Dimensional accuracy of ankle-foot orthoses constructed by rapid customization and manufacturing framework

Passive-dynamic ankle-foot orthoses (PD-AFOs) constitute a class of ankle braces that rely on material properties and physical features to establish functional characteristics such as bending or rotational stiffness. We have developed a novel framework that combines a fully parameterized PD-AFO computer-aided design (CAD) model and free-form fabrication to rapidly manufacture customized PD-AFOs. The three-dimensional locations of select anatomic landmarks serve to fit customize the PD-AFO CAD model. A virtual orthopedic alignment process and selection of discrete design parameter values further customize the orthosis, which is fabricated via selective laser sintering. CAD models were customized and full-scale orthoses were manufactured for two nondisabled subjects. The surface of one half-scale CAD model was marked with 3 mm hemispherical dimples, and four orthoses were manufactured in different build orientations and positions. Dimensional accuracy was determined by calculating discrepancies between corresponding CAD and fabricated orthoses interdimple distances. Subjective evaluations of the full-scale PD-AFOs following use in gait were positive. Dimension discrepancies were well under a 2 mm tolerance for the four half-scale orthoses. Mean foot plate, strut, and cuff component discrepancies were 0.31 +/- 0.28, 0.34 +/- 0.08, 0.52 +/- 0.39 mm, respectively, and 0.29 +/- 0.23 mm for the overall orthosis. Dimensional accuracy of the rapid customization and manufacturing framework was well within tolerances suggested in the literature.     

Temporal trends of mercury concentrations in Wisconsin walleye (<Emphasis Type="Italic">Sander vitreus</Emphasis>), 1982–2005

The Wisconsin Department of Natural Resources has monitored mercury (Hg) in several species of fish since the early 1970s primarily for fish consumption advisory purposes. We selected skin-on fillets of walleye (Sander vitreus) from inland lakes collected over the years 1982–2005 to assess temporal trends of Hg concentrations. While individual lakes are of interest, sample sizes, and unbalanced collections across fish lengths, seasons, or years prevent estimates of temporal trends of walleye Hg concentrations within most lakes. We evaluated temporal trends over all lakes using mixed effects models (3,024 records from 421 lakes). Relationships between Hg concentrations and a suite of lake chemistry, morphometry, and other variables were also explored. Hg concentrations generally increased with walleye length but the relationship varied among lakes. The best-fitting mixed effects models suggested that the overall rate of change in walleye Hg across all lakes in the dataset varied with latitude. Hg in walleye decreased 0.5% per year in northern lakes, increased 0.8% in southern lakes, and remained constant in middle latitude lakes over the period of 1982–2005. Season of collection was also an important predictor variable. Hg concentrations were highest in walleye captured in the spring and lowest in the fall. Other variables such as gender, lake area, and total alkalinity were also important predictors.     

Efficacy of 3,5-dibromo-L-phenylalanine in rat models of stroke,seizures and sensorimotor gating deficit

Background and purpose:

Abnormal glutamatergic activity is implicated in neurologic and neuropsychiatric disorders. Selective glutamate receptor antagonists were highly effective in animal models of stroke and seizures but failed in further clinical development because of serious side effects, including an almost complete set of symptoms of schizophrenia. Therefore, the novel polyvalent glutamatergic agent 3,5-dibromo-L-phenylalanine (3,5-DBr-L-Phe) was studied in rat models of stroke, seizures and sensorimotor gating deficit.

Experimental approach:

3,5-DBr-L-Phe was administered intraperitoneally as three boluses after intracerebral injection of endothelin-1 (ET-1) adjacent to the middle cerebral artery to cause brain injury (a model of stroke). 3,5-DBr-L-Phe was also given as a single bolus prior to pentylenetetrazole (PTZ) injection to induce seizures or prior to the administration of the N-methyl-D-aspartate (NMDA) receptor antagonist dizocilpine (MK-801) to cause disruption of prepulse inhibition (PPI) of startle (sensorimotor gating deficit).

Key results:

Brain damage caused by ET-1 was reduced by 52%, which is comparable with the effects of MK-801 in this model as reported by others. 3,5-DBr-L-Phe significantly reduced seizures induced by PTZ without the significant effects on arterial blood pressure and heart rate normally caused by NMDA antagonists. 3,5-DBr-L-Phe prevented the disruption of PPI measured 3 days after the administration of ET-1. 3,5-DBr-L-Phe also eliminated sensorimotor gating deficit caused by MK-801.

Conclusion and implications:

The pharmacological profile of 3,5-DBr-L-Phe might be beneficial not only for developing a therapy for the neurological and cognitive symptoms of stroke and seizures but also for some neuropsychiatric disorders.     

Timeline of Recurrence After Primary and Secondary Pilonidal Sinus Surgery

Purpose This study was designed to evaluate the timeline of recurrence of pilonidal sinus disease after primary vs. multiple surgery. Data of medical military service in Germany were reviewed. Methods Telephone interview of 205 patients after pilonidal sinus disease surgery after median interval of 14.8 (standard deviation ±3.9) years was conducted. A total of 345 patient charts with pilonidal sinus disease recurrence and fully documented previous surgery history were analyzed. Results Pilonidal sinus disease recurred in 41 of 205 patients (20 percent; actuarial survival 22 percent) after first surgery. Median recurrence-free-interval was 1.8 (range, 0.1–16.5) years. Twenty-nine of 41 of all recurrences (71 percent) were observed within four years after primary surgery. Fifteen of 50 patients (30 percent) treated by primary closure had recurrent disease after a median recurrence-free interval of 2.7 (range, 0.2–13.5) years compared with 24 of 144 patients (17 percent), who experienced recurrence after rhomboid excision and open wound treatment after a median of 1.8 (range 0.1–16.5) years (P = 0.081, long-rank-test). Analysis of 345 recurrent disease charts revealed that recurrence time decreased for multiple recurrences compared with first recurrence (R1 vs. R2: P = 0.07; R2 vs. R3: P = 0.03, Mann-Whitney U test). Conclusions Long-term recurrence rate was 22 percent and thus higher than previously reported. This may be attributed to the long follow-up interval. Recurrences up to 20 years after surgery were seen. Our data provide evidence that follow-up after first to the third pilonidal sinus surgery should complete or exceed five years, because the majority of recurrences occur during this postoperative interval. Nevertheless, even a five-year follow-up will still miss 25 percent of recurrences. Reprints are not available.     

Hope in psychiatry: a review of the literature

Objective: Hope has long been considered an important therapeutic factor in medicine, nursing and mental health and recently received attention as a central component of recovery. However, conceptual clarity, applicability and the predictive value of hope remain unclear. This review aims to define hope, review current approaches to assessment, and outline research evidence linking hope with effectiveness. Method: We conducted a comprehensive review of publications on the conceptualisation and measurement of hope, and on its use as a predictive variable specifically in mental health patients. Results: Forty‐nine definitions of hope were identified, which were grouped into seven emergent dimensions. Thirty‐two measurement tools were identified, although few have been used in research involving mental health patients. Eleven studies investigated hope as a predictive variable for differing outcomes, with inconclusive results. Conclusion: Many conceptual frameworks for hope have been proposed, but empirical evidence on its predictive power in mental health is lacking.     

Genetic implications and health consequences following the Chernobyl nuclear accident

Kozenko M, Chudley AE. Genetic implications and health consequences following the Chernobyl nuclear accident. It has been almost 25 years since the Chernobyl nuclear accident in Ukraine. We review relevant data derived from published reports originating in the Former Soviet Union. We cite census data from Ukraine and research studies from Western Europe that analyzed the effect of radiation on genetics and health outcome in the exposed populations. We also present philatelic materials that pictorially captured that fateful event in history.     

Isolation of Cryptococcus neoformans var. neoformans serotype D from Eucalypts in South Brazil.

Cryptococcus neoformans causes the second most common opportunistic infection in patients with AIDS. In Brazil, 4.5% of the AIDS-related opportunistic infections are caused by C. neoformans and all varieties are recognized as etiological agents of cryptococcosis. This pathogen is a ubiquitous environmental yeast, commonly associated with avian excreta and decaying wood, especially Eucalypt species. The aim of the present study was to search for C. neoformans in Eucalypts and analyze the genotypic diversity of the obtained isolates by RAPD and PCR fingerprinting. All obtained isolates have been C. neoformans var. neoformans, serotype D molecular type VNIV. Serotype D, was isolated from 3 (37.5%) out of 8 cities surveyed in the South Brazilian state Rio Grande do Sul. Nine (9%) out of 99 environmental samples were obtained from Eucalypt species, Eucalyptus calmadulensis and Eucalyptus tereticornis. Molecular analysis using RAPD and PCR-fingerprinting revealed very little genetic diversity in the obtained cryptococcal serotype D isolates. To our knowledge this is the first report of the isolation of serotype D from Eucalyptus trees in Brazil. More studies are required in order to establish the ecological significance of this finding.