and limit strains on the repair site are thought to contribute to re-tearing following rotator cuff repair. The purpose of this study was to use a collagen implant to augment rotator cuff repairs through the restoration of the native tendon footprint and the induction of new tissue to decrease overall tendon strain.

METHODS

repairs of full-thickness rotator cuff lesions in 9 adult patients were augmented with a novel collagen implant placed over the bursal surface of the repair. Tendon thickness and footprint anatomy were evaluated using MRI at 3, 6, 12, and 24 months. Clinical results were assessed using standard outcome metrics. Mean follow-up for all patients was 25.8 months.

RESULTS

the implant induced significant new tissue formation in all patients by 3 months. This tissue matured over time and became indistinguishable from the underlying tendon. At 24 months all repairs remained intact and normal footprint anatomy of the tendon was restored in all patients. All clinical scores improved significantly over time.

CONCLUSION

the ability of a collagen implant to induce new host tissue formation and restore the normal footprint anatomy may represent a significant advancement in the biological augmentation and ultimate durability of rotator cuff repairs.

Radiographic Anatomy of the Native Anterior Cruciate Ligament: a Systematic Review

BACKGROUND

In an attempt to improve the accuracy and reproducibility of tunnel positioning, radiographs are being analyzed in an attempt to recreate the native anatomy of the ACL. Understanding the native ACL radiographic anatomy is an essential prerequisite to understand the relevance of postoperative tunnel position.

QUESTIONS/PURPOSES

We performed a systematic review of the literature to delineate the radiographic location of the native ACL femoral and tibial footprints.

METHODS

A search was performed in March 2014 in PubMed, the Cochrane Collaboration Library, and EMBASE to identify all studies that evaluated the native anterior cruciate ligament (ACL) anatomy on radiographs. Various measurement methods were used in each study, and averages were obtained of the data from studies with the same measurement methods.

RESULTS

Fifteen papers were identified (which included data on 177 femora and 207 tibiae in total). Evaluation of the femoral footprint using the quadrant method on lateral knee radiographs showed that the average percent distance location of the anteromedial (AM) bundle and posterolateral (PL) bundle was 22.8% (95% confidence interval (CI) 16.59-28.90) and 32.5% (95% CI 27.71-37.26) from the posterior condyle, respectively, and 23.2% (95% CI 19.52-26.94) and 50.0% (95% CI 46.16-53.76) from Blumensaat's line, respectively. Using the Amis and Jacob method, the tibial footprint on the lateral knee radiograph average percent distances was 35.1% (95% CI 34.46-35.72) for the center of the AM bundle and 47.3% (95% CI 41.69-52.95) for the center of the PL bundle of the ACL. The femoral and tibial ACL footprints on the anteroposterior (AP) views of the knee were not well delineated by these studies.

CONCLUSION

The information presented in this systematic review offers surgeons another important tool for accurate ACL footprint identification.

Flatfoot in school-age children: prevalence and associated factors

BACKGROUND

Flatfoot has been shown to cause abnormal stresses on the foot and lower extremity. The altered mechanical stresses on these structures can aggravate the foot deformity. Screening of the flatfoot and its associated factors helps detect underlying risks influencing the stresses on the foot. The purpose of this study was to analyze the structure of the medial foot arch and investigate its associated factors in students, aged 7 to 14 years.

METHODS

Multistage cluster sampling was used and each cluster included 2 other random sampling levels. A total of 667 Iranian school children were recruited and their feet were bilaterally evaluated using a static footprint while standing in a fully weightbearing position. The footprint, an observational measurement, and a questionnaire were used for the foot assessment.

RESULTS

The prevalence of flatfoot was 17.1% in the population studied. There was no gender difference but the prevalence of flatfoot did decrease with age. The significant differences were observed in the prevalence of flatfoot between normal-weight, overweight, and obese groups (P < .01); more overweight participants had flatter feet.

CONCLUSION

This study demonstrated that development of the longitudinal plantar arch in school-age children is influenced by age and weight. Age and weight were the primary predictive factors of flatfoot.

LEVELS OF EVIDENCE

Prognostic, Level IV: Case series.

Eccentric graft positioning within the femoral tunnel aperture in anatomic double-bundle anterior cruciate ligament reconstruction using the transportal and outside-in techniques

BACKGROUND

Ellipticity of the femoral tunnel aperture, which is considered to better restore the native anterior cruciate ligament (ACL) footprint after ACL reconstruction, is different according to the femoral tunneling technique used. How much of the femoral tunnel aperture is filled with graft in different tunneling techniques has yet to be evaluated.

PURPOSE

The aim of this study was to evaluate and compare the graft filling area and graft position within the femoral tunnel aperture in ACL reconstruction using the transportal (TP) and outside-in (OI) techniques.

STUDY DESIGN

Randomized controlled trial; Level of evidence, 1.

METHODS

A total of 70 patients were randomized to undergo double-bundle ACL reconstruction using either the TP (n=35) or OI (n=35) technique. The aperture filling was evaluated by calculating the ratio of the cross-sectional area of the graft to that of the femoral tunnel, and the graft center position within the tunnel was assessed using immediate postoperative magnetic resonance imaging.

RESULTS

The cross-sectional area of the femoral anteromedial (AM) tunnel aperture in the TP group (605.5±112.7 mm2) was larger than that in the OI group (537.9±126.8 mm2). The cross-sectional area of the femoral posterolateral (PL) tunnel aperture in the TP group (369.9±88.3 mm2) did not differ significantly from that of the OI group (387.9±87.0 mm2). The grafts filled only 52.0% of the AM tunnel and 55.3% of the PL tunnel in the TP group, compared with 54.9% of the AM tunnel and 54.4% of the PL tunnel in the OI group, but there was no statistically significant difference (P>.05). The AM graft center was positioned 1.7±0.6 mm from the center of the tunnel aperture in the TP group and 1.6±0.5 mm in the OI group, and the PL graft center was positioned 1.4±0.4 mm from the center in the TP group and 1.3±0.4 mm in the OI group, with no significant intergroup differences (P=.406 and P=.629, respectively). In the OI group, the PL graft center was positioned more perpendicular to the Blumensaat line in relation to the tunnel aperture center (-10.8°±7.6°) compared with the TP group (-4.0°±11.8°) (P=.04).

CONCLUSION

The grafts did not fill the tunnel aperture area in either group, and the centers of the grafts differed slightly from the centers of the tunnel apertures. The finding of eccentric graft positioning in the tunnel with condensation in a particular direction in each technique might suggest the necessity of an underreamed femoral tunnel for graft. In addition, it may be useful to standardize the starting position of the femoral tunnel according to anatomic landmarks.

The birth of a dinosaur footprint: subsurface 3D motion reconstruction and discrete element simulation reveal track ontogeny

Locomotion over deformable substrates is a common occurrence in nature. Footprints represent sedimentary distortions that provide anatomical, functional, and behavioral insights into trackmaker biology. The interpretation of such evidence can be challenging, however, particularly for fossil tracks recovered at bedding planes below the originally exposed surface. Even in living animals, the complex dynamics that give rise to footprint morphology are obscured by both foot and sediment opacity, which conceals animal-substrate and substrate-substrate interactions. We used X-ray reconstruction of moving morphology (XROMM) to image and animate the hind limb skeleton of a chicken-like bird traversing a dry, granular material. Foot movement differed significantly from walking on solid ground; the longest toe penetrated to a depth of ∼5 cm, reaching an angle of 30° below horizontal before slipping backward on withdrawal. The 3D kinematic data were integrated into a validated substrate simulation using the discrete element method (DEM) to create a quantitative model of limb-induced substrate deformation. Simulation revealed that despite sediment collapse yielding poor quality tracks at the air-substrate interface, subsurface displacements maintain a high level of organization owing to grain-grain support. Splitting the substrate volume along "virtual bedding planes" exposed prints that more closely resembled the foot and could easily be mistaken for shallow tracks. DEM data elucidate how highly localized deformations associated with foot entry and exit generate specific features in the final tracks, a temporal sequence that we term "track ontogeny." This combination of methodologies fosters a synthesis between the surface/layer-based perspective prevalent in paleontology and the particle/volume-based perspective essential for a mechanistic understanding of sediment redistribution during track formation.

Mitigating the Goldilocks effect: the effects of different substrate models on track formation potential

In ichnology, the Goldilocks effect describes a scenario in which a substrate must be 'just right' in order for tracks to form-too soft, the animal will be unable to traverse the area, and too firm, the substrate will not deform. Any given substrate can therefore only preserve a range of tracks from those animals which exert an underfoot pressure at approximately the yield strength of the sediment. However, rarely are substrates vertically homogeneous for any great depth, varying either due to heterogeneity across sediment layers, or from mechanical behaviour such as strain hardening. Here, we explore the specificity of the Goldilocks effect in a number of virtual substrates simulated using finite-element analysis. We find that the inclusion of strain hardening into the model increases the potential range of trackmaker sizes somewhat, compared with a simple elastic-perfectly plastic model. The simulation of a vertically heterogeneous, strain hardening substrate showed a much larger range of potential trackmakers than strain hardening alone. We therefore show that the Goldilocks effect is lessened to varying degrees by the inclusion of more realistic soil parameters, though there still remains an upper and lower limit to the size of trackmaker able to traverse the area while leaving footprints.

Three-dimensional analysis of elbow soft tissue footprints and anatomy

BACKGROUND

Tendinous and ligamentous injuries commonly occur in the elbow. This study characterized the location, surface areas, and origin and insertional footprints of major elbow capsuloligamentous and tendinous structures in relation to bony landmarks with the use of a precision 3-dimensional modeling system.

METHODS

Nine unpaired cadaveric elbow specimens were dissected and mounted on a custom jig. Mapping of the medial collateral ligament (MCL), lateral ulnar collateral ligament (LUCL), triceps, biceps, brachialis, and capsular reflections was then performed with 3-dimensional digitizing technology. The location, surface areas, and footprints of the soft tissues were calculated.

RESULTS

The MCL had a mean origin (humeral) footprint of 216 mm(2), insertional footprint of 154 mm(2), and surface area of 421 mm(2). The LUCL had a mean origin footprint of 136 mm(2), an insertional footprint of 142 mm(2), and a surface area of 532 mm(2). Of the tendons, the triceps maintained the largest insertional footprint, followed by the brachialis and the biceps (P < .001-.03). The MCL, LUCL, and biceps footprint locations were consistent, with little variability. The surface areas of the anterior (1251 mm(2)) and posterior (1147 mm(2)) capsular reflections were similar (P = .82), and the anterior capsule extended farther proximally.

CONCLUSION

Restoring the normal anatomy of key elbow capsuloligamentous and tendinous structures is crucial for effective reconstruction after bony or soft tissue trauma. This study provides the upper extremity surgeon with information that may aid in restoring elbow biomechanics and preserving range of motion in these patients.

Sonographic assessment of the medial ulnar collateral ligament distal ulnar attachment

OBJECTIVES

The purpose of this study was to determine whether the long distal attachment of the medial ulnar collateral ligament (MUCL) can be delineated on sonography.

METHODS

We used 12 fresh-frozen cadaveric elbows for this study. We performed sonography of the elbow using a coronal-equivalent long-axis view of the MUCL. All sonographic examinations and measurements were performed by a board-certified, fellowship-trained musculoskeletal radiologist. Measurements were performed from the anteroinferior aspect of the medial epicondyle to the sublime tubercle and then from the sublime tubercle to the terminal fibers of the MUCL long ulnar attachment. We then measured the length of the MUCL from its attachment at the medial epicondyle of the humerus to the sublime tubercle and then from the sublime tubercle to the distal extent of its terminal fibers at the ulnar attachment with digital calipers.

RESULTS

On sonography, the average length of the MUCL from its humeral attachment to the sublime tubercle (transarticular) was 19.6 mm. The average length of the ulnar attachment was 27.9 mm. The MUCL was thickest (mediolateral dimension) at its humeral attachment and tapered as it coursed distally along the ulnar attachment. The MUCL was clearly identified on sonography and in all anatomic specimens. On gross measurement, the average lengths of the transarticular portion of the MUCL and its ulnar footprint were 21.5 and 30.2 mm, respectively.

CONCLUSIONS

We have successfully shown that the distal ulnar attachment of the MUCL can be visualized on high-resolution sonography. This preliminary work provides a framework for developing protocols for diagnosis of injuries to the distal ulnar collateral ligament.

Understanding the impact of crop and food production on the water environment--using sugar as a model

The availability of fresh water and the quality of aquatic ecosystems are important global concerns, and agriculture plays a major role. Consumers and manufacturers are increasingly sensitive to sustainability issues related to processed food products and drinks. The present study examines the production of sugar from the growing cycle through to processing to the factory gate, and identifies the potential impacts on water scarcity and quality and the ways in which the impact of water use can be minimised. We have reviewed the production phases and processing steps, and how calculations of water use can be complicated, or in some cases how assessments can be relatively straightforward. Finally, we outline several ways that growers and sugar processors are improving the efficiency of water use and reducing environmental impact, and where further advances can be made. This provides a template for the assessment of other crops.

Comparison balance and footprint parameters in normal and overweight children

BACKGROUND

The present study was done in order to compare balance and footprint parameters in two groups of normal and overweight children.

METHODS

This semi-experimental study included randomly selected 22 male children (11 normal and 11 overweight boys). To measure the footprint parameters, an ink paper system was used, i.e., after putting their feet in the ink, the subjects were asked to stand comfortably on paper and their footprints were recorded. Then, with the use of ImageJ software, the areas of anterior, middle, and posterior parts, the total area, and the arch index parameter were calculated. For measuring balance in three posterolateral, posteromedial, and anterior directions as well as the total balance, Y-balance test was done. Finally, to analyze the data, mean and standard deviation were calculated and ANOVA test was used to compare the parameters.

RESULTS

Data analysis showed a significant difference between normal and overweight subjects in the anterior and posterior areas, whereas, in balance test, only the anterior areas showed significant difference (P < 0.05).

CONCLUSIONS

It seems that area parameters in these two groups do not have significant difference; hence, it cannot be used as the criteria for analyzing the effects of being overweight on these parameters. In addition, it is probable that, in a dynamic situation, recorded footprints are more valid parameters for analyzing foot structure.

Assessment of Motor Coordination and Balance in Mice Using the Rotarod, Elevated Bridge, and Footprint Tests

In order fully to utilize animal models of disease states, to test experimental therapeutics, and to understand the underlying pathophysiology of neurodegenerative disease, behavioral characterization of the model is essential. Deterioration of normal motor function within a disease state signals the progression of an underlying pathological process, and identifies disease-sensitive time points according to which the onset of therapeutic trials may be scheduled. Deterioration in the performance of motor tasks may also indicate the point when motor deficits begin to compromise our ability to measure other deficits within cognitive and behavioral domains. In acute therapeutic trials, the separation of motor from cognitive or behavioral function may be crucial in determining the functional specificity of the drug effect. If we are to accurately measure motor performance in disease progression or during drug trials, tests of motor function that have been highly optimized with respect to sensitivity must be applied. Since motor coordination and balance are essential to normal motor function, tests that probe these facets are ideal for the purpose. In this chapter, we describe in detail three test protocols that principally measure motor coordination (the rotarod and footprint tests) and balance (the elevated bridge test) in mice. Curr. Protoc. Mouse Biol. 2:37-53 © 2012 by John Wiley & Sons, Inc.

Crime Scene Reconstruction Using a Fully Geomatic Approach

This paper is focused on two main topics: crime scene reconstruction, based on a geomatic approach, and crime scene analysis, through GIS based procedures. According to the experience of the authors in performing forensic analysis for real cases, the aforesaid topics will be examined with the specific goal of verifying the relationship of human walk paths at a crime scene with blood patterns on the floor. In order to perform such analyses, the availability of pictures taken by first aiders is mandatory, since they provide information about the crime scene before items are moved or interfered with. Generally, those pictures are affected by large geometric distortions, thus - after a brief description of the geomatic techniques suitable for the acquisition of reference data (total station surveying, photogrammetry and laser scanning) - it will be shown the developed methodology, based on photogrammetric algorithms, aimed at calibrating, georeferencing and mosaicking the available images acquired on the scene. The crime scene analysis is based on a collection of GIS functionalities for simulating human walk movements and creating a statistically significant sample. The developed GIS software component will be described in detail, showing how the analysis of this statistical sample of simulated human walks allows to rigorously define the probability of performing a certain walk path without touching the bloodstains on the floor.

High-throughput metabolic state analysis: the missing link in integrated functional genomics of yeasts

The lack of comparable metabolic state assays severely limits understanding the metabolic changes caused by genetic or environmental perturbations. The present study reports the application of a novel derivatization method for metabolome analysis of yeast, coupled to data-mining software that achieve comparable throughput, effort and cost compared with DNA arrays. Our sample workup method enables simultaneous metabolite measurements throughout central carbon metabolism and amino acid biosynthesis, using a standard GC-MS platform that was optimized for this purpose. As an implementation proof-of-concept, we assayed metabolite levels in two yeast strains and two different environmental conditions in the context of metabolic pathway reconstruction. We demonstrate that these differential metabolite level data distinguish among sample types, such as typical metabolic fingerprinting or footprinting. More importantly, we demonstrate that this differential metabolite level data provides insight into specific metabolic pathways and lays the groundwork for integrated transcription-metabolism studies of yeasts.