Name: assessment of child anthropometry in a large epidemiologic study
Uploaded: 2017-02-02T13:00:00
Description: Watch this Scientific Journal Video about Assessment of Child Anthropometry in a Large Epidemiologic Study at JoVE.com

We greatly appreciate the contributions of our expert anthropometry trainers Irwin Shorr and Jorge Chavarro; the many volunteers who have allowed themselves to be pinched and measured in our anthropometry workshops, and the Project Viva mothers and children for their invaluable contributions. We'd like to extend a special thanks to members of the Project Viva research staff, past and present, especially to Nicole Witham and Marleny Ortega, for their contribution to the video accompanying this manuscript. Funding from the National Institutes of Health supported this work (R01 HD 034568, K24 HD069408).

सभी प्रक्रियाओं हार्वर्ड तीर्थ स्वास्थ्य देखभाल संस्थागत समीक्षा बोर्ड द्वारा अनुमोदित कर रहे हैं। 1. प्रशिक्षण की प्रक्रिया <ol><li> प्रशिक्षुओं (अनुसंधान सहायकों) एक बहु-दिन, कई घंटे के प्रश...

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सटीक शरीर की संरचना के उपायों को ठीक से अनुसंधान अध्ययन में बचपन विकास का आकलन करने के लिए महत्वपूर्ण हैं। शोधकर्ताओं ने व्यापक रूप से एक सोने की मानक पद्धति के रूप में DXA स्वीकार करते हैं, और कई imprecise और ग?...

अधिक वजन और मोटापे, महामारी के स्तर पर रहने के अमेरिकी बच्चों और अधिक वजन या मोटापे से होने वयस्कों के दो तिहाई के लगभग एक तिहाई के साथ 2011 के अनुसार - 2012 का अनुमान है 2। अधिक वजन, मोटापा, और शरीर की अतिरिक्त वसा टाइप 2 मधुमेह और हृदय रोगों सहित प्रतिकूल cardiometabolic परिणामों का अधिक खतरा है, साथ ही अस्थमा और अवसाद 3, 4, 5, 6, सहित अन्य प्रतिकूल शारीरिक और मानसिक स्वास्थ्य के परिणामों, प्रदान करते हैं। अधिकांश अध्ययन है कि मोटापा और बाद में जीवन स्वास्थ्य के परिणामों के बीच संघों की जांच वजन और लंबाई / ऊंचाई का सही माप मान लेते हैं। वयस्कों और बच्चों में वजन का दर्जा श्रेणियाँ कम वजन (बॉडी मास इंडेक्स (बीएमआई) &lt;18.0 किलो वयस्कों के लिए / 2 मीटर और बच्चों के लिए &lt;5 वें उम्र-लिंग-विशिष्ट प्रतिशतक), कोई शामिलrmal वजन (बीएमआई 18.0 के लिए &lt;25.0 किलो वयस्कों के लिए / 2 मीटर और बच्चों के लिए &lt;85 वें प्रतिशतक के लिए 5 वीं), अधिक वजन (करने के लिए बीएमआई 25.0 &lt;30.0 किलो वयस्कों के लिए / 2 मीटर और 85 वें &lt;बच्चों के लिए 95 वें शतमक) और मोटापा (बीएमआई ≥ 30 किग्रा / एम वयस्कों के लिए 2 और ≥ 95 बच्चों के लिए वीं प्रतिशतक)। यहां तक कि मामूली माप त्रुटियों इन वर्गीकरण प्रभावित कर सकते हैं, विशेष रूप से बच्चों के लिए जिसे त्रुटि है कि एक पूर्ण पैमाने पर छोटे दिखाई देते हैं बच्चे का आकार 7 से एक बड़ी त्रुटि रिश्तेदार का प्रतिनिधित्व कर सकते हैं। उदाहरण के लिए, उम्र के 2 वर्ष से कम बच्चों के एक पूर्व अध्ययन में, लंबाई की तुलना लेटा हुआ लंबाई-बोर्ड विधि के साथ पारंपरिक नैदानिक ​​कागज और पेंसिल विधि द्वारा मापा संकेत दिया है कि कागज और पेंसिल व्यवस्थित एक औसत से लंबाई overestimated विधि 1.3 (1.5) सेमी - एक त्रुटि है कि पर्याप्त गलत वर्गीकरण 7 में परिणाम है। <p clगधा = &quot;jove_content&quot;&gt; वसा की मात्रा का अनुमान लगाने के लिए बीएमआई का उपयोग कर अनुसंधान के लिए कई फायदे हैं, कम उपकरणों की लागत और ऊंचाई और वजन माप की कम से कम बोझ है, साथ ही लाभ उठाने के लिए आत्म रिपोर्ट और नैदानिक ​​उपायों अवसर सहित प्रदान करता है। हालांकि, यहां तक ऊंचाई और वजन का सही माप के साथ, बीएमआई में बदलाव जरूरी वसा की मात्रा में भिन्नता को प्रतिबिंबित नहीं करता बीएमआई के बाद से शामिल किया गया है दोनों दुबला और वसा द्रव्यमान 1। इस प्रकार, तरीकों कि सीधे वसा की मात्रा को मापने के लिए भी स्वास्थ्य के परिणामों के साथ संबंधों को समझने के लिए महत्वपूर्ण हैं। वसा की मात्रा और शरीर की संरचना माप के सोने के मानक तरीकों आम तौर पर हवा विस्थापन plethysmography (ADP), हीड्रास्टाटिक वजन, चुंबकीय अनुनाद इमेजिंग (एमआरआई), और गणना टोमोग्राफी (सीटी), साथ ही दोहरी एक्स-रे अवशोषणमापी सहित तकनीकी विधियों, पर भरोसा करते हैं (DXA ) 8, 9, 10। इन जबकिविधियों के शरीर की संरचना का सबसे सटीक उपायों के कुछ प्रदान करते हैं, उनमें से कई नहीं बाल चिकित्सा अनुसंधान अध्ययन में व्यावहारिक, विशेष रूप से उन है कि क्षेत्र के आधार पर कर रहे हैं। उदाहरण के लिए, हीड्रास्टाटिक वजन की आवश्यकता है कि व्यक्ति पूरी तरह से पानी में डूबे हुए हो। ADP उपकरण है, जब तक काफी हाल ही में, उपलब्ध केवल 8 किलो या बच्चों और वयस्कों के लिए 6 साल की उम्र से अधिक शिशुओं को मापने के लिए किया गया है, लेकिन नहीं toddlers या पूर्वस्कूली उम्र के बच्चों को। सीटी स्कैन अन्य तकनीकों के साथ तुलना में विकिरण की एक बड़ी राशि का उत्सर्जन, और एमआरआई के लिए लंबे समय से अधिग्रहण के समय यह कई अध्ययनों से 8 के लिए अव्यावहारिक है। DXA 1/500 के बारे में एक सीटी स्कैन की विकिरण खुराक, लगभग प्राकृतिक पृष्ठभूमि विकिरण 11 के एक दिन के बराबर का उत्सर्जन करता है, यह अनुसंधान बच्चों को शामिल अध्ययन के लिए एक आकर्षक विकल्प बना रही है। इन तरीकों के सभी, हालांकि, खरीद के लिए महंगे हैं और कोई भी पोर्टेबल हैं, सीमित निधि के साथ क्षेत्र आधारित अध्ययन के लिए उन्हें अव्यवहार्य बनाआईएनजी। प्रतिबाधा विश्लेषण (BIA) है, जो शरीर की संरचना अनुमान लगाने के लिए शरीर के माध्यम से भेजे गए एक मिनट बिजली के संकेत के प्रतिबाधा के उपाय, कम खर्चीला और अधिक पोर्टेबल हो सकता है, लेकिन शरीर में वसा की गणना के अंतर्निहित मान्यताओं छोटे बच्चों के लिए 10 लागू नहीं कर रहे हैं। इन प्रौद्योगिकी आधारित उपायों के विपरीत, मैनुअल मानवशास्त्रीय उपायों सबसे क्षेत्र सेटिंग में एक प्रशिक्षित पर्यवेक्षक द्वारा और एक काफी कम कीमत पर उपकरण किया जा सकता है। मैनुअल anthropometry ऊंचाई की माप, वजन, circumferences, और skinfold मोटाई 8 भी शामिल है। मैनुअल anthropometry के अन्य लाभ यह है कि यह कोई अनावश्यक विकिरण जोखिम शामिल कर रहे हैं, और कुशल कर्मचारियों उन्हें कुशलता प्राप्त कर सकते हैं। हालांकि, मैनुअल मानवशास्त्रीय माप के बारे में एक आम चिंता का विषय है कि वे दोनों गलत और imprecise 12 हो सकती है। सटीक और जनसंपर्क प्राप्तecise माप मानकीकृत प्रक्रियाओं, पर्याप्त प्रशिक्षण, और गुणवत्ता नियंत्रण (क्यूसी) प्रक्रियाओं के लिए पर्याप्त ध्यान के साथ संभव है। परियोजना चिरायु टीम एक पुस्तिका anthropometry प्रशिक्षण प्रोटोकॉल है कि उच्च गुणवत्ता, कद, circumferences की प्रतिलिपि प्रस्तुत करने के उपाय, और skinfold मोटाई उपज कर सकते हैं विकसित किया है। अधिक से अधिक एक दशक के दौरान, हम मां और परियोजना चिरायु, एक अनुदैर्ध्य, पूर्व जन्म काउहोट अध्ययन में 13 बच्चों को यह प्रशिक्षण और QC प्रोटोकॉल आवेदन किया है। परियोजना चिरायु स्टाफ जन्म के समय यात्राओं के दौरान बच्चे पर मानवशास्त्रीय उपायों एकत्र (0 - 3 दिन), और दोनों माँ और बच्चे के लिए निम्नलिखित बिंदुओं पर समय के साथ: प्रारंभिक अवस्था (4.9 - 10.6 महीने), बचपन (2.8 - 6.3 वर्ष), मध्य -childhood (6.6 - 10.9 वर्ष), और जल्दी किशोर (11.5 - 16.5 साल) 13। इस पत्र प्रोटोकॉल हम विकसित किया है और ऊंचाई, वजन, skinfold मोटाई (triceps और subscapul की माप के लिए परिष्कृत का वर्णनएआर skinfolds), और शरीर circumferences (कमर, कूल्हे, और मध्य ऊपरी बांह circumferences [एमयूएसी]) परियोजना चिरायु में। हम यह भी वर्णन है कि कैसे हम सोने के मानक DXA माप की तुलना में माप (मंदिर) गणना और सटीकता की तकनीकी त्रुटि के माध्यम से दोनों मैनुअल मानवशास्त्रीय माप सटीक आकलन किया है।

<table border="0" cellpadding="0" cellspacing="0" width="596">
	<tbody>
		<tr height="210">
			<td height="210" style="height:210px;width:216px;">Stadiometer</td>
			<td style="width:95px;">Weigh and Measure, LLC&#160;</td>
			<td style="width:119px;">SSWM-1</td>
			<td style="width:167px;">Basic Shorr board (without smooth slide features) can also be used. In order to accommodate the width of children&#39;s hips during sitting height, the base of a stadiometer should be approximately 60 cm wide or larger.</td>
		</tr>
		<tr height="105">
			<td height="105" style="height:105px;width:216px;">Bioimpedance scale&#160;</td>
			<td style="width:95px;">Tanita Coporation of America</td>
			<td style="width:119px;">TBF 300A (model is discontinued), DC-430U is&#160; comparable&#160;&#160;&#160;</td>
			<td style="width:167px;">Scale is used for weight and bioimpedance. Any digital, standardized scale can be used for weight only.</td>
		</tr>
		<tr height="105">
			<td height="105" style="height:105px;width:216px;">Skinfold Caliper</td>
			<td style="width:95px;">Holtain Limited</td>
			<td style="width:119px;">n/a</td>
			<td style="width:167px;">This model uses a dial gauge in graduations of 0.2 mm. Models with a linear gauge are also acceptable.&#160;&#160;</td>
		</tr>
		<tr height="189">
			<td height="189" style="height:189px;width:216px;">Hip/waist tape measure</td>
			<td style="width:95px;">Gulick II Plus Measuring Tape</td>
			<td style="width:119px;">67019</td>
			<td style="width:167px;">This model uses compression bands, which makes it easier to identify how firmly the tape measure is being pulled. The compression band is not necessary, but highly recommended.</td>
		</tr>
		<tr height="105">
			<td height="105" style="height:105px;width:216px;">MUAC measuring tape (ShorrTape&#169; Measuring Tape)&#160;</td>
			<td style="width:95px;">Weigh and Measure, LLC</td>
			<td style="width:119px;">STape</td>
			<td style="width:167px;">The tape measure should be flexible with a single or double slotted insertion window.</td>
		</tr>
	</tbody>
</table>

assessment of child anthropometry in a large epidemiologic study

बच्चों की एक उच्च अनुपात अधिक वजन और संयुक्त राज्य अमेरिका और अन्य देशों में मोटापे की है। anthropometry का सही आकलन बच्चे के विकास और वसा की मात्रा के स्वास्थ्य के प्रभाव को समझने के लिए आवश्यक है। इस तरह के दोहरे एक्स-रे अवशोषणमापी (DXA) के रूप में वसा की मात्रा का मापने के सोने के मानक तरीकों, बड़े क्षेत्र के अध्ययन में संभव नहीं हो सकता है। अनुसंधान स्टाफ कर सकते हैं, हालांकि, इस तरह शरीर circumferences और skinfold माप, सस्ती पोर्टेबल उपकरणों का उपयोग कर के रूप में पूरा मानवशास्त्रीय माप,। इस प्रोटोकॉल हम विस्तार से बच्चों, खड़े हैं और ऊंचाई, वजन, कमर परिधि, हिप परिधि, मध्य ऊपरी बांह परिधि, ट्राइसेप्स skinfold मोटाई, और subscapular skinfold मोटाई बैठे सहित से मार्गदर्शन मानवशास्त्रीय माप, और प्रक्रियाओं प्राप्त करने के तरीके की गुणवत्ता का आकलन करने के लिए इन मापों। पूर्व जन्म पलटन परियोजना चिरायु हम गणना की स्पीयरमैन CORR में 1,110 स्कूल आयु वर्ग के बच्चों के बीच इन मापों की सटीकता को प्रदर्शित करने के लिए,उत्साह गुणांक शरीर में वसा, DXA वसा द्रव्यमान 1 के एक स्वर्ण मानक उपाय के साथ मैनुअल मानवशास्त्रीय माप की तुलना। विश्वसनीयता को संबोधित करने के लिए, हम वयस्क महिला स्वयंसेवकों पर किए गए एक गुणवत्ता नियंत्रण सत्र में माप की इंट्रा-करदाता तकनीकी त्रुटि का मूल्यांकन।

इस विश्लेषण गुणवत्ता नियंत्रण (क्यूसी) प्रक्रियाओं से उत्पन्न डेटा का उपयोग कर मैनुअल मानवशास्त्रीय माप की परिशुद्धता के पते, और माप के तकनीकी त्रुटि से इंट्रा-करदाता माप त्रुटि का मूल्य...

Watch this Scientific Journal Video about Assessment of Child Anthropometry in a Large Epidemiologic Study at JoVE.com

Assessment of Child Anthropometry in a Large Epidemiologic Study

In epidemiologic studies of children, well-trained research staff can accurately and precisely assess weight, height, sitting height, skinfold thicknesses, and body circumferences.

एक बड़े Epidemiologic अध्ययन में बाल एन्थ्रोपोमेट्री का आकलन

A high proportion of children have overweight and obesity in the United States and other countries. Accurate assessment of anthropometry is essential to ...

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Biomarkers in an Animal Model for Revealing Neural, Hematologic, and Behavioral Correlates of PTSD

Identification of biomarkers representing the evolution of the pathophysiology of Post Traumatic Stress Disorder (PTSD) is vitally important, not only for objective diagnosis but also for the evaluation of therapeutic efficacy and resilience to trauma. Ongoing research is directed at identifying molecular biomarkers for PTSD, including traumatic stress induced proteins, transcriptomes, genomic variances and genetic modulators, using biologic samples from subjects' blood, saliva, urine, and postmortem brain tissues. However, the correlation of these biomarker molecules in peripheral or postmortem samples to altered brain functions associated with psychiatric symptoms in PTSD remains unresolved. Here, we present an animal model of PTSD in which both peripheral blood and central brain biomarkers, as well as behavioral phenotype, can be collected and measured, thus providing the needed correlation of the central biomarkers of PTSD, which are mechanistic and pathognomonic but cannot be collected from people, with the peripheral biomarkers and behavioral phenotypes, which can.
Our animal model of PTSD employs restraint and tail shocks repeated for three continuous days - the inescapable tail-shock model (ITS) in rats. This ITS model mimics the pathophysiology of PTSD 17, 7, 4, 10. We and others have verified that the ITS model induces behavioral and neurobiological alterations similar to those found in PTSD subjects 17, 7, 10, 9. Specifically, these stressed rats exhibit (1) a delayed and exaggerated startle response appearing several days after stressor cessation, which given the compressed time scale of the rat's life compared to a humans, corresponds to the one to three months delay of symptoms in PTSD patients (DSM-IV-TR PTSD Criterian D/E 13), (2) enhanced plasma corticosterone (CORT) for several days, indicating compromise of the hypothalamopituitary axis (HPA), and (3) retarded body weight gain after stressor cessation, indicating dysfunction of metabolic regulation.
The experimental paradigms employed for this model are: (1) a learned helplessness paradigm in the rat assayed by measurement of acoustic startle response (ASR) and a charting of body mass; (2) microdissection of the rat brain into regions and nuclei; (3) enzyme-linked immunosorbent assay (ELISA) for blood levels of CORT; (4) a gene expression microarray plus related bioinformatics tools 18. This microarray, dubbed rMNChip, focuses on mitochondrial and mitochondria-related nuclear genes in the rat so as to specifically address the neuronal bioenergetics hypothesized to be involved in PTSD.

We describe a rat model of post traumatic stress disorder (PTSD) that reveals the persistent alterations in neuroendocrine function and the delayed long-term, exaggerated fear response, characteristic of PTSD patients. The animal model and methods described here are useful for correlating biomarkers in brain nuclei, which are mechanistic but cannot be measured in patients, with biomarkers in peripheral white blood cells, which can.

PTSD के तंत्रिका, hematologic, व्यवहार और संबद्ध खुलासा करने के लिए एक पशु मॉडल में Biomarkers

Identification of biomarkers representing the evolution of the pathophysiology of Post Traumatic Stress Disorder (PTSD) is vitally important, not only for ...

Real-time fMRI Biofeedback Targeting the Orbitofrontal Cortex for Contamination Anxiety

We present a method for training subjects to control activity in a region of their orbitofrontal cortex associated with contamination anxiety using biofeedback of real-time functional magnetic resonance imaging (rt-fMRI) data. Increased activity of this region is seen in relationship with contamination anxiety both in control subjects1 and in individuals with obsessive-compulsive disorder (OCD),2 a relatively common and often debilitating psychiatric disorder involving contamination anxiety. Although many brain regions have been implicated in OCD, abnormality in the orbitofrontal cortex (OFC) is one of the most consistent findings.3, 4 Furthermore, hyperactivity in the OFC has been found to correlate with OCD symptom severity5 and decreases in hyperactivity in this region have been reported to correlate with decreased symptom severity.6 Therefore, the ability to control this brain area may translate into clinical improvements in obsessive-compulsive symptoms including contamination anxiety. Biofeedback of rt-fMRI data is a new technique in which the temporal pattern of activity in a specific region (or associated with a specific distributed pattern of brain activity) in a subject's brain is provided as a feedback signal to the subject. Recent reports indicate that people are able to develop control over the activity of specific brain areas when provided with rt-fMRI biofeedback.7-12 In particular, several studies using this technique to target brain areas involved in emotion processing have reported success in training subjects to control these regions.13-18 In several cases, rt-fMRI biofeedback training has been reported to induce cognitive, emotional, or clinical changes in subjects.8, 9, 13, 19 Here we illustrate this technique as applied to the treatment of contamination anxiety in healthy subjects. This biofeedback intervention will be a valuable basic research tool: it allows researchers to perturb brain function, measure the resulting changes in brain dynamics and relate those to changes in contamination anxiety or other behavioral measures. In addition, the establishment of this method serves as a first step towards the investigation of fMRI-based biofeedback as a therapeutic intervention for OCD. Given that approximately a quarter of patients with OCD receive little benefit from the currently available forms of treatment,20-22 and that those who do benefit rarely recover completely, new approaches for treating this population are urgently needed.

Here we present a method for training people to control a brain area involved in contamination anxiety and for probing the relationship between contamination anxiety and brain connectivity patterns.

वास्तविक समय fMRI Biofeedback संदूषण चिंता के लिए orbitofrontal प्रांतस्था का लक्ष्य निर्धारण

We present a method for training subjects to control activity in a region of their orbitofrontal cortex associated with contamination anxiety using ...

A Novel Application of Musculoskeletal Ultrasound Imaging

Ultrasound is an attractive modality for imaging muscle and tendon motion during dynamic tasks and can provide a complementary methodological approach for biomechanical studies in a clinical or laboratory setting. Towards this goal, methods for quantification of muscle kinematics from ultrasound imagery are being developed based on image processing. The temporal resolution of these methods is typically not sufficient for highly dynamic tasks, such as drop-landing. We propose a new approach that utilizes a Doppler method for quantifying muscle kinematics. We have developed a novel vector tissue Doppler imaging (vTDI) technique that can be used to measure musculoskeletal contraction velocity, strain and strain rate with sub-millisecond temporal resolution during dynamic activities using ultrasound. The goal of this preliminary study was to investigate the repeatability and potential applicability of the vTDI technique in measuring musculoskeletal velocities during a drop-landing task, in healthy subjects. The vTDI measurements can be performed concurrently with other biomechanical techniques, such as 3D motion capture for joint kinematics and kinetics, electromyography for timing of muscle activation and force plates for ground reaction force. Integration of these complementary techniques could lead to a better understanding of dynamic muscle function and dysfunction underlying the pathogenesis and pathophysiology of musculoskeletal disorders.

We describe a new ultrasound-based vector tissue Doppler imaging technique to measure muscle contraction velocity, strain and strain rate with sub-millisecond temporal resolution during dynamic activities. This approach provides complementary measurements of dynamic muscle function and could lead to a better understanding of mechanisms underlying musculoskeletal disorders.

Musculoskeletal अल्ट्रासाउंड इमेजिंग के एक उपन्यास आवेदन

Ultrasound is an attractive modality for imaging muscle and tendon  motion during dynamic tasks and can provide a complementary methodological  approach ...

An Isolated Working Heart System for Large Animal Models

Since its introduction in the late 19th century, the Langendorff isolated heart perfusion apparatus, and the subsequent development of the working heart model, have been invaluable tools for studying cardiovascular function and disease1-15. Although the Langendorff heart preparation can be used for any mammalian heart, most studies involving this apparatus use small animal models (e.g., mouse, rat, and rabbit) due to the increased complexity of systems for larger mammals1,3,11. One major difficulty is ensuring a constant coronary perfusion pressure over a range of different heart sizes &#8211; a key component of any experiment utilizing this device1,11. By replacing the classic hydrostatic afterload column with a centrifugal pump, the Langendorff working heart apparatus described below allows for easy adjustment and tight regulation of perfusion pressures, meaning the same set-up can be used for various species or heart sizes. Furthermore, this configuration can also seamlessly switch between constant pressure or constant flow during reperfusion, depending on the user&#8217;s preferences. The open nature of this setup, despite making temperature regulation more difficult than other designs, allows for easy collection of effluent and ventricular pressure-volume data.

Most studies involving the Langendorff apparatus use small animal models due to the increased complexity of systems for larger mammals. We describe a Langendorff system for large animal models that allows for use across a range of species, including humans, and relatively easy data acquisition.

बड़े पशु मॉडल के लिए एक अलग कार्य हार्ट सिस्टम

Since its introduction in the late 19th century, the Langendorff isolated heart perfusion apparatus, and the subsequent development of the working heart ...

Clinical Assessment of Spatiotemporal Gait Parameters in Patients and Older Adults

Spatial and temporal characteristics of human walking are frequently evaluated to identify possible gait impairments, mainly in orthopedic and neurological patients1-4, but also in healthy older adults5,6. The quantitative gait analysis described in this protocol is performed with a recently-introduced photoelectric system (see&#160;Materials table) which has the potential to be used in the clinic because it is portable, easy to set up (no subject preparation is required before a test), and does not require maintenance and sensor calibration. The photoelectric system consists of series of high-density floor-based photoelectric cells with light-emitting and light-receiving diodes that are placed parallel to each other to create a corridor, and are oriented perpendicular to the line of progression7. The system simply detects interruptions in light signal, for instance due to the presence of feet within the recording area. Temporal gait parameters and 1D spatial coordinates of consecutive steps are subsequently calculated to provide common gait parameters such as step length, single limb support and walking velocity8, whose validity against a criterion instrument has recently been demonstrated7,9. The measurement procedures are very straightforward; a single patient can be tested in less than 5 min&#160;and a comprehensive report can be generated in less than 1&#160;min.

This protocol is used to evaluate spatial and temporal gait variables of neurological/orthopedic patients and older persons by means of a recently-introduced floor-based photocell system.

मरीजों और पुराने वयस्कों में spatiotemporal चाल पैरामीटर्स के नैदानिक ​​मूल्यांकन

Spatial and temporal characteristics of human walking are frequently evaluated to identify possible gait impairments, mainly in orthopedic and ...

Surgical Angiogenesis in Porcine Tibial Allotransplantation: A New Large Animal Bone Vascularized Composite Allotransplantation Model

Segmental bone loss resulting from trauma, infection malignancy and congenital anomaly remains a major reconstructive challenge. Current therapeutic options have significant risk of failure and substantial morbidity.
Use of bone vascularized composite allotransplantation (VCA) would offer both a close match of resected bone size and shape and the healing and remodeling potential of living bone. At present, life-long drug immunosuppression (IS) is required. Organ toxicity, opportunistic infection and neoplasm risks are of concern to treat such non-lethal indications.
We have previously demonstrated that bone and joint VCA viability may be maintained in rats and rabbits without the need of long-term-immunosuppression by implantation of recipient derived vessels within the VCA. It generates an autogenous, neoangiogenic circulation with measurable flow and active bone remodeling, requiring only 2 weeks of IS. As small animals differ from man substantially in anatomy, bone physiology and immunology, we have developed a porcine bone VCA model to evaluate this technique before clinical application is undertaken. Miniature swine are currently widely used for allotransplantation research, given their immunologic, anatomic, physiologic and size similarities to man. Here, we describe a new porcine orthotopic tibial bone VCA model to test the role of autogenous surgical angiogenesis to maintain VCA viability.
The model reconstructs segmental tibial bone defects using size- and shape-matched allogeneic tibial bone segments, transplanted across a major swine leukocyte antigen (SLA) mismatch in Yucatan miniature swine. Nutrient vessel repair and implantation of recipient derived autogenous vessels into the medullary canal of allogeneic tibial bone segments is performed in combination with simultaneous short-term IS. This permits a neoangiogenic autogenous circulation to develop from the implanted tissue, maintaining flow through the allogeneic nutrient vessels for a short time. Once established, the new autogenous circulation maintains bone viability following cessation of drug therapy and subsequent nutrient vessel thrombosis.

Currently any kind of vascularized composite allotransplantation depends on long-term-immunosuppression, difficult to support for non-life-critical indications. We present a new porcine tibial VCA model that can be used to study bone VCA and demonstrate the use of surgical angiogenesis to maintain bone viability without the need of long-term immune-modulation.

सर्जिकल Angiogenesis में सुअर टिबियल Allotransplantation: एक नई बड़ी पशु हड्डी संवहनी समग्र Allotransplantation मॉडल

Segmental bone loss resulting from trauma, infection malignancy and congenital anomaly remains a major reconstructive challenge. Current therapeutic ...

Assessment of Plasma Coagulation on Liver Tissue in a Large Animal Model In Vivo

Plasma coagulation as a form of electrocautery is used in liver surgery for decades to seal the large liver cut surface after major hepatectomy to prevent hemorrhages at a later stage. The exact effects of plasma coagulation on liver tissue are only poorly examined. In our porcine model, the coagulation effects can be examined close to the clinical application. A combined laser Doppler flowmeter and spectrophotometer documents microcirculation changes during coagulation at 8 mm tissue depth noninvasively, providing quantifiable information about hemostasis beyond the subjective clinical impression. The temperature at coagulation site is assessed with an infrared thermometer prior and post coagulation and with a thermographic camera during coagulation, a measurement of the gas beam temperature is not possible due to the upper threshold of the devices. The depth of coagulation is measured microscopically on hematoxylin/eosin stained sections after calibration with an object micrometer and gives an exact information about the power setting-coagulation depth-relation. The sealing effect is examined on the bile ducts as it is not possible for a plasma coagulator to seal larger blood vessels. Burst pressure experiments are carried out on explanted organs to rule out blood pressure related effects.

Assessment of Plasma Coagulation on Liver Tissue in a Large Animal Model In Vivo

Here we present a protocol to experimentally assess plasma coagulation in liver tissue in vivo. In a porcine model, microcirculation is examined by laser Doppler, coagulation depth is measured histologically, temperature at coagulation site by infrared thermometer and thermographic camera, and duct sealing effect is documented by burst pressure experiments.

Vivo में एक बड़े पशु मॉडल में जिगर ऊतक पर प्लाज्मा जमावट का आकलन

Plasma coagulation as a form of electrocautery is used in liver surgery for decades to seal the large liver cut surface after major hepatectomy to prevent ...

Objective Nociceptive Assessment in Ventilated ICU Patients: A Feasibility Study Using Pupillometry and the Nociceptive Flexion Reflex

The concept of objective nociceptive assessment and optimal pain management have gained increasing attention. Despite the known negative short- and long-term consequences of unresolved pain or excessive analgosedation, adequate nociceptive monitoring remains challenging in non-communicative, critically ill adults. In the intensive care unit (ICU), routine nociceptive evaluation is carried out by the attending nurse using the Behavior Pain Scale (BPS) in mechanically ventilated patients. This assessment is limited by medication use (e.g., neuromuscular blocking agents) and the inherent subjective character of nociceptive evaluation by third parties.
Here, we describe the use of two nociceptive reflex testing devices as tools for objective pain evaluation: the pupillary dilation reflex (PDR) and nociception flexion reflex (NFR). These measurement tools are non-invasive and well tolerated, providing clinicians and researchers with objective information regarding two different nociceptive processing pathways: (1)&#160;the pain-related autonomic reactivity&#160;and (2) the ascending component of the somatosensory system. The use of PDR and NFR measurements are currently limited to specialized pain clinics and research institutions because of impressions that these are technically demanding or time-consuming procedures, or even because of a lack of knowledge regarding their existence.
By focusing on the two abovementioned nociceptive reflex assessments, this study evaluated their feasibility as a physiological pain measurement method in daily practice. Pursuing novel technologies for evaluating the analgesia level in unconscious patients may further improve individual pharmacological treatment and patient related outcome measures. Therefore, future research must include large well-designed clinical trials in a real-life environment.

Pain assessment in anesthetized patients who cannot communicate with the outside world in any way remains challenging despite the development of innovative objective pain evaluation tools. In this project, the pupillary dilation reflex and the nociception flexion reflex are assessed in critically ill, mechanically ventilated adult patients.

उद्देश्य हवादार आईसीयू रोगियों में Nociceptive मूल्यांकन: एक व्यवहार्यता Pupillometry और Nociceptive फ्लेक्स पलटा का उपयोग अध्ययन

The concept of objective nociceptive assessment and optimal pain management have gained increasing attention. Despite the known negative short- and ...

In Vitro Model of Coronary Angiogenesis

Here, we describe an in vitro culture assay to study coronary angiogenesis. Coronary vessels feed the heart muscle and are of clinical importance. Defects in these vessels represent severe health risks such as in atherosclerosis, which can lead to myocardial infarctions and heart failures in patients. Consequently, coronary artery disease is one of the leading causes of death worldwide. Despite its clinical importance, relatively little progress has been made on how to regenerate damaged coronary arteries. Nevertheless, recent progress has been made in understanding the cellular origin and differentiation pathways of coronary vessel development. The advent of tools and technologies that allow researchers to fluorescently label progenitor cells, follow their fate, and visualize progenies in vivo have been instrumental in understanding coronary vessel development. In vivo studies are valuable, but have limitations in terms of speed, accessibility, and flexibility in experimental design. Alternatively, accurate in vitro models of coronary angiogenesis can circumvent these limitations and allow researchers to interrogate important biological questions with speed and flexibility. The lack of appropriate in vitro model systems may have hindered the progress in understanding the cellular and molecular mechanisms of coronary vessel growth. Here, we describe an in vitro culture system to grow coronary vessels from the sinus venosus (SV) and endocardium (Endo), the two progenitor tissues from which many of the coronary vessels arise. We also confirmed that the cultures accurately recapitulate some of the known in vivo mechanisms. For instance, we show that the angiogenic sprouts in culture from SV downregulate COUP-TFII expression similar to what is observed in vivo. In addition, we show that VEGF-A, a well-known angiogenic factor in vivo, robustly stimulates angiogenesis from both the SV and Endo cultures. Collectively, we have devised an accurate in vitro culture model to study coronary angiogenesis.

In vitro models of coronary angiogenesis can be utilized for the discovery of the cellular and molecular mechanisms of coronary angiogenesis. In vitro explant cultures of sinus venosus and endocardium tissues show robust growth in response to VEGF-A and display a similar pattern of COUP-TFII expression as in vivo.

कोरोनरी एंजियोजेनेसिस के विट्रो मॉडल में

Here, we describe an in vitro culture assay to study coronary angiogenesis. Coronary vessels feed the heart muscle and are of clinical importance. Defects ...

Using a Chemical Biopsy for Graft Quality Assessment

Kidney transplantation is a life-saving treatment for a large number of people with end-stage renal dysfunction worldwide. The procedure is associated with an increased survival rate and greater quality of patient&#8217;s life when compared to conventional dialysis. Regrettably, transplantology suffers from a lack of reliable methods for organ quality assessment. Standard diagnostic techniques are limited to macroscopic appearance inspection or invasive tissue biopsy, which do not provide comprehensive information about the graft. The proposed protocol aims to introduce solid phase microextraction (SPME) as an ideal analytical method for comprehensive metabolomics and lipidomic analysis of all low molecular compounds present in kidneys allocated for transplantation. The small size of the SPME probe enables performance of a chemical biopsy, which enables extraction of metabolites directly from the organ without any tissue collection. The minimum invasiveness of the method permits execution of multiple analyses over time: directly after organ harvesting, during its preservation, and immediately after revascularization at the recipient&#8217;s body. It is hypothesized that the combination of this novel sampling method with a high-resolution mass spectrometer will allow for discrimination of a set of characteristic compounds that could serve as biological markers of graft quality and indicators of possible development of organ dysfunction.

The protocol presents utilization of the chemical biopsy approach followed by comprehensive metabolomic and lipidomic analysis for quality assessment of kidney grafts allocated for transplantation.

भ्रष्टाचार गुणवत्ता मूल्यांकन के लिए एक रासायनिक बायोप्सी का उपयोग करना

Kidney transplantation is a life-saving treatment for a large number of people with end-stage renal dysfunction worldwide. The procedure is associated ...