Frontal NCAP crash tests with rear-seat occupant.

OBJECTIVES: The initial frontal NCAP tests in 1979 included lap-shoulder belted driver and right-front passenger and lap belted 6-year-old (yo) in the rear. The 35 mph barrier tests were reviewed and analyzed for the restraint performance of the front occupants and child in the rear. METHODS: The initial 100 crash tests (#1-#100) in the NHTSA database were searched for frontal barrier impacts. Fifteen tests met the criteria. There were three tests with the 1980 Chevrolet Citation at 35, 40 and 48 mph. There were 12 other tests with different passenger vehicles at 35 mph into the rigid barrier. The tests included a lap-shoulder belted Hybrid II (Part 572) dummy in the driver and right-front passenger seat and a lap belted 6 yo child dummy (Alderson VIP 6 C) in the center or right rear seat. Vehicle dynamics and occupant kinematics were analyzed, and dummy responses were compared. RESULTS: Vehicle deformation was progressive with impact speed for the Citation tests, leading NHTSA to settle on a 35 mph NCAP speed. The thirteen 35 mph NCAP tests had an average driver HIC of 1099 ± 381 (95th CI 207) and 3 ms chest acceleration of 55.7 ± 16.1 g (95th CI 8.8) with 7 of 13 vehicles failing FMVSS 208 injury criteria. The average right-front passenger HIC was 1179 ± 555 (95th CI 302) and 3 ms chest acceleration was 47.2 ± 14.6 g (95th CI 7.9) with 7 of 13 failing injury criteria. Only four tests (30.8%) passed driver and right-front passenger injury criteria.The responses in the rear seat were significantly worse. The average HIC was 2711 ± 1111 (95th CI 604) and 3 ms chest acceleration was 62.8 ± 10.6 g (95th CI 5.8). The films showed the child's upper body moved forward and rotated downward around the lap belt resulting in severe head impacts on the front seatback, floor, dummy legs or interior. All vehicles failed injury criteria by large margins. Submarining the lap belt was noted in 6 tests. HIC for the rear child was 2.47-times greater than the driver (t = 4.72, p < 0.001) and 2.30-times greater than the right-front passenger (t = 3.64, p < 0.005). CONCLUSIONS: In the 1979 NCAP tests, the child dummy experienced inadequate restraint by the lap belt in the rear seat. The child jackknifed around the lap belt, often submarined, with a severe head impact. No publication of the results has been found. NHTSA did not advise the public of the extremely poor restraint performance, even during the public discussions on the 1986 NTSB recommendation that U.S. vehicle manufacturers install lap-shoulder belts in rear outboard seats. None of the subsequent NCAP tests included a child or adult in the rear until nearly 25 years later.

CT-FEM of the human thorax: Frequency response function and 3D harmonic analysis at resonance.

BACKGROUND AND OBJECTIVE: High-frequency chest wall compression (HFCC) therapy by airway clearance devices (ACDs) acts on the rheological properties of bronchial mucus to assist in clearing pulmonary secretions. Investigating low-frequency vibrations on the human thorax through numerical simulations is critical to ensure consistency and repeatability of studies by reducing extreme variability in body measurements across individuals. This study aims to present the numerical investigation of the harmonic acoustic excitation of ACDs on the human chest as a gentle and effective HFCC therapy. METHODS: Four software programs were sequentially used to visualize medical images, decrease the number of surfaces, generate and repair meshes, and conduct numerical analysis, respectively. The developed methodology supplied the validation of the effect of HFCC through computed tomography-based finite element analysis (CT-FEM) of a human thorax. To illustrate the vibroacoustic characteristics of the HFCC therapy device, a 146-decibel sound pressure level (dBSPL) was applied on the back-chest surface of the model. Frequency response function (FRF) across 5-100 Hz was analyzed to characterize the behaviour of the human thorax with the state-space model. RESULTS: We discovered that FRF pertaining to accelerance equals 0.138 m/s2N at the peak frequency of 28 Hz, which is consistent with two independent experimental airway clearance studies reported in the literature. The state-space model assessed two apparent resonance frequencies at 28 Hz and 41 Hz for the human thorax. The total displacement, kinetic energy density, and elastic strain energy density were furthermore quantified at 1 µm, 5.2 µJ/m3, and 140.7 µJ/m3, respectively, at the resonance frequency. In order to deepen our understanding of the impact on internal organs, the model underwent simulations in both the time domain and frequency domain for a comprehensive analysis. CONCLUSION: Overall, the present study enabled determining and validating FRF of the human thorax to roll out the inconsistencies, contributing to the health of individuals with investigating gentle but effective HFCC therapy conditions with ACDs. This innovative finding furthermore provides greater clarity and a tangible understanding of the subject by simulating the responses of CT-FEM of the human thorax and internal organs at resonance.

Exposure to inclined trunk postures in surgical staff.

In surgical staff, low-back pain (LBP) is prevalent and prolonged trunk inclination is hypothesized to be one of its potential causes. The aim of this study was to evaluate the magnitude and duration of trunk inclination in the sagittal plane of surgical assistants during surgical procedures. The three-dimensional trunk orientation was measured in 91 surgical assistants across four medical facilities during surgical procedures using an inertial measurement unit on the thorax. Per participant, Exposure Variation Analysis was used to evaluate the percentage of the total time of trunk inclination (< -10° (backward inclination); -10-10° (upright posture); 10-20° (light inclination); 20-30° (moderate inclination); >30° (strong inclination)) taking into account posture duration (< 10 s; 10-60 s; 60-300 s; > 300 s). Participants reported their LBP history and perceived low-back load during the procedure via a questionnaire. Participants were in an upright posture for 75% [63-84%] (median [interquartile range]) of the total surgery time (average surgery time: 174 min). Trunk inclination was beyond 20° and 30° for 4.3% [2.1-8.7%] and 1.5% [0.5-3.2%] of the surgery time, respectively. In most of the participants, the duration of trunk inclination beyond 20° or 30° was less than 60 s. Questionnaire response rate was 81%. Persistent or repeated LBP was reported by 49% of respondents, and was unrelated to the exposure to inclined trunk postures. It is concluded that other factors than prolonged trunk inclination, for instance handling of loads or prolonged standing may be causally related to the reported LBP in the investigated population.

BRACETS: Bimodal repository of auscultation coupled with electrical impedance thoracic signals.

BACKGROUND AND OBJECTIVE: Respiratory diseases are among the most significant causes of morbidity and mortality worldwide, causing substantial strain on society and health systems. Over the last few decades, there has been increasing interest in the automatic analysis of respiratory sounds and electrical impedance tomography (EIT). Nevertheless, no publicly available databases with both respiratory sound and EIT data are available. METHODS: In this work, we have assembled the first open-access bimodal database focusing on the differential diagnosis of respiratory diseases (BRACETS: Bimodal Repository of Auscultation Coupled with Electrical Impedance Thoracic Signals). It includes simultaneous recordings of single and multi-channel respiratory sounds and EIT. Furthermore, we have proposed several machine learning-based baseline systems for automatically classifying respiratory diseases in six distinct evaluation tasks using respiratory sound and EIT (A1, A2, A3, B1, B2, B3). These tasks included classifying respiratory diseases at sample and subject levels. The performance of the classification models was evaluated using a 5-fold cross-validation scheme (with subject isolation between folds). RESULTS: The resulting database consists of 1097 respiratory sounds and 795 EIT recordings acquired from 78 adult subjects in two countries (Portugal and Greece). In the task of automatically classifying respiratory diseases, the baseline classification models have achieved the following average balanced accuracy: Task A1 - 77.9±13.1%; Task A2 - 51.6±9.7%; Task A3 - 38.6±13.1%; Task B1 - 90.0±22.4%; Task B2 - 61.4±11.8%; Task B3 - 50.8±10.6%. CONCLUSION: The creation of this database and its public release will aid the research community in developing automated methodologies to assess and monitor respiratory function, and it might serve as a benchmark in the field of digital medicine for managing respiratory diseases. Moreover, it could pave the way for creating multi-modal robust approaches for that same purpose.

Comparative biofidelity of the Hybrid III and THOR 50th male ATDs under three restraint conditions during frontal sled tests.

OBJECTIVE: The purpose of this study was to provide a whole-body biofidelity assessment of the Hybrid III (HIII) and THOR 50th percentile male anthropomorphic test devices (ATDs) during frontal sled tests, incorporating data from kinematics, chest deflection, and test buck reaction load cells. Additionally, the accuracy of the injury risk prediction capabilities for each ATD was evaluated against injuries observed in matched postmortem human surrogate (PMHS) tests. METHODS: Sled tests, designed to simulate a United States New Car Assessment Program (US-NCAP) frontal test, were conducted using the HIII, THOR, and 8 approximately 50th percentile male PMHS under 3 restraint conditions. The test buck was instrumented with load cells on the steering column, knee bolster supports, and foot supports. ATD and PMHS reaction force-time histories were quantitatively compared using the ISO/TS-18571 objective rating metric. Previously published biofidelity analyses of kinematic and chest deflection data from the same tests were combined with the reaction force analyses to perform an overall assessment of the comparative biofidelity of each ATD. Injury risk predictions from existing HIII and proposed THOR injury risk curves for the US-NCAP were compared to observed injuries. RESULTS: For the reaction forces, the HIII and THOR had similar levels of biofidelity on average, except for 2 locations. The HIII produced more biofidelic knee bolster support forces, and the THOR lap belt forces were more biofidelic. The comparative biofidelity of the ATDs also varied by body region. The THOR head response was more biofidelic, whereas the HIII thorax and lower extremity responses had higher biofidelity. When all body regions were pooled, the HIII was more biofidelic, but differences between ATDs were generally small. Both ATDs were able to predict the observed injuries, except for the HIII chest, HIII neck, and THOR neck, all of which underpredicted PMHS injury outcomes. CONCLUSIONS: This study revealed that biofidelity assessed through response time histories and accuracy of injury risk predictions do not always align. Specifically, the HIII had marginally better time history biofidelity, whereas the THOR had better injury prediction. However, not all THOR responses could be fully assessed, so more work is needed to assess the THOR in complex loading environments.

Thoracoabdominal asynchrony in a virtual preterm infant: computational modeling and analysis.

Thoracoabdominal asynchrony (TAA), the asynchronous volume changes between the rib cage and abdomen during breathing, is associated with respiratory distress, progressive lung volume loss, and chronic lung disease in the newborn infant. Preterm infants are prone to TAA risk factors such as weak intercostal muscles, surfactant deficiency, and a flaccid chest wall. The causes of TAA in this fragile population are not fully understood and, to date, the assessment of TAA has not included a mechanistic modeling framework to explore the role these risk factors play in breathing dynamics and how TAA can be resolved. We present a dynamic compartmental model of pulmonary mechanics that simulates TAA in the preterm infant under various adverse clinical conditions, including high chest wall compliance, applied inspiratory resistive loads, bronchopulmonary dysplasia, anesthesia-induced intercostal muscle deactivation, weakened costal diaphragm, impaired lung compliance, and upper airway obstruction. Sensitivity analyses performed to screen and rank model parameter influence on model TAA and respiratory volume outputs show that risk factors are additive so that maximal TAA occurs in a virtual preterm infant with multiple adverse conditions, and addressing risk factors individually causes incremental changes in TAA. An abruptly obstructed upper airway caused immediate nearly paradoxical breathing and tidal volume reduction despite greater effort. In most simulations, increased TAA occurred together with decreased tidal volume. Simulated indices of TAA are consistent with published experimental studies and clinically observed pathophysiology, motivating further investigation into the use of computational modeling for assessing and managing TAA.NEW & NOTEWORTHY A novel model of thoracoabdominal asynchrony incorporates literature-derived mechanics and simulates the impact of risk factors on a virtual preterm infant. Sensitivity analyses were performed to determine the influence of model parameters on TAA and respiratory volume. Predicted phase angles are consistent with prior experimental and clinical results, and influential parameters are associated with clinical scenarios that significantly alter phase angle, motivating further investigation into the use of computational modeling for assessing and managing thoracoabdominal asynchrony.

Relación entre dimensiones antropométricas de tronco y valores de espirometría / Association between anthropometric dimensions of trunk and spirometry indices

Los objetivos del presente estudio fueron primero evaluar la asociación de dimensiones antropométricas de tórax y tronco con índices espirométricos, segundo, ajustar una ecuación de predicción con dimensiones antropométricas de tronco y tercero, comparar nuestro modelo predictivo con dos ecuaciones diagnósticas. Se evaluaron 59 estudiantes universitarios entre 20 y 40 años, de ambos sexos, sin hábito tabáquico. Las variables consideradas fueron: edad, sexo, peso, estatura, diámetro transverso de tórax, diámetro anteroposterior de tórax, perímetro de tórax, altura de tórax, altura de tronco, flujo espiratorio máximo (FEM), volumen espiratorio forzado en el primer segundo (VEF1) y capacidad vital forzada (CVF). Se utilizó el análisis de regresión múltiple para estimar los valores espirométricos en función de las variables demográficas y antropométricas. La CVF y el VEF1 tienen asociación lineal directa con el diámetro transverso de tórax, altura de tórax, perímetro de tórax y altura de tronco. Se ajustó una ecuación de regresión lineal múltiple que indicó que es posible estimar la CVF y el VEF11 en función de la altura de tronco y el perímetro de tórax para ambos sexos. Estas variables son capaces de explicar el 74 % de los valores de CVF y el 68 % de los valores de VEF1. Al comparar los valores obtenidos por nuestras ecuaciones predictivas con las ecuaciones de referencia nacional observamos que nuestros resultados son más cercanos a los de Quanjer et al. (2012) que a los de Knudson et al. (1983). La altura de tronco y el perímetro de tórax tienen asociación directa con el VEF1 y CVF y son buenos predictores del VEF1 y CVF en estudiantes universitarios. Nuestros valores estimados son más cercanos a las ecuaciones de Quanjer et al. (2012) en comparación a las estimaciones de Knudson (1983).

SUMMARY: The purposes of the present study were first to evaluate the association between anthropometric dimensions of the thorax and trunk with spirometric indices, second, to fit a prediction equation with anthropometric dimensions of the trunk, and third, to compare our predictive model with two diagnostic equations. Fifty-nine university students between 20 and 40 years old, of both sexes and non-smokers were recruited. Variables considered were age, sex, weight, height, chest transverse diameter, chest anteroposterior diameter, chest perimeter, chest height, trunk height, maximum expiratory flow (PEF), forced expiratory volume in the first second (FEV1) and forced vital capacity (FVC). Multiple regression analysis was used to estimate spirometric values based on demographic and anthropometric variables. FVC and FEV1 have a direct linear association with chest transverse diameter, chest height, chest circumference, and trunk height. A multiple linear regression equation was fitted, indicating that it is possible to estimate FVC and FEV1 as a function of trunk height and chest girth for both sexes. These variables can explain 74% of the FVC values and 68% of the FEV1 values. Comparing the values obtained by our predictive equations with the national reference equations, we observe that our results are closer to those of Quanjer et al. (2012) than to those of Knudson et al. (1983). Trunk height and chest circumference have a direct association with FEV1 and FVC and are good predictors of FEV1 and FVC in university students. Our estimated values are closer to Quanjer et al. (2012) than Knudson et al. (1983) prediction equations.

Biofidelity Assessment of the WIAMan Thorax by a Comparative Study With Hybrid III, THOR, and PMHS in Frontal Sled Testing.

The Warrior Injury Assessment Manikin (WIAMan) anthropomorphic test device (ATD) has been originally developed to predict and prevent injuries for occupants in military vehicles, in an underbody blast environment. However, its crash performance and biofidelity of the thoracic region have not been explored. The aim of this study was to determine and evaluate the WIAMan thoracic responses in a typical frontal sled test. The 40 kph frontal sled tests were conducted to quantify the WIAMan thoracic kinematics, chest deflection, and belt loads. Comparative biofidelities of the WIAMan thorax and other surrogates, including postmortem human surrogates (PMHSs), Hybrid III, and test device for human occupant restraint (THOR) ATDs, were assessed under comparable testing conditions. The similarities and differences between WIAMan and the other surrogates were compared and analyzed, including the motion of bilateral shoulders and T1, time histories of chest deflections, and belt loads. The CORrelation and Analysis (CORA) ratings were used to evaluate the correlations of thoracic responses between the ATDs and PMHS. Compared to the PMHS and THOR, the WIAMan experienced a similar level of left shoulder forward excursions. Larger chest deflection was exhibited in WIAMan throughout the whole duration of belt compression. Differences were found in belt loads between subject types. Overall, WIAMan had slightly lower CORA scores but showed comparable overall performance. The overall thoracic responses of WIAMan under the frontal sled test were more compliant than HIII, but still reasonable compared with PMHS and THOR. Comprehensive systematic studies on comparative biofidelity of WIAMan and other surrogates under different impact conditions are expected in future research.

Comparison of small female PMHS thoracic responses to scaled response corridors in a frontal hub impact.

OBJECTIVE: The purpose of this study was to generate biomechanical response corridors of the small female thorax during a frontal hub impact and evaluate scaled corridors that have been used to assess biofidelity of small female anthropomorphic test devices (ATDs) and human body models (HBMs). METHODS: Three small female postmortem human subjects (PMHS) were tested under identical conditions, in which the thorax was impacted using a 14.0 kg pneumatic impactor at an impact velocity of 4.3 m/s. Impact forces to PMHS thoraces were measured using a load cell installed behind a circular impactor face with a 15.2 cm diameter. Thoracic deflections were quantified using a chestband positioned at mid-sternum. Strain gages installed on the ribs and sternum identified fracture timing. Biomechanical response corridors (force-deflection) were generated and compared to scaled small female thoracic corridors using a traditional scaling method (TSM) and rib response-based scaling method (RRSM). A BioRank System Score (BRSS) was used to quantify differences between the small female PMHS data and both scaled corridors. RESULTS: Coefficients of variation from the three small female PMHS responses were less than 2% for peak force and 7% for peak deflection. Overall, the scaled corridor means determined from the TSM and RRSM were less than two standard deviations away from the mean small female PMHS corridors (BRSS < 2.0). The RRSM resulted in smaller deviation (BRSS = 1.1) from the PMHS corridors than the TSM (BRSS = 1.7), suggesting the RRSM is an appropriate scaling method. CONCLUSIONS: New small female PMHS force-deflection data are provided in this study. Scaled corridors from the TSM, which have been used to optimize current safety tools, were comparable to the small female PMHS corridors. The RRSM, which has the great benefit of using rib structural properties instead of requiring whole PMHS data, resulted in better agreement with the small female PMHS data than the TSM and deserves further investigation to identify scaling factors for other population demographics.

An investigation of elderly occupant injury risks based on anthropometric changes compared to young counterparts.

OBJECTIVE: The objective of the study was to investigate the difference between elderly and young occupant injury risks using human body finite element modeling in frontal impacts. METHODS: Two elderly male occupant models (representative age 70-80 years) were developed using the Global Human Body Consortium (GHBMC) 50th percentile as the baseline model. In the first elderly model (EM-1), material property changes were incorporated, and in the second elderly model (EM-2), material and anthropometric changes were incorporated. Material properties were based on literature. The baseline model was morphed to elderly anthropometry for EM-2. The three models were simulated in a frontal crash vehicle environment at 56 km/h. Responses from the two elderly and baseline models were compared with cadaver experimental data in thoracic, abdominal, and frontal impacts. Correlation and analysis scores were used for correlation with experimental data. The probabilities of head, neck, and thoracic injuries were assessed. RESULTS: The elderly models showed a good correlation with experimental responses. The elderly EM-1 had higher risk of head and brain injuries compared to the elderly EM-2 and baseline GHBMC models. The elderly EM-2 demonstrated higher risk of neck, chest, and abdominal injuries than the elderly EM-1 and baseline models. CONCLUSIONS: The study investigated injury risks of two elderly occupants and compared to a young occupant in frontal crashes. The change in the material properties alone (EM-1) suggested that elderly occupants may be vulnerable to a greater risk of head and thoracic injuries, whereas change in both anthropometric and material properties (EM-2) suggested that elderly occupants may be vulnerable to a greater risk of thoracic and neck injuries. The second elderly model results were in better agreement with field injury data from the literature; thus, both anthropometric and material properties should be considered when assessing the injury risks of elderly occupants. The elderly models developed in this study can be used to simulate different impact conditions and determine injury risks for this group of our population.

Measurement of global mechanical properties of human thorax: Costal cartilage.

Surgical resection of chest wall tumours may lead to a loss of ribcage stability and requires reconstruction to allow for physical thorax functioning. When titanium implants are used especially for larger, lateral defects, they tend to break. Implant failures are mainly due to specific mechanical requirements for chest-wall reconstruction which must mimic the physiological properties and which are not yet met by available implants. In order to develop new implants, the mechanical characteristics of ribs, joints and cartilages are investigated. Rib loading is highly dependent on the global thorax kinematics, making implant development substantially challenging. Costal cartilage contributes vastly to the entire thorax load-deformation behaviour, and also to rib loading patterns. Computational models of the thoracic cage require mechanical properties on the global stiffness, to simulate rib kinematics and evaluate stresses in the ribs and costal cartilage. In this study the mechanical stiffness of human costal cartilage is assessed with bending, torsion and tensile tests. The elastic moduli for the bending in four major directions ranged from 2.2 to 60.8 MPa, shear moduli ranged from 5.7 to 24.7 MPa for torsion, and tensile elastic moduli ranging from 5.6 to 29.6 MPa. This article provides mechanical properties for costal cartilage. The results of these measurements are used for the development of a whole thorax finite element model to investigate ribcage biomechanics and subsequently to design improved rib implants.

Preliminary Study of an Adjustable, Wearable, Noninvasive Vest Providing Chest Compression to Assist with Breathing.

Respiratory muscle paralysis caused by acute cervical spinal cord injury usually leads to pulmonary ventilation dysfunction and even death from respiratory failure. In addition to invasive treatments such as mechanical ventilation, the utilization of noninvasive respiratory support equipment plays an important role in long-term assisted breathing. In this study, we describes a wearable, noninvasive vest with adjustable pressure that enables assisted breathing and with an automatic alarm, and we aims to explore its safety and effectiveness on healthy adult participants. The vest monitors the human heart rate and the blood oxygen index data in real time, the alarm is automatically activated when the data is abnormal. Eight healthy participants had no obvious discomfort during the test while wearing the vest. Lung volumes, antero-posterior diameters, and left-right diameters at the second, fourth, and sixth ribs levels were acquired before and after inflation of the vest airbag, the data acquired by the imaging analysis using chest computed tomography showed significant differences before and after the inflation (p < 0.05). Thus, The vest designed for this study can achieve uniform and effective compression of the thorax, significantly changed the size of the thorax and lungs. It is expected to be applied as noninvasive support for patients with respiratory dysfunction.

Development of a Strain-Based Model to Predict Eviscerated Thoracic Response From Dynamic Individual Rib Tests.

The objective of this study was to develop an analytical model using strain-force relationships from individual rib and eviscerated thorax impacts to predict bony thoracic response. Experimental eviscerated thorax forces were assumed to have two distinct responses: an initial inertial response and subsequently, the main response. A second-order mass-spring-damper model was used to characterize the initial inertial response of eviscerated thorax force using impactor kinematics. For the main response, equivalent strains in rib levels 4-7 were mapped at each time point and a strain-based summed force model was constructed using individual rib tests and the same ribs in the eviscerated thorax test. A piecewise approach was developed to join the two components of the curve and solve for mass, damping, stiffness parameters in the initial response, transition point, and scale factor of the strain-based summed force model. The final piecewise model was compared to the overall experimental eviscerated thorax forces for each postmortem human subjects (PMHS) (n = 5) and resulted in R2 values of 0.87-0.96. A bootstrapping approach was utilized to validate the model. Final model predictions for the validation subjects were compared with the corridors constructed for the eviscerated thorax tests. Biofidelity ranking system score (BRSS) values were approximately 0.71 indicating that this approach can predict eviscerated responses within one standard deviation from the mean response. This model can be expanded to other tissue states by quantifying soft tissue and visceral contributions, therefore successfully establishing a link between individual rib tests and whole thoracic response.

Thorax Dynamic Modeling and Biomechanical Analysis of Chest Breathing in Supine Lying Position.

During respiration, the expansion and contraction of the chest and abdomen are coupled with each other, presenting a complex torso movement pattern. A finite element (FE) model of chest breathing based on the HUMOS2 human body model was developed. One-dimensional muscle units with active contraction functions were incorporated into the model based on Hill's active muscle model so as to generate muscle contraction forces that can change over time. The model was validated by comparing it to the surface displacement of the chest and abdomen during respiration. Then, the mechanism of the coupled motion of the chest and abdomen was analyzed. The analyses revealed that since the abdominal wall muscles are connected to the lower edge of the rib cage through tendons, the movement of the rib cage may cause the abdominal wall muscles to be stretched in both horizontal and vertical in a supine position. The anteroposterior and the right-left diameters of the chest will increase at inspiration, while the right-left diameter of the abdomen will decrease even though the anteroposterior diameter of the abdomen increases. The external intercostal muscles at different regions had different effects on the motion of the ribs during respiration. In particular, the external intercostal muscles at the lateral region had a larger effect on pump handle movement than bucket handle movement, and the external intercostal muscles at the dorsal region had a greater influence on bucket handle movement than pump handle movement.

Traumatic Impact Assessment of CPR Load on a Human Ribcage.

Chest compression is a parameter of injury criteria assessment for human beings. Additionally, it is used to find the external compression response as a result of vehicle crashes, falls, or sporting impacts. This behavioral feature is described by many deterministic models related to specific experimental tests, hindering distinct scenarios. The present study evaluates the energy absorbed as a function of rib compression. The proposed model was obtained from three different computed tomography (CT) studies. The anthropometric values are interpolated to obtain a parametric curve for a human rib's average size. The computed results are compared against an STL-DICOM® file used to obtain a virtual reconstruction of one rib. A numerical model of the behavior of the thorax displacement expressed injury in the human rib model's stiffness. The proposed model is used to determine the correlation of the input payload versus the numerical stiffness value. The outcome is confirmed by numerical analyses applied to a virtual human rib reconstruction.

Changes in intrathoracic pressure, not arterial pulsations, exert the greatest effect on tracer influx in the spinal cord.

BACKGROUND: Cerebrospinal fluid (CSF) circulation in the brain has garnered considerable attention in recent times. In contrast, there have been fewer studies focused on the spine, despite the expected importance of CSF circulation in disorders specific to the spine, including syringomyelia. The driving forces that regulate spinal CSF flow are not well defined and are likely to be different to the brain given the anatomical differences and proximity to the heart and lungs. The aims of this study were to determine the effects of heart rate, blood pressure and respiration on the distribution of CSF tracers in the spinal subarachnoid space, as well as into the spinal cord interstitium. METHODS: In Sprague Dawley rats, physiological parameters were manipulated such that the effects of spontaneous breathing (generating alternating positive and negative intrathoracic pressures), mechanical ventilation (positive intrathoracic pressure only), tachy/bradycardia, as well as hyper/hypotension were separately studied. To investigate spinal CSF hydrodynamics, in vivo near-infrared imaging of intracisternally infused indocyanine green was performed. CSF tracer transport was further characterised with in vivo two-photon intravital imaging. Tracer influx at a microscopic level was quantitatively characterised by ex vivo epifluorescence imaging of fluorescent ovalbumin. RESULTS: Compared to mechanically ventilated controls, spontaneous breathing animals had significantly greater movement of tracer in the subarachnoid space. There was also greater influx into the spinal cord interstitium. Hypertension and tachycardia had no significant effect on spinal subarachnoid spinal CSF tracer flux and exerted less effect than respiration on tracer influx into the spinal cord. CONCLUSIONS: Intrathoracic pressure changes that occur over the respiratory cycle, particularly decreased intrathoracic pressures generated during inspiration, have a profound effect on tracer movement after injection into spinal CSF and increase cord parenchymal tracer influx. Arterial pulsations likely drive fluid transport from perivascular spaces into the surrounding interstitium, but their overall impact is less than that of the respiratory cycle on net tracer influx.

Influence of back muscle fatigue on dynamic lumbar spine stability and coordination variability of the thorax-pelvis during repetitive flexion-extension movements.

Previous work has identified that individuals adopt different dynamic lumbar spine stability responses when experiencing back muscle fatigue, and that the neuromuscular system adjusts multi-joint coordination in response to fatigue. Therefore, this study was designed to determine whether distinct differences in coordination and coordination variability would be observed for those who stabilize, destabilize, or demonstrate no change in dynamic stability when their back muscles are fatigued. Thirty participants completed two repetitive trunk flexion-extension trials (Rested, Fatigued) during which lumbar flexion-extension dynamic stability, thorax-pelvis movement coordination, and coupling angle variability (CAV) were assessed. Dynamic stability was evaluated using maximum Lyapunov exponents (λmax) with participants being allotted to stabilizer, destabilizer, or no change groups based on their stability response to fatigue. Each flexion-extension repetition was further segregated into two phases (flexion, extension) and vector coding analyses were implemented to determine thorax-pelvis coordination and CAV during each movement phase. Results demonstrated that when fatigued, ∼30% of individuals adopted more stable (lower λmax) flexion-extension movements and greater CAV during the extension phase, ∼17% of individuals became less stable (higher λmax) and exhibited decreased CAV during the extension phase, and the remaining âˆ¼53% of individuals expressed no change in dynamic stability or CAV. Additionally, more in-phase coordination patterns were generally observed across all individuals when fatigued. Altogether, this study highlights the heterogeneous nature of lumbar spine movement behaviours within a healthy population in response to fatigue.

Biomechanical analysis of thorax-abdomen response of vehicle occupant under seat belt load considering different frontal crash pulses.

PURPOSE: The purpose of this work was to understand the biomechanical response and injury risk of thorax and abdomen of vehicle front seat occupants caused by seat belt load under different frontal crash pulses. METHODS: A vehicle-seat-occupant subsystem finite element (FE) model was developed using the a assembly of vehicle front seat and seat belt together with the THUMS (Total Human body Model for Safety) AM50 (50th% Adult Male) occupant model. Then the typical vehicle frontal crash pulses from different impact scenarios were applied to the vehicle-seat-occupant subsystem FE model, and the predictions from the occupant model were analyzed. RESULTS: The modeling results indicate that the maximum sternal compression of the occupant caused by seat belt load is not sensitive to the peek of the crash pulse but sensitive to the energy contained by the crash pulse in the phrase before seat belt load reaching its limit. Injury risk analysis implies that seat belt load of the four crash scenarios considered in the current work could induce a high thorax AIS2+ injury risk (>80%) to the occupants older than 70 years, and a potential injury risk to the spleen. CONCLUSIONS: The findings suggest that control of the energy in the first 75 ms of the crash pulse is crucial for vehicle safety design, and thorax tolerance of the older population and spleen injury prevention are the key considerations in developing of seat belt system.

Impact of lung structure on airway opening index during mechanical versus manual chest compressions in a porcine model of cardiac arrest.

OBJECTIVES: The exhaled CO2 signal provides guidance during cardiopulmonary resuscitation. The Airway opening index (AOI) has been recently used to quantify chest-compression (CC) induced expired CO2 oscillations. We aimed to determine whether levels of intrathoracic pressures developed during CC or parameters related to lung structure may affect AOI. METHODS: Secondary analysis of a randomized animal study (n = 12) in a porcine model of cardiac arrest (CA) and cardiopulmonary resuscitation (CPR) during ambulance transport. Animals were randomized to 18-min of manual or mechanical CCs. Changes in AOI and right atrial pressure (ΔRAP) were recorded during CCs in animals undergoing manual (n = 6) or mechanical (n = 6) CCs. Lung CT scan and measurement of the respiratory system compliance (Cpl,rs) were performed immediately after return of spontaneous circulation. RESULTS: Animals undergoing mechanical CCs had a lower AOI compared to animals treated with manual CCs (p < 0.001). AOI negatively correlated with the swings of intrathoracic pressure, as measured by the change in ΔRAP (ρ=-0.727, p = 0.007). AOI correlated with the lung density (ρ=-0.818, p = 0.001) and with the Cpl,rs (ρ = 0.676, p = 0.016). Animals with cardiopulmonary resuscitation associated lung edema (CRALE) (i.e. mean CT≥-500 HU) showed lower levels of AOI compared to animals without it (29 ± 12 % versus 50 ± 16 %, p = 0.025). CONCLUSIONS: Animals undergoing mechanical CCs had lower levels of AOI compared to animals undergoing manual CCs. A higher swing of intrathoracic pressure during CC, a denser and a stiffer lung were associated with an impaired CO2 exhalation during CC as observed by a lower AOI.

Deflection-based parametric survival analysis side impact chest injury risk curves AIS 2015.

OBJECTIVES: The objective of this study was to reanalyze lateral postmortem human surrogate (PMHS) sled test chestband data to construct updated lateral thoracic injury risk curves (IRCs) using survival analysis. METHODS: Chestband and injury data were gathered from 16 previously conducted PMHS sled tests. Briefly, 2 chestbands were wrapped around the thorax's circumference at the levels of ribs 4 and 8. Tests were conducted at 6.7 m/s on a rigid and padded load wall fixed to the top of a rebound sled. The injuries were reclassified using the Abbreviated Injury Scale (AIS) 2015 coding scheme. Chestband signals were combined with pretest specimen measurements to calculate the chest deflection contour time history. Deflections were determined using updated processing techniques calculating the change in length of every point on the contour from the impacted side using the thorax's midpoint as the origin. Four candidate metrics were selected: the deflection from rib 4, the deflection from rib 8, the greater of the deflections from ribs 4 and 8, and the average of the deflections from ribs 4 and 8. AIS 3+ IRCs were developed considering outcomes of AIS ≥3 injuries. All injury data were uncensored, and noninjury data were right-censored. Three specimen mass-based IRCs were determined using the IRC with the lowest Brier score metric (BSM): The first corresponded to the 5th percentile female mass (49 kg), the second to the 50th percentile male mass (77 kg), and the third to the average mass of the PMHS ensemble (65 kg). RESULTS: Sixteen PMHS were used in the current study. Six specimens were right-censored, and 10 were uncensored. The average metric had the lowest BSM, and mass was a significant covariate with 50% risk of AIS3+ injury at 72mm of chest deflection. The 50% risk deflection magnitudes for the 5th percentile female (49 kg), 50th percentile male (77 kg), and PMHS ensemble (PMHS-E) (65 kg) were 59, 81, and 71 mm. IRCs for the 4 metrics and the 3 occupant masses are given. CONCLUSIONS: IRCs were developed using survival analysis, and the average of the peak deflections was found to best represent the thoracic chest deflection response. Mass-based side impact IRCs were calculated for occupants representing the WorldSID 5th percentile female and 50th percentile male anthropomorphic test device.