Outbreaks attributed to pork in the United States, 1998-2015.

Each year in the United States, an estimated 525 000 infections, 2900 hospitalizations, and 82 deaths are attributed to consumption of pork. We analyzed the epidemiology of outbreaks attributed to pork in the United States reported to the Centers for Disease Control and Prevention (CDC) 1998-2015. During that period, 288 outbreaks were attributed to pork, resulting in 6372 illnesses, 443 hospitalizations, and four deaths. The frequency of outbreaks attributed to pork decreased by 37% during this period, consistent with a decline in total foodborne outbreaks. However, outbreaks attributed to pork increased by 73% in 2015 (19 outbreaks) compared with the previous 3 years (average of 11 outbreaks per year), without a similar increase in total foodborne outbreaks. Most (>99%) of these outbreaks occurred among people exposed in the same state. The most frequent etiology shifted from Staphylococcus aureus toxin during 1998-2001 (19%) to Salmonella during 2012-2015 (46%). Outbreaks associated with ham decreased from eight outbreaks per year during 1998-2001, to one per year during 2012-2015 (P < 0·01). Additional efforts are necessary to reduce outbreaks and sporadic illnesses associated with pork products.

Effects of a hip belt on transverse plane trunk coordination and stability during load carriage.

This study examined the transverse plane kinematics of the pelvis, thorax and head while participants walked at a range of speeds on a treadmill under three load conditions: no load, with a loaded backpack with no hip belt and with a loaded backpack with a hip belt. Research has suggested that one mechanism for adapting to heavy loads carried with no hip belt is to reduce the amplitudes and relative phase of transverse plane pelvic and thoracic rotations, in order to minimize rotational torque on the loaded upper body. Transverse plane rotation amplitudes of the pelvis, thorax, backpack and head were calculated from 3D kinematic data for 12 healthy subjects, walking at speeds of 0.5, 0.9, 1.3 and 1.7 ms(-1). Relative phase relation and its variability were also computed for pelvis-thorax rotations and backpack-thorax rotations. Stability of the coordination pattern was estimated as an inverse function of the variability in relative phase. The backpack with the hip belt allowed significantly larger transverse plane rotation amplitudes, along with increased stability of the coordination pattern, than the backpack with no hip belt. Motion patterns of the backpack and thorax suggested that the backpack frame was used to assist with the deceleration and reversal of the loaded thorax, driven by the pelvis through the hip belt connection. Use of the frame in this way may have required less trunk muscle activation and allowed for improved pattern stability.

How do load carriage and walking speed influence trunk coordination and stride parameters?

To determine the effects of load carriage and walking speed on stride parameters and the coordination of trunk movements, 12 subjects walked on a treadmill at a range of walking speeds (0.6-1.6 m s(-1)) with and without a backpack containing 40% of their body mass. It was hypothesized that compared to unloaded walking, load carriage decreases transverse pelvic and thoracic rotation, the mean relative phase between pelvic and thoracic rotations, and increases hip excursion. In addition, it was hypothesized that these changes would coincide with a decreased stride length and increased stride frequency. The findings supported the hypotheses. Dimensionless analyses indicated that there was a significantly larger contribution of hip excursion and smaller contribution of transverse plane pelvic rotation to increases in stride length during load carriage. In addition, there was a significant effect of load carriage on the amplitudes of transverse pelvic and thoracic rotation and the relative phase of pelvic and thoracic rotation. It was concluded that the shorter stride length and higher stride frequency observed when carrying a backpack is the result of decreased pelvic rotation. During unloaded walking, increases in pelvic rotation contribute to increases in stride length with increasing walking speed. The decreased pelvic rotation during load carriage requires an increased hip excursion to compensate. However, the increase in hip excursion is insufficient to fully compensate for the observed decrease in pelvis rotation, requiring an increase in stride frequency during load carriage to maintain a constant walking speed.

Transverse plane kinetics during treadmill walking with and without a load.

OBJECTIVE: The purpose of this experiment was to determine the effects of wearing a backpack on transverse plane upper and lower body torque. BACKGROUND: During unloaded walking the upper and lower body counter-rotate to reduce the net angular momentum of the body. There is less counter-rotation while carrying a load, suggesting a more rigid link between the upper and lower body. We predicted that load carriage would result in an increase in upper body torque. Because the upper and lower body may be more rigidly linked during load carriage, we also predicted an increase in lower body torque. METHODS: Twelve subjects (5 male, 7 female, mean age=26) walked with and without a backpack containing 40% of their body mass on a treadmill at speeds from 0.6 to 1.6 ms(-1). Kinematic data were sampled for 30 s at each speed, upper and lower body torque were calculated from angular acceleration and moment of inertia. RESULTS: Higher levels of upper and lower body torque were observed during load carriage than during unloaded walking. However, the increase in upper body torque was 225%, while upper body moment of inertia increased by 400%. CONCLUSIONS: The differences in torque between loaded and unloaded walking suggest that a goal of loaded walking is to minimize upper body torque, which may reduce the likelihood of injury. RELEVANCE: Knowledge of the effects of load carriage on upper and lower body torque, and related changes in coordination may provide insight into injury reduction mechanisms during load carriage.

A dynamical model of locomotion in spastic hemiplegic cerebral palsy: influence of walking speed.

OBJECTIVE: The objective of this study was to assess the capability of an escapement-driven inverted pendulum with springs and damping model to estimate the effects of impairments (e.g. spasticity, muscle weakness) on the dynamics and patterns of locomotion of children with spastic cerebral palsy. METHODS: Kinematic data of six children with spastic hemiplegic cerebral palsy and six matched, typically developing children were collected at five different self-selected overground walking speeds ('very slow' to 'very fast'). Changes in forcing, stiffness and gravitational potentials were estimated during the stance phase of each leg according to the model's equation of motion. RESULTS: Significantly greater stiffness and decreased forcing was observed in the more affected limbs of children with spastic hemiplegic cerebral palsy and compared to typically developing peers. The forcing term of the non-affected limb was greater than that of the matched typically developing children. CONCLUSIONS: Results support the claim that disabled individuals with losses in dynamic resources (stiffness, muscle forcing capability) exploit and develop the remaining resources in their adapted gait patterns. It was suggested that clinical interventions aimed at normalizing a gait pattern may be contraindicated, and that rehabilitation might be more effective if focused at the level of dynamics. RELEVANCE: Pattern formation is seen as an optimal solution based on the individuals' action capabilities and dynamic properties under environmental and task demands. This perspective could lead to the development of interventions that address these dynamic variables with the objective of improving the functional capabilities of children with cerebral palsy.

Wet and dry deep cavity preparations compared by a novel odontoblast culture technique.

The human odontoblast's unique cellular extension within dentin does not easily allow culturing by traditional methods. This study leaves these cells in their natural position in the dentin. Deep preparations were made through the occlusal surfaces of extracted human third molars. The crowns were separated from the roots and the pulps gently teased from the chambers, leaving the odontoblast layer intact. These inverted pulp chambers were then incubated in cell culture medium for 2 to 4 days. Trypan blue staining was used to detect non-vital odontoblasts, and the differentiation between vital and nonvital cells was verified by SEM and toluidine vital staining. Control teeth and areas not adjacent to the preparation showed no blue staining, indicating intact cells. Areas of nonvital cells were greatest with wider preparation. Irrigation decreased odontoblast death with wide preparations. No difference due to irrigation was detected in narrow preps. A comparison of wet preparations to which heat was applied versus dry preparations showed statistically similar results. This study provides a simple in vitro method for the study of odontoblasts with their processes intact within dentin.

Head stability in walking in children with cerebral palsy and in children and adults without neurological impairment.

BACKGROUND AND PURPOSE: The location of several sensory systems in the head implies that maintenance of head stability may be a potentially important part of locomotor activity. A limited amount of research, however, has been conducted to measure stability or to compare head stability among different groups. The purpose of this study was to determine whether a method for measuring head stability during walking could differentiate among 3 groups: (1) children with cerebral palsy, (2) children without neurological impairment, and (3) adults without neurological impairment. SUBJECTS: Eight adults without known neurological impairment, 6 children without known neurological impairment, and 6 children with cerebral palsy and mild spastic hemiplegia were compared. METHODS: Subjects walked on a treadmill at their preferred speed at a number of frequencies. Head stability was characterized by fluctuations in period and amplitude of head motion in the sagittal plane across walking cycles. RESULTS: Mean period fluctuation was lower for the adults than for the children, and it was lower for the children without neurological impairments than for the children with cerebral palsy. CONCLUSION AND DISCUSSION: The method can be used to differentiate head stability among different groups during functional activities.

Can the Transition To and From Running and the Metabolic Cost of Running Be Determined From the Kinetic Energy of Running?

An experiment was conducted in which volume of used oxygen per stride time and the total segmental changes in kinetic energy generated per stride time, &grD;E(k)>s(-1), of 11 participants were determined on Day 1 for 7 treadmill running speeds. Gait transition speeds were determined on Day 2. Running metabolism and transition speed were predicted from the Day 1 mechanics of running expressed in Speed x &grD;E(k)>s(-1) coordinates. Predictions followed from the relation between 2 generalized quality ratios Q(metab), and Q(mech), with numerator &grD;E(k)>s(-1). In Q(metab), the denominator was the volume of used oxygen per stride time; in Q(mech), the denominator was the absolute regression constant from the linear dependency of &grD;E(k)>s(-1) on speed.

Can the transitions to and from running and the metabolic cost of running be determined from the kinetic energy of running?

An experiment was conducted in which volume of used oxygen per stride time and the total segmental changes in kinetic energy generated per stride time, DeltaEk s-1, of 11 participants were determined on Day 1 for 7 treadmill running speeds. Gait transition speeds were determined on Day 2. Running metabolism and transition speed were predicted from the Day 1 mechanics of running expressed in Speed x DeltaEk s-1 coordinates. Predictions followed from the relation between 2 generalized quality ratios Qmetab, and Qmech, with numerator DeltaEk s-1. In Qmetab, the denominator was the volume of used oxygen per stride time; in Qmech, the denominator was the absolute regression constant from the linear dependency of DeltaEk s-1 on speed.

Self-Optimization of Walking in Nondisabled Children and Children With Spastic Hemiplegic Cerebral Palsy.

Children voluntarily adopt a frequency and movement pattern for walking. The force-driven harmonic oscillator (FDHO) model was used in this study for accurate prediction of the preferred walking frequency of nondisabled children and children with spastic hemiplegic cerebral palsy. Four potential optimality criteria with which the preferred walking pattern was forced to comply were examined: minimization of physiological costs, maximization of mechanical energy conservation, minimization of asymmetry in lower limb movements and minimization of variability of interlimb and intralimb coordination. Age and gender-matched nondisabled children (n = 6) and children with spastic hemiplegic cerebral palsy (n = 6) were tested under six frequency conditions of walking at a constant speed on a treadmill. For the nondisabled children, the results indicated that their preferred walking frequency could be accurately predicted by the FDHO model. They freely adopted a walking pattern that minimized physiological costs, asymmetry, and variability of inter- and intralimb coordination. For the children with spastic hemiplegic cerebral palsy, the prediction of preferred overground walking frequency required that the FDHO model be modified to account for muscle mass and leg length discrepancies between limbs and increased stiffness. Most of the children achieved the same optimality goals as the nondisabled when walking at the preferred frequency. However, the children were found to use different mechanisms to attain these goals: for example, a steeper increase observed in physiological cost at higher frequencies; a lowered center of gravity of the body, which allowed for angular symmetry; and greater variability of between-joint coordination in the nonaffected limb and less variability in the affected limb.

Adiabatic transformability hypothesis of human locomotion.

It is hypothesized that metabolic and mechanical changes in human locomotion associated with changes in speed v are constrained by two attractive strategies: Qmetab = 1 and delta Qmetab/delta v = a positive definite constant. Qmetab = delta Eks-1/ml O2s-1 where delta Eks-1 is the summed increments and decrements per unit time in the translational and rotational kinetic energies of the body's segments and ml O2s-1 is the rate at which chemical energy is dissipated. The expected constancy of delta Qmetab/delta v was derived from an extension of Ehrenfest's adiabatic hypothesis by which transformations (increases, decreases) in locomotion v can be considered as adiabatic, even though the biological conditions are nonconservative and non-rate-limited. The expected significance of Qmetab = 1 was derived from stability considerations of the symmetry per stride of stored and dissipated energy. An experimental evaluation was provided by collecting metabolic and mechanical measures on walking (10 subjects) and running (9 subjects) at progressively greater treadmill speeds but within the aerobic limit. Results revealed that walking was restricted to Qmetab < or = 1, with a nonlinear trajectory in v x Qmetab coordinates shaped by Qmetab = 1 (primarily) and the constancy of delta Qmetab/delta v. Running satisfied Qmetab > 1, with a linear trajectory in v x Qmetab coordinates conforming to delta Qmetab/delta v = a constant, with the constant predicted from invariants in the mechanical space v x delta Eks-1. Results also suggested that the metabolic costs of running might be predictable from measures made in the v x delta Eks-1 space.

The hybrid mass-spring pendulum model of human leg swinging: stiffness in the control of cycle period.

Human leg swinging is modeled as the harmonic motion of a hybrid mass-spring pendulum. The cycle period is determined by a gravitational component and an elastic component, which is provided by the attachment of a soft-tissue/muscular spring of variable stiffness. To confirm that the stiffness of the spring changes with alterations in the inertial properties of the oscillator and that stiffness is relevant for the control of cycle period, we conducted this study in which the simple pendulum equivalent length was experimentally manipulated by adding mass to the ankle of a comfortably swinging leg. Twenty-four young, healthy adults were videotaped as they swung their right leg under four conditions: no added mass and with masses of 2.27, 4.55, and 6.82kg added to the ankle. Strong, linear relationships between the acceleration and displacement of the swinging leg within subjects and conditions were found, confirming the motion's harmonic nature. Cycle period significantly increased with the added mass. However, the observed increases were not as large as would be predicted by the induced changes in the gravitational component alone. These differences were interpreted as being due to increases in the active muscular stiffness. Significant linear increases in the elastic component (and hence stiffness) were demonstrated with increases in the simple pendulum equivalent length in 20 of the individual subjects, with r2 values ranging between 0.89 and 0.99. Significant linear relationships were also demonstrated between the elastic and gravitational components in 22 subjects, with individual r2 values between 0.90 and 0.99.(ABSTRACT TRUNCATED AT 250 WORDS)

Timing of lower extremity joint actions during treadmill running.

It has been suggested that a disruption in timing between the subtalar and knee joints may be a possible mechanism for knee injury. It has also been documented that shoe construction can alter rearfoot motion. The purpose of the study was to describe the relationship between the subtalar and knee joint actions during the support phase of treadmill running while wearing different shoes. Twelve healthy subjects ran in each of three running shoes with unique midsole durometers (C1, 70; C2, 55; C3, 45). High-speed video (200 Hz) of the rear and sagittal views of each subject/condition were taken during the last minute of a 5-min run. Retro-reflective markers were processed to determine the rearfoot angle and the sagittal view knee angle. The shoes were also subjected to a midsole material impact test. The impact test results indicated a linear trend in peak g and time to peak g across midsoles with the firmer midsole having a greater peak g and a shorter time to peak g. The results of the kinematic analysis indicated that there were no significant differences among the shoe conditions for the knee flexion parameters. However, there were significant differences in both the magnitude and the time to maximum pronation between the two firmer midsole conditions (C1 and C2) and the softer midsole condition (C3), indicating a nonlinear trend for these parameters. The softer midsole exhibited greater pronation values and a shorter time to maximum pronation.(ABSTRACT TRUNCATED AT 250 WORDS)

Predicting the minimal energy costs of human walking.

Preferred stride frequency (PSF) of human walking has been shown to be predictable as the resonant frequency of a force-drive harmonic oscillator (FDHO). The purpose of this study was to determine whether walking at the PSF and FDHO leads to minimal metabolic and mechanical costs. Subjects walked on a level treadmill at the PSF, FDHO, and frequencies above and below. Effects of stride length (SL) and speed (S) were assessed by two conditions, one in which SL was constant and the other in which S was constant. The predictability of PSF from resonance was replicated. Walking at the PSF and FDHO frequencies resulted in metabolic costs which were not significantly different (P greater than 0.05). A U-shaped oxygen consumption curve was observed with the minimum at the PSF and FDHO conditions when S was constant. A two-component curve in which a breakpoint was observed was found in the SL constant condition. A significant increase in metabolic cost was observed above the PSF/FDHO (P less than 0.01). Internal work (power) values were not significantly different between walking frequencies for the S constant condition. In the SL constant condition, internal work values showed linear increases as frequency increased. It was concluded that PSF of walking arises from the interface of the resonance properties of the limbs as oscillators and the tendency of biological systems to self-optimize.

Patterns of human interlimb coordination emerge from the properties of non-linear, limit cycle oscillatory processes: theory and data.

The present article represents an initial attempt to offer a principled solution to a fundamental problem of movement identified by Bernstein (1967), namely, how the degrees of freedom of the motor system are regulated. Conventional views of movement control focus on motor programs or closed-loop devices and have little or nothing to say on this matter. As an appropriate conceptual framework we offer Iberall and his colleagues' physical theory of homeokinetics first elaborated for movement by Kugler, Kelso, and Turvey (1980). Homeo kinetic theory characterizes biological systems as ensembles of non-linear, limit cycle oscillatory processes couple and mutually entrained at all the levels of organization. Patterns of interlimb coordination may be predicted from the properties of non-linear, limit cycle oscillators. In a set of experiments and formal demonstrations we show that cyclical, two-handed movements maintain fixed amplitude and frequency ( a stable limit cycle organization) under the following conditions: (a) when brief and constantly applied load perturbations are imposed on one hand or the other, (b) regardless of the presence or absence of fixed mechanical constraints, and (c) in the face of a range of external driving frequencies from a visual source. In addition, we observe a tight phasic relationship between the hands before and after perturbations (quantified by cross-correlation techniques), a tendency of one limb to entrain the other (mutual entrainment) and that limbs cycling at different frequencies reveal non-arbitrary, sub-harmonic relationships (small integer, subharmonic entrainment). In short, all the above patterns of interlimb coordination fall out of a non-linear oscillatory design. Discussion focuses on the compatibility of these results with past and present neurobiological work, and the theoretical insights into problems of movement offered by homeokinetic physics. Among these are, we think, the beginnings of a principled solution to the degrees of freedom problem, and the tentative claim that coordination and control are emergent consequences of dynamical interaction among non-linear, limit cycle oscillatory processes.

Patterns of human interlimb coordination emerge from the properties of non-linear, limit cycle oscillatory processes.

The present article represents an initial attempt to offer a principled solution to a fundamental problem of movement identified by Bernstein (1967), namely, how the degrees of freedom of the motor system are regulated. Conventional views of movement control focus on motor programs or closed-loop devices and have little or nothing to say on this matter. As an appropriate conceptual framework we offer Iberall and his colleagues' physical theory of homeokinetics first elaborated for movement by Kugler, Kelso, and Turvey (1980). Homeokinetic theory characterizes biological systems as ensembles of non-linear, limit cycle oscillatory processes coupled and mutually entrained at all levels of organization. Patterns of interlimb coordination may be predicted from the properties of non-linear, limit cycle oscillators. In a set of experiments and formal demonstrations we show that cyclical, two-handed movements maintain fixed amplitude and frequency (a stable limit cycle organization) under the following conditions: (a) when brief and constantly applied load perturbations are imposed on one hand or the other, (b) regardless of the presence or absence of fixed mechanical constraints, and (c) in the face of a range of external driving frequencies from a visual source. In addition, we observe a tight phasic relationship between the hands before and after perturbations (quantified by cross-correlation techniques), a tendency of one limb to entrain the other (mutual entrainment) and that limbs cycling at different frequencies reveal non-arbitrary, sub-harmonic relationships (small integer, subharmonic entrainment). In short, all the above patterns of interlimb coordination fall out of a non-linear oscillatory design. Discussion focuses on the compatibility of these results with past and present neurobiological work, and the theoretical insights into problems of movement offered by homeokinetic physics. Among these are, we think, the beginnings of a principled solution to the degrees of freedom problem, and the tentative claim that coordination and control are emergent consequences of dynamical interactions among non-linear, limit cycle oscillatory processes.