Contrast enhanced computed tomography of small ruminants: Caprine and ovine.

The use of small ruminants, mainly sheep and goats, is increasing in biomedical research. Small ruminants are a desirable animal model due to their human-like anatomy and physiology. However, the large variability between studies and lack of baseline data on these animals creates a barrier to further research. This knowledge gap includes a lack of computed tomography (CT) scans for healthy subjects. Full body, contrast enhanced CT scans of caprine and ovine subjects were acquired for subsequent modeling studies. Scans were acquired from an ovine specimen (male, Khatadin, 30-35 kg) and caprine specimen (female, Nubian 30-35 kg). Scans were acquired with and without contrast. Contrast enhanced scans utilized 1.7 mL/kg of contrast administered at 2 mL/s and scans were acquired 20 seconds, 80 seconds, and 5 minutes post-contrast. Scans were taken at 100 kV and 400 mA. Each scan was reconstructed using a bone window and a soft tissue window. Sixteen full body image data sets are presented (2 specimens by 4 contrast levels by 2 reconstruction windows) and are available for download through the form located at: https://redcap.link/COScanData. Scans showed that the post-contrast timing and scan reconstruction method affected structural visualization. The data are intended for further biomedical research on ruminants related to computational model development, device prototyping, comparative diagnostics, intervention planning, and other forms of translational research.

Micro-CT Imaging and Mechanical Properties of Ovine Ribs.

The use of ovine animal models in the study of injury biomechanics and modeling is increasing, due to their favorable size and other physiological characteristics. Along with this increase, there has also been increased interest in the development of in silico ovine models for computational studies to compliment physical experiments. However, there remains a gap in the literature characterizing the morphological and mechanical characteristics of ovine ribs. The objective of this study therefore is to report anatomical and mechanical properties of the ovine ribs using microtomography (micro-CT) and two types of mechanical testing (quasi-static bending and dynamic tension). Using microtomography, young ovine rib samples obtained from a local abattoir were cut into approximately fourteen 38 mm sections and scanned. From these scans, the cortical bone thickness and cross-sectional area were measured, and the moment of inertia was calculated to enhance the mechanical testing data. Based on a standard least squares statistical model, the cortical bone thickness varied depending on the region of the cross-section and the position along the length of the rib (p < 0.05), whereas the cross-sectional area remained consistent (p > 0.05). Quasi-static three-point bend testing was completed on ovine rib samples, and the resulting force-displacement data was analyzed to obtain the stiffness (44.67 ± 17.65 N/mm), maximum load (170.54 ± 48.28 N) and displacement at maximum load (7.19 ± 2.75 mm), yield load (167.81 ± 48.12 N) and displacement at yield (6.10 ± 2.25 mm), and the failure load (110.90 ± 39.30 N) and displacement at failure (18.43 ± 2.10 mm). The resulting properties were not significantly affected by the rib (p > 0.05), but by the animal they originated from (p < 0.05). For the dynamic testing, samples were cut into coupons and tested in tension with an average strain rate of 18.9 strain/sec. The resulting dynamic testing properties of elastic modulus (5.16 ± 2.03 GPa), failure stress (63.29 ± 14.02 MPa), and failure strain (0.0201 ± 0.0052) did not vary based on loading rate (p > 0.05).

Calcaneus fracture pattern and severity: Role of local trabecular bone density.

Calcaneus fracture is the most common tarsal bone fracture and is associated with external loads resulting from vehicle crashes, under body blasts, or sports. Almost 50% of weight bearing by the foot occurs through the calcaneus and its surgical fixation remains a challenging procedure. Postmortem human subjects were used to measure the regional trabecular BMD of the calcaneus. Mean age, height and weight of the included 14 specimens was 69 years, 177 cm and 80 kg respectively. Using a custom mode within Quantitative Computed Tomography clinical software; calcaneal trabecular BMD in the anterior and posterior regions was quantified. Tolerance data and calcaneus fracture patterns were also available for these specimens from previous tests. The posterior region of the calcaneus had a higher mean BMD (114 mg/cc) than the anterior region (81 mg/cc). These BMD differences also paralleled injury outcome of specimens from axial loading with 50% of specimens resulting in high severity anterior region calcaneal fractures and 36% of specimens resulting in low severity posterior calcaneal fractures. These findings may be reflective of the lower BMD in the anterior region, although the load was uniformly distributed across the plantar surface of the foot. Severity of fracture was greater (intraarticular/crush) in the anterior region as compared to fractures of the posterior region. The BMD ratio between anterior and posterior was significant (p = 0.02) between anterior region fractures and posterior region fractures. The ratio parameter may indicate that the disparity in trabecular BMD between anterior and posterior calcaneus regions is more important in predicting injury outcome than the absolute BMD value of each region.

Repeated measures analysis of projectile penetration in porcine legs as a function of storage condition.

Buried blast explosions create small projectiles which can become lodged in the tissue of personnel as far away as hundreds of meters. Without appropriate treatment, these lodged projectiles can become a source of infection and prolonged injury to soldiers in modern combat. Human cadavers can be used as surrogates for living humans for ballistic penetration testing, but human cadavers are frozen during transport and storage. The process of freezing and thawing the tissue before testing may change the biomechanical properties of the tissue. The goal of the current study was to understand penetration threshold differences between fresh, refrigerated, and frozen tissue and investigate factors that may contribute to these differences. A custom-built pneumatic launcher was used to accelerate 3/16″ stainless steel ball bearings toward porcine legs that were either tested fresh, following refrigerated storage, or following frozen storage. A generalized linear mixed model, accounting for within-animal dependence, owing to repeated observations, was found to be the most appropriate for these data and was used for analysis. The "generalized" model accommodated non-continuous observations, provided a straight-forward way to implement the repeated measures, and provided a risk estimate for projectile penetration. Both storage condition (p = 0.48) and leg (p = 0.07) were shown to be not significant and the confidence intervals for those variables were overlapping. As all covariates were found to be non-significant, a single model containing all impacts was used to develop a V50, or velocity at which 50% of impacts are expected to penetrate. From this model, 50% probability of penetration occurs at 137.3 m/s with 95% confidence intervals at 132.0 and 144.0 m/s. In this study, the fresh legs and previously frozen legs allowed penetration at similar velocities indicating that previously frozen legs were acceptable surrogates for fresh legs. This study only compared the penetration threshold in tissues that had been stored in differing conditions. To truly study penetration, more conditions will need to be studied including the effects of projectile mass and material, the effects of projectile shape, and the effects of clothing or protective layers on penetration threshold.

Influence of Friction at the Head-Helmet Interface on Advanced Combat Helmet (ACH) Blunt Impact Kinematic Performance.

INTRODUCTION: The purpose of this study was to compare the rotational blunt impact performance of an anthropomorphic test device (ATD: male 50% Hybrid III head and neck) headform donning an Advanced Combat Helmet (ACH) between conditions in which the coefficient of static friction (µs) at the head-to-helmet pad interface varied. MATERIALS AND METHODS: Two ACHs (size large) were used in this study and friction was varied using polytetrafluoroethylene (PTFE), human hair, skullcap, and the native vinyl skin of the ATD. A condition in which hook and loop material adhered the headform to the liner system was also tested, resulting in a total of five conditions: PTFE, Human Hair, Skullcap, Vinyl, and Hook. Blunt impact tests with each helmet in each of the five conditions were conducted on a pneumatic linear impactor at 4.3 m/s. The ATD donning the ACH was impacted in seven locations (Crown, Front, Rear, Left Side, Right Side, Left Nape, and Right Nape). The peak resultant angular acceleration (PAA), velocity (PAV), and the Diffuse Axonal Multi-Axis, General Evaluation (DAMAGE) metric were compared between conditions. RESULTS: No pairwise differences were observed between conditions for PAA. A positive correlation was observed between mean µs and PAA at the Front (τ = 0.28; P = .044) and Rear (τ = 0.31; P = .024) impact locations. The Hook condition had a mean PAV value that was often less than the other conditions (P ≤ .024). A positive correlation was observed between mean µs and PAV at the Front (τ = 0.32; P = .019) and Right Side (τ = 0.57; P < .001) locations. The Hook condition tended to have the lowest DAMAGE value compared to the other conditions (P ≤ .032). A positive correlation was observed between the mean µs and DAMAGE at the Rear (τ = 0.60; P < .001) location. A negative correlation was observed at the Left Side (τ = -0.28; P = .040), Right Side (τ = -0.58; P < .001) and Left Nape (τ = -0.56; P < .001) locations. CONCLUSIONS: The results of this study indicate that at some impact locations kinematic responses can vary as a function of the friction at the head-to-helmet pad interface. However, a reduction in the coupling of the head-helmet pad interface did not consistently reduce head angular kinematics or measures of brain strain across impact locations. Thus, for the ACH during collision-type impacts, impact location as opposed to µs seems to have a greater influence on head kinematics and rotational-based measures of brain strain.

Influence of foam thickness on the control of EMG activity during a step-down task in females.

Compliant foams can be used to mitigate ground reaction forces. However, it is unknown how foam surfaces influence the modulation of leg muscle activity. Thus, the current study aimed to investigate how the neuromuscular system managed changes in expected loading due to various thickness of foam placed on the landing surface during a step down task. The surface electromyographic signal (sEMG) pre-activation duration and the root mean square (RMS) amplitude of tibialis anterior (TA), lateral gastrocnemius (LG), and vastus medialis (VM) of 10 active females were measured as they stepped-down with a single leg onto polyurethane foam slabs of varying thickness (0-50 mm). Pre-activation duration was not affected by the thickness of the foam padding. LG RMS amplitude was less in the foam conditions than the control (no- foam) condition, with the greatest reduction observed for the 50 mm foam condition. In some trials, the muscles remained active throughout the step-down task. In such instances, a sEMG onset time and thus a pre-activation duration could not be determined. All foam conditions significantly increased the odds of continuous muscle activity above that of the no-foam condition. The results indicate that foam surfaces may alter the modulation of muscle activity during step-down tasks.

Trabecular bone mineral density correlations using QCT: Central and peripheral human skeleton.

Musculoskeletal injuries to the lower leg and foot-ankle joint are associated with external mechanical loads resulting from motor vehicle crashes, under body blasts, falls from height, or sports. As an intrinsic material property, the bone mineral density (BMD) is related to bone strength. The clinically recognized biological sites for BMD evaluation are the hip and spine. The focus of this study was to define the correlation between BMD from standard clinical sites (hip and lumbar spine) compared to BMD from non-standard sites (foot-ankle-distal tibia bones). Twenty-one post-mortem human subjects (PMHS) with mean age, height, and mass of 63 ± 11 years, 179 ± 7 cm, and 86 ± 13 kg, respectively were used for analysis. Clinical BMD software (Mindways Software, Inc.) was used for trabecular BMD quantification using quantitative computed tomography (QCT). In quantification of BMD of the foot-ankle-distal tibia (hind foot), the trabecular BMD of the talus (316 ± 86mg/cc) was highest followed by the distal tibia (238 ± 72 mg/cc) and then calcaneus (147 ± 51 mg/cc). To correlate BMD values from foot bone regions with the central skeleton BMD values within the same PMHS, there were 18 lumbar spine and 12 hip BMDs available. The BMD of the distal tibia correlated best with the hip intertrochanter BMD (R2 of 0.72). Calcaneus BMD best correlated with the hip femoral neck BMD (R2 = 0.64). In summary, the hind foot bone BMD values correlated better with the hip as compared to the lumbar spine BMD from the same PMHS. These findings indicate that, in the absence of a direct measure of foot-bone BMD, hip BMD might be a better predictor of injury risk to hind foot rather than lumbar spine BMD, or alternatively, calcaneal trabecular BMD can be used to predict the risk of injury to hip. Further, these relationships between central and peripheral regions can also be implemented in finite element models for improved failure predictions.

Analysis of Force Mitigation by Boots in Axial Impacts using a Lower Leg Finite Element Model.

Lower extremity injuries caused by floor plate impacts through the axis of the lower leg are a major source of injury and disability for civilian and military vehicle occupants. A collection of PMHS pendulum impacts was revisited to obtain data for paired booted/unbooted test on the same leg. Five sets of paired pendulum impacts (10 experiments in total) were found using four lower legs from two PMHS. The PMHS size and age was representative of an average young adult male. In these tests, a PMHS leg was impacted by a 3.4 or 5.8 kg pendulum with an initial velocity of 5, 7, or 10 m/s (42-288 J). A matching LS-DYNA finite element model was developed to replicate the experiments and provide additional energy, strain, and stress data. Simulation results matched the PMHS data using peak values and CORA curve correlations. Experimental forces ranged between 1.9 and 12.1 kN experimentally and 2.0 and 11.7 kN in simulation. Combat boot usage reduced the peak force by 36% experimentally (32% in simulation) by compressing the sole and insole with similar mitigations for calcaneus strain. The simulated Von Mises stress contours showed the boot both mitigating and shifting stress concentrations from the calcaneus in unbooted impacts to the talus-tibia joint in the booted impacts, which may explain why some previous studies have observed shifts to tibia injuries with boot or padding usage.

Biomechanical Response of Military Booted and Unbooted Foot-Ankle-Tibia from Vertical Loading.

A new anthropomorphic test device (ATD) is being developed by the US Army to be responsive to vertical loading during a vehicle underbody blast event. To obtain design parameters for the new ATD, a series of non-injurious tests were conducted to derive biofidelity response corridors for the foot-ankle complex under vertical loading. Isolated post mortem human surrogate (PMHS) lower leg specimens were tested with and without military boot and in different initial foot-ankle positions. Instrumentation included a six-axis load cell at the proximal end, three-axis accelerometers at proximal and distal tibia, and calcaneus, and strain gages. Average proximal tibia axial forces for a neutral-positioned foot were about 2 kN for a 4 m/s test, 4 kN for 6 m/s test and 6 kN for an 8 m/s test. The force time-to-peak values were from 3 to 5 msec and calcaneus acceleration rise times were 2 to 8 msec. Compared to the neutral posture, the "off-axis" measures (e.g. shear and bending moment) were much greater in magnitude in plantar- or dorsi-flexed posture. The results as a function of velocity demonstrated uniform increases with increasing test velocities. The response corridors supplied from the present investigation will serve as initial design parameters for the ATD lower leg, and can also be used for validation for a human computational model.

Foot-Ankle Fractures and Injury Probability Curves from Post-mortem Human Surrogate Tests.

This purpose of this study was to replicate foot-ankle injuries seen in the military and derive human injury probability curves using the human cadaver model. Lower legs were isolated below knee from seventeen unembalmed human cadavers and they were aligned in a 90-90 posture (plantar surface orthogonal to leg). The specimens were loaded along the tibia axis by applying short-time duration pulses, using a repeated testing protocol. Injuries were documented using pre- and post-test X-rays, computed tomography scans, and dissection. Peak force-based risk curves were derived using survival analysis and accounted for data censoring. Fractures were grouped into all foot-ankle (A), any calcaneus (B), and any tibia injuries (C), respectively. Calcaneus and/or distal tibia/pilon fractures occurred in fourteen tests. Axial forces were the greatest and least for groups C and B, respectively. Times attainments of forces for all groups were within ten milliseconds. The Weibull function was the optimal probability distribution for all groups. Age was significant (p < 0.05) for groups A and C. Survival analysis-based probability curves were derived for all groups. Data are given in the body of paper. Age-based, risk-specific, and continuous distribution probability curves/responses guide in the creation of an injury assessment capability for military blast environments.

Vertical accelerator device to apply loads simulating blast environments in the military to human surrogates.

The objective of the study was to develop a simple device, Vertical accelerator (Vertac), to apply vertical impact loads to Post Mortem Human Subject (PMHS) or dummy surrogates because injuries sustained in military conflicts are associated with this vector; example, under-body blasts from explosive devices/events. The two-part mechanically controlled device consisted of load-application and load-receiving sections connected by a lever arm. The former section incorporated a falling weight to impact one end of the lever arm inducing a reaction at the other/load-receiving end. The "launch-plate" on this end of the arm applied the vertical impact load/acceleration pulse under different initial conditions to biological/physical surrogates, attached to second section. It is possible to induce different acceleration pulses by using varying energy absorbing materials and controlling drop height and weight. The second section of Vertac had the flexibility to accommodate different body regions for vertical loading experiments. The device is simple and inexpensive. It has the ability to control pulses and flexibility to accommodate different sub-systems/components of human surrogates. It has the capability to incorporate preloads and military personal protective equipment (e.g., combat helmet). It can simulate vehicle roofs. The device allows for intermittent specimen evaluations (x-ray and palpation, without changing specimen alignment). The two free but interconnected sections can be used to advance safety to military personnel. Examples demonstrating feasibilities of the Vertac device to apply vertical impact accelerations using PMHS head-neck preparations with helmet and booted Hybrid III dummy lower leg preparations under in-contact and launch-type impact experiments are presented.

Aortic injuries in newer vehicles.

The occurrence of AI was studied in relation to vehicle model year (MY) among front seat vehicular occupants, age≥16 in vehicles MY≥1994, entered in the National Automotive Sampling System Crashworthiness Data System between 1997 and 2010 to determine whether newer vehicles, due to their crashworthiness improvements, are linked to a lower risk of aortic injuries (AI). MY was categorized as 1994-1997, 1998-2004, or 2005-2010 reflecting the introduction of newer occupant protection technology. Logistic regression was used to calculate odds ratios (OR) and 95% confidence intervals for the association between AI and MY independent of possible confounders. Analysis was repeated, stratified by frontal and near lateral impacts. AI occurred in 19,187 (0.06%) of the 31,221,007 (weighted) cases, and contributed to 11% of all deaths. AIs were associated with advanced age, male gender, high BMI, near-side impact, rollover, ejection, collision against a fixed object, high ΔV, vehicle mismatch, unrestrained status, and forward track position. Among frontal crashes, MY 98-04 and MY 05-10 showed increased adjusted odds of AI when compared to MY 94-97 [OR 1.84 (1.02-3.32) and 1.99 (0.93-4.26), respectively]. In contrast, among near-side impact crashes, MY 98-04 and MY 05-10 showed decreased adjusted odds of AI [OR 0.50 (0.25-0.99) and 0.27 (0.06-1.31), respectively]. While occupants of newer vehicles experience lower odds of AI in near side impact crashes, a higher AI risk is present in frontal crashes.

Biomechanical analysis and injury prevention in off-highway vehicular crashes - biomed 2010.

Traffic safety has significantly improved over the past several decades reducing injury and fatality rates. However, there is a paucity of research effort directed to address the safety issues in off-highway vehicular crashes, specifically the all terrain/utility vehicular crashes. Rollover crashes are severe accidents leading to the increase in fatalities and injuries. The appropriate safety measures to contain occupants in vehicular compartments are crucial in mitigating injuries in rollover crashes. The purpose of this study is to delineate the occupant kinematics in simulated rollover conditions and to evaluate the injury prevention aspects. Two utility/all terrain vehicles were used. Each vehicle was placed on the motorized test equipment in the laboratory. The motorized dynamic rollover test equipment simulated the rollover environment in a controlled manner. Human surrogate models representing 1th percentile female, 50th percentile male and 96th percentile male were utilized in the testing. The multi-phase dynamic testing was conducted to quantify the occupant kinematic responses in foreseeable real world conditions. A total of 39 tests were conducted. The vehicle with belted surrogates was rolled 90 degrees at a roll rate up to 45 degrees/second. The excursion of the head, upper extremity and lower extremities beyond the plane of the vehicular structure was measured and compared between the two vehicles using two onboard cameras and three off-board cameras. Results show that the advanced restraint system with the occupant containment feature significantly reduced the occupant excursion. Such a significant reduction of occupant movement will better protect occupants in rollover off-highway accidents.

Aging is not a risk factor for femoral and tibial fractures in motor vehicle crashes.

OBJECTIVE: To determine the effect of aging on the occurrence of femoral and tibial fractures during vehicular crashes. METHODS: The Crash Injury Research and Engineering Network (CIREN), which includes occupants of a vehicle < 8 years old with at least one AIS > or = 3 or two AIS > or = 2 injuries in different body regions, comprised the study population. The occurrence of femoral and tibial fractures during vehicular crashes was analyzed in relation to age and other confounders [gender, BMI, stature, change in velocity (Deltav), restraint use, occupant position (driver vs. passenger) and principal direction of force (PDOF)] using chi2, Mantel-Haenszel chi2 and student t test. Multiple logistic regression (MLR) models were built for the prediction of femoral and tibial fractures with age as the independent variable and possible confounders as co-variates. An alpha = 0.05 was used for all statistics. RESULTS: The incidence of femoral and tibial fractures in the study population (N=1,418) was 23% and 27%, respectively. Univariate analyses revealed a negative association between increasing age and femoral fractures and no association between age and tibial fractures. MLR models revealed no clear effect of increasing age on the occurrence of either femoral or tibial fractures. Obesity, frontal PDOF, and high Deltav affected the occurrence of femoral fractures. Tibial fractures were influenced by occupant position (driver), frontal PDOF, high Deltav and shorter stature. CONCLUSION: Despite the known changes in bone composition and strength with aging, elderly vehicular occupants do not experience higher odds of incurring femoral and tibial fractures during crashes.