Seki, Eiko; Matsushita, Isao; Sugiyama, Eiji; Taki, Hirohumi; Shinoda, Koichiro; Hounoki, Hiroyuki; Motomura, Hiraku; Kimura, Tomoatsu
2009-04-01
The aim of the present study was to assess the influence of tumor necrosis factor (TNF)-blocking therapies on weight-bearing joints in patients with rheumatoid arthritis. Changes in clinical variables and radiological findings in 213 weight-bearing joints (69 hip joints, 63 knee joints, and 81 ankle joints) of 42 consecutive patients were investigated at baseline and at 1 year of TNF-blocking therapies. Structural damage to the weight-bearing joints was assessed using the Larsen scoring method. Detailed comparisons of the sizes and locations of erosions were performed for each set of radiographs of the respective joints. Assessment of radiographs of the 213 weight-bearing joints indicated progression of the Larsen grade in eight joints. Another five joints without Larsen grade progression showed apparent radiographic progression of joint damage based on increases in bony erosions. Overall, 13 joints (6%) of eight patients (19%) showed progression of joint damage after 1 year of TNF-blocking therapies. Analysis of each baseline grade indicated that radiographic progression of joint damage was inhibited in most grade 0-II joints. On the other hand, all hip and knee joints with pre-existing damage of grade III/IV showed apparent progression even in patients with good response. The results further suggested that radiographic progression may occur in less damaged joints when the patients were non-responders to the therapy. Among the weight-bearing joints, ankle joints showed different radiographic behavior and four ankle joints displayed improvement of radiographic damage. Early initiation of anti-TNF therapy should be necessary especially when the patients are starting to show early structural damage in weight-bearing joints.
Güler-Yüksel, Melek; Klarenbeek, Naomi B; Goekoop-Ruiterman, Yvonne P M; de Vries-Bouwstra, Jeska K; van der Kooij, Sjoerd M; Gerards, Andreas H; Ronday, H Karel; Huizinga, Tom W J; Dijkmans, Ben A C; Allaart, Cornelia F; Lems, Willem F
2010-01-01
To investigate whether accelerated hand bone mineral density (BMD) loss is associated with progressive joint damage in hands and feet in the first year of rheumatoid arthritis (RA) and whether it is an independent predictor of subsequent progressive total joint damage after 4 years. In 256 recent-onset RA patients, baseline and 1-year hand BMD was measured in metacarpals 2-4 by digital X-ray radiogrammetry. Joint damage in hands and feet were scored in random order according to the Sharp-van der Heijde method at baseline and yearly up to 4 years. 68% of the patients had accelerated hand BMD loss (>-0.003 g/cm2) in the first year of RA. Hand BMD loss was associated with progressive joint damage after 1 year both in hands and feet with odds ratios (OR) (95% confidence intervals [CI]) of 5.3 (1.3-20.9) and 3.1 (1.0-9.7). In univariate analysis, hand BMD loss in the first year was a predictor of subsequent progressive total joint damage after 4 years with an OR (95% CI) of 3.1 (1.3-7.6). Multivariate analysis showed that only progressive joint damage in the first year and anti-citrullinated protein antibody positivity were independent predictors of long-term progressive joint damage. In the first year of RA, accelerated hand BMD loss is associated with progressive joint damage in both hands and feet. Hand BMD loss in the first year of recent-onset RA predicts subsequent progressive total joint damage, however not independent of progressive joint damage in the first year.
Nakajima, Arata; Aoki, Yasuchika; Sonobe, Masato; Takahashi, Hiroshi; Saito, Masahiko; Terayama, Keiichiro; Nakagawa, Koichi
2016-07-01
Radiographic progression of damage to the small joints in patients with rheumatoid arthritis (RA) is well known; however, it has not been studied fully in the large joints. In this study, we looked at the prevalence of radiographic progression of large joint damage in patients with RA treated with biological disease-modifying anti-rheumatic drugs (bDMARDs). A total of 273 large joints in the upper and lower extremities of 67 patients with RA treated with bDMARDs were investigated. Radiographs for tender and/or swollen large joints were taken at least twice during the study period (mean 18.6 months), and the progression of damage was evaluated. Progressive damage was found in 20.9% of patients and 6.2% of joints. A multivariate analysis revealed that the Larsen grade (LG) alone was a risk factor for progressive damage. The LG cutoff value was determined to be 2.5 (sensitivity: 0.529, specificity: 0.805). The only factor to predict progressive damage was the LG of the joints with symptoms, and the damage must be stopped within LG II. Regular radiographic examinations for large joints should be performed in addition to routine examinations for small joints, such as the hand and foot.
Matsushita, Isao; Motomura, Hiraku; Seki, Eiko; Kimura, Tomoatsu
2017-07-01
The long-term effects of tumor necrosis factor (TNF)-blocking therapies on weight-bearing joints in patients with rheumatoid arthritis (RA) have not been fully characterized. The purpose of this study was to assess the radiographic changes of weight-bearing joints in patients with RA during 3-year of TNF-blocking therapies and to identify factors related to the progression of joint damage. Changes in clinical variables and radiological findings in 243 weight-bearing joints (63 hips, 54 knees, 71 ankles, and 55 subtalar joints) in 38 consecutive patients were investigated during three years of treatment with TNF-blocking agents. Multivariate logistic regression analysis was used to identify risk factors for the progression of weight-bearing joint damage. Seventeen (14.5%) of proximal weight-bearing joints (hips and knees) showed apparent radiographic progression during three years of treatment, whereas none of the proximal weight-bearing joints showed radiographic evidence of improvement or repair. In contrast, distal weight-bearing joints (ankle and subtalar joints) displayed radiographic progression and improvement in 20 (15.9%) and 8 (6.3%) joints, respectively. Multivariate logistic analysis for proximal weight-bearing joints identified the baseline Larsen grade (p < 0.001, OR:24.85, 95%CI: 5.07-121.79) and disease activity at one year after treatment (p = 0.003, OR:3.34, 95%CI:1.50-7.46) as independent factors associated with the progression of joint damage. On the other hand, multivariate analysis for distal weight-bearing joints identified disease activity at one year after treatment (p < 0.001, OR:2.13, 95%CI:1.43-3.18) as an independent factor related to the progression of damage. Baseline Larsen grade was strongly associated with the progression of damage in the proximal weight-bearing joints. Disease activity after treatment was an independent factor for progression of damage in proximal and distal weight-bearing joints. Early treatment with TNF-blocking agents and tight control of disease activity are necessary to prevent the progression of damage of the weight-bearing joints.
Klarenbeek, N B; Güler-Yüksel, M; van der Heijde, D M F M; Hulsmans, H M J; Kerstens, P J S M; Molenaar, T H E; de Sonnaville, P B J; Huizinga, T W J; Dijkmans, B A C; Allaart, C F
2010-12-01
To assess the relationship between joint tenderness, swelling and joint damage progression in individual joints and to evaluate the influence of treatment on these relationships. First-year data of the Behandel Strategieën (BeSt) study were used, in which patients recently diagnosed as having rheumatoid arthritis (RA) were randomly assigned into four different treatment strategies. Baseline and 1-year x-rays of the hands and feet were assessed using the Sharp-van der Heijde score (SHS). With generalised estimating equations, 3-monthly assessments of tender and swollen joints of year 1 were related to erosion progression, joint space narrowing (JSN) progression and total SHS progression at the individual joint level (definition > 0.5 SHS units) in year 1, corrected for potential confounders and within-patient correlation for multiple joints per patient. During year 1, 59% of all 13 959 joints analysed were ever tender and 45% ever swollen, 2.1% showed erosion progression, 1.9% JSN progression and 3.6% SHS progression. Swelling and tenderness were both independently associated with erosion and JSN progression with comparable OR, although with higher OR in the hands than in the feet. Local swelling and tenderness were not associated with local damage progression in patients initially treated with infliximab. Clinical signs of synovitis are associated with erosion and JSN progression in individual joints after 1 year in RA. A disconnect between synovitis and joint damage progression was observed at joint level in patients who were treated with methotrexate and infliximab as initial treatment, confirming the disconnect between synovitis and the development of joint damage in tumour necrosis factor blockers seen at patient level.
Giancane, Gabriella; Pederzoli, Silvia; Norambuena, Ximena; Ioseliani, Maka; Sato, Juliana; Gallo, Maria Chiara; Negro, Giorgia; Pistorio, Angela; Ruperto, Nicolino; Martini, Alberto; Ravelli, Angelo
2014-01-01
To evaluate the presence and progression of radiographic joint damage, as assessed with the adapted Sharp/van der Heijde score (SHS), in individual joints in the hand and wrist in patients with juvenile idiopathic arthritis (JIA) and to compare progression of damage among different JIA categories. A total of 372 radiographs of both wrists and hands obtained at first observation and at last followup visit (after 1-10 years) in 186 children with polyarticular-course JIA were evaluated. All radiographs were scored using the adapted SHS by 2 independent readers. Radiographic assessment included evaluation of joint space narrowing (JSN) and erosions on baseline and last followup radiographs and of progression of radiographic changes from baseline to last followup radiographs. Both JSN and erosions occurred in all adapted SHS areas. Overall, radiographic damage and progression were more common in the wrist and less common in metacarpophalangeal (MCP) joints. The hamate and capitate areas appeared particularly vulnerable to cartilage loss. Erosions were identified most frequently in the hamate and capitate bones as well as in the second and third metacarpal bases. Patients with extended oligoarthritis were distinctly less susceptible to JSN in hand joints, whereas patients with polyarthritis showed a greater tendency to developing erosions in hand joints. Radiographic joint damage and progression in our patients with JIA were seen most commonly in the wrist and less commonly in MCP joints. The frequency and localization of structural abnormalities differed markedly across disease categories. Copyright © 2014 by the American College of Rheumatology.
Simon, P; Pfoehler, C; Bergner, R; Schreiber, M; Pfreundschuh, M; Assmann, G
2012-01-01
Psoriatic arthritis (PsA) may progress to joint damage. Determining clinical predictors of joint damage assessed by radiography is important. The aim of this study was to determine clinical factors as possible predictors for radiological damage in hands and feet of PsA patients with a 12-month follow-up. We conducted a retrospective study on 53 PsA patients who were taking disease-modifying anti-rheumatic drugs (DMARDs) and/or tumour necrosis factor (TNF)-alpha-blockers at a fixed dosage. The patients were observed in 118 follow-up visits (intervals of 12 months ± 3 months), according to a clinical and radiological protocol which included the documentation of the number of swollen and tender joints in hands and feet, the applied therapy, psoriasis, erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), and global health assessment. Outcome was defined as radiographic damage of hands and feet (Ratingen score). For the statistical analysis the Chi-Square test for 2x2 crosstables (with Fisher's correction, as required) was used. Progressive radiological damage was more frequent among patients with an increasing swollen joint count (8 of 26 visits; 30.8%) than among those with a stable or decreased number of swollen joints (5 of 89 visits; 5.6%; p=0.001). The analysis of the patients stratified into the different treatment modalities resulted in a significant higher rate of radiological progress (20.8%) in patients on DMARD therapy compared with TNF-alpha blocking agents (0%) (p=0.009). During a 12-month follow-up of PsA patients, an increasing number of swollen joints heralds progression of radiological damage. TNF-alpha-blocker therapy appears to be superior to DMARDs in the protection from radiological progress.
Progressive Damage Analysis of Bonded Composite Joints
NASA Technical Reports Server (NTRS)
Leone, Frank A., Jr.; Girolamo, Donato; Davila, Carlos G.
2012-01-01
The present work is related to the development and application of progressive damage modeling techniques to bonded joint technology. The joint designs studied in this work include a conventional composite splice joint and a NASA-patented durable redundant joint. Both designs involve honeycomb sandwich structures with carbon/epoxy facesheets joined using adhesively bonded doublers.Progressive damage modeling allows for the prediction of the initiation and evolution of damage within a structure. For structures that include multiple material systems, such as the joint designs under consideration, the number of potential failure mechanisms that must be accounted for drastically increases the complexity of the analyses. Potential failure mechanisms include fiber fracture, intraply matrix cracking, delamination, core crushing, adhesive failure, and their interactions. The bonded joints were modeled using highly parametric, explicitly solved finite element models, with damage modeling implemented via custom user-written subroutines. Each ply was discretely meshed using three-dimensional solid elements. Layers of cohesive elements were included between each ply to account for the possibility of delaminations and were used to model the adhesive layers forming the joint. Good correlation with experimental results was achieved both in terms of load-displacement history and the predicted failure mechanism(s).
Progressive Damage Modeling of Durable Bonded Joint Technology
NASA Technical Reports Server (NTRS)
Leone, Frank A.; Davila, Carlos G.; Lin, Shih-Yung; Smeltzer, Stan; Girolamo, Donato; Ghose, Sayata; Guzman, Juan C.; McCarville, Duglas A.
2013-01-01
The development of durable bonded joint technology for assembling composite structures for launch vehicles is being pursued for the U.S. Space Launch System. The present work is related to the development and application of progressive damage modeling techniques to bonded joint technology applicable to a wide range of sandwich structures for a Heavy Lift Launch Vehicle. The joint designs studied in this work include a conventional composite splice joint and a NASA-patented Durable Redundant Joint. Both designs involve a honeycomb sandwich with carbon/epoxy facesheets joined with adhesively bonded doublers. Progressive damage modeling allows for the prediction of the initiation and evolution of damage. For structures that include multiple materials, the number of potential failure mechanisms that must be considered increases the complexity of the analyses. Potential failure mechanisms include fiber fracture, matrix cracking, delamination, core crushing, adhesive failure, and their interactions. The joints were modeled using Abaqus parametric finite element models, in which damage was modeled with user-written subroutines. Each ply was meshed discretely, and layers of cohesive elements were used to account for delaminations and to model the adhesive layers. Good correlation with experimental results was achieved both in terms of load-displacement history and predicted failure mechanisms.
Adhesive Characterization and Progressive Damage Analysis of Bonded Composite Joints
NASA Technical Reports Server (NTRS)
Girolamo, Donato; Davila, Carlos G.; Leone, Frank A.; Lin, Shih-Yung
2014-01-01
The results of an experimental/numerical campaign aimed to develop progressive damage analysis (PDA) tools for predicting the strength of a composite bonded joint under tensile loads are presented. The PDA is based on continuum damage mechanics (CDM) to account for intralaminar damage, and cohesive laws to account for interlaminar and adhesive damage. The adhesive response is characterized using standard fracture specimens and digital image correlation (DIC). The displacement fields measured by DIC are used to calculate the J-integrals, from which the associated cohesive laws of the structural adhesive can be derived. A finite element model of a sandwich conventional splice joint (CSJ) under tensile loads was developed. The simulations indicate that the model is capable of predicting the interactions of damage modes that lead to the failure of the joint.
Fischenich, Kristine M.; Pauly, Hannah M.; Button, Keith D.; Fajardo, Ryan S.; DeCamp, Charles E.; Haut, Roger C.; Haut Donahue, Tammy L.
2016-01-01
Objective The objective of this study was to monitor the progression of joint damage in two animal models of knee joint trauma using two non-invasive, clinically available imaging modalities. Methods A 3-T clinical magnet and micro-computed tomography (mCT) was used to document changes immediately following injury (acute) and post-injury (chronic) at time points of 4, 8, or 12 weeks. Joint damage was recorded at dissection and compared to the chronic magnetic resonance imaging (MRI) record. Fifteen Flemish Giant rabbits were subjected to a single tibiofemoral compressive impact (ACLF), and 18 underwent a combination of anterior cruciate ligament (ACL) and meniscal transection (mACLT). Results All ACLF animals experienced ACL rupture, and 13 also experienced acute meniscal damage. All ACLF and mACLT animals showed meniscal and articular cartilage damages at dissection. Meniscal damage was documented as early as 4 weeks and worsened in 87% of the ACLF animals and 71% of the mACLT animals. Acute cartilage damage also developed further and increased in occurrence with time in both models. A progressive decrease in bone quantity and quality was documented in both models. The MRI data closely aligned with dissection notes suggesting this clinical tool may be a non-invasive method for documenting joint damage in lapine models of knee joint trauma. Conclusions The study investigates the acute to chronic progression of meniscal and cartilage damage at various time points, and chronic changes to the underlying bone in two models of posttraumatic osteoarthritis (PTOA), and highlights the dependency of the model on the location, type, and progression of damage over time. PMID:27756698
O'Keeffe, Aidan G; Tom, Brian D M; Farewell, Vernon T
2011-01-01
In psoriatic arthritis, permanent joint damage characterizes disease progression and represents a major debilitating aspect of the disease. Understanding the process of joint damage will assist in the treatment and disease management of patients. Multistate models provide a means to examine patterns of disease, such as symmetric joint damage. Additionally, the link between damage and the dynamic course of disease activity (represented by joint swelling and stress pain) at both the individual joint level and otherwise can be represented within a correlated multistate model framework. Correlation is reflected through the use of random effects for progressive models and robust variance estimation for non-progressive models. Such analyses, undertaken with data from a large psoriatic arthritis cohort, are discussed and the extent to which they permit causal reasoning is considered. For this, emphasis is given to the use of the Bradford Hill criteria for causation in observational studies and the concept of local (in)dependence to capture the dynamic nature of the relationships. PMID:22163372
NASA Technical Reports Server (NTRS)
Girolamo, Donato; Davila, Carlos G.; Leone, Frank A.; Lin, Shih-Yung
2015-01-01
The results of an experimental/numerical campaign aimed to develop progressive damage analysis (PDA) tools for predicting the strength of a composite bonded joint under tensile loads are presented. The PDA is based on continuum damage mechanics (CDM) to account for intralaminar damage, and cohesive laws to account for interlaminar and adhesive damage. The adhesive response is characterized using standard fracture specimens and digital image correlation (DIC). The displacement fields measured by DIC are used to calculate the J-integrals, from which the associated cohesive laws of the structural adhesive can be derived. A finite element model of a sandwich conventional splice joint (CSJ) under tensile loads was developed. The simulations, in agreement with experimental tests, indicate that the model is capable of predicting the interactions of damage modes that lead to the failure of the joint.
Tak, Paul P; Rigby, William; Rubbert-Roth, Andrea; Peterfy, Charles; van Vollenhoven, Ronald F; Stohl, William; Healy, Emma; Hessey, Eva; Reynard, Mark; Shaw, Tim
2012-03-01
In the IMAGEstudy, rituximab plus methotrexate (MTX) inhibited joint damage and improved clinical outcomes at 1 year in MTX-naïve patients with early active rheumatoid arthritis. The aim of this study was to assess joint damage progression and clinical outcomes over 2 years. Patients (n=755) were randomised to receive rituximab 2×500 mg+MTX, 2×1000 mg+MTX or placebo+MTX. The placebo-controlled period continued to week 104. Two-year end points were defined as secondary or exploratory and included change in total Genant-modified Sharp score (mTSS), total erosion score and joint space narrowing score from baseline to week 104. Clinical efficacy and physical function end points were also assessed. At 2 years, rituximab 2×1000 mg+MTX maintained inhibition of progressive joint damage versus MTX alone (mTSS change 0.41 vs 1.95; p<0.0001 (79% inhibition)), and a higher proportion of patients receiving rituximab 2×1000 mg+MTX had no radiographic progression over 2 years compared with those receiving MTX alone (57% vs 37%; p<0.0001). Contrary to 1-year results, exploratory analysis of rituximab 2×500 mg+MTX at 2 years showed that progressive joint damage was slowed by ∼61% versus placebo+MTX (mTSS, exploratory p=0.0041). Improvements in clinical signs and symptoms and physical function seen after 1 year in rituximab-treated patients versus those receiving placebo were maintained at year 2. Safety profiles were similar between groups. Treatment with rituximab 2×1000 mg+MTX was associated with sustained improvements in radiographic, clinical and functional outcomes over 2 years. Clinical trials.gov identifier NCT00299104.
Physiotherapy in Rheumatoid Arthritis
Kavuncu, Vural; Evcik, Deniz
2004-01-01
Rheumatoid arthritis (RA) is a chronic and painful clinical condition that leads to progressive joint damage, disability, deterioration in quality of life, and shortened life expectancy. Even mild inflammation may result in irreversible damage and permanent disability. The clinical course according to symptoms may be either intermittent or progressive in patients with RA. In most patients, the clinical course is progressive, and structural damage develops in the first 2 years. The aim of RA management is to achieve pain relief and prevent joint damage and functional loss. Physiotherapy and rehabilitation applications significantly augment medical therapy by improving the management of RA and reducing handicaps in daily living for patients with RA. In this review, the application of physiotherapy modalities is examined, including the use of cold/heat applications, electrical stimulation, and hydrotherapy. Rehabilitation treatment techniques for patients with RA such as joint protection strategies, massage, exercise, and patient education are also presented. PMID:15266230
Zhu, Junqing; Li, Aiwu; Jia, Ertao; Zhou, Yi; Xu, Juan; Chen, Shixian; Huang, Yinger; Xiao, Xiang; Li, Juan
2017-05-02
Previous studies have revealed that ankylosing spondylitis (AS), as the progenitor of axial spondyloarthritis (AxSpA), has been characterized by the insidiously progressive nature of sacroiliitis and spondylitis. Dual-energy computed tomography (DECT) has recently been used to analyse the deposition of monosodium urate (MSU) crystals with higher sensitivity and specificity. However, it remains unclear whether the existence of the MSU crystal deposition detected by DECT at the sacroiliac joint in patients with AxSpA also is associated with the existing structural damage. Here, we performed this study to show the DECT MSU crystal deposits in AxSpA patients without coexisting gout and to ascertain the relationship between the MSU crystal deposition and the structural joint damage of sacroiliac joints. One hundred and eighty-six AxSpA patients without coexisting gout were recruited. The plain radiographs of the sacroiliac joint were obtained, along with the DECT scans at the pelvis and the clinical variables. All statistics based on the left or right sacroiliac joint damage grading (0-4) were calculated independently. Bivariate analysis and ordinal logistic regression was performed between the clinical features and radiographic grades at the sacroiliac joint. At the pelvis, large quantities of MSU crystal deposition were found in patients with AxSpA. The average MSU crystal volume at the left sacroiliac joint, the right sacroiliac joint, and the pelvis were 0.902 ± 1.345, 1.074 ± 1.878, and 5.272 ± 9.044 cm 3 , values which were correlated with serum uric acid concentrations (r = 0.727, 0.740, 0.896; p < 0.001). In bivariate analysis, wide clinical variables were associated with the changes in sacroiliac joint damage. Further, the AxSpA duration, BASFI score, and the volume of MSU crystal at both sides of sacroiliac joint were associated with the progress of radiographic grade at the sacroiliac joints in the ordinal logistic models (left AOR = 1.180, 3.800, 1.920; right AOR = 1.190, 3.034, 1.418; p < 0.01). Large quantities of MSU crystal deposition detected by DECT were found at the pelvis in AxSpA patients without coexisting gout. In addition to AxSpA duration and BASFI score, the MSU crystal deposition at the sacroiliac joint is associated with the progress of radiographic grade at sacroiliac joints in those patients.
Crema, M D; Nevitt, M C; Guermazi, A; Felson, D T; Wang, K; Lynch, J A; Marra, M D; Torner, J; Lewis, C E; Roemer, F W
2014-10-01
To determine the association of MRI-assessed worsening of tibiofemoral cartilage damage, meniscal damage, meniscal extrusion, separately and together, with progression of radiographic joint space narrowing (JSN). The Multicenter Osteoarthitis Study (MOST) Study is a cohort study of subjects with or at risk for knee osteoarthritis (OA). Knees with radiographic OA Kellgren-Lawrence grade 2 at baseline and with baseline and 30-month 1.0 T MRIs were selected for reading using the WORMS system for cartilage damage, meniscal damage, and meniscal extrusion. The association of worsening of cartilage damage, meniscal damage, and/or meniscal extrusion with increases in the JSN was performed using logistic regression. A total of 276 knees (one per subject) were included (women 68.5%, mean age 62.9 ± 7.8, mean body mass index (BMI) 30.2 ± 5.0). Worsening of each MRI feature was associated with any increase in JSN (P < 0.01). Worsening of cartilage damage was more frequently observed than worsening of meniscal damage and extrusion, and was significantly associated with both slow and fast progression of JSN. An increasing risk of JSN worsening was associated with increasing number of worsening MRI features (P for trend < 0.0001). Worsening of tibiofemoral cartilage damage, meniscal damage, and meniscal extrusion are independent predictors of JSN progression in the same compartment. Worsening of cartilage damage is more frequently observed in JSN when compared to meniscal worsening. A strong cumulative effect on JSN progression is observed for worsening of more than one MRI feature. Copyright © 2014 Osteoarthritis Research Society International. Published by Elsevier Ltd. All rights reserved.
Lobet, S; Detrembleur, C; Francq, B; Hermans, C
2010-09-01
A major complication in haemophilia is the destruction of joint cartilage because of recurrent intraarticular and intramuscular bleeds. Therefore, joint assessment is critical to quantify the extent of joint damage, which has traditionally been evaluated using both radiological and clinical joint scores. Our study aimed to evaluate the natural progression of haemophilic arthopathy using three-dimensional gait analysis (3DGA) and to assess the reproducibility of this technique. We hypothesized that the musculoskeletal function was relatively stable in patients with haemophilia. Eighteen adults with established haemophilic arthropathies were evaluated twice by 3DGA (mean follow-up: 18 +/- 5 weeks). Unexpectedly, our findings revealed infraclinical deterioration of gait pattern, characterized by a 3.2% decrease in the recovery index, which is indicative of the subject's ability to save energy while walking. A tendency towards modification of segmental joint function was also observed. Gait analysis was sufficiently reproducible with regards to spatiotemporal parameters as well as kinetic, mechanical and energetic gait variables. The kinematic variables were reproducible in both the sagittal and frontal planes. In conclusion, 3DGA is a reproducible tool to assess abnormal gait patterns and monitor natural disease progression in haemophilic patients.
Acoustic emissions (AE) monitoring of large-scale composite bridge components
NASA Astrophysics Data System (ADS)
Velazquez, E.; Klein, D. J.; Robinson, M. J.; Kosmatka, J. B.
2008-03-01
Acoustic Emissions (AE) has been successfully used with composite structures to both locate and give a measure of damage accumulation. The current experimental study uses AE to monitor large-scale composite modular bridge components. The components consist of a carbon/epoxy beam structure as well as a composite to metallic bonded/bolted joint. The bonded joints consist of double lap aluminum splice plates bonded and bolted to carbon/epoxy laminates representing the tension rail of a beam. The AE system is used to monitor the bridge component during failure loading to assess the failure progression and using time of arrival to give insight into the origins of the failures. Also, a feature in the AE data called Cumulative Acoustic Emission counts (CAE) is used to give an estimate of the severity and rate of damage accumulation. For the bolted/bonded joints, the AE data is used to interpret the source and location of damage that induced failure in the joint. These results are used to investigate the use of bolts in conjunction with the bonded joint. A description of each of the components (beam and joint) is given with AE results. A summary of lessons learned for AE testing of large composite structures as well as insight into failure progression and location is presented.
Ichikawa, Shota; Kamishima, Tamotsu; Sutherland, Kenneth; Fukae, Jun; Katayama, Kou; Aoki, Yuko; Okubo, Takanobu; Okino, Taichi; Kaneda, Takahiko; Takagi, Satoshi; Tanimura, Kazuhide
2017-10-01
We have developed a refined computer-based method to detect joint space narrowing (JSN) progression with the joint space narrowing progression index (JSNPI) by superimposing sequential hand radiographs. The purpose of this study is to assess the validity of a computer-based method using images obtained from multiple institutions in rheumatoid arthritis (RA) patients. Sequential hand radiographs of 42 patients (37 females and 5 males) with RA from two institutions were analyzed by a computer-based method and visual scoring systems as a standard of reference. The JSNPI above the smallest detectable difference (SDD) defined JSN progression on the joint level. The sensitivity and specificity of the computer-based method for JSN progression was calculated using the SDD and a receiver operating characteristic (ROC) curve. Out of 314 metacarpophalangeal joints, 34 joints progressed based on the SDD, while 11 joints widened. Twenty-one joints progressed in the computer-based method, 11 joints in the scoring systems, and 13 joints in both methods. Based on the SDD, we found lower sensitivity and higher specificity with 54.2 and 92.8%, respectively. At the most discriminant cutoff point according to the ROC curve, the sensitivity and specificity was 70.8 and 81.7%, respectively. The proposed computer-based method provides quantitative measurement of JSN progression using sequential hand radiographs and may be a useful tool in follow-up assessment of joint damage in RA patients.
Damage Progression in Bolted Composites
NASA Technical Reports Server (NTRS)
Minnetyan, Levon; Chamis, Christos C.; Gotsis, Pascal K.
1998-01-01
Structural durability, damage tolerance, and progressive fracture characteristics of bolted graphite/epoxy composite laminates are evaluated via computational simulation. Constituent material properties and stress and strain limits are scaled up to the structure level to evaluate the overall damage and fracture propagation for bolted composites. Single and double bolted composite specimens with various widths and bolt spacings are evaluated. The effect of bolt spacing is investigated with regard to the structural durability of a bolted joint. Damage initiation, growth, accumulation, and propagation to fracture are included in the simulations. Results show the damage progression sequence and structural fracture resistance during different degradation stages. A procedure is outlined for the use of computational simulation data in the assessment of damage tolerance, determination of sensitive parameters affecting fracture, and interpretation of experimental results with insight for design decisions.
Damage Progression in Bolted Composites
NASA Technical Reports Server (NTRS)
Minnetyan, Levon; Chamis, Christos; Gotsis, Pascal K.
1998-01-01
Structural durability,damage tolerance,and progressive fracture characteristics of bolted graphite/epoxy composite laminates are evaluated via computational simulation. Constituent material properties and stress and strain limits are scaled up to the structure level to evaluate the overall damage and fracture propagation for bolted composites. Single and double bolted composite specimens with various widths and bolt spacings are evaluated. The effect of bolt spacing is investigated with regard to the structural durability of a bolted joint. Damage initiation, growth, accumulation, and propagation to fracture are included in the simulations. Results show the damage progression sequence and structural fracture resistance during different degradation stages. A procedure is outlined for the use of computational simulation data in the assessment of damage tolerance, determination of sensitive parameters affecting fracture, and interpretation of experimental results with insight for design decisions.
Tak, P P; Rigby, W F; Rubbert-Roth, A; Peterfy, C G; van Vollenhoven, R F; Stohl, W; Hessey, E; Chen, A; Tyrrell, H; Shaw, T M
2011-01-01
Rituximab is an effective treatment in patients with established rheumatoid arthritis (RA). The objective of the IMAGE study was to determine the efficacy of rituximab in the prevention of joint damage and its safety in combination with methotrexate (MTX) in patients initiating treatment with MTX. In this double-blind randomised controlled phase III study, 755 MTX-naïve patients with active RA were randomly assigned to MTX alone, rituximab 2×500 mg + MTX or rituximab 2×1000 mg + MTX. The primary end point at week 52 was the change in joint damage measured using a Genant-modified Sharp score. 249, 249 and 250 patients were randomly assigned to MTX alone, rituximab 2×500 mg + MTX or rituximab 2×1000 mg + MTX, respectively. At week 52, treatment with rituximab 2×1000 mg + MTX compared with MTX alone was associated with a reduction in progression of joint damage (mean change in total modified Sharp score 0.359 vs 1.079; p=0.0004) and an improvement in clinical outcomes (ACR50 65% vs 42%; p<0.0001); rituximab 2×500 mg + MTX improved clinical outcomes (ACR50 59% vs 42%; p<0.0001) compared with MTX alone but did not significantly reduce the progression of joint damage. Safety outcomes were similar between treatment groups. Treatment with rituximab 2×1000 mg in combination with MTX is an effective therapy for the treatment of patients with MTX-naïve RA. ClinicalTrials.gov identifier NCT00299104.
Galil, Sahar Mahfouz Abdel; El-Shafey, Abeer Mohamed; Hagrass, Hoda A; Fawzy, Faten; Sammak, Ahmed El
2016-04-01
Matrix metalloproteinase-3 (MMP-3) plays a pivotal role in the destruction of bone and degradation of cartilage components in rheumatoid arthritis (RA). We aimed in this study to analyze the relation between baseline levels of MMP-3 and the progression of joint damage in RA. Eighty-one untreated RA patients with joint symptoms for <1 year were evaluated at baseline and after 12 months as regards erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), rheumatoid factor (RF), anti-cyclic citrullinated peptide (anti-CCP) and plain X-ray of both hands and wrists. Baseline levels of MMP-3 were measured by enzyme-linked immunosorbent assay and magnetic resonance imaging (MRI) of hands/wrists was performed. Disease Activity Score (DAS28) and Health Assessment Questionnaire (HAQ) were performed at baseline evaluation and after 12 months. The baseline MMP-3 levels were significantly higher in the high-progression group compared with the low-progression one (95.75 ± 42.84 vs. 50.45 ± 12.83, P < 0.001). There was a positive correlation between baseline levels of MMP-3 and MRI erosion score and other baseline clinical parameters, except for HAQ and the van der Heijde modification of the Sharp scoring system (SvdH) scores, while after 12 months, there were high positive correlations between MMP-3 and SvdH score, as well as all parameters except for ESR. Serum baseline levels of MMP-3 are strong prognostic markers of disease activity, and act well as an early predictor of progressive joint damage in recent-onset RA disease. © 2014 Asia Pacific League of Associations for Rheumatology and Wiley Publishing Asia Pty Ltd.
King, Lauren K.; March, Lyn; Anandacoomarasamy, Ananthila
2013-01-01
The most significant impact of obesity on the musculoskeletal system is associated with osteoarthritis (OA), a disabling degenerative joint disorder characterized by pain, decreased mobility and negative impact on quality of life. OA pathogenesis relates to both excessive joint loading and altered biomechanical patterns together with hormonal and cytokine dysregulation. Obesity is associated with the incidence and progression of OA of both weight-bearing and non weight-bearing joints, to rate of joint replacements as well as operative complications. Weight loss in OA can impart clinically significant improvements in pain and delay progression of joint structural damage. Further work is required to determine the relative contributions of mechanical and metabolic factors in the pathogenesis of OA. PMID:24056594
DOE Office of Scientific and Technical Information (OSTI.GOV)
Gauntt, Randall O.; Mattie, Patrick D.
Sandia National Laboratories (SNL) has conducted an uncertainty analysis (UA) on the Fukushima Daiichi unit (1F1) accident progression with the MELCOR code. The model used was developed for a previous accident reconstruction investigation jointly sponsored by the US Department of Energy (DOE) and Nuclear Regulatory Commission (NRC). That study focused on reconstructing the accident progressions, as postulated by the limited plant data. This work was focused evaluation of uncertainty in core damage progression behavior and its effect on key figures-of-merit (e.g., hydrogen production, reactor damage state, fraction of intact fuel, vessel lower head failure). The primary intent of this studymore » was to characterize the range of predicted damage states in the 1F1 reactor considering state of knowledge uncertainties associated with MELCOR modeling of core damage progression and to generate information that may be useful in informing the decommissioning activities that will be employed to defuel the damaged reactors at the Fukushima Daiichi Nuclear Power Plant. Additionally, core damage progression variability inherent in MELCOR modeling numerics is investigated.« less
Weichman, B M; Chau, T T; Rona, G
1987-04-01
Histopathologic evaluation of hindpaws from control rats with established adjuvant arthritis showed severe alterations in soft tissue and bone, as well as progressive, moderate-to-severe articular changes. Following treatment with etodolac for 28 days, soft tissue and articular changes were rated mild, and bone changes were rated moderate, but with remodeling. These findings indicate that etodolac partially reversed the joint damage in these rats.
NASA Astrophysics Data System (ADS)
Liu, Yi; Dai, Feng; Dong, Lu; Xu, Nuwen; Feng, Peng
2018-01-01
Intermittently jointed rocks, widely existing in many mining and civil engineering structures, are quite susceptible to cyclic loading. Understanding the fatigue mechanism of jointed rocks is vital to the rational design and the long-term stability analysis of rock structures. In this study, the fatigue mechanical properties of synthetic jointed rock models under different cyclic conditions are systematically investigated in the laboratory, including four loading frequencies, four maximum stresses, and four amplitudes. Our experimental results reveal the influence of the three cyclic loading parameters on the mechanical properties of jointed rock models, regarding the fatigue deformation characteristics, the fatigue energy and damage evolution, and the fatigue failure and progressive failure behavior. Under lower loading frequency or higher maximum stress and amplitude, the jointed specimen is characterized by higher fatigue deformation moduli and higher dissipated hysteresis energy, resulting in higher cumulative damage and lower fatigue life. However, the fatigue failure modes of jointed specimens are independent of cyclic loading parameters; all tested jointed specimens exhibit a prominent tensile splitting failure mode. Three different crack coalescence patterns are classified between two adjacent joints. Furthermore, different from the progressive failure under static monotonic loading, the jointed rock specimens under cyclic compression fail more abruptly without evident preceding signs. The tensile cracks on the front surface of jointed specimens always initiate from the joint tips and then propagate at a certain angle with the joints toward the direction of maximum compression.
Damage detection of an in-service condensation pipeline joint
NASA Astrophysics Data System (ADS)
Briand, Julie; Rezaei, Davood; Taheri, Farid
2010-04-01
The early detection of damage in structural or mechanical systems is of vital importance. With early detection, the damage may be repaired before the integrity of the system is jeopardized, resulting in monetary losses, loss of life or limb, and environmental impacts. Among the various types of structural health monitoring techniques, vibration-based methods are of significant interest since the damage location does not need to be known beforehand, making it a more versatile approach. The non-destructive damage detection method used for the experiments herein is a novel vibration-based method which uses an index called the EMD Energy Damage Index, developed with the aim of providing improved qualitative results compared to those methods currently available. As part of an effort to establish the integrity and limitation of this novel damage detection method, field testing was completed on a mechanical pipe joint on a condensation line, located in the physical plant of Dalhousie University. Piezoceramic sensors, placed at various locations around the joint were used to monitor the free vibration of the pipe imposed through the use of an impulse hammer. Multiple damage progression scenarios were completed, each having a healthy state and multiple damage cases. Subsequently, the recorded signals from the healthy and damaged joint were processed through the EMD Energy Damage Index developed in-house in an effort to detect the inflicted damage. The proposed methodology successfully detected the inflicted damages. In this paper, the effects of impact location, sensor location, frequency bandwidth, intrinsic mode functions, and boundary conditions are discussed.
The Growth of Multi-Site Fatigue Damage in Fuselage Lap Joints
NASA Technical Reports Server (NTRS)
Piascik, Robert S.; Willard, Scott A.
1999-01-01
Destructive examinations were performed to document the progression of multi-site damage (MSD) in three lap joint panels that were removed from a full scale fuselage test article that was tested to 60,000 full pressurization cycles. Similar fatigue crack growth characteristics were observed for small cracks (50 microns to 10 mm) emanating from counter bore rivets, straight shank rivets, and 100 deg counter sink rivets. Good correlation of the fatigue crack growth data base obtained in this study and FASTRAN Code predictions show that the growth of MSD in the fuselage lap joint structure can be predicted by fracture mechanics based methods.
NASA Technical Reports Server (NTRS)
Lin, Shih-Yung; Splinter, Scott C.; Tarkenton, Chris; Paddock, David A.; Smeltzer, Stanley S.; Ghose, Sayata; Guzman, Juan C.; Stukus, Donald J.; McCarville, Douglas A.
2013-01-01
The development of durable bonded joint technology for assembling composite structures is an essential component of future space technologies. While NASA is working toward providing an entirely new capability for human space exploration beyond low Earth orbit, the objective of this project is to design, fabricate, analyze, and test a NASA patented durable redundant joint (DRJ) and a NASA/Boeing co-designed fluted-core joint (FCJ). The potential applications include a wide range of sandwich structures for NASA's future launch vehicles. Three types of joints were studied -- splice joint (SJ, as baseline), DRJ, and FCJ. Tests included tension, after-impact tension, and compression. Teflon strips were used at the joint area to increase failure strength by shifting stress concentration to a less sensitive area. Test results were compared to those of pristine coupons fabricated utilizing the same methods. Tensile test results indicated that the DRJ design was stiffer, stronger, and more impact resistant than other designs. The drawbacks of the DRJ design were extra mass and complex fabrication processes. The FCJ was lighter than the DRJ but less impact resistant. With barely visible but detectable impact damages, all three joints showed no sign of tensile strength reduction. No compression test was conducted on any impact-damaged sample due to limited scope and resource. Failure modes and damage propagation were also studied to support progressive damage modeling of the SJ and the DRJ.
Chen, Y; Sun, Y; Pan, X; Ho, K; Li, G
2015-10-01
Osteoarthritis (OA) is a progressive joint disorder. To date, there is not effective medical therapy. Joint distraction has given us hope for slowing down the OA progression. In this study, we investigated the benefits of joint distraction in OA rat model and the probable underlying mechanisms. OA was induced in the right knee joint of rats through anterior cruciate ligament transaction (ACLT) plus medial meniscus resection. The animals were randomized into three groups: two groups were treated with an external fixator for a subsequent 3 weeks, one with and one without joint distraction; and one group without external fixator as OA control. Serum interleukin-1β level was evaluated by ELISA; cartilage quality was assessed by histology examinations (gross appearance, Safranin-O/Fast green stain) and immunohistochemistry examinations (MMP13, Col X); subchondral bone aberrant changes was analyzed by micro-CT and immunohistochemistry (Nestin, Osterix) examinations. Characters of OA were present in the OA group, contrary to in general less severe damage after distraction treatment: firstly, IL-1β level was significantly decreased; secondly, cartilage degeneration was attenuated with lower histologic damage scores and the lower percentage of MMP13 or Col X positive chondrocytes; finally, subchondral bone abnormal change was attenuated, with reduced bone mineral density (BMD) and bone volume/total tissue volume (BV/TV) and the number of Nestin or Osterix positive cells in the subchondral bone. In the present study, we demonstrated that joint distraction reduced the level of secondary inflammation, cartilage degeneration and subchondral bone aberrant change, joint distraction may be a strategy for slowing OA progression. Copyright © 2015 Osteoarthritis Research Society International. Published by Elsevier Ltd. All rights reserved.
Vectra DA for the objective measurement of disease activity in patients with rheumatoid arthritis.
Segurado, O G; Sasso, E H
2014-01-01
Quantitative and regular assessment of disease activity in rheumatoid arthritis (RA) is required to achieve treatment targets such as remission and to optimize clinical outcomes. To assess inflammation accurately, predict joint damage and monitor treatment response, a measure of disease activity in RA should reflect the pathological processes resulting in irreversible joint damage and functional disability. The Vectra DA blood test is an objective measure of disease activity for patients with RA. Vectra DA provides an accurate, reproducible score on a scale of 1 to 100 based on the concentrations of 12 biomarkers that reflect the pathophysiologic diversity of RA. The analytical validity, clinical validity, and clinical utility of Vectra DA have been evaluated for patients with RA in registries and prospective and retrospective clinical studies. As a biomarker-based instrument for assessing disease activity in RA, the Vectra DA test can help monitor therapeutic response to methotrexate and biologic agents and assess clinically challenging situations, such as when clinical measures are confounded by non-inflammatory pain from fibromyalgia. Vectra DA scores correlate with imaging of joint inflammation and are predictive for radiographic progression, with high Vectra DA scores being associated with more frequent and severe progression and low scores being predictive for non-progression. In summary, the Vectra DA score is an objective measure of RA disease activity that quantifies inflammatory status. By predicting risk for joint damage more effectively than conventional clinical and laboratory measures, it has the potential to complement these measures and optimise clinical decision making.
Failure analysis of single-bolted joint for lightweight composite laminates and metal plate
NASA Astrophysics Data System (ADS)
Li, Linjie; Qu, Junli; Liu, Xiangdong
2018-01-01
A three-dimensional progressive damage model was developed in ANSYS to predict the damage accumulation of single bolted joint in composite laminates under in-plane tensile loading. First, we describe the formulation and algorithm of this model. Second, we calculate the failure loads of the joint in fibre reinforced epoxy laminated composite plates and compare it with the experiment results, which validates that our model can appropriately simulate the ultimate tensile strength of the joints and the whole process of failure of structure. Finally, this model is applied to study the failure process of the light-weight composite material (USN125). The study also has a great potential to provide a strong basis for bolted joints design in composite Laminates as well as a simple tool for comparing different laminate geometries and bolt arrangements.
Unloading joints to treat osteoarthritis, including joint distraction.
Lafeber, Floris P J G; Intema, Femke; Van Roermund, Peter M; Marijnissen, Anne C A
2006-09-01
Patients are increasingly becoming interested in nonpharmacologic approaches to manage their osteoarthritis. This review examines the recent literature on the potential beneficial effects of unloading joints in the treatment of osteoarthritis, with a focus on joint distraction. Mechanical factors are involved in the development and progression of osteoarthritis. If "loading" is a major cause in development and progression of osteoarthritis, then "unloading" may be able to prevent progression. There is evidence that unloading may be effective in reducing pain and slowing down structural damage. This review describes unloading by footwear and bracing (nonsurgical), unloading by osteotomy (surgical), and has a focus on unloading by joint distraction. Excellent reviews in all these three fields have been published over the past few years. Recent studies argue for the usefulness of a biomechanical approach to improve function and possibly reduce disease progression in osteoarthritis. To improve patient function and possibly reduce disease progression, a biomechanical approach should be considered in treating patients with osteoarthritis. Further research (appropriate high-quality clinical trials) and analysis (clinical as well as preclinical and fundamental) are still necessary, however, to understand, validate, and refine the different approaches of unloading to treat osteoarthritis.
NASA Astrophysics Data System (ADS)
Ioussoufovitch, Seva; Morrison, Laura B.; Lee, Ting-Yim; St. Lawrence, Keith; Diop, Mamadou
2015-03-01
Rheumatoid arthritis (RA) is characterized by chronic synovial inflammation, which can cause progressive joint damage and disability. Diffuse optical spectroscopy (DOS) and imaging have the potential to become potent monitoring tools for RA. We devised a method that combined time-resolved DOS and tracer kinetics modeling to rapidly and reliably quantify blood flow in the joint. Preliminary results obtained from two animals show that the technique can detect joint inflammation as early as 5 days after onset.
Ito, Yukiko; Hozumi, Kaori; Okada, Yukiko; Kurimoto, Sarina
2017-06-01
The objective of this study was to evaluate the real-world safety and effectiveness of adalimumab with methotrexate (MTX) in disease-modifying antirheumatic drug (DMARD)- and biologic-naïve Japanese patients with rheumatoid arthritis (RA) at risk of progressive structural joint damage. This multicenter, prospective, observational, postmarketing surveillance study was conducted between February 2013 and April 2015 at 84 centers in Japan. Patients with RA at risk of progressive structural joint damage were enrolled and initiated treatment with adalimumab and MTX. Adverse events were recorded up to week 28. Effectiveness/disease activity was assessed using the Disease Activity Score based on a 28-joint count with erythrocyte sedimentation rate and C-reactive protein (DAS28-4ESR and DAS28-4CRP), Clinical Disease Activity Index, and Simplified Disease Activity Index at 0, 4, 12, and 24 weeks. DAS28-4CRP response was evaluated in the low-dose (<8 mg/week) and high-dose (≥8 mg to ≤16 mg/week) MTX groups at week 24. One hundred fifty-seven of 163 patients comprised the safety cohort: mean (SD) age, 56.5 (13.9) years; females, 65.6%; rheumatoid factor positive, 73.2%; anti-cyclic citrullinated peptide antibody positive, 66.9%; bone erosions, 51.6%; mean disease duration, 9.5 months. The majority of patients (≥80%) had moderate or high disease activity at baseline, and ≥50% with available data achieved remission or low disease activity at week 24 (DAS28-4CRP <3.2). Five serious adverse drug reactions occurred in four patients, including pyelonephritis, Pneumocystis jiroveci pneumonia, interstitial lung disease, pleurisy, and pericarditis; the outcomes were either recovered or recovering. Significant improvements/reductions in disease activity over 24 weeks were noted in all effectiveness measures (P < 0.0001). Most of the population achieved DAS28-4CRP remission (<2.6) at week 24 regardless of the MTX dose. Adalimumab in combination with MTX could be a beneficial treatment option for DMARD- and biologic-naïve Japanese patients with RA at risk of progressive structural joint damage. AbbVie GK and Eisai. ClinicalTrials.gov identifier, NCT01783730.
Probabilistic Simulation of Progressive Fracture in Bolted-Joint Composite Laminates
NASA Technical Reports Server (NTRS)
Minnetyan, L.; Singhal, S. N.; Chamis, C. C.
1996-01-01
This report describes computational methods to probabilistically simulate fracture in bolted composite structures. An innovative approach that is independent of stress intensity factors and fracture toughness was used to simulate progressive fracture. The effect of design variable uncertainties on structural damage was also quantified. A fast probability integrator assessed the scatter in the composite structure response before and after damage. Then the sensitivity of the response to design variables was computed. General-purpose methods, which are applicable to bolted joints in all types of structures and in all fracture processes-from damage initiation to unstable propagation and global structure collapse-were used. These methods were demonstrated for a bolted joint of a polymer matrix composite panel under edge loads. The effects of the fabrication process were included in the simulation of damage in the bolted panel. Results showed that the most effective way to reduce end displacement at fracture is to control both the load and the ply thickness. The cumulative probability for longitudinal stress in all plies was most sensitive to the load; in the 0 deg. plies it was very sensitive to ply thickness. The cumulative probability for transverse stress was most sensitive to the matrix coefficient of thermal expansion. In addition, fiber volume ratio and fiber transverse modulus both contributed significantly to the cumulative probability for the transverse stresses in all the plies.
Kahn, David; Mittelstaedt, Daniel; Matyas, John; Qu, Xiangui; Lee, Ji Hyun; Badar, Farid; Les, Clifford; Zhuang, Zhiguo; Xia, Yang
2016-01-01
Background: The predictable outcome of the anterior cruciate ligament transection (ACLT) canine model, and the similarity to naturally occurring osteoarthritis (OA) in humans, provide a translatable method for studying OA. Still, evidence of direct meniscus-induced cartilaginous damage has not been identified, and gross-anatomical blinded scoring of early-stage OA has not been performed. Objective: A gross anatomical observation and statistical analysis of OA progression to determine meniscus induced cartilaginous damage, to measure the macroscopic progression of OA, and to address matters involving arthroscopic and surgical procedures of the knee. Method: Unblinded assessment and blinded scoring of meniscal, tibial, femoral, and patellar damage were performed for control and at four time points following unilateral ACLT: 3-week (N=4), 8-week (N=4), 12-week (N=5), and 25-week (N=4). Mixed-model statistics illustrates damage (score) progression; Wilcoxon rank-sum tests compared time-point scores; and Wilcoxon signed-rank tests compared ACLT and contralateral scores, and meniscus and tibia scores. Result: Damage was manifest first on the posterior aspect of the medial meniscus and subsequently on the tibia and femur, implying meniscal damage can precede, coincide with, and aggravate cartilage damage. Damage extent varied chronologically and was dependent upon the joint component. Meniscal damage was evident at 3 weeks and progressed through 25-weeks. Meniscal loose bodies corresponded to tibial cartilage damage location and extent through 12 weeks, followed by cartilage repair activity after complete meniscal degeneration. Conclusion: This study provides additional information for understanding OA progression, identifying OA biomarkers, and arthroscopic and meniscectomy procedures. PMID:28144379
Infliximab in active early rheumatoid arthritis
Breedveld, F; Emery, P; Keystone, E; Patel, K; Furst, D; Kalden, J; St, C; Weisman, M; Smolen, J; Lipsky, P; Maini, R
2004-01-01
Objective: To examine the impact of the combination of infliximab plus methotrexate (MTX) on the progression of structural damage in patients with early rheumatoid arthritis (RA). Methods: Subanalyses were carried out on data for patients with early RA in the Anti-TNF Therapy in RA with Concomitant Therapy (ATTRACT) study, in which 428 patients with active RA despite MTX therapy received placebo with MTX (MTX-only) or infliximab 3 mg/kg or 10 mg/kg every (q) 4 or 8 weeks with MTX (infliximab plus MTX) for 102 weeks. Early RA was defined as disease duration of 3 years or less; 82 of the 428 patients (19%) met this definition. Structural damage was assessed with the modified van der Heijde-Sharp score. The changes from baseline to week 102 in total modified van der Heijde-Sharp score were compared between the infliximab plus MTX groups and the MTX-only group. Results: The erosion and joint space narrowing scores from baseline to week 102 in the cohort of patients with early RA decreased significantly in each infliximab dose regimen compared with the MTX-only regimen. Consistent benefit was seen in the joints of both hands and feet. Conclusions: Infliximab combined with MTX inhibited the progression of structural damage in patients with early RA during the 2 year period of treatment. Early intervention with infliximab in patients with active RA despite MTX therapy may provide long term benefits by preventing radiographic progression and preserving joint integrity. PMID:14722203
Prinold, Joe A I; Mazzà, Claudia; Di Marco, Roberto; Hannah, Iain; Malattia, Clara; Magni-Manzoni, Silvia; Petrarca, Maurizio; Ronchetti, Anna B; Tanturri de Horatio, Laura; van Dijkhuizen, E H Pieter; Wesarg, Stefan; Viceconti, Marco
2016-01-01
Juvenile idiopathic arthritis (JIA) is the leading cause of childhood disability from a musculoskeletal disorder. It generally affects large joints such as the knee and the ankle, often causing structural damage. Different factors contribute to the damage onset, including altered joint loading and other mechanical factors, associated with pain and inflammation. The prediction of patients' joint loading can hence be a valuable tool in understanding the disease mechanisms involved in structural damage progression. A number of lower-limb musculoskeletal models have been proposed to analyse the hip and knee joints, but juvenile models of the foot are still lacking. This paper presents a modelling pipeline that allows the creation of juvenile patient-specific models starting from lower limb kinematics and foot and ankle MRI data. This pipeline has been applied to data from three children with JIA and the importance of patient-specific parameters and modelling assumptions has been tested in a sensitivity analysis focused on the variation of the joint reaction forces. This analysis highlighted the criticality of patient-specific definition of the ankle joint axes and location of the Achilles tendon insertions. Patient-specific detection of the Tibialis Anterior, Tibialis Posterior, and Peroneus Longus origins and insertions were also shown to be important.
Experimental investigation of reinforced bonded joints for composite laminates.
Bisagni, Chiara; Furfari, Domenico; Pacchione, Marco
2018-02-01
An experimental study has been carried out to investigate the behaviour of co-bonded carbon fibre reinforced plastics joints with a novel design incorporating a through the thickness local reinforcement. Different specimens were manufactured to investigate static and fatigue behaviour, as well as delamination size after impact and damage tolerance characteristics. The mechanical performances of the specimens with local reinforcement, consisting of the insertion of spiked thin metal sheets between co-bonded laminates, were compared with those ones obtained from specimens with purely co-bonded joints. This novel design demonstrated by tests that damage progression under cycling load results significantly delayed by the reinforcements. A significant number of experimental results were obtained that can be used to define preliminary design guidelines.
Experimental investigation of reinforced bonded joints for composite laminates
Bisagni, Chiara; Furfari, Domenico; Pacchione, Marco
2017-01-01
An experimental study has been carried out to investigate the behaviour of co-bonded carbon fibre reinforced plastics joints with a novel design incorporating a through the thickness local reinforcement. Different specimens were manufactured to investigate static and fatigue behaviour, as well as delamination size after impact and damage tolerance characteristics. The mechanical performances of the specimens with local reinforcement, consisting of the insertion of spiked thin metal sheets between co-bonded laminates, were compared with those ones obtained from specimens with purely co-bonded joints. This novel design demonstrated by tests that damage progression under cycling load results significantly delayed by the reinforcements. A significant number of experimental results were obtained that can be used to define preliminary design guidelines. PMID:29568127
Epidemiology of osteoarthritis: state of the evidence
Allen, Kelli D.; Golightly, Yvonne M.
2015-01-01
Purpose of review This review focuses on recent studies of osteoarthritis epidemiology, including research on prevalence, incidence, and a broad array of potential risk factors at the person level and joint level. Recent findings Studies continue to illustrate the high impact of osteoarthritis worldwide, with increasing incidence. Person-level risk factors with strong evidence regarding osteoarthritis incidence and/or progression include age, sex, socioeconomic status, family history, and obesity. Joint-level risk factors with strong evidence for incident osteoarthritis risk include injury and occupational joint loading; the associations of injury and joint alignment with osteoarthritis progression are compelling. Moderate levels of physical activity have not been linked to increased osteoarthritis risk. Some topics of high recent interest or emerging evidence for association with osteoarthritis include metabolic pathways, vitamins, joint shape, bone density, limb length inequality, muscle strength and mass, and early structural damage. Summary Osteoarthritis is a complex, multifactorial disease, and there is still much to learn regarding mechanisms underlying incidence and progression. However, there are several known modifiable and preventable risk factors, including obesity and joint injury; efforts to mitigate these risks can help to lessen the impact of osteoarthritis. PMID:25775186
Tanaka, Yoshiya
Rheumatoid arthritis is a systemic autoimmune disease characterized by inflammation and joint damage that causes significant morbidity and mortality. Rapid and appropriate intervention using disease-modifying anti-rheumatic drugs(DMARDs)is prerequisite to halt joint destruction and long-term functional disabilities. Recent progress in the treatment strategy has brought about paradigm shift for the management of the disease, namely, the combined use of methotrexate, a synthetic DMARD, and a biologic DMARD targeting TNF, IL-6 and T cells has revolutionized treatment of rheumatoid arthritis. Clinical remission is now realistic targets for the treatment, achieved by a large proportion of rheumatoid arthritis patients, which leads to structural remission without damage in bone and cartilage as well as functional remission. Furthermore, orally available small but strong molecules targeting Janus kinase(JAK)are emerging. When DMARDs are prescribed, appropriate selection of DMARDs, adequate screening, regular monitoring and systemic management are required.
Wang, Huan; Wang, Qingguo; Yang, Meijuan; Yang, Lili; Wang, Weili; Ding, Haobin; Zhang, Dong; Xu, Jing; Tang, Xuezhang; Ding, Haitao; Wang, Qingfu
2018-02-01
Osteoarthritis (OA) is a common chronic degenerative disease that affects all joints. At present, the pathological processes and mechanisms of OA are still unclear. Innate immunity, a key player in damage to the structure of the joint and the mechanism by which the host attempts to repair OA, affects all pathological stages of the disease. In the present study, our aim was to assess changes in innate immunity during the pathological processes of OA in articular cartilage (AC) and the synovial membrane (SM), which are the major structures in joints, and to systematically examine the histological changes in AC and SM in mild, moderate and severe cases of OA, in order to further speculate about the manner in which the interactions of AC and SM are facilitated by innate immunity. Histological methods (including HE and Safranin O-fast green staining), immunofluorescent double staining, TUNEL stain, and Western blots were used to assess the morphological changes within AC and SM tissues in healthy and mild, moderate, or severe OA rats. Our results showed that the damage to AC and SM within the joints progressively worsened in different degrees during the course of the disease, and that the innate immune system was closely involved in the AC and SM during each stage of OA. These findings also confirmed that SM may affect the pathological changes in AC through the innate immune system, and therefore affect the progress of OA. © 2017 Wiley Periodicals, Inc.
Qi, Xiaoyang; Flick, Matthew J.; Frederick, Malinda; Chu, Zhengtao; Mason, Rachel; DeLay, Monica; Thornton, Sherry
2012-01-01
Rheumatoid arthritis is a chronic inflammatory disease affecting approximately 1% of the population and is characterized by cartilage and bone destruction ultimately leading to loss of joint function. Early detection and intervention of disease provides the best hope for successful treatment and preservation of joint mobility and function. Reliable and non-invasive techniques that accurately measure arthritic disease onset and progression are lacking. We recently developed a novel agent, SapC-DOPS, which is composed of the membrane-associated lysosomal protein saposin C (SapC) incorporated into 1,2-dioleoyl-sn-glycero-3-phospho-L-serine (DOPS) lipid nanovesicles. SapC-DOPS has a high fusogenic affinity for phosphatidylserine-enriched microdomains on surfaces of target cell membranes. Incorporation of a far-red fluorophore, CellVue Maroon (CVM), into the nanovesicles allows for in vivo non-invasive visualization of the agent in targeted tissue. Given that phosphatidylserine is present only on the inner leaflet of healthy plasma membranes but is “flipped” to the outer leaflet upon cell damage, we hypothesized that SapC-DOPS would target tissue damage associated with inflammatory arthritis due to local surface-exposure of phosphatidylserine. Optical imaging with SapC-DOPS-CVM in two distinct models of arthritis, serum-transfer arthritis (e.g., K/BxN) and collagen-induced arthritis (CIA) revealed robust SapC-DOPS-CVM specific localization to arthritic paws and joints in live animals. Importantly, intensity of localized fluorescent signal correlated with macroscopic arthritic disease severity and increased with disease progression. Flow cytometry of cells extracted from arthritic joints demonstrated that SapC-DOPS-CVM localized to an average of 7–8% of total joint cells and primarily to CD11b+Gr-1+ cells. Results from the current studies strongly support the application of SapC-DOPS-CVM for advanced clinical and research applications including: detecting early arthritis onset, assessing disease progression real-time in live subjects, and providing novel information regarding cell types that may mediate arthritis progression within joints. PMID:22470501
DOE Office of Scientific and Technical Information (OSTI.GOV)
Farrar, Charles R; Gobbato, Maurizio; Conte, Joel
2009-01-01
The extensive use of lightweight advanced composite materials in unmanned aerial vehicles (UAVs) drastically increases the sensitivity to both fatigue- and impact-induced damage of their critical structural components (e.g., wings and tail stabilizers) during service life. The spar-to-skin adhesive joints are considered one of the most fatigue sensitive subcomponents of a lightweight UAV composite wing with damage progressively evolving from the wing root. This paper presents a comprehensive probabilistic methodology for predicting the remaining service life of adhesively-bonded joints in laminated composite structural components of UAVs. Non-destructive evaluation techniques and Bayesian inference are used to (i) assess the current statemore » of damage of the system and, (ii) update the probability distribution of the damage extent at various locations. A probabilistic model for future loads and a mechanics-based damage model are then used to stochastically propagate damage through the joint. Combined local (e.g., exceedance of a critical damage size) and global (e.g.. flutter instability) failure criteria are finally used to compute the probability of component failure at future times. The applicability and the partial validation of the proposed methodology are then briefly discussed by analyzing the debonding propagation, along a pre-defined adhesive interface, in a simply supported laminated composite beam with solid rectangular cross section, subjected to a concentrated load applied at mid-span. A specially developed Eliler-Bernoulli beam finite element with interlaminar slip along the damageable interface is used in combination with a cohesive zone model to study the fatigue-induced degradation in the adhesive material. The preliminary numerical results presented are promising for the future validation of the methodology.« less
Validation of automatic joint space width measurements in hand radiographs in rheumatoid arthritis.
Schenk, Olga; Huo, Yinghe; Vincken, Koen L; van de Laar, Mart A; Kuper, Ina H H; Slump, Kees C H; Lafeber, Floris P J G; Bernelot Moens, Hein J
2016-10-01
Computerized methods promise quick, objective, and sensitive tools to quantify progression of radiological damage in rheumatoid arthritis (RA). Measurement of joint space width (JSW) in finger and wrist joints with these systems performed comparable to the Sharp-van der Heijde score (SHS). A next step toward clinical use, validation of precision and accuracy in hand joints with minimal damage, is described with a close scrutiny of sources of error. A recently developed system to measure metacarpophalangeal (MCP) and proximal interphalangeal (PIP) joints was validated in consecutive hand images of RA patients. To assess the impact of image acquisition, measurements on radiographs from a multicenter trial and from a recent prospective cohort in a single hospital were compared. Precision of the system was tested by comparing the joint space in mm in pairs of subsequent images with a short interval without progression of SHS. In case of incorrect measurements, the source of error was analyzed with a review by human experts. Accuracy was assessed by comparison with reported measurements with other systems. In the two series of radiographs, the system could automatically locate and measure 1003/1088 (92.2%) and 1143/1200 (95.3%) individual joints, respectively. In joints with a normal SHS, the average (SD) size of MCP joints was [Formula: see text] and [Formula: see text] in the two series of radiographs, and of PIP joints [Formula: see text] and [Formula: see text]. The difference in JSW between two serial radiographs with an interval of 6 to 12 months and unchanged SHS was [Formula: see text], indicating very good precision. Errors occurred more often in radiographs from the multicenter cohort than in a more recent series from a single hospital. Detailed analysis of the 55/1125 (4.9%) measurements that had a discrepant paired measurement revealed that variation in the process of image acquisition (exposure in 15% and repositioning in 57%) was a more frequent source of error than incorrect delineation by the software (25%). Various steps in the validation of an automated measurement system for JSW of MCP and PIP joints are described. The use of serial radiographs from different sources, with a short interval and limited damage, is helpful to detect sources of error. Image acquisition, in particular repositioning, is a dominant source of error.
Preventing Collateral Damage in Crohn’s Disease: The Lémann Index
Fiorino, Gionata; Bonifacio, Cristiana; Peyrin-Biroulet, Laurent
2016-01-01
Crohn’s disease [CD] is a chronic progressive and destructive condition. Half of all CD patients will develop bowel damage at 10 years. As in rheumatic diseases, preventing the organ damage consequent to CD complications [fistula, abscess, and/or stricture] is emerging as a new therapeutic goal for these patients in clinical practice. This might be the only way to alter disease course, as surgery is often required for disease complications. Similar to the joint damage in rheumatoid arthritis, bowel damage has also emerged as a new endpoint in disease-modification trials such as the REACT trial. Recently, the Lemann Index [LI] has been developed to measure CD-related bowel damage, and to assess damage progression over time, in order to evaluate the impact of therapeutic strategies in terms of preventing bowel damage. While validation is pending, recent reports suggested that bowel damage is reversible by anti-tumour necrosis factor [TNF] therapy. The Lémann index may play a key role in CD management, and should be implemented in all upcoming disease-modification trials in CD. PMID:26744441
Fukae, Jun; Kon, Yujiro; Henmi, Mihoko; Sakamoto, Fumihiko; Narita, Akihiro; Shimizu, Masato; Tanimura, Kazuhide; Matsuhashi, Megumi; Kamishima, Tamotsu; Atsumi, Tatsuya; Koike, Takao
2010-05-01
To investigate the relationship between synovial vascularity assessed by quantitative power Doppler sonography (PDS) and progression of structural bone damage in a single finger joint in patients with rheumatoid arthritis (RA). We studied 190 metacarpophalangeal (MCP) joints and 190 proximal interphalangeal (PIP) joints of 19 patients with active RA who had initial treatment with disease-modifying antirheumatic drugs (DMARDs). Patients were examined by clinical and laboratory assessments throughout the study. Hand and foot radiography was performed at baseline and the twentieth week. Magnetic resonance imaging (MRI) was performed at baseline. PDS was performed at baseline and the eighth week. Synovial vascularity was evaluated according to both quantitative and semiquantitative methods. Quantitative PDS was significantly correlated with the enhancement rate of MRI in each single finger joint. Comparing quantitative synovial vascularity and radiographic change in single MCP or PIP joints, the level of vascularity at baseline showed a significant positive correlation with radiographic progression at the twentieth week. The change of vascularity in response to DMARDs, defined as the percentage change in vascularity by the eighth week from baseline, was inversely correlated with radiographic progression in each MCP joint. The quantitative PDS method was more useful than the semiquantitative method for the evaluation of synovial vascularity in a single finger joint. The change of synovial vascularity in a single finger joint determined by quantitative PDS could numerically predict its radiographic progression. Using vascularity as a guide to consider a therapeutic approach would have benefits for patients with active RA.
Suzuki, Taku; Ikari, Katsunori; Yano, Koichiro; Inoue, Eisuke; Toyama, Yoshiaki; Taniguchi, Atsuo; Yamanaka, Hisashi; Momohara, Shigeki
2013-01-01
Rheumatoid arthritis (RA) is a systemic, chronic inflammatory disease influenced by both genetic and environmental factors, leading to joint destruction and functional impairment. Recently, a large-scaled GWAS meta-analysis using more than 37,000 Japanese samples were conducted and 13 RA susceptibility loci were identified. However, it is not clear whether these loci have significant impact on joint destruction or not. This is the first study focused on the 13 loci to investigate independent genetic risk factors for radiographic progression in the first five years from onset of RA. Sharp/van der Heijde score of hands at 5-year disease duration, which represents joint damage, were measured retrospectively and used as an outcome variable in 865 Japanese RA patients. Genetic factors regarded as putative risk factors were RA-susceptible polymorphisms identified by the Japanese GWAS meta-analysis, including HLA-DRB1 (shared epitope, SE), rs2240340 (PADI4), rs2230926 (TNFAIP3), rs3093024 (CCR6), rs11900673 (B3GNT2), rs2867461 (ANXA3), rs657075 (CSF2), rs12529514 (CD83), rs2233434 (NFKBIE), rs10821944 (ARID5B), rs3781913 (PDE2A-ARAP1), rs2841277 (PLD4) and rs2847297 (PTPN2). These putative genetic risk factors were assessed by a stepwise multiple regression analysis adjusted for possible non-genetic risk factors: autoantibody positivity (anti-citrullinated peptide antibody [ACPA] and rheumatoid factor), history of smoking, gender and age at disease onset. The number of SE alleles (P = 0.002) and risk alleles of peptidyl arginine deiminase type IV gene (PADI4, P = 0.04) had significant impact on progressive joint destruction, as well as following non-genetic factors: ACPA positive (P = 0.0006), female sex (P = 0.006) and younger age of onset (P = 0.02). In the present study, we found that PADI4 risk allele and HLA-DRB1 shared epitope are independent genetic risks for radiographic progression in Japanese rheumatoid arthritis patients. The results of this study give important knowledge of the risks on progressive joint damage in RA patients.
In Vivo Dual Fluorescence Imaging to Detect Joint Destruction.
Cho, Hongsik; Bhatti, Fazal-Ur-Rehman; Lee, Sangmin; Brand, David D; Yi, Ae-Kyung; Hasty, Karen A
2016-10-01
Diagnosis of cartilage damage in early stages of arthritis is vital to impede the progression of disease. In this regard, considerable progress has been made in near-infrared fluorescence (NIRF) optical imaging technique. Arthritis can develop due to various mechanisms but one of the main contributors is the production of matrix metalloproteinases (MMPs), enzymes that can degrade components of the extracellular matrix. Especially, MMP-1 and MMP-13 have main roles in rheumatoid arthritis and osteoarthritis because they enhance collagen degradation in the process of arthritis. We present here a novel NIRF imaging strategy that can be used to determine the activity of MMPs and cartilage damage simultaneously by detection of exposed type II collagen in cartilage tissue. In this study, retro-orbital injection of mixed fluorescent dyes, MMPSense 750 FAST (MMP750) dye and Alexa Fluor 680 conjugated monoclonal mouse antibody immune-reactive to type II collagen, was administered in the arthritic mice. Both dyes were detected with different intensity according to degree of joint destruction in the animal. Thus, our dual fluorescence imaging method can be used to detect cartilage damage as well as MMP activity simultaneously in early stage arthritis. © 2016 International Center for Artificial Organs and Transplantation and Wiley Periodicals, Inc.
Quantification of Energy Release in Composite Structures
NASA Technical Reports Server (NTRS)
Minnetyan, Levon
2003-01-01
Energy release rate is usually suggested as a quantifier for assessing structural damage tolerance. Computational prediction of energy release rate is based on composite mechanics with micro-stress level damage assessment, finite element structural analysis and damage progression tracking modules. This report examines several issues associated with energy release rates in composite structures as follows: Chapter I demonstrates computational simulation of an adhesively bonded composite joint and validates the computed energy release rates by comparison with acoustic emission signals in the overall sense. Chapter II investigates the effect of crack plane orientation with respect to fiber direction on the energy release rates. Chapter III quantifies the effects of contiguous constraint plies on the residual stiffness of a 90 ply subjected to transverse tensile fractures. Chapter IV compares ICAN and ICAN/JAVA solutions of composites. Chapter V examines the effects of composite structural geometry and boundary conditions on damage progression characteristics.
Quantification of Energy Release in Composite Structures
NASA Technical Reports Server (NTRS)
Minnetyan, Levon; Chamis, Christos C. (Technical Monitor)
2003-01-01
Energy release rate is usually suggested as a quantifier for assessing structural damage tolerance. Computational prediction of energy release rate is based on composite mechanics with micro-stress level damage assessment, finite element structural analysis and damage progression tracking modules. This report examines several issues associated with energy release rates in composite structures as follows: Chapter I demonstrates computational simulation of an adhesively bonded composite joint and validates the computed energy release rates by comparison with acoustic emission signals in the overall sense. Chapter II investigates the effect of crack plane orientation with respect to fiber direction on the energy release rates. Chapter III quantifies the effects of contiguous constraint plies on the residual stiffness of a 90 deg ply subjected to transverse tensile fractures. Chapter IV compares ICAN and ICAN/JAVA solutions of composites. Chapter V examines the effects of composite structural geometry and boundary conditions on damage progression characteristics.
ACEE composite structures technology
NASA Technical Reports Server (NTRS)
Klotzsche, M. (Compiler)
1984-01-01
The NASA Aircraft Energy Efficiency (ACEE) Composite Primary Aircraft Structures Program has made significant progress in the development of technology for advanced composites in commercial aircraft. Commercial airframe manufacturers have demonstrated technology readiness and cost effectiveness of advanced composites for secondary and medium primary components and have initiated a concerted program to develop the data base required for efficient application to safety-of-flight wing and fuselage structures. Oral presentations were compiled into five papers. Topics addressed include: damage tolerance and failsafe testing of composite vertical stabilizer; optimization of composite multi-row bolted joints; large wing joint demonstation components; and joints and cutouts in fuselage structure.
Fonseca, João Eurico; Cavaleiro, João; Teles, José; Sousa, Elsa; Andreozzi, Valeska L; Antunes, Marília; Amaral-Turkman, Maria A; Canhão, Helena; Mourão, Ana F; Lopes, Joana; Caetano-Lopes, Joana; Weinmann, Pamela; Sobral, Marta; Nero, Patrícia; Saavedra, Maria J; Malcata, Armando; Cruz, Margarida; Melo, Rui; Braña, Araceli; Miranda, Luis; Patto, José V; Barcelos, Anabela; da Silva, José Canas; Santos, Luís M; Figueiredo, Guilherme; Rodrigues, Mário; Jesus, Herberto; Quintal, Alberto; Carvalho, Teresa; da Silva, José A Pereira; Branco, Jaime; Queiroz, Mário Viana
2007-01-01
The objective of this study was to assess whether clinical measures of rheumatoid arthritis activity and severity were influenced by tumor necrosis factor-alpha (TNF-alpha) promoter genotype/haplotype markers. Each patient's disease activity was assessed by the disease activity score using 28 joint counts (DAS28) and functional capacity by the Health Assessment Questionnaire (HAQ) score. Systemic manifestations, radiological damage evaluated by the Sharp/van der Heijde (SvdH) score, disease-modifying anti-rheumatic drug use, joint surgeries, and work disability were also assessed. The promoter region of the TNF-alpha gene, between nucleotides -1,318 and +49, was sequenced using an automated platform. Five hundred fifty-four patients were evaluated and genotyped for 10 single-nucleotide polymorphism (SNP) markers, but 5 of these markers were excluded due to failure to fall within Hardy-Weinberg equilibrium or to monomorphism. Patients with more than 10 years of disease duration (DD) presented significant associations between the -857 SNP and systemic manifestations, as well as joint surgeries. Associations were also found between the -308 SNP and work disability in patients with more than 2 years of DD and radiological damage in patients with less than 10 years of DD. A borderline effect was found between the -238 SNP and HAQ score and radiological damage in patients with 2 to 10 years of DD. An association was also found between haplotypes and the SvdH score for those with more than 10 years of DD. An association was found between some TNF-alpha promoter SNPs and systemic manifestations, radiological progression, HAQ score, work disability, and joint surgeries, particularly in some classes of DD and between haplotypes and radiological progression for those with more than 10 years of DD.
Fonseca, João Eurico; Cavaleiro, João; Teles, José; Sousa, Elsa; Andreozzi, Valeska L; Antunes, Marília; Amaral-Turkman, Maria A; Canhão, Helena; Mourão, Ana F; Lopes, Joana; Caetano-Lopes, Joana; Weinmann, Pamela; Sobral, Marta; Nero, Patrícia; Saavedra, Maria J; Malcata, Armando; Cruz, Margarida; Melo, Rui; Braña, Araceli; Miranda, Luis; Patto, José V; Barcelos, Anabela; da Silva, José Canas; Santos, Luís M; Figueiredo, Guilherme; Rodrigues, Mário; Jesus, Herberto; Quintal, Alberto; Carvalho, Teresa; da Silva, José A Pereira; Branco, Jaime; Queiroz, Mário Viana
2007-01-01
The objective of this study was to assess whether clinical measures of rheumatoid arthritis activity and severity were influenced by tumor necrosis factor-alpha (TNF-α) promoter genotype/haplotype markers. Each patient's disease activity was assessed by the disease activity score using 28 joint counts (DAS28) and functional capacity by the Health Assessment Questionnaire (HAQ) score. Systemic manifestations, radiological damage evaluated by the Sharp/van der Heijde (SvdH) score, disease-modifying anti-rheumatic drug use, joint surgeries, and work disability were also assessed. The promoter region of the TNF-α gene, between nucleotides -1,318 and +49, was sequenced using an automated platform. Five hundred fifty-four patients were evaluated and genotyped for 10 single-nucleotide polymorphism (SNP) markers, but 5 of these markers were excluded due to failure to fall within Hardy-Weinberg equilibrium or to monomorphism. Patients with more than 10 years of disease duration (DD) presented significant associations between the -857 SNP and systemic manifestations, as well as joint surgeries. Associations were also found between the -308 SNP and work disability in patients with more than 2 years of DD and radiological damage in patients with less than 10 years of DD. A borderline effect was found between the -238 SNP and HAQ score and radiological damage in patients with 2 to 10 years of DD. An association was also found between haplotypes and the SvdH score for those with more than 10 years of DD. An association was found between some TNF-α promoter SNPs and systemic manifestations, radiological progression, HAQ score, work disability, and joint surgeries, particularly in some classes of DD and between haplotypes and radiological progression for those with more than 10 years of DD. PMID:17408492
The characterization of widespread fatigue damage in fuselage structure
NASA Technical Reports Server (NTRS)
Piascik, Robert S.; Willard, Scott A.; Miller, Matthew
1994-01-01
The characteristics of widespread fatigue damage (WSFD) in fuselage riveted structure were established by detailed nondestructive and destructive examinations of fatigue damage contained in a full size fuselage test article. The objectives of this were to establish an experimental data base for validating emerging WSFD analytical prediction methodology and to identify first order effects that contribute to fatigue crack initiation and growth. Detailed examinations were performed on a test panel containing four bays of a riveted lap splice joint. The panel was removed from a full scale fuselage test article after receiving 60,000 full pressurization cycles. The results of in situ examinations document the progression of fuselage skin fatigue crack growth through crack linkup. Detailed tear down examinations and fractography of the lap splice joint region revealed fatigue crack initiation sites, crack morphology, and crack linkup geometry. From this large data base, distributions of crack size and locations are presented and discussions of operative damage mechanisms are offered.
The characterization of widespread fatigue damage in fuselage structure
NASA Technical Reports Server (NTRS)
Piascik, Robert S.; Willard, Scott A.; Miller, Matthew
1994-01-01
The characteristics of widespread fatigue damage (WSFD) in fuselage riveted structure were established by detailed nondestructive and destructive examinations of fatigue damage contained in a full size fuselage test article. The objectives of this work were to establish an experimental data base for validating emerging WSFD analytical prediction methodology and to identify first order effects that contribute to fatigue crack initiation and growth. Detailed examinations were performed on a test panel containing four bays of a riveted lap splice joint. The panel was removed from a full scale fuselage test article after receiving 60,000 full pressurization cycles. The results of in situ examinations document the progression of fuselage skin fatigue crack growth through crack linkup. Detailed tear down examinations and fractography of the lap splice joint region revealed fatigue crack initiation sites, crack morphology and crack linkup geometry. From this large data base, distributions of crack size and locations are presented and discussions of operative damage mechanisms are offered.
Multiple Damage Progression Paths in Model-Based Prognostics
NASA Technical Reports Server (NTRS)
Daigle, Matthew; Goebel, Kai Frank
2011-01-01
Model-based prognostics approaches employ domain knowledge about a system, its components, and how they fail through the use of physics-based models. Component wear is driven by several different degradation phenomena, each resulting in their own damage progression path, overlapping to contribute to the overall degradation of the component. We develop a model-based prognostics methodology using particle filters, in which the problem of characterizing multiple damage progression paths is cast as a joint state-parameter estimation problem. The estimate is represented as a probability distribution, allowing the prediction of end of life and remaining useful life within a probabilistic framework that supports uncertainty management. We also develop a novel variance control mechanism that maintains an uncertainty bound around the hidden parameters to limit the amount of estimation uncertainty and, consequently, reduce prediction uncertainty. We construct a detailed physics-based model of a centrifugal pump, to which we apply our model-based prognostics algorithms. We illustrate the operation of the prognostic solution with a number of simulation-based experiments and demonstrate the performance of the chosen approach when multiple damage mechanisms are active
High-Resolution Methods for Diagnosing Cartilage Damage In Vivo
Novakofski, Kira D.; Pownder, Sarah L.; Koff, Matthew F.; Williams, Rebecca M.; Potter, Hollis G.; Fortier, Lisa A.
2016-01-01
Advances in current clinical modalities, including magnetic resonance imaging and computed tomography, allow for earlier diagnoses of cartilage damage that could mitigate progression to osteoarthritis. However, current imaging modalities do not detect submicrometer damage. Developments in in vivo or arthroscopic techniques, including optical coherence tomography, ultrasonography, bioelectricity including streaming potential measurement, noninvasive electroarthrography, and multiphoton microscopy can detect damage at an earlier time point, but they are limited by a lack of penetration and the ability to assess an entire joint. This article reviews current advancements in clinical and developing modalities that can aid in the early diagnosis of cartilage injury and facilitate studies of interventional therapeutics. PMID:26958316
Huebner, Janet L; Bay-Jensen, Anne C; Huffman, Kim M; He, Yi; Leeming, Diana J; McDaniel, Gary E; Karsdal, Morten A; Kraus, Virginia B
2014-01-01
Objective To evaluate joint tissue remodeling, with urinary collagen biomarkers, uALPHA CTX and uCTXII, and their association with osteoarthritis (OA) severity, progression, and localized knee bone turnover. Methods Participants (N=149) with symptomatic and radiographic knee OA underwent fixed flexion knee radiography at baseline and 3 years, and late-phase bone scintigraphy of both knees at baseline, scored semi-quantitatively for osteophyte (OST) and joint space narrowing (JSN) severity and uptake intensity with scores summed across knees. Urinary concentrations of ALPHA CTX and CTXII were determined by ELISA. Immunohistochemistry of human OA knees was performed to localize the joint tissue origin of the biomarker epitopes. Results uALPHA CTX correlated strongly with intensity of bone scintigraphic uptake, and JSN and OST progression (risk ratio=13.2 and 3, respectively). uCTXII was strongly associated with intensity of bone scintigraphic uptake, with JSN and OST severity, and OA progression based on OST. uALPHA CTX localized primarily to high bone turnover areas in subchondral bone; CTXII localized to the bone-cartilage interface, the tidemark, and damaged articular cartilage. Conclusion Baseline uALPHA CTX, localized to high turnover areas of subchondral bone, was associated with dynamic bone turnover of knees signified by scintigraphy, and progression of both OST and JSN. uCTXII correlated with JSN and OST severity, and progression of OST. To our knowledge, this represents the first report of serological markers reflecting subchondral bone turnover. These collagen markers may be useful for non-invasive detection and quantification of active subchondral bone turnover and joint remodeling in knee OA. PMID:24909851
Hayami, Tadashi; Pickarski, Maureen; Zhuo, Ya; Wesolowski, Gregg A; Rodan, Gideon A; Duong, Le T
2006-02-01
Osteoarthritis (OA) is a chronic joint disease characterized by cartilage destruction, subchondral bone sclerosis, and osteophyte formation. Subchondral bone stiffness has been proposed to initiate and/or contribute to cartilage deterioration in OA. The purpose of this study was to characterize subchondral bone remodeling, cartilage damage, and osteophytosis during the disease progression in two models of surgically induced OA. Rat knee joints were subjected either to anterior cruciate ligament transection (ACLT) alone or in combination with resection of medial menisci (ACLT + MMx). Histopathological changes in the surgical joints were compared with sham at 1, 2, 4, 6, and 10 weeks post-surgery. Using a modified Mankin scoring system, we demonstrate that articular cartilage damage occurs within 2 weeks post-surgery in both surgical models. Detectable cartilage surface damage and proteoglycan loss were observed as early as 1 week post-surgery. These were followed by the increases in vascular invasion into cartilage, in loss of chondrocyte number and in cell clustering. Histomorphometric analysis revealed subchondral bone loss in both models within 2 weeks post-surgery followed by significant increases in subchondral bone volume relative to sham up to 10 weeks post-surgery. Incidence of osteophyte formation was optimally observed in ACLT joints at 10 weeks and in ACLT + MMx joints at 6 weeks post-surgery. In summary, the two surgically induced rat OA models share many characteristics seen in human and other animal models of OA, including progressive articular cartilage degradation, subchondral bone sclerosis, and osteophyte formation. Moreover, increased subchondral bone resorption is associated with early development of cartilage lesions, which precedes significant cartilage thinning and subchondral bone sclerosis. Together, these findings support a role for bone remodeling in OA pathogenesis and suggest that these rat models are suitable for evaluating bone resorption inhibitors as potential disease-modifying pharmaco-therapies.
Validation of automatic joint space width measurements in hand radiographs in rheumatoid arthritis
Schenk, Olga; Huo, Yinghe; Vincken, Koen L.; van de Laar, Mart A.; Kuper, Ina H. H.; Slump, Kees C. H.; Lafeber, Floris P. J. G.; Bernelot Moens, Hein J.
2016-01-01
Abstract. Computerized methods promise quick, objective, and sensitive tools to quantify progression of radiological damage in rheumatoid arthritis (RA). Measurement of joint space width (JSW) in finger and wrist joints with these systems performed comparable to the Sharp–van der Heijde score (SHS). A next step toward clinical use, validation of precision and accuracy in hand joints with minimal damage, is described with a close scrutiny of sources of error. A recently developed system to measure metacarpophalangeal (MCP) and proximal interphalangeal (PIP) joints was validated in consecutive hand images of RA patients. To assess the impact of image acquisition, measurements on radiographs from a multicenter trial and from a recent prospective cohort in a single hospital were compared. Precision of the system was tested by comparing the joint space in mm in pairs of subsequent images with a short interval without progression of SHS. In case of incorrect measurements, the source of error was analyzed with a review by human experts. Accuracy was assessed by comparison with reported measurements with other systems. In the two series of radiographs, the system could automatically locate and measure 1003/1088 (92.2%) and 1143/1200 (95.3%) individual joints, respectively. In joints with a normal SHS, the average (SD) size of MCP joints was 1.7±0.2 and 1.6±0.3 mm in the two series of radiographs, and of PIP joints 1.0±0.2 and 0.9±0.2 mm. The difference in JSW between two serial radiographs with an interval of 6 to 12 months and unchanged SHS was 0.0±0.1 mm, indicating very good precision. Errors occurred more often in radiographs from the multicenter cohort than in a more recent series from a single hospital. Detailed analysis of the 55/1125 (4.9%) measurements that had a discrepant paired measurement revealed that variation in the process of image acquisition (exposure in 15% and repositioning in 57%) was a more frequent source of error than incorrect delineation by the software (25%). Various steps in the validation of an automated measurement system for JSW of MCP and PIP joints are described. The use of serial radiographs from different sources, with a short interval and limited damage, is helpful to detect sources of error. Image acquisition, in particular repositioning, is a dominant source of error. PMID:27921071
Yiu, Sean; Farewell, Vernon T; Tom, Brian D M
2017-08-01
Many psoriatic arthritis patients do not progress to permanent joint damage in any of the 28 hand joints, even under prolonged follow-up. This has led several researchers to fit models that estimate the proportion of stayers (those who do not have the propensity to experience the event of interest) and to characterize the rate of developing damaged joints in the movers (those who have the propensity to experience the event of interest). However, when fitted to the same data, the paper demonstrates that the choice of model for the movers can lead to widely varying conclusions on a stayer population, thus implying that, if interest lies in a stayer population, a single analysis should not generally be adopted. The aim of the paper is to provide greater understanding regarding estimation of a stayer population by comparing the inferences, performance and features of multiple fitted models to real and simulated data sets. The models for the movers are based on Poisson processes with patient level random effects and/or dynamic covariates, which are used to induce within-patient correlation, and observation level random effects are used to account for time varying unobserved heterogeneity. The gamma, inverse Gaussian and compound Poisson distributions are considered for the random effects.
Scott, Ian C; Rijsdijk, Frühling; Walker, Jemma; Quist, Jelmar; Spain, Sarah L; Tan, Rachael; Steer, Sophia; Okada, Yukinori; Raychaudhuri, Soumya; Cope, Andrew P; Lewis, Cathryn M
2015-07-01
Genetic variants affect both the development and severity of rheumatoid arthritis (RA). Recent studies have expanded the number of RA susceptibility variants. We tested the hypothesis that these associated with disease severity in a clinical trial cohort of patients with early, active RA. We evaluated 524 patients with RA enrolled in the Combination Anti-Rheumatic Drugs in Early RA (CARDERA) trials. We tested validated susceptibility variants - 69 single-nucleotide polymorphisms (SNP), 15 HLA-DRB1 alleles, and amino acid polymorphisms in 6 HLA molecule positions - for their associations with progression in Larsen scoring, 28-joint Disease Activity Scores, and Health Assessment Questionnaire (HAQ) scores over 2 years using linear mixed-effects and latent growth curve models. HLA variants were associated with joint destruction. The *04:01 SNP (rs660895, p = 0.0003), *04:01 allele (p = 0.0002), and HLA-DRβ1 amino acids histidine at position 13 (p = 0.0005) and valine at position 11 (p = 0.0012) significantly associated with radiological progression. This association was only significant in anticitrullinated protein antibody (ACPA)-positive patients, suggesting that while their effects were not mediated by ACPA, they only predicted joint damage in ACPA-positive RA. Non-HLA variants did not associate with radiograph damage (assessed individually and cumulatively as a weighted genetic risk score). Two SNP - rs11889341 (STAT4, p = 0.0001) and rs653178 (SH2B3-PTPN11, p = 0.0004) - associated with HAQ scores over 6-24 months. HLA susceptibility variants play an important role in determining radiological progression in early, active ACPA-positive RA. Genome-wide and HLA-wide analyses across large populations are required to better characterize the genetic architecture of radiological progression in RA.
[Cytokines in bone diseases. Anti-cytokine therapies for bone and joint diseases].
Tanaka, Yoshiya
2010-10-01
The efficacy of biologics targeting inflammatory cytokines such as TNF and IL-6 for bone and joint diseases has been emerging. Rheumatoid arthritis (RA) is a systemic autoimmune disease characterized by chronic synovitis and bone damage. By the use of TNF-inhibitors, clinical remission, structural remission and functional remission have become possible during the treatment of RA. Especially, the progress of joint and bone destruction is completely suppressed by TNF-inhibitors in the vast majority of RA patients. On the other hand, anti-RANKL antibody inhibits joint destruction as well as systemic osteoporosis, though no effects on synovitis of RA. Thus, differential efficacy of different therapies in bone destruction and osteoporosis would warrant further study to clarify the mechanisms of bone and joints diseases.
Martin, Richard W; Brower, Matthew E; Geralds, Alexander; Gallagher, Patience J; Tellinghuisen, Donald J
2012-03-01
To explore how effectively information presentation formats used in a patient decision aid communicated the ability of a disease modifying anti-rheumatic drug to slow the rate of progression of rheumatoid arthritis related structural joint damage (SJD). 91 first year psychology students and 91 RA patients participated in a prospective randomized, single blind, factorial experimental design evaluating the effect of four information formats on: satisfaction with risk communication, verbatim and gist recall of a hypothetical anti-rheumatic drug's ability to slow the rate of progression of SJD. Both groups underestimated the hypothetical drug's ability to slow SJD. Formats that supported the narrative statement with a reinforcing graphic element resulted in recall closer to the true value. Comparison of the results from testing of RA patients and college students were remarkably similar across formats. Rate of progression as communicated by narrative statement plus a graphic element (i.e. speedometer metaphor or pictograph) aided recall better than a narrative statement alone. Our results suggest that testing decision aid components with non-patients may provide data generalizable to patient populations. Graphics must be used carefully in patient decision aids as they can enhance recall, but may also introduce unintended recall bias. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.
Kang, Kwi Young; Woo, Jung-Won; Park, Sung-Hwan
2014-01-01
S100A8 and S100A9 are major leukocyte proteins, known as damage-associated molecular patterns, found at high concentrations in the synovial fluid of patients with rheumatoid arthritis (RA). A heterodimeric complex of S100A8/A9 is secreted by activated leukocytes and binds to Toll-like receptor 4, which mediates downstream signaling and promotes inflammation and autoimmunity. Serum and synovial fluid levels of S100A8/A9 are markedly higher in patients with RA than in patients with osteoarthritis or miscellaneous inflammatory arthritis. Serum levels of S100A8/A9 are significantly correlated with clinical and laboratory markers of inflammation, such as C-reactive protein, erythrocyte sedimentation rate, rheumatoid factor, and the Disease Activity Score for 28 joints. Significant correlations have also been found between S100A8/A9 and radiographic and clinical assessments of joint damage, such as hand radiographs and the Rheumatoid Arthritis Articular Damage score. In addition, among known inflammatory markers, S100A8/A9 has the strongest correlation with total sum scores of ultrasonography assessment. Furthermore, baseline levels of S100A8/A9 are independently associated with progression of joint destruction in longitudinal studies and are responsive to change during conventional and biologic treatments. These findings suggest S100A8/A9 to be a valuable diagnostic and prognostic biomarker for RA.
Sreerangaiah, Dee; Grayer, Michael; Fisher, Benjamin A; Ho, Meilien; Abraham, Sonya; Taylor, Peter C
2016-01-01
To assess the value of quantitative vascular imaging by power Doppler US (PDUS) as a tool that can be used to stratify patient risk of joint damage in early seropositive RA while still biologic naive but on synthetic DMARD treatment. Eighty-five patients with seropositive RA of <3 years duration had clinical, laboratory and imaging assessments at 0 and 12 months. Imaging assessments consisted of radiographs of the hands and feet, two-dimensional (2D) high-frequency and PDUS imaging of 10 MCP joints that were scored for erosions and vascularity and three-dimensional (3D) PDUS of MCP joints and wrists that were scored for vascularity. Severe deterioration on radiographs and ultrasonography was seen in 45 and 28% of patients, respectively. The 3D power Doppler volume and 2D vascularity scores were the most useful US predictors of deterioration. These variables were modelled in two equations that estimate structural damage over 12 months. The equations had a sensitivity of 63.2% and specificity of 80.9% for predicting radiographic structural damage and a sensitivity of 54.2% and specificity of 96.7% for predicting structural damage on ultrasonography. In seropositive early RA, quantitative vascular imaging by PDUS has clinical utility in predicting which patients will derive benefit from early use of biologic therapy. © The Author 2015. Published by Oxford University Press on behalf of the British Society for Rheumatology. All rights reserved. For Permissions, please email: journals.permissions@oup.com.
Huebner, Janet L; Bay-Jensen, Anne C; Huffman, Kim M; He, Yi; Leeming, Diana J; McDaniel, Gary E; Karsdal, Morten A; Kraus, Virginia B
2014-09-01
To evaluate joint tissue remodeling using the urinary collagen biomarkers urinary α-C-telopeptide of type I collagen (α-CTX) and urinary C-telopeptide of type II collagen (CTX-II) and to determine the association of these biomarkers with osteoarthritis (OA) severity, progression, and localized knee bone turnover. Participants (n = 149) with symptomatic and radiographic knee OA underwent fixed-flexion knee radiography at baseline and 3 years, and late-phase bone scintigraphy of both knees at baseline, which were scored semiquantitatively for osteophyte and joint space narrowing (JSN) severity and uptake intensity, with scores summed across knees. Urinary concentrations of α-CTX and CTX-II were determined by enzyme-linked immunosorbent assay. Immunohistochemical analysis of human OA knees was performed to localize the joint tissue origin of the biomarker epitopes. Urinary α-CTX concentrations correlated strongly with the intensity of bone scintigraphic uptake and with JSN progression (risk ratio 13.2) and osteophyte progression (risk ratio 3). Urinary CTX-II concentrations were strongly associated with intensity of bone scintigraphic uptake, with JSN and osteophyte severity, and with OA progression based on osteophyte score. Urinary α-CTX localized primarily to high bone turnover areas in subchondral bone. CTX-II localized to the bone-cartilage interface, the tidemark, and damaged articular cartilage. Baseline urinary α-CTX, which was localized to high turnover areas of subchondral bone, was associated with dynamic bone turnover of knees, as signified by scintigraphy, and progression of both osteophytes and JSN. Urinary CTX-II correlated with JSN and osteophyte severity and progression of osteophytes. To our knowledge, this represents the first report of serologic markers reflecting subchondral bone turnover. These collagen markers may be useful for noninvasive detection and quantification of active subchondral bone turnover and joint remodeling in knee OA. Copyright © 2014 by the American College of Rheumatology.
Monitoring of fatigue damage in composite lap-joints using guided waves and FBG sensors
NASA Astrophysics Data System (ADS)
Karpenko, Oleksii; Khomenko, Anton; Koricho, Ermias; Haq, Mahmoodul; Udpa, Lalita
2016-02-01
Adhesive bonding is being increasingly employed in many applications as it offers possibility of light-weighting and efficient multi-material joining along with reduction in time and cost of manufacturing. However, failure initiation and progression in critical components like joints, specifically in fatigue loading is not well understood, which necessitates reliable NDE and SHM techniques to ensure structural integrity. In this work, concurrent guided wave (GW) and fiber Bragg grating (FBG) sensor measurements were used to monitor fatigue damage in adhesively bonded composite lap-joints. In the present set-up, one FBG sensor was strategically embedded in the adhesive bond-line of a lap-joint, while two other FBGs were bonded on the surface of the adherends. Full spectral responses of FBG sensors were collected and compared at specific intervals of fatigue loading. In parallel, guided waves were actuated and sensed using PZT wafers mounted on the composite adherends. Experimental results demonstrated that time-of-flight (ToF) of the fundamental modes transmitted through the bond-line and spectral response of FBG sensors were sensitive to fatigue loading and damage. Combination of guided wave and FBG measurements provided the desired redundancy and synergy in the data to evaluate the degradation in bond-line properties. Measurements taken in the presence of continuously applied load replicated the in-situ/service conditions. The approach shows promise in understanding the behavior of bonded joints subjected to complex loading.
NASA Astrophysics Data System (ADS)
Tamaddon, Maryam; Chen, Shen Mao; Vanaclocha, Leyre; Hart, Alister; El-Husseiny, Moataz; Henckel, Johann; Liu, Chaozong
2017-11-01
Osteoarthritis (OA) is the most common type of arthritis and a major cause of disability in the adult population. It affects both cartilage and subchondral bone in the joints. There has been some progress in understanding the changes in subchondral bone with progression of osteoarthritis. However, local changes in subchondral bone such as microstructure or volumetric bone mineral density in connection with the defect in cartilage are relatively unexplored. To develop an effective treatment for progression of OA, it is important to understand how the physical environment provided by the subchondral bone affects the overlying cartilage. In this study we examined the volumetric bone mineral density (vBMD) distribution in the osteoarthritic joint tissues obtained from total hip replacement surgeries due to osteoarthritis, using peripheral quantitative CT (pQCT). It was found that there is a significant decrease in volumetric bone mineral density, which co-localises with the damage in the overlying cartilage. This was not limited to the subchondral bone immediately adjacent to the cartilage defect but continued in the layers below. Bone resorption and cyst formation in the OA tissues were also detected. We observed that the bone surrounding subchondral bone cysts exhibited much higher volumetric bone mineral density than that of the surrounding bones. PQCT was able to detect significant changes in vBMD between OA and non-OA samples, as well as between areas of different cartilage degeneration, which points to its potential as a technique for detection of early OA.
Martín, Irene; Loza, Estibaliz; Carmona, Loreto; Ivorra, José; Narváez, José Antonio; Hernández-Gañán, Javier; Alía, Pedro
2016-01-01
Objective To analyze the association between circulating osteoprotegerin (OPG) and Dickkopf-related protein 1 (DKK-1) and radiological progression in patients with tightly controlled rheumatoid arthritis (RA). Methods Serum levels of OPG and DKK-1 were measured in 97 RA patients who were treated according to a treat-to-target strategy (T2T) aimed at remission (DAS28<2.6). Radiologic joint damage progression was assessed by changes in the total Sharp-van der Heijde score (SHS) on serial radiographs of the hands and feet. The independent association between these biomarker levels and the structural damage endpoint was examined using regression analysis Results The mean age of the 97 RA patients (68 women) at the time of the study was 54 ± 14 years, and the median disease duration was 1.6 ± 1.5 years. Most patients were seropositive for either RF or ACPA, and the large majority (76%) were in remission or had low disease activity. After a median follow-up time of 3.3 ± 1.5 years (range, 1–7.5 yrs.), the mean total SHS annual progression was 0.88 ± 2.20 units. Fifty-two percent of the patients had no progression (defined as a total SHS of zero). The mean serum OPG level did not change significantly over the study period (from 3.9 ± 1.8 to 4.07 ± 2.23 pmol/L), whereas the mean serum DKK-1 level decreased, although not significantly (from 29.9 ± 10.9 to 23.6 ± 18.8 pmol/L). In the multivariate analysis, the predictive factors increasing the likelihood of total SHS progression were age (OR per year = 1.10; p = 0.003) and a high mean C-reactive protein level over the study period (OR = 1.29; p = 0.005). Circulating OPG showed a protective effect reducing the likelihood of joint space narrowing by 60% (95% CI: 0.38–0.94) and the total SHS progression by 48% (95% CI: 0.28–0.83). The DKK-1 levels were not associated with radiological progression. Conclusion In patients with tightly controlled RA, serum OPG was inversely associated with progression of joint destruction. This biomarker may be useful in combination with other risk factors to improve prediction in patients in clinical remission or low disease activity state. PMID:27911913
Turley, Sean M; Thambyah, Ashvin; Riggs, Christopher M; Firth, Elwyn C; Broom, Neil D
2014-01-01
The palmar aspect of the third metacarpal (MC3) condyle of equine athletes is known to be subjected to repetitive overloading that can lead to the accumulation of joint tissue damage, degeneration, and stress fractures, some of which result in catastrophic failure. However, there is still a need to understand at a detailed microstructural level how this damage progresses in the context of the wider joint tissue complex, i.e. the articular surface, the hyaline and calcified cartilage, and the subchondral bone. MC3 bones from non-fractured joints were obtained from the right forelimbs of 16 Thoroughbred racehorses varying in age between 3 and 8 years, with documented histories of active race training. Detailed microstructural analysis of two clinically important sites, the parasagittal grooves and the mid-condylar regions, identified extensive levels of microdamage in the calcified cartilage and subchondral bone concealed beneath outwardly intact hyaline cartilage. The study shows a progression in microdamage severity, commencing with mild hard-tissue microcracking in younger animals and escalating to severe subchondral bone collapse and lesion formation in the hyaline cartilage with increasing age and thus athletic activity. The presence of a clearly distinguishable fibrous tissue layer at the articular surface immediately above sites of severe subchondral collapse suggested a limited reparative response in the hyaline cartilage. PMID:24689513
[Mechanical behavior of the subchondral bone in the experimentally induced osteoarthritis].
Miyanaga, Y
1979-06-01
In order to evaluate the role of the subchondral bone (cancellous bone) in the development and progression of the joint degeneration, osteoarthritis of the knee joint was produced experimentally in the rabbits and viscoelasticity and strength of the subchondral bone from the femoral medial condyle have been investigated along with the pathological, histological study of the joint. The viscoelastic spectrometer and the Instron type testing machine were used. As the first change after operation, osteophyte formation around the joint margin has been observed before the initiation of the degeneration of articular cartilage and there is a possibility that mechanical properties of subchondral bone such as high deformability and low elasticity to the mechanism of osteophyte formation. Subchondral bone softening with marked increase of ultimate strain and phase lag, marked decrease of compressive elastic modulus and ultimate stress precedes or occurs concurrently with the degeneration of the articular cartilage. These facts indicate the relationship between the mechanical properties of the subchondral bone and joint degeneration. Once the joint degeneration starts, degeneration continues progressively while the subchondral bone tends to become brittle. These changes may be considered as a kind of functional adaptation to the damage or denudation of articular cartilage. It is postulated that some architectural changes of the subchondral bone may provide alterations of the mechanical properties. Biomechanical roles of the subchondral bone is suggested as one of the factors in the joint degeneration.
Zayed, Mohammed; Adair, Steve; Ursini, Tena; Schumacher, James; Misk, Nabil; Dhar, Madhu
2018-03-20
Osteoarthritis (OA), the most common form of joint disease affecting humans and horses, is characterized by the advance and decline of cartilage and loss of function of the affected joint. The progression of OA is steadily accompanied with biochemical events, which interfere with the cytokines and proteolytic enzymes responsible for progress of the disease. Recently, regenerative therapies have been used with an assumption that mesenchymal stem cells (MSCs) possess the potential to prevent the advancement of cartilage damage and potentially regenerate the injured tissue with an ultimate goal of preventing OA. We believe that despite various challenges, the use of allogenic versus autologous MSCs in cartilage regeneration, is a major issue which can directly or indirectly affect the other factors including, the timing of implantation, dose or cell numbers for implantation, and the source of MSCs. Current knowledge reporting some of these challenges that the clinicians might face in the treatment of cartilage damage in horses are presented. In this regard we conducted two independent studies. In the first study we compared donor matched bone marrow and synovial fluid - derived equine MSCs in vitro, and showed that the SFMSCs were similar to the BMMSCs in their proliferation, expression of CD29, CD44 and CD90, but, exhibited a significantly different chondrogenesis. Additionally, 3.2-21% of all SFMSCs were positive for MHC II, whereas, BMMSCs were negative. In the second study we observed that injection of both the autologous and allogenic SFMSCs into the tarsocrural joint resulted in elevated levels of total protein and total nucleated cell counts. Further experiments to evaluate the in vivo acute or chronic response to allogenic or autologous MSCs are imperative. Copyright © 2018 Elsevier Ltd. All rights reserved.
Bertuglia, Andrea; Pagliara, Eleonora; Grego, Elena; Ricci, Alessandro; Brkljaca-Bottegaro, Nika
2016-11-08
Joint impact injuries initiate a progressive articular damage finally leading to post-traumatic osteoarthritis (PTOA). Racehorses represent an ideal, naturally available, animal model of the disease. Standardbred racehorses developing traumatic osteoarthritis of the fetlock joint during the first year of their career were enrolled in our study. Age-matched controls were contemporarily included. Biomarker levels of equine osteoarthritis were measured in serum and synovial fluid (SF) at baseline, and repeated yearly over the next 4 years of training (from T1 to T4). The effect of time and disease on the biomarker concentrations were analysed, and their relationship with clinical and radiographic parameters were assessed. We hypothesized that the kinetics of pro-inflammatory cytokines and structural biomarkers of joint disease would demonstrate progression of degenerative joint status during post-traumatic osteoarthritis and clarify the effect of early joint trauma. The concentrations of IL1-ß, IL-6, TNF-α in the SF of PTOA group peaked at T0, decreased at T1, and then progressively increased with time, reaching levels higher than those observed at baseline starting from T3. CTXII and COMP levels were similar in PTOA and control horses at baseline, and increased in serum and synovial fluid of PTOA horses starting from T2 (serum and synovial CTXII, and serum COMP) or T3 (synovial COMP). The percentual change of TNF-α in the SF of the affected joints independently contributed to explaining the radiological changes at T3 vs T2 and T4 vs T3. Temporal changes of selected biomarkers in STBRs with an acute episode of traumatic fetlock OA demonstrated that long-term increased concentrations of inflammatory cytokines, type II collagen fragments and COMP, in the SF and serum, are related to PTOA. Based on the observed decrease in inflammatory merkers at T1, we hypothesize that the progression of PTOA could be effectively modulated by proper treatment strategies. Annual variations of synovial concentration of TNF-α can reliably predict radiographic progression of PTOA.
Nowak, Natalia; Skupien, Jan; Niewczas, Monika A.; Yamanouchi, Masayuki; Major, Melissa; Croall, Stephanie; Smiles, Adam; Warram, James H.; Bonventre, Joseph V.; Krolewski, Andrzej S.
2015-01-01
Progressively decreasing glomerular filtration rate (GFR), or renal decline, is seen in patients with type 1 diabetes (T1D) and normoalbuminuria or microalbuminuria. Here we examined the associations of kidney injury molecule-1 (KIM-1) in plasma and urine with the risk of renal decline and determine whether those associations are independent of markers of glomerular damage. The study group comprised patients with T1D from the 2nd Joslin Kidney Study of which 259 had normoalbuminuria and 203 had microalbuminuria. Serial measurements over 4 to 10 years of follow-up (median 8 years) of serum creatinine and cystatin C were used jointly to estimate eGFRcr-cys slopes and time of onset of CKD stage 3 or higher. Baseline urinary excretion of IgG2 and albumin were used as markers of glomerular damage, and urinary excretion of KIM-1 and its plasma concentration were used as markers of proximal tubular damage. All patients had normal renal function at baseline. During follow-up, renal decline (eGFRcr-cys loss 3.3% or more per year) developed in 96 patients and 62 progressed to CKD stage 3. For both outcomes, the risk rose with increasing baseline levels of plasma KIM-1. In multivariable models, elevated baseline plasma KIM-1 was strongly associated with risk of early progressive renal decline, regardless of baseline clinical characteristics, serum TNFR1 or markers of glomerular damage. Thus, damage to proximal tubules may play an independent role in the development of early progressive renal decline in non-proteinuric patients with T1D. PMID:26509588
Carpenter, Lewis; Norton, Sam; Nikiphorou, Elena; Jayakumar, Keeranur; McWilliams, Daniel F; Rennie, Kirsten L; Dixey, Josh; Kiely, Patrick; Walsh, David Andrew; Young, Adam
2017-12-01
To assess the 5-year progression of erosions and joint space narrowing (JSN) and their associations with rheumatoid factor (RF) status in 2 large, multicenter, early rheumatoid arthritis cohorts, spanning 25 years. Radiographic joint damage was recorded using the Sharp/van der Heijde (SHS) method in the Early Rheumatoid Arthritis Study (ERAS), 1986-2001, and the Early Rheumatoid Arthritis Network (ERAN), 2002-2013. Mixed-effects negative binomial regression estimated changes in radiographic damage over 5 years, including erosions and JSN, separately. RF, along with age, sex, and baseline markers of disease activity were controlled for. A total of 1,216 patients from ERAS and 446 from ERAN had radiographic data. Compared to ERAS, ERAN patients had a lower mean total SHS score at baseline (ERAN 6.2 versus ERAS 10.5; P < 0.001) and mean annual rate of change (ERAN 2.5 per year versus ERAS 6.9 per year; P < 0.001). Seventy-four percent of ERAS and 27% of ERAN patients progressed ≥5 units. Lower scores at baseline in ERAN were largely driven by reductions in JSN (ERAS 3.9 versus ERAN 1.2; P < 0.001), along with erosions (ERAS 1.9 versus ERAN 0.8; P < 0.001). RF was associated with greater progression in each cohort, but the absolute difference in mean annual rate of change for RF-positive patients was substantially higher for ERAS (RF positive 8.6 versus RF negative 5.1; P < 0.001), relative to ERAN (RF positive 2.0 versus RF negative 1.9; P = 0.855). Radiographic progression was shown to be significantly reduced between the 2 cohorts, and was associated with lower baseline damage and other factors, including changes in early disease-modifying antirheumatic drug use. The impact of RF status as a prognostic marker of clinically meaningful change in radiographic progression has markedly diminished in the context of more modern treatment. © 2017, American College of Rheumatology.
The detrimental effects of iron on the joint: a comparison between haemochromatosis and haemophilia.
van Vulpen, Lize F D; Roosendaal, Goris; van Asbeck, B Sweder; Mastbergen, Simon C; Lafeber, Floris P J G; Schutgens, Roger E G
2015-08-01
Joint damage due to (recurrent) joint bleeding in haemophilia causes major morbidity. Although the exact pathogenesis has not been fully elucidated, a central role for iron is hypothesised. Likewise, in hereditary haemochromatosis joint destruction is caused by iron overload. A comparison between these types of arthropathy could provide more insight in the influence of iron in inducing joint damage. A literature review was performed to compare both disorders with respect to their clinical and histological characteristics, and preclinical studies on the influence of iron on different joint components were reviewed. Similarities in the features of arthropathy in haemochromatosis and haemophilia are cartilage degeneration, subchondral bone changes with osteophyte and cyst formation, and osteoporosis. In both disorders synovial inflammation and proliferation are seen, although this is much more explicit in haemophilia. Other substantial differences are the age at onset, the occurrence of chondrocalcinosis radiographically and calcium pyrophosphate dihydrate deposition disease in haemochromatosis, and a rapid progression with joint deformity and neovascularisation in haemophilia. Preclinical studies demonstrate detrimental effects of iron to all components of the joint, resulting in synovial inflammation and hyperplasia, chondrocyte death, and impaired osteoblast function. These effects, particularly the synovial changes, are aggravated in the presence of a pro-inflammatory signal, which is prominent in haemophilic arthropathy and minimal in haemochromatosis. Additional research is needed to further specify the role of iron as a specific target in treating these types of arthropathy. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.
Forslind, K; Svensson, B
2016-01-01
To determine the value of magnetic resonance imaging (MRI) of bones and joints in patients with recent-onset rheumatoid arthritis (RA) treated for 2 years from diagnosis with disease-modifying anti-rheumatic drugs (DMARDs) and glucocorticoids. Thirteen patients with early RA were treated according to clinical practice and followed with MRI, radiographs, and Disease Activity Score calculated on 28 joints (DAS28) at inclusion (baseline) and after 1, 4, 7, 13, and 25 months. MRI of the dominant wrist and metacarpophalangeal (MCP) joints were assessed for synovitis, bone oedema, and erosions using the RA MRI Score (RAMRIS) and for tenosynovitis by an MRI tenosynovitis scoring method. Radiographs were assessed by the van der Heijde modified Sharp score (SHS). Clinical remission was defined by a DAS28 < 2.6. MRI at baseline detected inflammation in joints and tendons in all patients as well as erosions in 10 out of 13 patients. Over time, the erosion score increased while the synovitis and tenosynovitis scores remained almost unchanged. Bone oedema strongly correlated with synovitis. Synovitis and tenosynovitis correlated well with the erosion score at baseline but not thereafter. The MRI changes showed that joint damage started early and continued in the presence of persistent synovial and tenosynovial inflammation. The observations made in this small study suggest that the treatment goal of 'clinical remission' should be supplemented by a 'joint remission' goal. To this end, MRI is an appropriate tool. Further studies are needed to evaluate the optimal use of MRI in early RA.
Raffeiner, Bernd; Grisan, Enrico; Botsios, Costantino; Stramare, Roberto; Rizzo, Gaia; Bernardi, Livio; Punzi, Leonardo; Ometto, Francesca; Doria, Andrea
2017-08-01
To investigate power Doppler (PD) signal, grade and location and their association with radiographic progression in RA patients in remission. A prospective observational study was conducted in 125 consecutive RA patients in stable 28-joint DAS (DAS28) remission (⩾6 months) achieved on anti-TNF-α. At baseline, patients in stable remission underwent radiographic and US examination of the wrists and MCP, PIP and MTP joints. Semi-quantitative PD scoring (0-3) was recorded. We scored PD according to two locations: capsular or within synovial tissue without bone contact (location 1) and with bone contact or penetrating bone cortex (location 2). Radiographic progression was evaluated at the 1 year follow-up and defined as a change in van der Heijde-modified total Sharp score >0. Risk ratios (RRs) of radiographic progression according to presence, grade and location of PD were calculated. Four patients were excluded because of missing data. At baseline, 59/121 (48.7%) patients had a PD signal in one or more joints. PD location 2 was found in 74.6% patients (44/59). At the 1 year follow-up, 17/121 patients experienced radiographic progression: all had PD signal in one or more joints at baseline (RR 2.47, P < 0.0001). Radiographic progression was associated with the following baseline US features: PD grade 2 (RR 4.58, P < 0.01), PD grade 3 (RR 3.49, P < 0.05), total PD score ⩾2 (sum of all PD scores) (RR 3.19, P < 0.0001) and PD location 2 (RR 3.49, P < 0.0001). Higher PD grades and PD in contact with/or penetrating bone are associated with radiographic progression in patients in DAS28 remission. © The Author 2017. Published by Oxford University Press on behalf of the British Society for Rheumatology. All rights reserved. For Permissions, please email: journals.permissions@oup.com
Rodriguez-Rodriguez, Luis; Ivorra-Cortes, Jose; Carmona, F David; Martín, Javier; Balsa, Alejandro; van Steenbergen, Hanna W; van der Helm-van Mil, Annette H M; González-Álvaro, Isidoro; Fernandez-Gutiérrez, Benjamín
2015-11-05
Prostaglandin E receptor 4 (PTGER4) is implicated in immune regulation and bone metabolism. The aim of this study was to analyze its role in radiological joint damage in rheumatoid arthritis (RA). Six independent cohorts of patients with RA of European or North American descent were included, comprising 1789 patients with 5083 sets of X-rays. The Hospital Clínico San Carlos Rheumatoid Arthritis, Princesa Early Arthritis Register Longitudinal study, and Hospital Universitario de La Paz early arthritis (Spain) cohorts were used as discovery cohorts, and the Leiden Early Arthritis Clinic (The Netherlands), Wichita (United States), and National Databank for Rheumatic Diseases (United States and Canada) cohorts as replication cohorts. First, the PTGER4 rs6896969 single-nucleotide polymorphism (SNP) was genotyped using TaqMan assays and available Illumina Immunochip data and studied in the discovery and replication cohorts. Second, the PTGER4 gene and adjacent regions were analyzed using Immunochip genotyping data in the discovery cohorts. On the basis of pooled p values, linkage disequilibrium structure of the region, and location in regions with transcriptional properties, SNPs were selected for replication. The results from discovery, replication, and overall cohorts were pooled using inverse-variance-weighted meta-analysis. Influence of the polymorphisms on the overall radiological damage (constant effect) and on damage progression over time (time-varying effect) was analyzed. The rs6896969 polymorphism showed a significant association with radiological damage in the constant effect pooled analysis of the discovery cohorts, although no significant association was observed in the replication cohorts or the overall pooled analysis. Regarding the analysis of the PTGER4 region, 976 variants were analyzed in the discovery cohorts. From the constant and time-varying effect analyses, 12 and 20 SNPs, respectively, were selected for replication. Only the rs76523431 variant showed a significant association with radiographic progression in the time-varying effect pooled analysis of the discovery, replication, and overall cohorts. The overall pooled effect size was 1.10 (95 % confidence interval 1.05-1.14, p = 2.10 × 10(-5)), meaning that radiographic yearly progression was 10 % greater for each copy of the minor allele. The PTGER4 gene is a candidate risk factor for radiological progression in RA.
2014-01-01
Background Permanent joint damage is a major consequence of rheumatoid arthritis (RA), the most common and destructive form of inflammatory arthritis. In aggressive disease, joint damage can occur within 6 months from symptom onset. Early, intensive treatment with conventional and biologic disease-modifying anti-rheumatic drugs (DMARDs) can delay the onset and progression of joint damage. The primary objective of the study is to investigate the value of magnetic resonance imaging (MRI) or radiography (X-ray) over standard of care as tools to guide DMARD treatment decision-making by rheumatologists for the care of RA. Methods A double-blind, randomized controlled trial has been designed. Rheumatoid and undifferentiated inflammatory arthritis patients will undergo an MRI and X-ray assessment every 6 months. Baseline adaptive randomization will be used to allocate participants to MRI, X-ray, or sham-intervention groups on a background of standard of care. Prognostic markers, treating physician, and baseline DMARD therapy will be used as intervention allocation parameters. The outcome measures in rheumatology RA MRI score and the van der Heijde-modified Sharp score will be used to evaluate the MRI and X-ray images, respectively. Radiologists will score anonymized images for all patients regardless of intervention allocation. Disease progression will be determined based on the study-specific, inter-rater smallest detectable difference. Allocation-dependent, intervention-concealed reports of positive or negative disease progression will be reported to the treating rheumatologist. Negative reports will be delivered for the sham-intervention group. Study-based radiology clinical reports will be provided to the treating rheumatologists for extra-study X-ray requisitions to limit patient radiation exposure as part of diagnostic imaging standard of care. DMARD treatment dose escalation and therapy changes will be measured to evaluate the primary objective. A sample size of 186 (62 per group) patients will be required to determine a 36% difference in pharmacological treatment escalation between the three groups with intermediate dispersion of data with 90% power at a 5% level of significance. Discussion This study will determine if monitoring RA and undifferentiated inflammatory arthritis patients using MRI and X-ray every 6 months over 2 years provides incremental evidence over standard of care to influence pharmacotherapeutic decision-making and ultimately hinder disease progression. Trial registration This trial has been registered at ClinicalTrials.gov: NCT00808496 (registered on 12 December 2008). PMID:24997587
Huo, Yinghe; Vincken, Koen L; van der Heijde, Desiree; de Hair, Maria J H; Lafeber, Floris P; Viergever, Max A
2017-11-01
Objective: Wrist joint space narrowing is a main radiographic outcome of rheumatoid arthritis (RA). Yet, automatic radiographic wrist joint space width (JSW) quantification for RA patients has not been widely investigated. The aim of this paper is to present an automatic method to quantify the JSW of three wrist joints that are least affected by bone overlapping and are frequently involved in RA. These joints are located around the scaphoid bone, viz. the multangular-navicular, capitate-navicular-lunate, and radiocarpal joints. Methods: The joint space around the scaphoid bone is detected by using consecutive searches of separate path segments, where each segment location aids in constraining the subsequent one. For joint margin delineation, first the boundary not affected by X-ray projection is extracted, followed by a backtrace process to obtain the actual joint margin. The accuracy of the quantified JSW is evaluated by comparison with the manually obtained ground truth. Results: Two of the 50 radiographs used for evaluation of the method did not yield a correct path through all three wrist joints. The delineated joint margins of the remaining 48 radiographs were used for JSW quantification. It was found that 90% of the joints had a JSW deviating less than 20% from the mean JSW of manual indications, with the mean JSW error less than 10%. Conclusion: The proposed method is able to automatically quantify the JSW of radiographic wrist joints reliably. The proposed method may aid clinical researchers to study the progression of wrist joint damage in RA studies. Objective: Wrist joint space narrowing is a main radiographic outcome of rheumatoid arthritis (RA). Yet, automatic radiographic wrist joint space width (JSW) quantification for RA patients has not been widely investigated. The aim of this paper is to present an automatic method to quantify the JSW of three wrist joints that are least affected by bone overlapping and are frequently involved in RA. These joints are located around the scaphoid bone, viz. the multangular-navicular, capitate-navicular-lunate, and radiocarpal joints. Methods: The joint space around the scaphoid bone is detected by using consecutive searches of separate path segments, where each segment location aids in constraining the subsequent one. For joint margin delineation, first the boundary not affected by X-ray projection is extracted, followed by a backtrace process to obtain the actual joint margin. The accuracy of the quantified JSW is evaluated by comparison with the manually obtained ground truth. Results: Two of the 50 radiographs used for evaluation of the method did not yield a correct path through all three wrist joints. The delineated joint margins of the remaining 48 radiographs were used for JSW quantification. It was found that 90% of the joints had a JSW deviating less than 20% from the mean JSW of manual indications, with the mean JSW error less than 10%. Conclusion: The proposed method is able to automatically quantify the JSW of radiographic wrist joints reliably. The proposed method may aid clinical researchers to study the progression of wrist joint damage in RA studies.
Orthopaedic management of haemophilia arthropathy of the ankle.
Pasta, G; Forsyth, A; Merchan, C R; Mortazavi, S M J; Silva, M; Mulder, K; Mancuso, E; Perfetto, O; Heim, M; Caviglia, H; Solimeno, L
2008-07-01
Joint bleeding, or haemarthrosis, is the most common type of bleeding episode experienced by individuals with haemophilia A and B. This leads to changes within the joints, including synovial proliferation, which results in further bleeding and chronic synovitis. Blood in the joint can also directly damage the cartilage, and with repeated bleeding, there is progressive destruction of both cartilage and bone. The end result is known as haemophilic arthropathy. The joints most commonly affected are the knees, elbows and ankles, although any synovial joint may be involved. In the ankle, both the tibiotalar and subtalar joints may be affected and joint bleeding and arthropathy can lead to a number of deformities. Haemophilic arthropathy can be prevented through regular factor replacement prophylaxis and implementing physiotherapy. However, when necessary, there are multiple surgical and non-surgical options available. In early ankle arthropathy with absent or minimal joint changes, both radioisotopic and chemical synoviorthesis can be used to reduce the hypertrophied synovium. These procedures can decrease the frequency of bleeding episodes, minimizing the risk of articular cartilage damage. Achilles tendon lengthening can be performed, in isolation or in combination with other surgical measures, to correct Achilles tendon contractures. Both arthroscopic and open synovectomies are available as a means to remove the friable villous layer of the synovium and are often indicated when bleeding episodes cannot be properly controlled by factor replacement therapy or synoviorthesis. In the later stages of ankle arthropathy, other surgical options may be considered. Debridement may be indicated when there are loose pieces of cartilage or anterior osteophytes, and can help to improve the joint function, even in the presence of articular cartilage damage. Supramalleolar tibial osteotomy may be indicated in patients with a valgus deformity of the hindfoot without degenerative radiographic findings. Joint fusion, or arthrodesis, is the treatment of choice in the advanced stages of ankle arthropathy although total ankle replacement is currently available. Early ankle replacement components were associated with a poor outcome, but as implant designs have improved, there have been successful outcomes achieved. As the ankle is a commonly affected joint in many individuals with haemophilia, it is important to add to the knowledge base to validate indications and timing of surgical and non-surgical interventions in ankle arthropathy.
Landewé, Robert B.; Mease, Philip J.; McInnes, Iain B.; Conaghan, Philip G.; Pricop, Luminita; Ligozio, Greg; Richards, Hanno B.; Mpofu, Shephard
2016-01-01
Objective To assess whether secukinumab treatment in patients with active psoriatic arthritis (PsA) is associated with sustained inhibition of radiographic progression. Methods In this phase III, double‐blind, placebo‐controlled study, 606 patients with PsA were randomized to receive intravenous (IV) secukinumab at a dose of 10 mg/kg (weeks 0, 2, 4) followed by subcutaneous secukinumab at a dose of 150 mg or 75 mg (the IV→150 mg and IV→75 mg groups, respectively) or placebo. Patients were stratified according to prior anti–tumor necrosis factor (anti‐TNF) exposure (71% were anti‐TNF naive). At week 16, placebo‐treated patients who had at least a 20% reduction in the tender and swollen joint counts (responders) continued to receive placebo until week 24; nonresponders were re‐randomized to receive secukinumab at a dose of 150 mg or 75 mg. The modified total Sharp/van der Heijde score (SHS) was determined at baseline, week 16 or 24, and week 52. Results In the overall population, radiographic progression was inhibited through 52 weeks; efficacy was demonstrated for both erosion and joint space narrowing scores and in patients who switched from placebo to secukinumab at week 24. Subgroup analyses showed that secukinumab reduced radiographic progression at week 24, regardless of previous anti‐TNF treatment. Among anti‐TNF–naive patients, the mean changes from baseline to week 24 in the modified total SHS were 0.05 in the pooled secukinumab group and 0.57 in the placebo group; among patients with an inadequate response or intolerance to anti‐TNF treatment, the mean changes were 0.16 and 0.58, respectively. Anti‐TNF–naive patients showed negligible progression through week 52. Inhibition of structural damage was observed through week 52 irrespective of concomitant methotrexate use. A high proportion of patients receiving secukinumab showed no progression (change in SHS of ≤ 0.5) from baseline to week 24 (82.3% of the IV→150 mg group and 92.3% of the IV→75 mg group) and from week 24 to week 52 (85.7% of the IV→150 mg group and 85.8% of the IV→75 mg group). Conclusion Secukinumab inhibited radiographic progression over 52 weeks of treatment in patients with active PsA. PMID:27014997
Tenascin-C Prevents Articular Cartilage Degeneration in Murine Osteoarthritis Models.
Matsui, Yuriyo; Hasegawa, Masahiro; Iino, Takahiro; Imanaka-Yoshida, Kyoko; Yoshida, Toshimichi; Sudo, Akihiro
2018-01-01
Objective The objective of this study was to determine whether intra-articular injections of tenascin-C (TNC) could prevent cartilage damage in murine models of osteoarthritis (OA). Design Fluorescently labeled TNC was injected into knee joints and its distribution was examined at 1 day, 4 days, 1 week, 2 weeks, and 4 weeks postinjection. To investigate the effects of TNC on cartilage degeneration after surgery to knee joints, articular spaces were filled with 100 μg/mL (group I), 10 μg/mL (group II) of TNC solution, or control (group III). TNC solution of 10 μg/mL was additionally injected twice after 3 weeks (group IV) or weekly after 1 week, 2 weeks, and 3 weeks (group V). Joint tissues were histologically assessed using the Mankin score and the modified Chambers system at 2 to 8 weeks after surgery. Results Exogenous TNC was maintained in the cartilage and synovium for 1 week after administration. Histological scores in groups I and II were better than scores in group III at 4 and 6 weeks, but progressive cartilage damage was seen in all groups 8 weeks postoperatively. Sequential TNC injections (groups IV and V) showed significantly better Mankin score than single injection (group II) at 8 weeks. Conclusion TNC administered exogenously remained in the cartilage of knee joints for 1 week, and could decelerate articular cartilage degeneration in murine models of OA. We also showed that sequential administration of TNC was more effective than a single injection. TNC could be an important molecule for prevention of articular cartilage damage.
NASA Technical Reports Server (NTRS)
Bergan, Andrew C.; Bakuckas, John G., Jr.; Lovejoy, Andrew E.; Jegley, Dawn C.; Awerbuch, Jonathan; Tan, Tein-Min
2012-01-01
An area that shows promise in enhancing structural integrity of aircraft and aerospace structures is the integrally stitched composite technology. The most recent generation of this technology is the Pultruded Rod Stitched Efficient Unitized Structure (PRSEUS) concept developed by Boeing Research and Technology and the National Aeronautics and Space Administration. A joint test program on the assessment of damage containment capabilities of the PRSEUS concept for curved fuselage structures was conducted recently at the Federal Aviation Administration William J. Hughes Technical Center. The panel was subjected to axial tension, internal pressure, and combined axial tension and internal pressure load conditions up to fracture, with a through-the-thickness, two-bay notch severing the central stiffener. For the purpose of future progressive failure analysis development and verification, extensive post failure nondestructive and teardown inspections were conducted. Detailed inspections were performed directly ahead of the notch tip where stable damage progression was observed. These examinations showed: 1) extensive delaminations developed ahead of the notch tip, 2) the extent and location of damage, 3) the typical damage mechanisms observed in composites, and 4) the role of stitching and warp-knitting in the failure mechanisms. The objective of this paper is to provide a summary of results from these posttest inspections.
A Mechanistic Thermal Fatigue Model for SnAgCu Solder Joints
NASA Astrophysics Data System (ADS)
Borgesen, Peter; Wentlent, Luke; Hamasha, Sa'd.; Khasawneh, Saif; Shirazi, Sam; Schmitz, Debora; Alghoul, Thaer; Greene, Chris; Yin, Liang
2018-02-01
The present work offers both a complete, quantitative model and a conservative acceleration factor expression for the life span of SnAgCu solder joints in thermal cycling. A broad range of thermal cycling experiments, conducted over many years, has revealed a series of systematic trends that are not compatible with common damage functions or constitutive relations. Complementary mechanical testing and systematic studies of the evolution of the microstructure and damage have led to a fundamental understanding of the progression of thermal fatigue and failure. A special experiment was developed to allow the effective deconstruction of conventional thermal cycling experiments and the finalization of our model. According to this model, the evolution of damage and failure in thermal cycling is controlled by a continuous recrystallization process which is dominated by the coalescence and rotation of dislocation cell structures continuously added to during the high-temperature dwell. The dominance of this dynamic recrystallization contribution is not consistent with the common assumption of a correlation between the number of cycles to failure and the total work done on the solder joint in question in each cycle. It is, however, consistent with an apparent dependence on the work done during the high-temperature dwell. Importantly, the onset of this recrystallization is delayed by pinning on the Ag3Sn precipitates until these have coarsened sufficiently, leading to a model with two terms where one tends to dominate in service and the other in accelerated thermal cycling tests. Accumulation of damage under realistic service conditions with varying dwell temperatures and times is also addressed.
NASA Astrophysics Data System (ADS)
Liu, Yi; Dai, Feng; Zhao, Tao; Xu, Nu-wen
2017-01-01
Intermittent jointed rocks, which exist in a myriad of engineering projects, are extraordinarily susceptible to cyclic loadings. Understanding the dynamic fatigue properties of jointed rocks is necessary for evaluating the stability of rock engineering structures. This study numerically investigated the influences of cyclic loading conditions (i.e., frequency, maximum stress and amplitude) and joint geometric configurations (i.e., dip angle, persistency and interspace) on the dynamic fatigue mechanisms of jointed rock models. A reduction model of stiffness and strength was first proposed, and then, sixteen cyclic uniaxial loading tests with distinct loading parameters and joint geometries were simulated. Our results indicate that the reduction model can effectively reproduce the hysteresis loops and the accumulative plastic deformation of jointed rocks in the cyclic process. Both the loading parameters and the joint geometries significantly affect the dynamic properties, including the irreversible strain, damage evolution, dynamic residual strength and fatigue life. Three failure modes of jointed rocks, which are principally controlled by joint geometries, occur in the simulations: splitting failure through the entire rock sample, sliding failure along joint planes and mixed failure, which are principally controlled by joint geometries. Furthermore, the progressive failure processes of the jointed rock samples are numerically observed, and the different loading stages can be distinguished by the relationship between the number of broken bonds and the axial stress.
Engineering tendon and ligament tissues: present developments towards successful clinical products.
Rodrigues, Márcia T; Reis, Rui L; Gomes, Manuela E
2013-09-01
Musculoskeletal diseases are one of the leading causes of disability worldwide. Among them, tendon and ligament injuries represent an important aspect to consider in both athletes and active working people. Tendon and ligament damage is an important cause of joint instability, and progresses into early onset of osteoarthritis, pain, disability and eventually the need for joint replacement surgery. The social and economical burden associated with these medical conditions presents a compelling argument for greater understanding and expanding research on this issue. The particular physiology of tendons and ligaments (avascular, hypocellular and overall structural mechanical features) makes it difficult for currently available treatments to reach a complete and long-term functional repair of the damaged tissue, especially when complete tear occurs. Despite the effort, the treatment modalities for tendon and ligament are suboptimal, which have led to the development of alternative therapies, such as the delivery of growth factors, development of engineered scaffolds or the application of stem cells, which have been approached in this review. Copyright © 2012 John Wiley & Sons, Ltd.
2014-01-01
Introduction High levels of the oncoprotein survivin may be detected in the majority of patients with early rheumatoid arthritis (RA). Survivin is a sensitive predictor of joint damage and persistent disease activity. Survivin-positive patients are often poor responders to antirheumatic and biological treatment. The aim of this study was to investigate the reproducibility of survivin status and its significance for clinical and immunological assessment of RA patients. Methods Survivin levels were measured in 339 patients from the Better Anti-Rheumatic FarmacOTherapy (BARFOT) cohort of early RA at baseline and after 24 months. The association of survivin status with joint damage (total Sharp-van der Heijde score), disease activity (Disease Activity Score based on evaluation of 28 joints (DAS28)), functional disability (Health Assessment Questionnaire (HAQ)), and pain perception (Visual Analogue Scale (VAS)) was calculated in the groups positive and negative for survivin on both occasions, and for the positive-negative and negative-positive groups. Results In 268 patients (79%) the levels of survivin were similar at baseline and after 24 months, 15% converted from survivin-positive to survivin-negative, and 5% from survivin-negative to survivin-positive. A combination of smoking and antibodies against cyclic citrullinated peptides (aCCP) predicted persistently (baseline and 24 months) high levels of survivin (odds ratio 4.36 (95% CI: 2.64 to 7.20), P < 0.001), positive predictive value 0.66 and specificity 0.83). The independent nature of survivin and aCCP was demonstrated by statistical and laboratory analysis. Survivin positivity on both test occasions was associated with the progression of joint damage, significantly higher DAS28 and lower rate of remission at 24 and 60 months compared to negative-negative patients. Survivin status was less associated with changes in HAQ and VAS. Conclusions Survivin is a relevant and reproducible marker of severe RA. Persistently high levels of survivin were associated with smoking and the presence of aCCP and/or RF antibodies and predicted persistent disease activity and joint damage. PMID:24428870
S100-alarmins: potential therapeutic targets for arthritis.
Austermann, Judith; Zenker, Stefanie; Roth, Johannes
2017-07-01
In arthritis, inflammatory processes are triggered by numerous factors that are released from joint tissues, promoting joint destruction and pathological progression. During inflammation, a novel family of pro-inflammatory molecules called alarmins is released, amplifying inflammation and joint damage. Areas covered: With regard to the role of the alarmins S100A8 and S100A9 in the pathogenesis of arthritis, recent advances and the future prospects in terms of therapeutic implications are considered. Expert opinion: There is still an urgent need for novel treatment strategies addressing the local mechanisms of joint inflammation and tissue destruction, offering promising therapeutic alternatives. S100A8 and S100A9, which are the most up-regulated alarmins during arthritis, are endogenous triggers of inflammation, defining these proteins as promising targets for local suppression of arthritis. In murine models, the blockade of S100A8/S100A9 ameliorates inflammatory processes, including arthritis, and there are several lines of evidence that S100-alarmins may already be targeted in therapeutic approaches in man.
Cartilage and bone damage in rheumatoid arthritis
Maśliński, Włodzimierz; Prochorec-Sobieszek, Monika; Nieciecki, Michał; Sudoł-Szopińska, Iwona
2018-01-01
Rheumatoid arthritis (RA), which is a chronic inflammatory disease with a multifactorial aetiology, leads to partial or permanent disability in the majority of patients. It is characterised by persistent synovitis and formation of pannus, i.e. invasive synovial tissue, which ultimately leads to destruction of the cartilage, subchondral bone, and soft tissues of the affected joint. Moreover, inflammatory infiltrates in the subchondral bone, which can lead to inflammatory cysts and later erosions, play an important role in the pathogenesis of RA. These inflammatory infiltrates can be seen in magnetic resonance imaging (MRI) as bone marrow oedema (BME). BME is observed in 68–75% of patients in early stages of RA and is considered a precursor of rapid disease progression. The clinical significance of synovitis and bone marrow oedema as precursors of erosions is well established in daily practice, and synovitis, BME, cysts, hyaline cartilage defects and bone erosions can be detected by ultrasonography (US) and MRI. A less explored subject is the inflammatory and destructive potential of intra- and extra-articular fat tissue, which can also be evaluated in US and MRI. Finally, according to certain hypotheses, hyaline cartilage damage may trigger synovitis and lead to irreversible joint damage, and MRI may be used for preclinical detection of cartilage biochemical abnormalities. This review discusses the pathomechanisms that lead to articular cartilage and bone damage in RA, including erosion precursors such as synovitis and osteitis and panniculitis, as well as the role of imaging techniques employed to detect early cartilage damage and bone erosions. PMID:29853727
NASA Astrophysics Data System (ADS)
Walton, G.; Alejano, L. R.; Arzua, J.; Markley, T.
2018-06-01
A database of post-peak triaxial test results was created for artificially jointed planes introduced in cylindrical compression samples of a Blanco Mera granite. Aside from examining the artificial jointing effect on major rock and rock mass parameters such as stiffness, peak strength and residual strength, other strength parameters related to brittle cracking and post-yield dilatancy were analyzed. Crack initiation and crack damage values for both the intact and artificially jointed samples were determined, and these damage envelopes were found to be notably impacted by the presence of jointing. The data suggest that with increased density of jointing, the samples transition from a combined matrix damage and joint slip yielding mechanism to yield dominated by joint slip. Additionally, post-yield dilation data were analyzed in the context of a mobilized dilation angle model, and the peak dilation angle was found to decrease significantly when there were joints in the samples. These dilatancy results are consistent with hypotheses in the literature on rock mass dilatancy.
GRAPPA 2015 Research and Education Project Reports.
Mease, Philip J; Helliwell, Philip S; Boehncke, Wolf-Henning; Coates, Laura C; FitzGerald, Oliver; Gladman, Dafna D; Deodhar, Atul A; Callis Duffin, Kristina
2016-05-01
At the 2015 annual meeting of the Group for Research and Assessment of Psoriasis and Psoriatic Arthritis (GRAPPA), attendees were presented with brief updates on several ongoing initiatives, including educational projects. Updates were presented on the treatment recommendations project, the development of simple criteria to identify inflammatory musculoskeletal disease, new patient/physician Delphi exercises, and BIODAM (identifying biomarkers that predict progressive structural joint damage). The publication committee also gave a report. Herein we summarize those project updates.
The chondrocyte clock gene Bmal1 controls cartilage homeostasis and integrity.
Dudek, Michal; Gossan, Nicole; Yang, Nan; Im, Hee-Jeong; Ruckshanthi, Jayalath P D; Yoshitane, Hikari; Li, Xin; Jin, Ding; Wang, Ping; Boudiffa, Maya; Bellantuono, Ilaria; Fukada, Yoshitaka; Boot-Handford, Ray P; Meng, Qing-Jun
2016-01-01
Osteoarthritis (OA) is the most prevalent and debilitating joint disease, and there are currently no effective disease-modifying treatments available. Multiple risk factors for OA, such as aging, result in progressive damage and loss of articular cartilage. Autonomous circadian clocks have been identified in mouse cartilage, and environmental disruption of circadian rhythms in mice predisposes animals to OA-like damage. However, the contribution of the cartilage clock mechanisms to the maintenance of tissue homeostasis is still unclear. Here, we have shown that expression of the core clock transcription factor BMAL1 is disrupted in human OA cartilage and in aged mouse cartilage. Furthermore, targeted Bmal1 ablation in mouse chondrocytes abolished their circadian rhythm and caused progressive degeneration of articular cartilage. We determined that BMAL1 directs the circadian expression of many genes implicated in cartilage homeostasis, including those involved in catabolic, anabolic, and apoptotic pathways. Loss of BMAL1 reduced the levels of phosphorylated SMAD2/3 (p-SMAD2/3) and NFATC2 and decreased expression of the major matrix-related genes Sox9, Acan, and Col2a1, but increased p-SMAD1/5 levels. Together, these results define a regulatory mechanism that links chondrocyte BMAL1 to the maintenance and repair of cartilage and suggest that circadian rhythm disruption is a risk factor for joint diseases such as OA.
The chondrocyte clock gene Bmal1 controls cartilage homeostasis and integrity
Dudek, Michal; Gossan, Nicole; Yang, Nan; Im, Hee-Jeong; Ruckshanthi, Jayalath P.D.; Yoshitane, Hikari; Li, Xin; Jin, Ding; Wang, Ping; Boudiffa, Maya; Bellantuono, Ilaria; Fukada, Yoshitaka; Boot-Handford, Ray P.; Meng, Qing-Jun
2015-01-01
Osteoarthritis (OA) is the most prevalent and debilitating joint disease, and there are currently no effective disease-modifying treatments available. Multiple risk factors for OA, such as aging, result in progressive damage and loss of articular cartilage. Autonomous circadian clocks have been identified in mouse cartilage, and environmental disruption of circadian rhythms in mice predisposes animals to OA-like damage. However, the contribution of the cartilage clock mechanisms to the maintenance of tissue homeostasis is still unclear. Here, we have shown that expression of the core clock transcription factor BMAL1 is disrupted in human OA cartilage and in aged mouse cartilage. Furthermore, targeted Bmal1 ablation in mouse chondrocytes abolished their circadian rhythm and caused progressive degeneration of articular cartilage. We determined that BMAL1 directs the circadian expression of many genes implicated in cartilage homeostasis, including those involved in catabolic, anabolic, and apoptotic pathways. Loss of BMAL1 reduced the levels of phosphorylated SMAD2/3 (p-SMAD2/3) and NFATC2 and decreased expression of the major matrix-related genes Sox9, Acan, and Col2a1, but increased p-SMAD1/5 levels. Together, these results define a regulatory mechanism that links chondrocyte BMAL1 to the maintenance and repair of cartilage and suggest that circadian rhythm disruption is a risk factor for joint diseases such as OA. PMID:26657859
NASA Astrophysics Data System (ADS)
Gao, Xiao-Long; Zhang, Lin-Jie; Liu, Jing; Zhang, Jian-Xun
2014-12-01
The present paper studied the evolution of tensile damage in joints welded using laser beam welding (LBW) and gas tungsten arc welding (TIG) under a uniaxial tensile load. The damage evolution in the LBW joints and TIG-welded joints was studied by using digital image correlation (DIC) technology and monitoring changes in Young's modulus during tensile testing. To study the mechanism of void nucleation and growth in the LBW joints and TIG-welded joints, test specimens with various amounts of plastic deformation were analyzed using a scanning electron microscope (SEM). Compared with TIG-welded joints, LBW-welded joints have a finer microstructure and higher microhardness in the fusion zone. The SEM analysis and DIC test results indicated that the critical strain of void nucleation was greater in the LBW-welded joints than in the TIG-welded joints, while the growth rate of voids was lower in the LBW-welded joints than in the TIG-welded joints. Thus, the damage ratio in the LBW joints was lower than that in the TIG-welded joints during tensile testing. This can be due to the coarser martensitic α' and the application of TC-1 welding rods in the TIG-welded joint.
Flaw Tolerance In Lap Shear Brazed Joints. Part 2
NASA Technical Reports Server (NTRS)
Wang, Len; Flom, Yury
2003-01-01
This paper presents results of the second part of an on-going effort to gain better understanding of defect tolerance in braze joints. In the first part of this three-part series, we mechanically tested and modeled the strength of the lap joints as a function of the overlap distance. A failure criterion was established based on the zone damage theory, which predicts the dependence of the lap joint shear strength on the overlap distance, based on the critical size of a finite damage zone or an overloaded region in the joint. In this second part of the study, we experimentally verified the applicability of the damage zone criterion on prediction of the shear strength of the lap joint and introduced controlled flaws into the lap joints. The purpose of the study was to evaluate the lap joint strength as a function of flaw size and its location through mechanical testing and nonlinear finite element analysis (FEA) employing damage zone criterion for definition of failure. The results obtained from the second part of the investigation confirmed that the failure of the ductile lap shear brazed joints occurs when the damage zone reaches approximately 10% of the overlap width. The same failure criterion was applicable to the lap joints containing flaws.
Osteoarthritis year in review 2014: mechanics--basic and clinical studies in osteoarthritis.
Moyer, R F; Ratneswaran, A; Beier, F; Birmingham, T B
2014-12-01
The purpose of this review was to highlight recent research in mechanics and osteoarthritis (OA) by summarizing results from selected studies spanning basic and clinical research methods. Databases were searched from January 2013 through to March 2014. Working in pairs, reviewers selected 67 studies categorized into four themes--mechanobiology, ambulatory mechanics, biomechanical interventions and mechanical risk factors. Novel developments in mechanobiology included the identification of cell signaling pathways that mediated cellular responses to loading of articular cartilage. Studies in ambulatory mechanics included an increased focus on instrumented knee implants and progress in computational models, both emphasizing the importance of muscular contributions to load. Several proposed biomechanical interventions (e.g., shoe insoles and knee braces) produced variable changes in external knee joint moments during walking, while meta-analysis of randomized clinical trials did not support the use of lateral wedge insoles for decreasing pain. Results from high quality randomized trials suggested diet with or without exercise decreased indicators of knee joint load during walking, whereas similar effects from exercise alone were not detected with the measures used. Data from longitudinal cohorts suggested mechanical alignment was a risk factor for incidence and progression of OA, with the mechanism involving damage to the meniscus. In combination, the basic and clinical studies highlight the importance of considering multiple contributors to joint loading that can evoke both protective and damaging responses. Although challenges clearly exist, future studies should strive to integrate basic and clinical research methods to gain a greater understanding of the interactions among mechanical factors in OA and to develop improved preventive and therapeutic strategies. Copyright © 2014 Osteoarthritis Research Society International. Published by Elsevier Ltd. All rights reserved.
Modeling thermal and irradiation-induced swelling effects on the integrity of Ti3SiC2/SiC joints
NASA Astrophysics Data System (ADS)
Nguyen, Ba Nghiep; Henager, Charles H.; Kurtz, Richard J.
2017-11-01
Previously, results for CVD-SiC joined by a solid state displacement reaction to form a dual-phase SiC/MAX phase joint subsequently irradiated at 800 °C to 5 dpa indicated some cracking in the joint. This paper elucidates the cracking origin by developing a model that accounts for differential thermal expansion and irradiation-induced swelling between the substrate and joint materials by using a continuum damage mechanics approach with support from micromechanical modeling. Damage accumulation in joined specimens irradiated at four temperatures (300 °C, 400 °C, 500 °C and 800 °C) is analyzed. We assume the experimental irradiation dose is sufficient to cause saturation swelling in SiC. The analyses indicate that the SiC/MAX joint survives irradiation-induced swelling at all the irradiation temperatures considered. The joint experiences only minor damage when heated to and irradiated at 800 °C as well as cooling to room temperature. The prediction agrees with the experimental findings available for this case. However, the joint heated to 300 °C suffers severe damage during irradiation-induced swelling at this temperature, and additional damage after cooling to room temperature. Irradiation at 400 °C and subsequent cooling to room temperature produced similar damage to the irradiation 300 °C case, but to a lesser extent. The joint heated to 500 °C and irradiated at this temperature suffered only very minor damage, but further moderate damage occurred after cooling to room temperature.
Modeling thermal and irradiation-induced swelling effects on the integrity of Ti 3SiC 2/SiC joints
DOE Office of Scientific and Technical Information (OSTI.GOV)
Nguyen, Ba Nghiep; Henager, Charles H.; Kurtz, Richard J.
Previously, results for CVD-SiC joined by a solid state displacement reaction to form a dual-phase SiC/MAX phase joint subsequently irradiated at 800 °C to 5 dpa indicated some cracking in the joint. Here, this paper elucidates the cracking origin by developing a model that accounts for differential thermal expansion and irradiation-induced swelling between the substrate and joint materials by using a continuum damage mechanics approach with support from micromechanical modeling. Damage accumulation in joined specimens irradiated at four temperatures (300 °C, 400 °C, 500 °C and 800 °C) is analyzed. We assume the experimental irradiation dose is sufficient to causemore » saturation swelling in SiC. The analyses indicate that the SiC/MAX joint survives irradiation-induced swelling at all the irradiation temperatures considered. The joint experiences only minor damage when heated to and irradiated at 800 °C as well as cooling to room temperature. The prediction agrees with the experimental findings available for this case. However, the joint heated to 300 °C suffers severe damage during irradiation-induced swelling at this temperature, and additional damage after cooling to room temperature. Irradiation at 400 °C and subsequent cooling to room temperature produced similar damage to the irradiation 300 °C case, but to a lesser extent. Finally, the joint heated to 500 °C and irradiated at this temperature suffered only very minor damage, but further moderate damage occurred after cooling to room temperature.« less
Modeling thermal and irradiation-induced swelling effects on the integrity of Ti 3SiC 2/SiC joints
Nguyen, Ba Nghiep; Henager, Charles H.; Kurtz, Richard J.
2017-09-08
Previously, results for CVD-SiC joined by a solid state displacement reaction to form a dual-phase SiC/MAX phase joint subsequently irradiated at 800 °C to 5 dpa indicated some cracking in the joint. Here, this paper elucidates the cracking origin by developing a model that accounts for differential thermal expansion and irradiation-induced swelling between the substrate and joint materials by using a continuum damage mechanics approach with support from micromechanical modeling. Damage accumulation in joined specimens irradiated at four temperatures (300 °C, 400 °C, 500 °C and 800 °C) is analyzed. We assume the experimental irradiation dose is sufficient to causemore » saturation swelling in SiC. The analyses indicate that the SiC/MAX joint survives irradiation-induced swelling at all the irradiation temperatures considered. The joint experiences only minor damage when heated to and irradiated at 800 °C as well as cooling to room temperature. The prediction agrees with the experimental findings available for this case. However, the joint heated to 300 °C suffers severe damage during irradiation-induced swelling at this temperature, and additional damage after cooling to room temperature. Irradiation at 400 °C and subsequent cooling to room temperature produced similar damage to the irradiation 300 °C case, but to a lesser extent. Finally, the joint heated to 500 °C and irradiated at this temperature suffered only very minor damage, but further moderate damage occurred after cooling to room temperature.« less
Recent Advances in Tissue Engineering Strategies for the Treatment of Joint Damage.
Stephenson, Makeda K; Farris, Ashley L; Grayson, Warren L
2017-08-01
While the clinical potential of tissue engineering for treating joint damage has yet to be realized, research and commercialization efforts in the field are geared towards overcoming major obstacles to clinical translation, as well as towards achieving engineered grafts that recapitulate the unique structures, function, and physiology of the joint. In this review, we describe recent advances in technologies aimed at obtaining biomaterials, stem cells, and bioreactors that will enable the development of effective tissue-engineered treatments for repairing joint damage. 3D printing of scaffolds is aimed at improving the mechanical structure and microenvironment necessary for bone regeneration within a damaged joint. Advances in our understanding of stem cell biology and cell manufacturing processes are informing translational strategies for the therapeutic use of allogeneic and autologous cells. Finally, bioreactors used in combination with cells and biomaterials are promising strategies for generating large tissue grafts for repairing damaged tissues in pre-clinical models. Together, these advances along with ongoing research directions are making tissue engineering increasingly viable for the treatment of joint damage.
van der Heijde, Désirée; Landewé, Robert B; Mease, Philip J; McInnes, Iain B; Conaghan, Philip G; Pricop, Luminita; Ligozio, Greg; Richards, Hanno B; Mpofu, Shephard
2016-08-01
To assess whether secukinumab treatment in patients with active psoriatic arthritis (PsA) is associated with sustained inhibition of radiographic progression. In this phase III, double-blind, placebo-controlled study, 606 patients with PsA were randomized to receive intravenous (IV) secukinumab at a dose of 10 mg/kg (weeks 0, 2, 4) followed by subcutaneous secukinumab at a dose of 150 mg or 75 mg (the IV→150 mg and IV→75 mg groups, respectively) or placebo. Patients were stratified according to prior anti-tumor necrosis factor (anti-TNF) exposure (71% were anti-TNF naive). At week 16, placebo-treated patients who had at least a 20% reduction in the tender and swollen joint counts (responders) continued to receive placebo until week 24; nonresponders were re-randomized to receive secukinumab at a dose of 150 mg or 75 mg. The modified total Sharp/van der Heijde score (SHS) was determined at baseline, week 16 or 24, and week 52. In the overall population, radiographic progression was inhibited through 52 weeks; efficacy was demonstrated for both erosion and joint space narrowing scores and in patients who switched from placebo to secukinumab at week 24. Subgroup analyses showed that secukinumab reduced radiographic progression at week 24, regardless of previous anti-TNF treatment. Among anti-TNF-naive patients, the mean changes from baseline to week 24 in the modified total SHS were 0.05 in the pooled secukinumab group and 0.57 in the placebo group; among patients with an inadequate response or intolerance to anti-TNF treatment, the mean changes were 0.16 and 0.58, respectively. Anti-TNF-naive patients showed negligible progression through week 52. Inhibition of structural damage was observed through week 52 irrespective of concomitant methotrexate use. A high proportion of patients receiving secukinumab showed no progression (change in SHS of ≤ 0.5) from baseline to week 24 (82.3% of the IV→150 mg group and 92.3% of the IV→75 mg group) and from week 24 to week 52 (85.7% of the IV→150 mg group and 85.8% of the IV→75 mg group). Secukinumab inhibited radiographic progression over 52 weeks of treatment in patients with active PsA. © 2016 The Authors. Arthritis & Rheumatology published by Wiley Periodicals, Inc. on behalf of the American College of Rheumatology.
Martin, James A.; Anderson, Donald D.; Goetz, Jessica E.; Fredericks, Douglas; Pedersen, Douglas R.; Ayati, Bruce P.; Marsh, J. Lawrence; Buckwalter, Joseph A.
2016-01-01
Two categories of joint overloading cause post-traumatic osteoarthritis (PTOA): single acute traumatic loads/impactions and repetitive overloading due to incongruity/instability. We developed and refined three classes of complementary models to define relationships between joint overloading and progressive cartilage loss across the spectrum of acute injuries and chronic joint abnormalities: explant and whole joint models that allow probing of cellular responses to mechanical injury and contact stresses, animal models that enable study of PTOA pathways in living joints and pre-clinical testing of treatments, and patient-specific computational models that define the overloading that causes OA in humans. We coordinated methodologies across models so that results from each informed the others, maximizing the benefit of this complementary approach. We are incorporating results from these investigations into biomathematical models to provide predictions of PTOA risk and guide treatment. Each approach has limitations, but each provides opportunities to elucidate PTOA pathogenesis. Taken together, they help define levels of joint overloading that cause cartilage destruction, show that both forms of overloading can act through the same biologic pathways, and create a framework for initiating clinical interventions that decrease PTOA risk. PMID:27509320
Lamb wave propagation in Z-pin reinforced co-cured composite pi-joints
NASA Astrophysics Data System (ADS)
Swenson, Eric D.; Soni, Som R.; Kapoor, Hitesh
2010-04-01
This paper presents an initial study on Lamb wave propagation characteristics in z-pin reinforced, co-cured composite pi-joints for the purposes of structural health monitoring (SHM). Pi-joint test articles were designed and created to replicate a co-cured, all composite skin-spar joint found within a typical aircraft wing structure. Because pi-joints exhibit various complex damage modes, formal studies are required if SHM systems are to be developed to monitor these types of joints for potential damage. Experiments were conducted on a undamaged (healthy) and damaged test articles where Lamb waves were excited using one lead zirconate titanate (PZT) transducer. A three-dimensional (3D) scanning laser Doppler vibrometer (LDV) was used to collect high-density scans of both the in-plane and out-of-plane velocity measurements. In the damaged test article, where delamination, matrix cracking, and fiber breakage can clearly be seen, changes in both the fundamental antisymmetric A0 and symmetric S0 Lamb wave modes are apparent. In both test articles, the effects of narrow geometry, discontinuity due to the attachment of the web, and thickness has detectable effects on Lamb wave propagation. From the comparisons between Lamb waves propagating through the undamaged and damaged test articles, it is clear that damage can be detected using Lamb waves in z-pin reinforced, co-cured composite pi-joints for this case of extensive damage.
NASA Astrophysics Data System (ADS)
Stolz, Martin; Gottardi, Riccardo; Raiteri, Roberto; Miot, Sylvie; Martin, Ivan; Imer, Raphaël; Staufer, Urs; Raducanu, Aurelia; Düggelin, Marcel; Baschong, Werner; Daniels, A. U.; Friederich, Niklaus F.; Aszodi, Attila; Aebi, Ueli
2009-03-01
The pathological changes in osteoarthritis-a degenerative joint disease prevalent among older people-start at the molecular scale and spread to the higher levels of the architecture of articular cartilage to cause progressive and irreversible structural and functional damage. At present, there are no treatments to cure or attenuate the degradation of cartilage. Early detection and the ability to monitor the progression of osteoarthritis are therefore important for developing effective therapies. Here, we show that indentation-type atomic force microscopy can monitor age-related morphological and biomechanical changes in the hips of normal and osteoarthritic mice. Early damage in the cartilage of osteoarthritic patients undergoing hip or knee replacements could similarly be detected using this method. Changes due to aging and osteoarthritis are clearly depicted at the nanometre scale well before morphological changes can be observed using current diagnostic methods. Indentation-type atomic force microscopy may potentially be developed into a minimally invasive arthroscopic tool to diagnose the early onset of osteoarthritis in situ.
NASA Astrophysics Data System (ADS)
Stockdale, G.; Milani, G.
2017-11-01
In seismic regions, the retrofitting of masonry structures subjected to differential foundation settlements is of the upmost importance. This practice however poses significant challenges, most notably in the consideration of historical monuments where the integrity of the original structure must be weighted alongside public safety. Fiber reinforced polymers (FRPs), when appropriately applied, provide the potential to balance this duality of heritage preservation and modern safety. Using an advanced FE point of view, this work studies the seismic response of a progressive reinforcement strategy aimed at strengthening and controlling the failure mechanism for masonry arches that exist in a damaged state induced through a differential abutment settlement. A heterogeneous FE approach of a semi-circular block and mortar arch on continuously spreading supports is examined. In this model hinge formation is obtained by assigning a damage plasticity behavior to the mortar joints. Strategically placed FRPs, designed through the utilization of the Italian CNR recommendations for externally bonded FRP systems, are applied through the Abaqus birth and death approach and introduced to the spreading support model after settlement. Finally, the structural behavior of the reinforced and unreinforced models are examined for a seismic response.
1990-06-30
since the projected ion range is of the order of lattice constants. Thus, we have extended our thermal-dopant incorporation model and have developed...bombardment results in residual lattice damage, which degrades electrical and optical properties. Obviously, at sufficiently high acceleration energies...understand the details of collisional lattice dynamics and ion-induced defect for- mation and annihilation. In addition, the simulations are providing, for
Survey views of the Mir space station taken after undocking
1997-10-20
STS086-710-007 (25 Sept - 6 Oct 1997) --- A 70mm view of Russia?s Mir Space Station backdropped against a cloud-covered Earth was photographed during a fly-around by the Space Shuttle Atlantis following the conclusion of joint docking activities between the Mir-24 and STS-86 crews. One of the solar array panels on the Spektr Module shows damage incurred during the impact of a Russian unmanned Progress re-supply ship with collided with the space station on June 25, 1997.
Raman spectroscopy of synovial fluid as a tool for diagnosing osteoarthritis
NASA Astrophysics Data System (ADS)
Esmonde-White, Karen A.; Mandair, Gurjit S.; Raaii, Farhang; Jacobson, Jon A.; Miller, Bruce S.; Urquhart, Andrew G.; Roessler, Blake J.; Morris, Michael D.
2009-05-01
For many years, viscosity has been the primary method used by researchers in rheumatology to assess the physiochemical properties of synovial fluid in both normal and osteoarthritic patients. However, progress has been limited by the lack of methods that provide multiple layers of information, use small sample volumes, and are rapid. Raman spectroscopy was used to assess the biochemical composition of synovial fluid collected from 40 patients with clinical evidence of knee osteoarthritis (OA) at the time of elective surgical treatment. Severity of knee osteoarthritis was assessed by a radiologist using Kellgren/Lawrence (K/L) scores from knee joint x rays, while light microscopy and Raman spectroscopy were used to examine synovial fluid (SF) aspirates (2 to 10 μL), deposited on fused silica slides. We show that Raman bands used to describe protein secondary structure and content can be used to detect changes in synovial fluid from osteoarthritic patients. Several Raman band intensity ratios increased significantly in spectra collected from synovial fluid in patients with radiological evidence of moderate-to-severe osteoarthritis damage. These ratios can be used to provide a ``yes/no'' damage assessment. These studies provide evidence that Raman spectroscopy would be a suitable candidate in the evaluation of joint damage in knee osteoarthritis patients.
Camps, Montserrat; Rückle, Thomas; Ji, Hong; Ardissone, Vittoria; Rintelen, Felix; Shaw, Jeffrey; Ferrandi, Chiara; Chabert, Christian; Gillieron, Corine; Françon, Bernard; Martin, Thierry; Gretener, Denise; Perrin, Dominique; Leroy, Didier; Vitte, Pierre-Alain; Hirsch, Emilio; Wymann, Matthias P; Cirillo, Rocco; Schwarz, Matthias K; Rommel, Christian
2005-09-01
Phosphoinositide 3-kinases (PI3K) have long been considered promising drug targets for the treatment of inflammatory and autoimmune disorders as well as cancer and cardiovascular diseases. But the lack of specificity, isoform selectivity and poor biopharmaceutical profile of PI3K inhibitors have so far hampered rigorous disease-relevant target validation. Here we describe the identification and development of specific, selective and orally active small-molecule inhibitors of PI3Kgamma (encoded by Pik3cg). We show that Pik3cg(-/-) mice are largely protected in mouse models of rheumatoid arthritis; this protection correlates with defective neutrophil migration, further validating PI3Kgamma as a therapeutic target. We also describe that oral treatment with a PI3Kgamma inhibitor suppresses the progression of joint inflammation and damage in two distinct mouse models of rheumatoid arthritis, reproducing the protective effects shown by Pik3cg(-/-) mice. Our results identify selective PI3Kgamma inhibitors as potential therapeutic molecules for the treatment of chronic inflammatory disorders such as rheumatoid arthritis.
Li, Rong; Zhang, Yujuan; Zheng, Xiufen; Peng, Shanshan; Yuan, Keng; Zhang, Xusheng; Min, Weiping
2017-01-01
Rheumatoid arthritis (RA) is an autoimmune disease characterized by progressive immune-mediated joint deterioration. Current treatments are not antigen specific and are associated with various adverse. We have previously demonstrated that tolerogenic dendritic cells (Tol-DC) are potent antigen-specific immune regulators, which hold great promise in immunotherapy of autoimmune diseases. In this study, we aimed to develop new immunotherapy by combining Tol-DC and mesenchymal stem cells (MSC). We demonstrated that RelB gene silencing resulted in generation of Tol-DC that suppressed T cell responses and selectively promoted Treg generation. The combination of MSC synergized the tolerogenic capacity of Tol-DC in inhibition of T cell responses. In murine collagen-induced arthritis (CIA) model, we demonstrated that progression of arthritis was inhibited with administration of RelB gene-silenced Tol-DC or MSC. This therapeutic effect was remarkably enhanced with concurrent treatment of combination Tol-DC and MSC as demonstrated by improved clinical symptoms, decreased clinical scores and attenuated joint damage. These therapeutic effects were associated with suppression of CII-specific T cell responses, polarization of Th and inhibition of proinflammatory cytokines, and reduced cartilage degeneration. This study for the first time demonstrates a new approach to treat autoimmune inflammatory joint disease with concurrent treatment of RelB gene-silenced Tol-DC and MSC. PMID:28230210
Crema, M D; Watts, G J; Guermazi, A; Kim, Y-J; Kijowski, R; Roemer, F W
2017-01-01
To review and discuss the role of magnetic resonance imaging (MRI) in the context of hip osteoarthritis (OA) research. The content of this narrative review, based on an extensive PubMed database research including English literature only, describes the advances in MRI of the hip joint and its potential usefulness in hip OA research, reviews the relevance of different MRI features in regard to symptomatic and structural progression in hip OA, and gives an outlook regarding future use of MRI in hip OA research endeavors. Recent technical advances have helped to overcome many of the past difficulties related to MRI assessment of hip OA. MRI-based morphologic scoring systems allow for detailed assessment of several hip joint tissues and, in combination with the recent advances in MRI, may increase reproducibility and sensitivity to change. Compositional MRI techniques may add to our understanding of disease onset and progression. Knowledge about imaging pitfalls and anatomical variants is crucial to avoid misinterpretation. In comparison to research on knee OA, the associations between MRI features and the incidence and progression of disease as well as with clinical symptoms have been little explored. Anatomic alterations of the hip joint as seen in femoro-acetabular impingement (FAI) seem to play a role in the onset and progression of structural damage. With the technical advances occurring in recent years, MRI may play a major role in investigating the natural history of hip OA and provide an improved method for assessment of the efficacy of new therapeutic approaches. Copyright © 2016 Osteoarthritis Research Society International. Published by Elsevier Ltd. All rights reserved.
Bonitsky, Craig M; McGann, Megan E; Selep, Michael J; Ovaert, Timothy C; Trippel, Stephen B; Wagner, Diane R
2017-03-01
High energy trauma to cartilage causes surface fissures and microstructural damage, but the degree to which this damage renders the tissue more susceptible to wear and contributes to the progression of post-traumatic osteoarthritis (PTOA) is unknown. Additionally, no treatments are currently available to strengthen cartilage after joint trauma and to protect the tissue from subsequent degradation and wear. The purposes of this study were to investigate the role of mechanical damage in the degradation and wear of cartilage, to evaluate the effects of impact and subsequent genipin crosslinking on the changes in the viscoelastic parameters of articular cartilage, and to test the hypothesis that genipin crosslinking is an effective treatment to enhance the resistance to biochemical degradation and mechanical wear. Results demonstrate that cartilage stiffness decreases after impact loading, likely due to the formation of fissures and microarchitectural damage, and is partially or fully restored by crosslinking. The wear resistance of impacted articular cartilage was diminished compared to undamaged cartilage, suggesting that mechanical damage that is directly induced by the impact may contribute to the progression of PTOA. However, the decrease in wear resistance was completely reversed by the crosslinking treatments. Additionally, the crosslinking treatments improved the resistance to collagenase digestion at the impact-damaged articular surface. These results highlight the potential therapeutic value of collagen crosslinking via genipin in the prevention of cartilage degeneration after traumatic injury. © 2016 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 35:558-565, 2017. © 2016 Orthopaedic Research Society. Published by Wiley Periodicals, Inc.
Axelsen, Mette Bjørndal; Eshed, Iris; Duer-Jensen, Anne; Møller, Jakob M; Pedersen, Susanne Juhl; Østergaard, Mikkel
2014-05-01
The aim of this study was to investigate the ability of whole-body MRI (WBMRI) to visualize inflammation [synovitis, bone marrow oedema (BME) and enthesitis] and structural damage in patients with RA. The 3T WBMR images were acquired in a head-to-toe scan in 20 patients with RA and at least one swollen or tender joint. Short Tau Inversion Recovery and pre- and post-contrast T1-weighted images were evaluated for readability and the presence/absence of inflammation (synovitis, BME and enthesitis) and structural damage (erosions and fat infiltrations) in 76 peripheral joints, 30 entheseal sites and in the spine. The readability was >70% for all individual joints, except for the most peripheral joints of the hands and feet. Synovitis was most frequent in the wrist, first tarsometatarsal, first CMC joints and glenohumeral joints (67-61%); BME in the wrist, CMC, acromioclavicular and glenohumeral joints (45-35%) and erosions in the wrist, MTP and CMC joints (19-16%). Enthesitis at ≥ 1 site was registered in 16 patients. BME was frequently seen in the cervical (20%) but not the thoracic and lumbar spine, while fat infiltrations and erosions were rare. The intrareader agreement was high (85-100%) for all pathologies. The agreement between WBMRI and clinical findings was low. Peripheral and axial inflammation and structural damage at joints and entheses was frequently identified by WBMRI, and more frequently than by clinical examination. WBMRI is a promising tool for evaluation of the total inflammatory load of inflammation (an MRI joint count) and structural damage in RA patients.
Fatigue damage behavior of a surface-mount electronic package under different cyclic applied loads
NASA Astrophysics Data System (ADS)
Ren, Huai-Hui; Wang, Xi-Shu
2014-04-01
This paper studies and compares the effects of pull-pull and 3-point bending cyclic loadings on the mechanical fatigue damage behaviors of a solder joint in a surface-mount electronic package. The comparisons are based on experimental investigations using scanning electron microscopy (SEM) in-situ technology and nonlinear finite element modeling, respectively. The compared results indicate that there are different threshold levels of plastic strain for the initial damage of solder joints under two cyclic applied loads; meanwhile, fatigue crack initiation occurs at different locations, and the accumulation of equivalent plastic strain determines the trend and direction of fatigue crack propagation. In addition, simulation results of the fatigue damage process of solder joints considering a constitutive model of damage initiation criteria for ductile materials and damage evolution based on accumulating inelastic hysteresis energy are identical to the experimental results. The actual fatigue life of the solder joint is almost the same and demonstrates that the FE modeling used in this study can provide an accurate prediction of solder joint fatigue failure.
Segmentation of hand radiographs using fast marching methods
NASA Astrophysics Data System (ADS)
Chen, Hong; Novak, Carol L.
2006-03-01
Rheumatoid Arthritis is one of the most common chronic diseases. Joint space width in hand radiographs is evaluated to assess joint damage in order to monitor progression of disease and response to treatment. Manual measurement of joint space width is time-consuming and highly prone to inter- and intra-observer variation. We propose a method for automatic extraction of finger bone boundaries using fast marching methods for quantitative evaluation of joint space width. The proposed algorithm includes two stages: location of hand joints followed by extraction of bone boundaries. By setting the propagation speed of the wave front as a function of image intensity values, the fast marching algorithm extracts the skeleton of the hands, in which each branch corresponds to a finger. The finger joint locations are then determined by using the image gradients along the skeletal branches. In order to extract bone boundaries at joints, the gradient magnitudes are utilized for setting the propagation speed, and the gradient phases are used for discriminating the boundaries of adjacent bones. The bone boundaries are detected by searching for the fastest paths from one side of each joint to the other side. Finally, joint space width is computed based on the extracted upper and lower bone boundaries. The algorithm was evaluated on a test set of 8 two-hand radiographs, including images from healthy patients and from patients suffering from arthritis, gout and psoriasis. Using our method, 97% of 208 joints were accurately located and 89% of 416 bone boundaries were correctly extracted.
Composite skid landing gear design investigation
NASA Astrophysics Data System (ADS)
Shrotri, Kshitij
A Composite Skid Landing Gear Design investigation has been conducted. Limit Drop Test as per Federal Aviation Regulations (FAR) Part 27.725 and Crash test as per MIL STD 1290A (AV) were simulated using ABAQUS to evaluate performance of multiple composite fiber-matrix systems. Load factor developed during multiple landing scenarios and energy dissipated during crash were computed. Strength and stiffness based constraints were imposed. Tsai-Wu and LaRC04 physics based failure criteria were used for limit loads. Hashin's damage initiation criteria with Davila-Camanho's energy based damage evolution damage evolution law were used for crash. Initial results indicate that all single-composite skid landing gear may no be feasible due to strength concerns in the cross member bends. Hybridization of multiple composites with elasto-plastic aluminum 7075 showed proof of strength under limit loads. Laminate tailoring for load factor optimization under limit loads was done by parameterization of a single variable fiber orientation angle for multiple laminate families. Tsai-Wu failure criterion was used to impose strength contraints. A quasi-isotropic N = 4 (pi/4) 48 ply IM7/8552 laminate was shown to be the optimal solution with a load failure will be initiated as matrix cracking under compression and fiber kinking under in-plane shear and longitudinal compression. All failures under limit loads being reported in the metal-composite hybrid joint region, the joint was simulated by adhesive bonding and filament winding, separately. Simply adhesive bonding the metal and composite regions does not meet strength requirements. A filament wound metal-composite joint shows proof of strength. Filament wound bolted metal-composite joint shows proof of strength. Filament wound composite bolted to metal cross member radii is the final joining methodology. Finally, crash analysis was conducted as per requirements from MIL STD 1290A (AV). Crash at 42 ft/sec with 1 design gross weight (DGW) lift was simulated using ABAQUS. Plastic and friction energy dissipation in the reference aluminum skid landing gear was compared with plastic, friction and damage energy dissipation in the hybrid composite design. Damage in composites was modeled as progressive damage with Hashin's damage initiation criteria and an energy based damage evolution law. The latter meets requirements of aircraft kinetic energy dissipation up to 20 ft/sec (67.6 kJ) as per MIL STD 1290A (AV). Weight saving possibility of up to 49% over conventional metal skid landing gear is reported. The final design recommended includes Ke49/PEEK skids, 48 ply IM7/8552 (or IM7/PEEK) cross member tapered beams and Al 7075 cross member bend radii, the latter bolted to the filament wound composite-metal tapered beam. Concerns in composite skid landing gear designs, testing requirements and future opportunities are addressed.
Nondestructive Evaluation of Adhesively Bonded Joints
NASA Technical Reports Server (NTRS)
Nayeb-Hashemi, Hamid; Rossettos, J. N.
1997-01-01
The final report consists of 5 published papers in referred journals and a technical letter to the technical monitor. These papers include the following: (1) Comparison of the effects of debonds and voids in adhesive; (2) On the peak shear stresses in adhesive joints with voids; (3) Nondestructive evaluation of adhesively bonded joints by acousto-ultrasonic technique and acoustic emission; (4) Multiaxial fatigue life evaluation of tubular adhesively bonded joints; (5) Theoretical and experimental evaluation of the bond strength under peeling loads. The letter outlines the progress of the research. Also included is preliminary information on the study of nondestructive evaluation of composite materials subjected to localized heat damage. The investigators studied the effects of localized heat on unidirectional fiber glass epoxy composite panels. Specimens of the fiber glass epoxy composites were subjected to 400 C heat for varying lengths of time. The specimens were subjected to nondestructive tests. The specimens were then pulled to their failure and acoustic emission of these specimens were measured. The analysis of the data was continuing as of the writing of the letter, and includes a finite element stress analysis of the problem.
Biomarkers for rheumatoid and psoriatic arthritis.
Verheul, M K; Fearon, U; Trouw, L A; Veale, D J
2015-11-01
Rheumatic diseases, such as rheumatoid and psoriatic arthritis are systemic inflammatory conditions characterized by a chronic form of arthritis, often leading to irreversible joint damage. Early treatment for patients with rheumatic diseases is required to reduce or prevent joint injury. However, early diagnosis can be difficult and currently it is not possible to predict which individual patient will develop progressive erosive disease or who may benefit from a specific treatment according to their clinical features at presentation. Biomarkers are therefore required to enable earlier diagnosis and predict prognosis in both rheumatoid arthritis and psoriatic arthritis. In this review we will examine the evidence and current status of established and experimental biomarkers in rheumatoid and psoriatic arthritis for three important purposes; disease diagnosis, prognosis and prediction of response to therapy. Copyright © 2015 Elsevier Inc. All rights reserved.
A dual-phase microstructural approach to damage and fracture of Ti3SiC2/SiC joints
NASA Astrophysics Data System (ADS)
Nguyen, Ba Nghiep; Henager, Charles H.; Kurtz, Richard J.
2018-02-01
The microcracking mechanisms responsible for Ti3SiC2/SiC joint damage observed at the macroscopic scale after neutron irradiation experiments are investigated in detail. A dual-phase microstructural approach to damage and fracture of Ti3SiC2/SiC joints is developed that uses a finely discretized two-phase domain based on a digital image of an actual microstructure involving embedded Ti3SiC2 and SiC phases. The behaviors of SiC and Ti3SiC2 in the domain are described by the continuum damage mechanics (CDM) model reported in Nguyen et al., J. Nucl. Mater., 2017, 495:504-515. This CDM model describes microcracking damage in brittle ceramics caused by thermomechanical loading and irradiation-induced swelling. The dual-phase microstructural model is applied to predict the microcracking mechanisms occurring in a typical Ti3SiC2/SiC joint subjected to heating to 800 °C followed by irradiation-induced swelling at this temperature and cooling to room temperature after the applied swelling has reached the maximum swelling levels observed in the experiments for SiC and Ti3SiC2. The model predicts minor damage of the joint after heating but significant microcracking in the SiC phase and along the boundaries between SiC and Ti3SiC2 as well as along the bonding joint during irradiation-induced swelling and cooling to room temperature. These predictions qualitatively agree with the limited experimental observations of joint damage at this irradiation temperature.
Bone effects of biologic drugs in rheumatoid arthritis.
Corrado, Addolorata; Neve, Anna; Maruotti, Nicola; Cantatore, Francesco Paolo
2013-01-01
Biologic agents used in the treatment of rheumatoid arthritis (RA) are able to reduce both disease activity and radiographic progression of joint disease. These drugs are directed against several proinflammatory cytokines (TNF α , IL-6, and IL-1) which are involved both in the pathogenesis of chronic inflammation and progression of joint structural damage and in systemic and local bone loss typically observed in RA. However, the role of biologic drugs in preventing bone loss in clinical practice has not yet clearly assessed. Many clinical studies showed a trend to a positive effect of biologic agents in preventing systemic bone loss observed in RA. Although the suppression of inflammation is the main goal in the treatment of RA and the anti-inflammatory effects of biologic drugs exert a positive effect on bone metabolism, the exact relationship between the prevention of bone loss and control of inflammation has not been clearly established, and if the available biologic drugs against TNF α , IL-1, and IL-6 can exert their effect on systemic and local bone loss also through a direct mechanism on bone cell metabolism is still to be clearly defined.
[Progress in diagnosis and treatment of distal tibiofibular syndesmosis injury].
Liu, Xiang; Yu, Guangrong
2012-05-01
To review the progress in the diagnosis and treatment of distal tibiofibular syndesmosis injury. Different kinds of documents were widely collected, current developments of the diagnosis and treatment of distal tibiofibular syndesmosis injury were summarized. The disease history (damage mechanism), clinical examination, and imaging examination (X-ray, CT scan, and MRI) can assist the diagnosis of distal tibiofibular syndesmosis injury. Patients with unstable distal tibiofibular syndesmosis injury needs active surgery treatment, and the principle is anatomical reduction and fixation so as to avoid the instability of the ankle joint, long-term chronic pain, and traumatic arthritis. The diagnosis of distal tibiofibular syndesmosis injury is still lack of specific quantitative parameters, so clinical study for large sample is needed to explicit the effectiveness.
Genetic epidemiology of hip and knee osteoarthritis.
Valdes, Ana M; Spector, Tim D
2011-01-01
Osteoarthritis (OA) is the most common cause of arthritis and represents an enormous healthcare burden in industrialized societies. Current therapeutic approaches for OA are limited and are insufficient to prevent the initiation and progression of the disease. Genetic studies of patients with OA can help to unravel the molecular mechanisms responsible for specific disease manifestations, including joint damage, nociception and chronic pain. Indeed, these studies have identified molecules, such as growth/differentiation factor 5, involved in signaling cascades that are important for the pathology of joint components. Genome-wide association studies have uncovered a likely role in OA for the genes encoding structural extracellular matrix components (such as DVWA) and molecules involved in prostaglandin metabolism (such as DQB1 and BTNL2). A ∼300 kilobase region in chromosome 7q22 is also associated with OA susceptibility. Finally, the identification of individuals at a high risk of OA and of total joint arthroplasty failure might be facilitated by the use of combinations of genetic markers, allowing for the application of preventive and disease-management strategies.
Buder-Bakhaya, Kristina; Benesova, Karolina; Schulz, Carsten; Anwar, Hoda; Dimitrakopoulou-Strauss, Antonia; Weber, Tim F; Enk, Alexander; Lorenz, Hanns-Martin; Hassel, Jessica C
2018-02-01
PD-1 antibodies (PD1ab) are increasingly used in metastatic melanoma and other malignancies. Arthralgia is an underestimated side effect of PD-1 antibody treatment with unknown cause. Our aim was to characterize PD1ab-induced arthralgia. We retrospectively included patients with metastatic cutaneous malignancies treated with pembrolizumab or nivolumab ± ipilimumab at the National Center for Tumor Diseases (Heidelberg) between 01/2013 and 09/2016. Arthralgia was characterized by laboratory diagnostics, imaging, and if indicated, rheumatologic consultation. 26 of 195 patients (13.3%) developed arthralgia. The median onset of symptoms was 100 days (7-780 days). Most frequently, arthralgia involved large joints (shoulders, knees) in a predominantly symmetrical pattern. Only two patients were seropositive for rheumatoid factor and/or anti-citrullinated protein antibodies. Ten patients developed the clinical picture of arthritis, with seven of them showing synovitis in MRI or PET/CT. Five patients showed inflammation in joints pre-damaged by osteoarthritis. In 11 patients arthralgia could not be specified. The majority of patients was satisfactorily treated with non-steroidal anti-inflammatory drugs (NSAIDs), 23.1% required additional low-dose corticosteroids and only 7.6% of our patients received further immunosuppressive treatment. Patients with arthralgia showed a better treatment response and improved PFS and OS. Arthralgia is frequent during PD1ab treatment. The clinical picture varies between synovitis of predominantly large joints, progressive osteoarthritis and arthralgia without evident joint damage. Vast majority of cases can be satisfactorily managed by NSAID and/or low-dose corticosteroids.
DOE Office of Scientific and Technical Information (OSTI.GOV)
Denman, Matthew R.; Brooks, Dusty Marie
Sandia National Laboratories (SNL) has conducted an uncertainty analysi s (UA) on the Fukushima Daiichi unit (1F1) accident progression wit h the MELCOR code. Volume I of the 1F1 UA discusses the physical modeling details and time history results of the UA. Volume II of the 1F1 UA discusses the statistical viewpoint. The model used was developed for a previous accident reconstruction investigation jointly sponsored by the US Department of Energy (DOE) and Nuclear Regulatory Commission (NRC). The goal of this work was to perform a focused evaluation of uncertainty in core damage progression behavior and its effect on keymore » figures - of - merit (e.g., hydrogen production, fraction of intact fuel, vessel lower head failure) and in doing so assess the applicability of traditional sensitivity analysis techniques .« less
Cartilage repair and joint preservation: medical and surgical treatment options.
Madry, Henning; Grün, Ulrich Wolfgang; Knutsen, Gunnar
2011-10-01
Articular cartilage defects are most often caused by trauma and osteoarthritis and less commonly by metabolic disorders of the subchondral bone, such as osteonecrosis and osteochondritis dissecans. Such defects do not heal spontaneously in adults and can lead to secondary osteoarthritis. Medications are indicated for symptomatic relief. Slow-acting drugs in osteoarthritis (SADOA), such as glucosamine and chondroitin, are thought to prevent cartilage degeneration. Reconstructive surgical treatment strategies aim to form a repair tissue or to unload compartments of the joint with articular cartilage damage. In this article, we selectively review the pertinent literature, focusing on original publications of the past 5 years and older standard texts. Particular attention is paid to guidelines and clinical studies with a high level of evidence, along with review articles, clinical trials, and book chapters. There have been only a few randomized trials of medical versus surgical treatments. Pharmacological therapies are now available that are intended to treat the cartilage defect per se, rather than the associated symptoms, yet none of them has yet been shown to slow or reverse the progression of cartilage destruction. Surgical débridement of cartilage does not prevent the progression of osteoarthritis and is thus not recommended as the sole treatment. Marrow-stimulating procedures and osteochondral grafts are indicated for small focal articular cartilage defects, while autologous chondrocyte implantationis mainly indicated for larger cartilage defects. These surgical reconstructive techniques play a lesser role in the treatment of osteoarthritis. Osteotomy near the knee joint is indicated for axial realignment when unilateral osteoarthritis of the knee causes axis deviation. Surgical reconstructive techniques can improve joint function and thereby postpone the need for replacement of the articular surface with an artificial joint.
A dual-phase microstructural approach to damage and fracture of Ti 3SiC 2/SiC joints
DOE Office of Scientific and Technical Information (OSTI.GOV)
Nguyen, Ba Nghiep; Henager, Charles H.; Kurtz, Richard J.
We investigate the microcracking mechanisms responsible for Ti 3SiC 2/SiC joint damage observed at the macroscopic scale after neutron irradiation experiments in detail. A dual-phase microstructural approach to damage and fracture of Ti 3SiC 2/SiC joints is developed that uses a finely discretized two-phase domain based on a digital image of an actual microstructure involving embedded Ti 3SiC 2 and SiC phases. The behaviors of SiC and Ti 3SiC 2 in the domain are described by the continuum damage mechanics (CDM) model reported in Nguyen et al., J. Nucl. Mater., 2017, 495:504–515. This CDM model describes microcracking damage in brittlemore » ceramics caused by thermomechanical loading and irradiation-induced swelling. The dual-phase microstructural model is applied to predict the microcracking mechanisms occurring in a typical Ti 3SiC 2/SiC joint subjected to heating to 800 °C followed by irradiation-induced swelling at this temperature and cooling to room temperature after the applied swelling has reached the maximum swelling levels observed in the experiments for SiC and Ti 3SiC 2. The model predicts minor damage of the joint after heating but significant microcracking in the SiC phase and along the boundaries between SiC and Ti 3SiC 2 as well as along the bonding joint during irradiation-induced swelling and cooling to room temperature. Our predictions qualitatively agree with the limited experimental observations of joint damage at this irradiation temperature.« less
A dual-phase microstructural approach to damage and fracture of Ti 3SiC 2/SiC joints
Nguyen, Ba Nghiep; Henager, Charles H.; Kurtz, Richard J.
2017-12-05
We investigate the microcracking mechanisms responsible for Ti 3SiC 2/SiC joint damage observed at the macroscopic scale after neutron irradiation experiments in detail. A dual-phase microstructural approach to damage and fracture of Ti 3SiC 2/SiC joints is developed that uses a finely discretized two-phase domain based on a digital image of an actual microstructure involving embedded Ti 3SiC 2 and SiC phases. The behaviors of SiC and Ti 3SiC 2 in the domain are described by the continuum damage mechanics (CDM) model reported in Nguyen et al., J. Nucl. Mater., 2017, 495:504–515. This CDM model describes microcracking damage in brittlemore » ceramics caused by thermomechanical loading and irradiation-induced swelling. The dual-phase microstructural model is applied to predict the microcracking mechanisms occurring in a typical Ti 3SiC 2/SiC joint subjected to heating to 800 °C followed by irradiation-induced swelling at this temperature and cooling to room temperature after the applied swelling has reached the maximum swelling levels observed in the experiments for SiC and Ti 3SiC 2. The model predicts minor damage of the joint after heating but significant microcracking in the SiC phase and along the boundaries between SiC and Ti 3SiC 2 as well as along the bonding joint during irradiation-induced swelling and cooling to room temperature. Our predictions qualitatively agree with the limited experimental observations of joint damage at this irradiation temperature.« less
Effect of Heat Input on the Tensile Damage Evolution in Pulsed Laser Welded Ti6Al4V Titanium Sheets
NASA Astrophysics Data System (ADS)
Liu, Jing; Gao, Xiaolong; Zhang, Jianxun
2016-11-01
The present paper is focused on studying the effect of heat input on the tensile damage evolution of pulsed Nd:YAG laser welding of Ti6Al4V alloy under monotonic loading. To analyze the reasons that the tensile fracture site of the pulsed-laser-welded Ti6Al4V sheet joints changes with the heat input under monotonic loading, the microstructure of the sample with different nominal strain values was investigated by in situ observation. Experiment results show that the tensile ductility and fatigue life of welded joints with low heat input are higher than that of welded joints with high heat input. Under tensile loads, the critical engineering strain for crack initiation is much lower in the welded joint with high heat input than in the welded joints with low and medium heat input. And the microstructural damage accumulation is much faster in the fusion zone than in the base metal for the welded joints with high input, whereas the microstructural damage accumulation is much faster in the base metal than in the fusion zone for the welded joints with low input. Consequently, the welded joints fractured in the fusion zone for the welds with high heat input, whereas the welded joints ruptured in the base metal for the welds with low heat input. It is proved that the fine grain microstructure produced by low heat input can improve the critical nominal strain for crack initiation and the resistance ability of microstructural damage.
Evidence of cartilage repair by joint distraction in a canine model of osteoarthritis.
Wiegant, Karen; Intema, Femke; van Roermund, Peter M; Barten-van Rijbroek, Angelique D; Doornebal, Arie; Hazewinkel, Herman A W; Lafeber, Floris P J G; Mastbergen, Simon C
2015-02-01
Knee osteoarthritis (OA) is a degenerative joint disorder characterized by cartilage, bone, and synovial tissue changes that lead to pain and functional impairment. Joint distraction is a treatment that provides long-term improvement in pain and function accompanied by cartilage repair, as evaluated indirectly by imaging studies and measurement of biochemical markers. The purpose of this study was to evaluate cartilage tissue repair directly by histologic and biochemical assessments after joint distraction treatment. In 27 dogs, OA was induced in the right knee joint (groove model; surgical damage to the femoral cartilage). After 10 weeks of OA development, the animals were randomized to 1 of 3 groups. Two groups were fitted with an external fixator, which they wore for a subsequent 10 weeks (one group with and one without joint distraction), and the third group had no external fixation (OA control group). Pain/function was studied by force plate analysis. Cartilage integrity and chondrocyte activity of the surgically untouched tibial plateaus were analyzed 25 weeks after removal of the fixator. Changes in force plate analysis values between the different treatment groups were not conclusive. Features of OA were present in the OA control group, in contrast to the generally less severe damage after joint distraction. Those treated with joint distraction had lower macroscopic and histologic damage scores, higher proteoglycan content, better retention of newly formed proteoglycans, and less collagen damage. In the fixator group without distraction, similarly diminished joint damage was found, although it was less pronounced. Joint distraction as a treatment of experimentally induced OA results in cartilage repair activity, which corroborates the structural observations of cartilage repair indicated by surrogate markers in humans. Copyright © 2015 by the American College of Rheumatology.
Characteristics of Asperity Damage and Its Influence on the Shear Behavior of Granite Joints
NASA Astrophysics Data System (ADS)
Meng, Fanzhen; Zhou, Hui; Wang, Zaiquan; Zhang, Chuanqing; Li, Shaojun; Zhang, Liming; Kong, Liang
2018-02-01
Surface roughness significantly affects the shear behavior of rock joints; thus, studies on the asperity damage characteristics and its influence on the shear behavior of joints are extremely important. In this paper, shear tests were conducted on tensile granite joints; asperity damage was evaluated based on acoustic emission (AE) events; and the influence of asperity damage on joint shear behavior was analyzed. The results indicated that the total AE events tended to increase with normal stress. In addition, the asperity damage initiation shear stress, which is defined as the transition point from slow growth to rapid growth in the cumulative events curve, was approximately 0.485 of the peak shear strength regardless of the normal stress. Moreover, 63-85% of the AE events were generated after the peak shear stress, indicating that most of the damage occurred in this stage. Both the dilation and the total AE events decreased with shear cycles because of the damage inflicted on asperities during the previous shear cycle. Two stages were observed in the normal displacement curves under low normal stress, whereas three stages (compression, dilation and compression again) were observed at a higher normal stress; the second compression stage may be caused by tensile failure outside the shear plane. The magnitude of the normal stress and the state of asperity are two important factors controlling the post-peak stress drop and stick-slip of granite joints. Serious deterioration of asperities will stop stick-slip from recurring under the same normal stress because the ability to accumulate energy is decreased. The AE b-value increases with the number of shear cycles, indicating that the stress concentration inside the fault plane is reduced because of asperity damage; thus, the potential for dynamic disasters, such as fault-slip rockbursts, will be decreased.
DOE Office of Scientific and Technical Information (OSTI.GOV)
Nguyen, Ba Nghiep; Henager, Charles H.; Kurtz, Richard J.
2016-09-30
Finite element (FE) continuum damage mechanics (CDM) models have been developed to simulate and model dual-phase joints and cracked joints for improved analysis of SiC materials in nuclear environments. This report extends the analysis from the last reporting cycle by including preliminary thermomechanical analyses of cracked joints and implementation of dual-phase damage models.
van Vulpen, Lize F D; Schutgens, Roger E G; Coeleveld, Katja; Alsema, Els C; Roosendaal, Goris; Mastbergen, Simon C; Lafeber, Floris P J G
2015-11-05
Joint bleeding after (sports) trauma, after major joint surgery, or as seen in hemophilia in general leads to arthropathy. Joint degeneration is considered to result from the direct effects of blood components on cartilage and indirectly from synovial inflammation. Blood-provided proinflammatory cytokines trigger chondrocytes and induce the production of cartilage-degrading proteases. In the presence of erythrocyte-derived iron, cytokines stimulate radical formation in the vicinity of chondrocytes inducing apoptosis. To unravel the role of interleukin (IL) 1β and tumor necrosis factor (TNF) α in the pathogenesis of this blood-induced cartilage damage, the effect of antagonizing these cytokines was examined in human in vitro cultures. Addition of recombinant human IL-1β monoclonal antibody or IL-1 receptor antagonist resulted in a dose- and time-dependent protection of cartilage from blood-induced damage. In higher concentrations, almost complete normalization of cartilage matrix proteoglycan turnover was achieved. This was accompanied by a reduction in IL-1β and IL-6 production in whole blood cultures, whereas TNFα production remained unaffected. Interestingly, addition of a TNFα monoclonal antibody, although demonstrated to inhibit the direct (transient) effects of TNFα on cartilage, exhibited no effect on blood-induced (prolonged) cartilage damage. It is demonstrated that IL-1β is crucial in the development of blood-induced joint damage, whereas TNFα is not. This hierarchical position of IL-1β in blood-induced joint damage warrants studies on targeting IL-1β to potentially prevent joint degeneration after a joint bleed. © 2015 by The American Society of Hematology.
Mediators of Inflammation-Induced Bone Damage in Arthritis and Their Control by Herbal Products
Nanjundaiah, Siddaraju M.; Astry, Brian; Moudgil, Kamal D.
2013-01-01
Rheumatoid arthritis (RA) is an autoimmune disease characterized by chronic inflammation of the synovial joints leading to bone and cartilage damage. Untreated inflammatory arthritis can result in severe deformities and disability. The use of anti-inflammatory agents and biologics has been the mainstay of treatment of RA. However, the prolonged use of such agents may lead to severe adverse reactions. In addition, many of these drugs are quite expensive. These limitations have necessitated the search for newer therapeutic agents for RA. Natural plant products offer a promising resource for potential antiarthritic agents. We describe here the cellular and soluble mediators of inflammation-induced bone damage (osteoimmunology) in arthritis. We also elaborate upon various herbal products that possess antiarthritic activity, particularly mentioning the specific target molecules. As the use of natural product supplements by RA patients is increasing, this paper presents timely and useful information about the mechanism of action of promising herbal products that can inhibit the progression of inflammation and bone damage in the course of arthritis. PMID:23476694
Fotouhi, Ali; Maleki, Arash; Dolati, Sanam; Aghebati-Maleki, Ali; Aghebati-Maleki, Leili
2018-08-01
Osteoarthritis (OA) is a multifactorial chronic disease, causing several problems on patients, hygiene and community care systems. Conventional therapies, such as non-pharmacological mediations, systemic drug treatment and intra-articular therapies are applying previously; however, controlling and management approaches of the disease mainly remain insufficient. Injections of intra-articular therapies directly into the joint evade conservative obstacles to joint entry, rise bioavailability and minor systemic toxicity. Current progresses in osteoarthritis management have designed better diversity of treatment approaches. Innovative treatments, such as autologous blood products and mesenchymal stem cells, are in progress. Platelet-rich plasma (PRP) is one of the several novel therapeutic approaches that stay to progress in the field of orthopedic medicine. Stromal vascular fraction (SVF) comprises a lesser amount of mesenchymal stem cells and is a treatment for OA and cartilage damage. Based on novel opinions, an innovative therapy by autologous conditioned serum (ACS) from the whole blood was settled. The inoculation of ACS into tissues has revealed clinical efficacy for the treatment of osteoarthritis and muscle injuries. Here, we make available historical perspective of PRP, SVF, and ACS and the other existing researches on using PRP, SVF and ACS for the treatment of knee OA. In conclusion, in current years, OA stem cell therapy has rapidly progressed, with optimistic consequences in animals and human studies. Additionally, PRP, SVF and ASC injection seem to be accompanied with numerous favorable results for treatment of patients with OA. Copyright © 2018. Published by Elsevier Masson SAS.
Herrero-Fresneda, Immaculada; Torras, Joan; Cruzado, Josep M.; Condom, Enric; Vidal, August; Riera, Marta; Lloberas, Nuria; Alsina, Jeroni; Grinyo, Josep M.
2003-01-01
This study assesses the individual contributions of the nonalloreactive factor, cold ischemia (CI), and alloreactivity to late functional and structural renal graft changes, and examines the effect of the association of both factors on the progression of chronic allograft nephropathy. Lewis rats acted as receptors of kidneys from either Lewis or Fischer rats. For CI, kidneys were preserved for 5 hours. The rats were divided into four groups: Syn, syngeneic graft; SynI, syngeneic graft and CI; Allo, allogeneic graft; AlloI, allogeneic graft and CI. Renal function was assessed every 4 weeks for 24 weeks. Grafts were evaluated for acute inflammatory response at 1 week and for chronic histological damage at 24 weeks. Only when CI and allogenicity were combined did immediate posttransplant mortality occur, while survivors showed accelerated renal insufficiency that induced further mortality at 12 weeks after transplant. Solely ischemic rats developed renal insufficiency. Renal structural damage in ischemic rats was clearly tubulointerstitial, while significant vasculopathy and glomerulosclerosis appeared only in the allogeneic groups. There was increased infiltration of macrophages and expression of mRNA-transforming growth factor-β1 in the ischemic groups, irrespective of the allogeneic background. The joint association of CI plus allogenicity significantly increased cellular infiltration at both early and late stages, aggravating tubulointerstitial and vascular damage considerably. In summary, CI is mainly responsible for tubulointerstitial damage, whereas allogenicity leads to vascular lesion. The association of both factors accelerates and aggravates the progression of experimental chronic allograft nephropathy. PMID:12507896
Radiographic Severity of Rheumatoid Arthritis in African-Americans: Results from the CLEAR Registry
Bridges, S. Louis; Causey, Zenoria L.; Burgos, Paula I.; Huynh, B. Quynh N.; Hughes, Laura B.; Danila, Maria I.; van Everdingen, Amalia; Ledbetter, Stephanie; Conn, Doyt L.; Tamhane, Ashutosh; Westfall, Andrew O.; Jonas, Beth L.; Callahan, Leigh F.; Smith, Edwin A.; Brasington, Richard; Moreland, Larry W.; Alarcón, Graciela S.; van der Heijde, Désirée M.
2010-01-01
Objective To describe radiographic changes in African-Americans with rheumatoid arthritis (RA) from the CLEAR (Consortium for the Longitudinal Evaluation of African-Americans with Early Rheumatoid Arthritis) Registry, a multicenter observational study. Methods Self-declared African-American patients, were enrolled in CLEAR I, a longitudinal cohort of early RA (disease duration <2 years) from 2000 to 2005; or in CLEAR II, a cross-sectional cohort (any disease duration), from 2006 to the present. Demographic and clinical data were obtained, and sets of hand/wrist and foot radiographs were scored using the modified Sharp/van der Heijde scoring system. Results A total of 357 and 418 patients, respectively, have been enrolled into CLEAR I and CLEAR II. We report here an interim analysis of radiographic severity in these patients. For the CLEAR I cohort, 294 patients had a mean radiographic score of 2.89 at the baseline visit; 32.0% showed either erosions (25.9%) or joint space narrowing (JSN) (19.4%). At the 36-month visit the mean score was 5.65; 44.2% had erosions, 41.5% JSN and 55.4% had either. Among those patients without radiographic damage at baseline, 18.9% had progressed at the 36-month visit, compared to 57.1% of those with baseline damage (p<0.0001). For the CLEAR II cohort, 167 patients with RA of any duration, 65.3% exhibited joint erosions, 65.3% JSN and 74.8% exhibited either. The mean radiographic score was 33.42. Conclusion This is the largest radiographic study of African American RA patients. Damage occurs early in the disease and is associated with radiographic progression at 3 years of disease duration. The CLEAR Registry will provide a valuable resource for future analyses of genetic, clinical, and environmental factors associated with radiographic severity of RA in African-Americans. PMID:20461784
Pushover analysis of reinforced concrete frames considering shear failure at beam-column joints
NASA Astrophysics Data System (ADS)
Sung, Y. C.; Lin, T. K.; Hsiao, C. C.; Lai, M. C.
2013-09-01
Since most current seismic capacity evaluations of reinforced concrete (RC) frame structures are implemented by either static pushover analysis (PA) or dynamic time history analysis, with diverse settings of the plastic hinges (PHs) on such main structural components as columns, beams and walls, the complex behavior of shear failure at beam-column joints (BCJs) during major earthquakes is commonly neglected. This study proposes new nonlinear PA procedures that consider shear failure at BCJs and seek to assess the actual damage to RC structures. Based on the specifications of FEMA-356, a simplified joint model composed of two nonlinear cross struts placed diagonally over the location of the plastic hinge is established, allowing a sophisticated PA to be performed. To verify the validity of this method, the analytical results for the capacity curves and the failure mechanism derived from three different full-size RC frames are compared with the experimental measurements. By considering shear failure at BCJs, the proposed nonlinear analytical procedures can be used to estimate the structural behavior of RC frames, including seismic capacity and the progressive failure sequence of joints, in a precise and effective manner.
NASA Astrophysics Data System (ADS)
Tiwari, Nivedan; Chabra, Sanjay; Mehdi, Sheherbano; Sweet, Paula; Krasieva, Tatiana B.; Pool, Roy; Andrews, Brian; Peavy, George M.
2010-09-01
An estimated 1.3 million people in the United States suffer from rheumatoid arthritis (RA). RA causes profound changes in the synovial membrane of joints, and without early diagnosis and intervention, progresses to permanent alterations in joint structure and function. The purpose of this study is to determine if nonlinear optical microscopy (NLOM) can utilize the natural intrinsic fluorescence properties of tissue to generate images that would allow visualization of the structural and cellular composition of fresh, unfixed normal and pathologic synovial tissue. NLOM is performed on rabbit knee joint synovial samples using 730- and 800-nm excitation wavelengths. Less than 30 mW of excitation power delivered with a 40×, 0.8-NA water immersion objective is sufficient for the visualization of synovial structures to a maximum depth of 70 μm without tissue damage. NLOM imaging of normal and pathologic synovial tissue reveals the cellular structure, synoviocytes, adipocytes, collagen, vascular structures, and differential characteristics of inflammatory infiltrates without requiring tissue processing or staining. Further study to evaluate the ability of NLOM to assess the characteristics of pathologic synovial tissue and its potential role for the management of disease is warranted.
The Roles of Mechanical Stresses in the Pathogenesis of Osteoarthritis
Anderson, Donald D.; Brown, Thomas D.; Tochigi, Yuki; Martin, James A.
2013-01-01
Excessive joint surface loadings, either single (acute impact event) or repetitive (cumulative contact stress), can cause the clinical syndrome of osteoarthritis (OA). Despite advances in treatment of injured joints, the risk of OA following joint injuries has not decreased in the past 50 years. Cumulative excessive articular surface contact stress that leads to OA results from posttraumatic joint incongruity and instability, and joint dysplasia, but may also cause OA in patients without known joint abnormalities. In vitro investigations show that excessive articular cartilage loading triggers release of reactive oxygen species (ROS) from mitochondria, and that these ROS cause chondrocyte death and matrix degradation. Preventing release of ROS or inhibiting their effects preserves chondrocytes and their matrix. Fibronectin fragments released from articular cartilage subjected to excessive loads also stimulate matrix degradation; inhibition of molecular pathways initiated by these fragments prevents this effect. Additionally, injured chondrocytes release alarmins that activate chondroprogentior cells in vitro that propogate and migrate to regions of damaged cartilage. These cells also release chemokines and cytokines that may contribute to inflammation that causes progressive cartilage loss. Distraction and motion of osteoarthritic human ankles can promote joint remodeling, decrease pain, and improve joint function in patients with end-stage posttraumatic OA. These advances in understanding of how altering mechanical stresses can lead to remodeling of osteoarthritic joints and how excessive stress causes loss of articular cartilage, including identification of mechanically induced mediators of cartilage loss, provide the basis for new biologic and mechanical approaches to the prevention and treatment of OA. PMID:25067995
McCann, M R; Yeung, C; Pest, M A; Ratneswaran, A; Pollmann, S I; Holdsworth, D W; Beier, F; Dixon, S J; Séguin, C A
2017-05-01
Low-amplitude, high-frequency whole-body vibration (WBV) has been adopted for the treatment of musculoskeletal diseases including osteoarthritis (OA); however, there is limited knowledge of the direct effects of vibration on joint tissues. Our recent studies revealed striking damage to the knee joint following exposure of mice to WBV. The current study examined the effects of WBV on specific compartments of the murine tibiofemoral joint over 8 weeks, including microarchitecture of the tibia, to understand the mechanisms associated with WBV-induced joint damage. Ten-week-old male CD-1 mice were exposed to WBV (45 Hz, 0.3 g peak acceleration; 30 min/day, 5 days/week) for 4 weeks, 8 weeks, or 4 weeks WBV followed by 4 weeks recovery. The knee joint was evaluated histologically for tissue damage. Architecture of the subchondral bone plate, subchondral trabecular bone, primary and secondary spongiosa of the tibia was assessed using micro-CT. Meniscal tears and focal articular cartilage damage were induced by WBV; the extent of damage increased between 4 and 8-week exposures to WBV. WBV did not alter the subchondral bone plate, or trabecular bone of the tibial spongiosa; however, a transient increase was detected in the subchondral trabecular bone volume and density. The lack of WBV-induced changes in the underlying subchondral bone suggests that damage to the articular cartilage may be secondary to the meniscal injury we detected. Our findings underscore the need for further studies to assess the safety of WBV in the human population to avoid long-term joint damage. Copyright © 2016 Osteoarthritis Research Society International. Published by Elsevier Ltd. All rights reserved.
78 FR 6251 - Airworthiness Directives; The Boeing Company Airplanes
Federal Register 2010, 2011, 2012, 2013, 2014
2013-01-30
... airplanes. This proposed AD was prompted by reports of cracks and heat damage on pivot joint components... proposing this AD to detect and correct heat damage and cracks in the pivot pin, truck beam lugs, and inner... joint components have been found with cracks or heat damage. There have been 11 such findings on Model...
Ko, Frank C; Dragomir, Cecilia; Plumb, Darren A; Goldring, Steven R; Wright, Timothy M; Goldring, Mary B; van der Meulen, Marjolein C H
2013-06-01
Alterations in the mechanical loading environment in joints may have both beneficial and detrimental effects on articular cartilage and subchondral bone, and may subsequently influence the development of osteoarthritis (OA). Using an in vivo tibial loading model, the aim of this study was to investigate the adaptive responses of cartilage and bone to mechanical loading and to assess the influence of load level and duration. Cyclic compression at peak loads of 4.5N and 9.0N was applied to the left tibial knee joint of adult (26-week-old) C57BL/6 male mice for 1, 2, and 6 weeks. Only 9.0N loading was utilized in young (10-week-old) mice. Changes in articular cartilage and subchondral bone were analyzed by histology and micro-computed tomography. Mechanical loading promoted cartilage damage in both age groups of mice, and the severity of joint damage increased with longer duration of loading. Metaphyseal bone mass increased with loading in young mice, but not in adult mice, whereas epiphyseal cancellous bone mass decreased with loading in both young and adult mice. In both age groups, articular cartilage thickness decreased, and subchondral cortical bone thickness increased in the posterior tibial plateau. Mice in both age groups developed periarticular osteophytes at the tibial plateau in response to the 9.0N load, but no osteophyte formation occurred in adult mice subjected to 4.5N peak loading. This noninvasive loading model permits dissection of temporal and topographic changes in cartilage and bone and will enable investigation of the efficacy of treatment interventions targeting joint biomechanics or biologic events that promote OA onset and progression. Copyright © 2013 by the American College of Rheumatology.
Experimental investigation on frequency shifting of imperfect adhesively bonded pipe joints
NASA Astrophysics Data System (ADS)
Haiyam, F. N.; Hilmy, I.; Sulaeman, E.; Firdaus, T.; Adesta, E. Y. T.
2018-01-01
Inspection tests for any manufactured structure are compulsory in order to detect the existence of damage.It is to ensure the product integrity, reliability and to avoid further catastrophic failure. In this research, modal analysis was utilized to detect structural damage as one of the Non Destructive Testing (NDT) methods. Comparing the vibration signal of a healthy structure with a non-healthy signal was performed. A modal analysis of an adhesively bonded pipe joint was investigated with a healthy joint as a reference. The damage joint was engineered by inserting a nylon fiber, which act as an impurity at adhesive region. The impact test using hammer was utilized in this research. Identification of shifting frequency of a free supported and clamped pipe joint was performed.It was found that shifting frequency occurred to the lower side by 5%.
Stefanik, J J; Niu, J; Gross, K D; Roemer, F W; Guermazi, A; Felson, D T
2013-05-01
To describe the prevalence of magnetic resonance imaging (MRI) detected structural damage in the patellofemoral joint (PFJ) and tibiofemoral joint (TFJ) in a population-based cohort. A secondary aim was to evaluate the patterns of compartmental involvement in knees with pain, between men and women, and in different age and body mass index (BMI) categories. We studied 970 knees, one knee per subject, from the Framingham Osteoarthritis Study, a population-based cohort study of persons 51-92 years old. Cartilage damage and bone marrow lesions (BMLs) were assessed using the Whole Organ Magnetic Resonance Imaging Score (WORMS). The prevalence of isolated PFJ, isolated TFJ, and mixed structural damage was determined using the following definitions: any cartilage damage, full thickness cartilage loss, any BML, and the combination of full thickness cartilage loss with any BML. The mean age and BMI was 63.4 years and 28.6 m/kg(2), respectively; 57% were female. Isolated PFJ damage occurred in 15-20% of knees and isolated TFJ damage occurred in 8-17% of knees depending on the definition used. The prevalence of isolated PFJ damage was greater than isolated TFJ damage using all definitions except the any BML definition. This pattern was similar between genders and among age and BMI categories. In those with knee pain, isolated PFJ was at least as common as TFJ damage depending on the definition used. Using MRI to assess knee joint structural damage, isolated PFJ damage was at least as common as, if not more common than, isolated TFJ damage. Copyright © 2013 Osteoarthritis Research Society International. Published by Elsevier Ltd. All rights reserved.
Wrist Pain in Gymnasts: A Review of Common Overuse Wrist Pathology in the Gymnastics Athlete.
Benjamin, Holly J; Engel, Sean C; Chudzik, Debra
Injury rates among gymnasts are among the highest of any sport at the high school and collegiate level per athletic exposure. The wrist has increased injury risk due to repetitive physical stresses predisposing it to acute injury, overuse, and degenerative damage. This article will review the most common overuse wrist injuries seen in gymnasts. Prompt evaluation and management is necessary to avoid the negative sequelae that can often accompany these injuries. Little is known about effective sport-specific injury prevention strategies, but general guidelines for overuse injury prevention including limiting excessive loading of the wrist, maintaining wrist joint flexibility, an emphasis on proper technique, and incorporating wrist and general core strengthening seem beneficial. General return to play principles are similar for all gymnast-related wrist injuries, including resolution of pain, restoration of normal wrist joint function, completion of a progressive rehabilitation program, and use of proper technique.
The role of peel stresses in cyclic debonding
NASA Technical Reports Server (NTRS)
Everett, R. A., Jr.
1982-01-01
When an adhesively bonded joint is undergoing cyclic loading, one of the possible damage modes that occurs is called cyclic debonding - progressive separation of the adherends by failure of the adhesive bond under cyclic loading. In most practical structures, both peel and shear stresses exist in the adhesive bonding during cyclic loading. The results of an experimental and analytical study to determine the role of peel stresses on cyclic debonding in a mixed mode specimen are presented. Experimentally, this was done by controlling the forces that create the peel stresses by applying a clamping force to oppose the peel stresses. Cracked lap shear joints were chosen for this study. A finite element analysis was developed to assess the effect of the clamping force on the strain energy release rates due to shear and peel stresses. The results imply that the peel stress is the principal stress causing cyclic debonding.
Judicious use of biologicals in juvenile idiopathic arthritis.
Zhao, Yongdong; Wallace, Carol
2014-11-01
Juvenile idiopathic arthritis (JIA) is a chronic inflammatory disorder that may cause joint destruction. Biological treatments targeting specific cytokines and cell interactions have transformed the outcomes of JIA. This review focuses on the selection of patients for and the timing and selection of biological treatment in JIA. Tumor necrosis factor (TNF) inhibitors remain the first choice for polyarticular JIA, followed by abatacept and tocilizumab. Monoclonal-antibody TNF inhibitors and abatacept are usually chosen for methotrexate-resistant uveitis. Recent clinical trials of canakinumab, rilonacept, and tocilizumab have obtained great improvement in both systemic and arthritic features in chronic systemic JIA patients. Current guidelines support the early use of a short-acting IL-1 antagonist for macrophage activation syndrome, a life-threatening complication. TREAT and ACUTE studies suggest that a therapeutic window of opportunity during early disease may exist in JIA. Early initiation of biological therapy may be associated with slower progression of joint damage and longer remission.
2014-01-01
Background Early appearance of antibodies specific for native human type II collagen (anti-CII) characterizes an early inflammatory and destructive phenotype in adults with rheumatoid arthritis (RA). The objective of this study was to investigate the occurrence of anti-CII, IgM RF, IgA RF and anti-CCP in serum samples obtained early after diagnosis, and to relate the occurrence of autoantibodies to outcome after eight years of disease in children with juvenile idiopathic arthritis (JIA). Methods The Nordic JIA database prospectively included JIA patients followed for eight years with data on remission and joint damage. From this database, serum samples collected from 192 patients, at a median of four months after disease onset, were analysed for IgG anti-CII, IgM RF, IgA RF and IgG anti-CCP. Joint damage was assessed based on Juvenile Arthritis Damage Index for Articular damage (JADI-A), a validated clinical instrument for joint damage. Results Elevated serum levels of anti-CII occurred in 3.1%, IgM RF in 3.6%, IgA RF in 3.1% and anti-CCP in 2.6% of the patients. Occurrence of RF and anti-CCP did to some extent overlap, but rarely with anti-CII. The polyarticular and oligoarticular extended categories were overrepresented in patients with two or more autoantibodies. Anti-CII occurred in younger children, usually without overlap with the other autoantibodies and was associated with high levels of C-reactive protein (CRP) early in the disease course. All four autoantibodies were significantly associated with joint damage, but not with active disease at the eight-year follow up. Conclusions Anti-CII, anti-CCP, IgA RF and IgM RF detected early in the disease course predicted joint damage when assessed after eight years of disease. The role of anti-CII in JIA should be further studied. PMID:24944545
De la Corte-Rodriguez, Hortensia; Rodriguez-Merchan, E Carlos; Alvarez-Roman, M Teresa; Martin-Salces, Mónica; Martinoli, Carlo; Jimenez-Yuste, Víctor
2018-03-01
Prevention of hemarthrosis is the key factor in the adequate management of people with hemophilia (PWH). If hemarthrosis occurs, early diagnosis of joint damage is essential to make personalized treatments. This study is aimed at gaining an understanding of the ability of point-of-care ultrasound (US) using the `Hemophilia Early Arthropathy Detection with Ultrasound´ (HEAD-US) protocol to detect abnormalities in joints without history of hemarthrosis and clinically asymptomatic joints of PWH. The sample included 976 joints from 167 PWH (mean age 24.86 years). Data were collected from routine practice over a 3-year period and analyzed based on history of hemarthrosis and results of clinical (HJHS 2.1) and HEAD-US examinations. In our series, 14% of patients exhibited HEAD-US signs of incipient arthropathy in joints with no history of bleeding and with a HJHS 2.1 score of 0. The most severely involved joint was the right ankle. Synovitis, articular cartilage and subchondral bone damage scores in joints with subclinical findings were slower than in joints with previous hemarthroses or HJHS 2.1 > 1 Conclusions: Our study demonstrates that HEAD-US is better than hemarthrosis records and the HJHS 2.1 scale in detecting the early signs of joint damage in PWH.
Characterization of the surface and interfacial properties of the lamina splendens
NASA Astrophysics Data System (ADS)
Rexwinkle, Joe T.; Hunt, Heather K.; Pfeiffer, Ferris M.
2017-06-01
Joint disease affects approximately 52.5 million patients in the United States alone, costing 80.8 billion USD in direct healthcare costs. The development of treatment programs for joint disease and trauma requires accurate assessment of articular cartilage degradation. The articular cartilage is the interfacial tissue between articulating surfaces, such as bones, and acts as low-friction interfaces. Damage to the lamina splendens, which is the articular cartilage's topmost layer, is an early indicator of joint degradation caused by injury or disease. By gaining comprehensive knowledge on the lamina splendens, particularly its structure and interfacial properties, researchers could enhance the accuracy of human and animal biomechanical models, as well as develop appropriate biomimetic materials for replacing damaged articular cartilage, thereby leading to rational treatment programs for joint disease and injury. Previous studies that utilize light, electron, and force microscopy techniques have found that the lamina splendens is composed of collagen fibers oriented parallel to the cartilage surface and encased in a proteoglycan matrix. Such orientation maximizes wear resistance and proteoglycan retention while promoting the passage of nutrients and synovial fluid. Although the structure of the lamina splendens has been explored in the literature, the low-friction interface of this tissue remains only partially characterized. Various functional models are currently available for the interface, such as pure boundary lubrication, thin films exuded under pressure, and sheets of trapped proteins. Recent studies suggest that each of these lubrication models has certain advantages over one another. Further research is needed to fully model the interface of this tissue. In this review, we summarize the methods for characterizing the lamina splendens and the results of each method. This paper aims to serve as a resource for existing studies to date and a roadmap of the investigations needed to gain further insight into the lamina splendens and the progression of joint disease.
NASA Astrophysics Data System (ADS)
Okafor, A. C.; Natarajan, S.
2007-03-01
Aging aircraft are prone to corrosion damage and fatigue cracks in riveted lap joints of fuselage skin panels. This can cause catastrophic failure if not detected and repaired. Hence detection of corrosion damage and monitoring its effect on structural integrity are essential. This paper presents multifrequency eddy current (EC) inspection of corrosion damage and machined material loss defect in clad A1 2024-T3 riveted lap joints and its effect on fatigue life. Results of eddy current inspection, corrosion product removal and fatigue testing are presented.
Fatigue Damage Monitoring of a Composite Step Lap Joint Using Distributed Optical Fibre Sensors
Wong, Leslie; Chowdhury, Nabil; Wang, John; Chiu, Wing Kong; Kodikara, Jayantha
2016-01-01
Over the past few decades, there has been a considerable interest in the use of distributed optical fibre sensors (DOFS) for structural health monitoring of composite structures. In aerospace-related work, health monitoring of the adhesive joints of composites has become more significant, as they can suffer from cracking and delamination, which can have a significant impact on the integrity of the joint. In this paper, a swept-wavelength interferometry (SWI) based DOFS technique is used to monitor the fatigue in a flush step lap joint composite structure. The presented results will show the potential application of distributed optical fibre sensor for damage detection, as well as monitoring the fatigue crack growth along the bondline of a step lap joint composite structure. The results confirmed that a distributed optical fibre sensor is able to enhance the detection of localised damage in a structure. PMID:28773496
Rosenberg, John H; Rai, Vikrant; Dilisio, Matthew F; Sekundiak, Todd D; Agrawal, Devendra K
2017-12-01
Osteoarthritis (OA) is a degenerative disease characterized by the destruction of cartilage. The greatest risk factors for the development of OA include age and obesity. Recent studies suggest the role of inflammation in the pathogenesis of OA. The two most common locations for OA to occur are in the knee and hip joints. The knee joint experiences more mechanical stress, cartilage degeneration, and inflammation than the hip joint. This could contribute to the increased incidence of OA in the knee joint. Damage-associated molecular patterns (DAMPs), including high-mobility group box-1, receptor for advanced glycation end products, and alarmins (S100A8 and S100A9), are released in the joint in response to stress-mediated chondrocyte and cartilage damage. This facilitates increased cartilage degradation and inflammation in the joint. Studies have documented the role of DAMPs in the pathogenesis of OA; however, the comparison of DAMPs and its influence on OA has not been discussed. In this study, we compared the DAMPs between OA knee and hip joints and found a significant difference in the levels of DAMPs expressed in the knee joint compared to the hip joint. The increased levels of DAMPs suggest a difference in the underlying pathogenesis of OA in the knee and the hip and highlights DAMPs as potential therapeutic targets for OA in the future.
[Rheumatoid arthritis as a connective tissue disease].
Targońska-Stępniak, Bożena
2018-01-01
The available data indicate that seropositive rheumatoid arthritis (RA) develops as a result of systemic, autoimmune reaction directed against a range of "self" peptides/proteins that have undergone specific forms of post-translational modification. The development and progress of autoimmunity may be triggered by non-specific, local inflammatory processes outside the joints, for example in the oral or respiratory mucous membrane. The disease occurs in genetically susceptible individuals under the influence of environmental risk factors that promote autoimmunity and consequently the inflammatory process. Smoking is particularly linked with RA pathogenesis. Synovitis of multiple, symmetrical, peripheral joints is the most typical feature of RA which results in irreversible damage to joints structure and as a consequence in disability of patients. However, the inflammatory process in the course of RA has a systemic, constitutional nature. Therefore, extra-articular symptoms with internal organ involvement may occur additionally to synovitis, what is an unfavorable prognostic factor. Extra-articular manifestations of RA are associated with the high disease activity both inflammatory and immunological. They occur in patients with severe form of the disease and contribute to a significant lifespan reduction. This is usually associated with progressive atherosclerosis and cardiovascular complications. The systemic inhibition of an abnormal immune system activity is the mainstay of the effective RA treatment. The currently used disease modifying antirheumatic drugs affect the activity and function of different constituents of the immune system, including B and T lymphocytes and the main pro-inflammatory cytokines, and contribute to autoimmune and inflammatory processes.
A role for interleukins in ochronosis in a chondrocyte in vitro model of alkaptonuria.
Mistry, J B; Jackson, D J; Bukhari, M; Taylor, A M
2016-07-01
Alkaptonuria is a rare autosomal recessive condition resulting from inability to breakdown homogentisic acid (HGA), an intermediate in tyrosine degradation. The condition has a triad of clinical features, the most damaging of which is ochronotic osteoarthropathy. HGA is elevated from birth, but pigmentation takes many years. We hypothesise that interleukins play a role in initiation and progression of ochronotic osteoarthropathy. C20/A4 cells were cultured and maintained in 9-cm petri dishes containing either HGA at 0.33 mM, a single interleukin (IL-1β, IL-6 or IL-10) at 1 ng/ml or a combination of HGA and a single interleukin. Statistical analysis of pigment deposits and cell viability was performed using analysis of variance with Newman-Keuls post-test. All cultures containing HGA showed a significant increase in pigment deposition compared to control and IL cultures alone. The cultures containing HGA and IL-6 showed a significant increase in pigment deposits compared to HGA alone. The cell viability counts across all cultures on day 10 demonstrated a significant decrease in cultures containing HGA compared to those which did not. There was no significant difference between cultures containing just HGA or those combined with an interleukin. This work demonstrates a role for cytokines present in the joint(s) in the pigmentation process, particularly IL-6, and that the presence of HGA in joint tissues appears more detrimental to chondrocytes than the presence of any of the interleukins found in response to joint injury, trauma and osteoarthritis (OA). This further supports the evidence that the arthropathy in alkaptonuria is much more severe and rapidly progressing.
Mancarella, Luana; Addimanda, Olga; Cavallari, Carlotta; Meliconi, Riccardo
2017-01-01
Ultrasound is one of the most promising candidates for the detection of inflammation and structural damage in hand osteoarthritis. To evaluate new advances of US as a diagnostic and prognostic tool in hand osteoarthritis assessment. We conducted a Medline on PubMed search for articles about "ultrasonography" and "hand OA" published between January 2012 and 15th April 2016, limiting our search to articles on human adults in English, excluding those involving systemic inflammatory diseases, visualization of joints other than hands, ultrasound guided injections and surgical procedures. Reviews, case reports, letters, position statements and ex vivo studies were excluded. Concordance between ultrasound and conventional radiography and magnetic resonance imaging was evaluated. Total 46 records were identified, and 16 articles were selected: four showed only ultrasound structural damage (osteophytes, cartilage pathology), six only ultrasound inflammatory variables (synovial thickness, effusion and power Doppler signal), six should considered both ultrasound structural and inflammatory features as well as erosions and two were epidemiological studies. Ultrasound synovitis and power Doppler signal were more frequent in erosive hand osteoarthritis. Followup studies found that ultrasound inflammatory features at baseline are independently associated with radiographic progression; power Doppler signal was the strongest predictor of structural damage. Ultrasound is a reliable tool for cartilage and osteophyte assessment (when performed with static images) and shows a good concordance with magnetic resonance imaging for osteophytes, erosions and synovitis. Ultrasound detected inflammation may predict radiographic progression and may be used in prospective clinical trials of hand osteoarthritis and in everyday clinical practice. Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.org.
van Galen, K P M; Sanders, Y V; Vojinovic, U; Eikenboom, J; Cnossen, M H; Schutgens, R E G; van der Bom, J G; Fijnvandraat, K; Laros-Van Gorkom, B A P; Meijer, K; Leebeek, F W G; Mauser-Bunschoten, E P
2015-05-01
Joint bleeds (JB) are reported in a minority of patients with von Willebrand disease (VWD) but may lead to structural joint damage. Prevalence, severity and impact of JB in VWD are largely unknown. The aim of this study was to assess JB prevalence, onset, treatment and impact on health-related quality of life (HR-QoL) and joint integrity in moderate and severe VWD. In the Willebrand in the Netherlands study 804 moderate and severe VWD patients [von Willebrand factor (VWF) activity ≤30U dL(-1)] completed a questionnaire on occurrence, sites and consequences of JB. To analyse JB number, onset, treatment and impact on joint integrity we additionally performed a patient-control study on medical file data comparing patients with JB to age, gender, factor VIII (FVIII)- and VWF activity matched VWD patients without JB. Of all VWD patients 23% (184/804) self-reported JB. These 184 patients reported joint damage more often (54% vs. 18%, P < 0.001) and had lower HR-QoL (SF36, P < 0.05) compared to VWD patients not reporting JB. Of 55 patients with available JB data, 65% had the first JB before age 16. These 55 patients used more clotting factor concentrate (CFC; median dose 43 vs. 0 IE FVIII kg(-1) year(-1) , P < 0.001), more often had X-ray joint damage (44% vs. 11%, P = 0.001] and chronic joint pain (44% vs. 18%, P = 0.008) compared to 55 control VWD patients without JB. In conclusion, joint bleeds are reported by 23% of moderate and severe VWD patients, mostly start in childhood, are associated with more CFC use, joint pain, lower HR-QoL and significantly more radiological and self-reported joint damage. © 2015 John Wiley & Sons Ltd.
Analyzer-based imaging technique in tomography of cartilage and metal implants: a study at the ESRF
COAN, Paola; MOLLENHAUER, Juergen; WAGNER, Andreas; Muehleman, Carol; BRAVIN, Alberto
2009-01-01
Monitoring the progression of osteoarthritis (OA) and the effects of therapy during clinical trials is still a challenge for present clinical imaging techniques since they present intrinsic limitations and can be sensitive only in case of advanced OA stages. In very severe cases, partial or complete joint replacement surgery is the only solution for reducing pain and restoring the joint functions. Poor imaging quality in practically all medical imaging technologies with respect to joint surfaces and to metal implant imaging calls for the development of new techniques that are sensitive to stages preceding the point of irreversible damage of the cartilage tissue. In this scenario, X-ray phase contrast modalities could play an important role since they can provide improved contrast compared to conventional absorption radiography, with a similar or even reduced tissue radiation dose. In this study, the Analyzer-based imaging (ABI), a technique sensitive to the X-ray refraction and permitting a high scatter rejection, has been successfully applied in-vitro on excised human synovial joints and sheep implants. Pathological and healthy joints as well as metal implants have been imaged in projection and computed tomography ABI mode at high resolution and clinically compatible doses (< 10 mGy). Volume rendering and segmentation permitted visualization of the cartilage from volumetric CT-scans. Results demonstrate that ABI can provide an unequivocal non-invasive diagnosis of the state of disease of the joint and be considered a new tool in orthopaedic research. PMID:18584983
[Patellofemoral arthroplasty].
Cotic, M; Forkel, P; Imhoff, A B
2017-02-01
Isolated resurfacing of the trochlea using an inlay prosthesis without changing the complex kinematics of the patellofemoral joint. Symptomatic, isolated patellofemoral osteoarthritis or isolated osteochondral lesions, failed conservative and cartilage regeneration procedures. No or concurrently corrected ligament instability, tibiofemoral and patellofemoral malalignment. Symptomatic patellofemoral osteoarthritis, inflammatory joint disease, chondrocalcinosis, chronic pain syndromes, active infections or knee ankylosis. Following a medial arthrotomy, coronal and sagittal curvatures of the trochlea are measured. Based on these measurements, corresponding surface reamers create an implant bed by removing damaged cartilage of the trochlea. A central fixation screw is placed to the desired depth and the inlay prosthesis is tapped carefully onto it. Final placement of the prosthesis is targeted slightly recessed to the surrounding joint surface. Free passive range of motion exercises of the knee joint are recommended starting on postoperative day 1. Depending on symptoms (e.g., pain and joint effusion), partial weight-bearing of 20 kg is allowed during postoperative weeks 1 and 2, which is increased by 20 kg/week thereafter. In a prospective study of 29 patients (mean age: 42 years) treated with inlay arthroplasty, 2‑year follow-up results showed significant improvements (p < 0.05) in WOMAC, IKDC and VAS (pain) scores when compared to baseline. Compared to onlay PF arthroplasty modern inlay prosthetic placement showed a better preservation of the tibiofemoral joint without progression of tibiofemoral degeneration. This may be due to possible avoidance of patellofemoral overstuffing using a more physiological placement of the inlay prosthesis.
Seismic performance of the typical RC beam-column joint subjected to repeated earthquakes
NASA Astrophysics Data System (ADS)
Hassanshahi, Omid; Majid, Taksiah A.; Lau, Tze Liang; Yousefi, Ali; Tahara, R. M. K.
2017-10-01
It is common that a building experience repeated earthquakes throughout its lifetime. Such earthquake is capable of creating severe damage in primary elements of the building due to accumulation of inelastic displacement from repetition. The present study focuses on the influence of repeated earthquakes on a typical Reinforced Concrete (RC) beam-column joint, especially on the maximum inelastic displacement demand and maximum residual displacement. For this purpose, the capability of nonlinear modelling in simulating the hysteretic behaviour of the prototype experimental specimen is first determined using RUAUMOKO. A nonlinear Incremental Dynamic Analysis (IDA) on the verified model is then carried out in order to estimate with maximum accuracy the ultimate load bearing capacity to progressive collapse of the RC joint under investigation. Twenty ground motions are selected, and single (C1), double (C2), and triple (C3) event of synthetic repeated earthquakes are then considered. The results show that the repeated earthquakes significantly increase the inelastic demand of the RC joint. On average, relative increment of maximum inelastic displacement demand is experienced about 28.9% and 39.4% when C2 and C3 events of repeated earthquakes are induced, respectively. Residual displacements for repeated earthquakes are also significantly higher than that for single earthquakes.
Segmentation and determination of joint space width in foot radiographs
NASA Astrophysics Data System (ADS)
Schenk, O.; de Muinck Keizer, D. M.; Bernelot Moens, H. J.; Slump, C. H.
2016-03-01
Joint damage in rheumatoid arthritis is frequently assessed using radiographs of hands and feet. Evaluation includes measurements of the joint space width (JSW) and detection of erosions. Current visual scoring methods are timeconsuming and subject to inter- and intra-observer variability. Automated measurement methods avoid these limitations and have been fairly successful in hand radiographs. This contribution aims at foot radiographs. Starting from an earlier proposed automated segmentation method we have developed a novel model based image analysis algorithm for JSW measurements. This method uses active appearance and active shape models to identify individual bones. The model compiles ten submodels, each representing a specific bone of the foot (metatarsals 1-5, proximal phalanges 1-5). We have performed segmentation experiments using 24 foot radiographs, randomly selected from a large database from the rheumatology department of a local hospital: 10 for training and 14 for testing. Segmentation was considered successful if the joint locations are correctly determined. Segmentation was successful in only 14%. To improve results a step-by-step analysis will be performed. We performed JSW measurements on 14 randomly selected radiographs. JSW was successfully measured in 75%, mean and standard deviation are 2.30+/-0.36mm. This is a first step towards automated determination of progression of RA and therapy response in feet using radiographs.
NASA Astrophysics Data System (ADS)
Liu, Yi; Dai, Feng; Fan, Pengxian; Xu, Nuwen; Dong, Lu
2017-06-01
Intermittent joints in rock mass are quite sensitive to cyclic loading conditions. Understanding the fatigue mechanical properties of jointed rocks is beneficial for rational design and stability analysis of rock engineering projects. This study experimentally investigated the influences of joint geometry (i.e., dip angle, persistency, density and spacing) on the fatigue mechanism of synthetic jointed rock models. Our results revealed that the stress-strain curve of jointed rock under cyclic loadings is dominated by its curve under monotonic uniaxial loadings; the terminal strain in fatigue curve is equal to the post-peak strain corresponding to the maximum cyclic stress in the monotonic stress-strain curve. The four joint geometrical parameters studied significantly affect the fatigue properties of jointed rocks, including the irreversible strains, the fatigue deformation modulus, the energy evolution, the damage variable and the crack coalescence patterns. The higher the values of the geometrical parameters, the lower the elastic energy stores in this jointed rock, the higher the fatigue damage accumulates in the first few cycles, and the lower the fatigue life. The elastic energy has certain storage limitation, at which the fatigue failure occurs. Two basic micro-cracks, i.e., tensile wing crack and shear crack, are observed in cyclic loading and unloading tests, which are controlled principally by joint dip angle and persistency. In general, shear cracks only occur in the jointed rock with higher dip angle or higher persistency, and the jointed rock is characterized by lower fatigue strength, larger damage variable and lower fatigue life.
Barouta, Georgia; Katsiari, Christina G; Alexiou, Ioannis; Liaskos, Christos; Varna, Areti; Bogdanos, Dimitrios P; Germenis, Anastasios E; Sakkas, Lazaros I
2017-04-01
This study aimed to assess the diagnostic and prognostic value of anti-mutated citrullinated vimentin (MCV) antibodies in very early rheumatoid arthritis (VERA) and in established rheumatoid arthritis (RA). Seventy-one patients with undifferentiated arthritis (UA) of <3 months duration, 141 with established RA, 53 with other rheumatic diseases, and 40 healthy individuals were included in the study. Anti-MCV, anti-cyclic citrullinated peptide (CCP) antibodies, and rheumatoid factor (RF) were determined and hand radiographs were recorded. Patients were assessed prospectively for 2 years, and hand radiographs were repeated. Diagnostic performance of anti-MCV was studied with receiver operating characteristic (ROC) curves and evaluation of sensitivity, specificity, and likelihood ratios. Forty-six percent of UA patients progressed to RA at 2 years. In VERA patients, sensitivity of anti-MCV was 52 %, compared to 44 % of anti-CCP and 37 % of RF, while specificity was 91 %, compared to 91 % of RF and 84 % of anti-CCP. Anti-MCV were detected in 25 % of VERA patients negative for both anti-CCP and RF. In established RA, anti-MCV did not sustain its diagnostic performance. By multivariable analysis, anti-MCV, but not anti-CCP or RF, showed significant correlation with radiographic progression in VERA patients. In established RA, anti-MCV, anti-CCP, and RF were associated with active disease (p ≤ 0.03) and joint damage (p ≤ 0.004). By multivariate analysis, the strongest factors for radiographic damage were disease duration (p = 0.000), HAQ score (p = 0.000), and RF (p = 0.002). In conclusion, in patients with very early UA, anti-MCV predict both progression to RA and radiological damage, and therefore, anti-MCV antibody testing may be useful in every day practice.
NASA Astrophysics Data System (ADS)
Owen, S. E.; Simons, M.; Hua, H.; Yun, S. H.; Agram, P. S.; Milillo, P.; Sacco, G. F.; Webb, F.; Rosen, P. A.; Lundgren, P.; Milillo, G.; Manipon, G. J. M.; Moore, A. W.; Liu, Z.; Polet, J.; Cruz, J.
2014-12-01
ARIA is a joint JPL/Caltech project to automate synthetic aperture radar (SAR) and GPS imaging capabilities for scientific understanding, hazard response, and societal benefit. We have built a prototype SAR and GPS data system that forms the foundation for hazard monitoring and response capability, as well as providing imaging capabilities important for science studies. Together, InSAR and GPS have the ability to capture surface deformation in high spatial and temporal resolution. For earthquakes, this deformation provides information that is complementary to seismic data on location, geometry and magnitude of earthquakes. Accurate location information is critical for understanding the regions affected by damaging shaking. Regular surface deformation measurements from SAR and GPS are useful for monitoring changes related to many processes that are important for hazard and resource management such as volcanic deformation, groundwater withdrawal, and landsliding. Observations of SAR coherence change have a demonstrated use for damage assessment for hazards such as earthquakes, tsunamis, hurricanes, and volcanic eruptions. These damage assessment maps can be made from imagery taken day or night and are not affected by clouds, making them valuable complements to optical imagery. The coherence change caused by the damage from hazards (building collapse, flooding, ash fall) is also detectable with intelligent algorithms, allowing for rapid generation of damage assessment maps over large areas at fine resolution, down to the spatial scale of single family homes. We will present the progress and results we have made on automating the analysis of SAR data for hazard monitoring and response using data from the Italian Space Agency's (ASI) COSMO-SkyMed constellation of X-band SAR satellites. Since the beginning of our project with ASI, our team has imaged deformation and coherence change caused by many natural hazard events around the world. We will present progress on our data system technology that enables rapid and reliable production of imagery. Lastly, we participated in the March 2014 FEMA exercise based on a repeat of the 1964 M9.2 Alaska earthquake, providing simulated data products for use in this hazards response exercise. We will present lessons learned from this and other simulation exercises.
DOE Office of Scientific and Technical Information (OSTI.GOV)
Sakharov, B.V.
1963-08-01
Clinical aspects and the course of treatment of open infected fractures in the knee joint region against a background of moderate and severe radiation sickness are discussed. The experiment involved 35 healthy dogs of both sexes. In all, three experiments were involved: on open infected fractures in the knee joint region in conjunction with radiation sickness; open infected fractures in the knee joint region without radiation sickness; radiation sickness without trauma. Infected open injury to the knee joint against a radiation sickness background is a severe affection. The use of delayed surgical and drug treatment (antibiotics, vitamins, antihistamine preparations) affordedmore » survival of at least one-half of the animals. Oral use of phenoxymethyl-penicillin in large doses established in the blood and synovial fluid of the damaged knee joint a therapeutic concentration of antibiotic of long duration (not less than a day). In radiation damage to knee joint accompanied by fracture of the bone fragment, the best method of surgical treatment is osteosynthesis using metal parts. In open infection of a damaged knee joint against a radiation sickness background, even with proper treatment a tendency toward formation of deforming arthrosis was observed. (OTS)« less
Devesa, V; Rovesti, G L; Urrutia, P G; Sanroman, F; Rodriguez-Quiros, J
2015-06-01
The objective of this study was to evaluate technical feasibility and efficacy of a joint distraction technique by traction stirrup to facilitate shoulder arthroscopy and assess potential soft tissue damage. Twenty shoulders were evaluated radiographically before distraction. Distraction was applied with loads from 40 N up to 200 N, in 40 N increments, and the joint space was recorded at each step by radiographic images. The effects of joint flexion and intra-articular air injection at maximum load were evaluated. Radiographic evaluation was performed after distraction to evaluate ensuing joint laxity. Joint distraction by traction stirrup technique produces a significant increase in the joint space; an increase in joint laxity could not be inferred by standard and stress radiographs. However, further clinical studies are required to evaluate potential neurovascular complications. A wider joint space may be useful to facilitate arthroscopy, reducing the likelihood for iatrogenic damage to intra-articular structures. Copyright © 2015 Elsevier Ltd. All rights reserved.
Pate, Kathryn M; Sherk, Vanessa D; Carpenter, R Dana; Weaver, Michael; Crapo, Silvia; Gally, Fabienne; Chatham, Lillian S; Goldstrohm, David A; Crapo, James D; Kohrt, Wendy M; Bowler, Russell P; Oberley-Deegan, Rebecca E; Regan, Elizabeth A
2015-03-15
Osteoarthritis (OA) is associated with increased mechanical damage to joint cartilage. We have previously found that extracellular superoxide dismutase (ECSOD) is decreased in OA joint fluid and cartilage, suggesting oxidant damage may play a role in OA. We explored the effect of forced running as a surrogate for mechanical damage in a transgenic mouse with reduced ECSOD tissue binding. Transgenic mice heterozygous (Het) for the human ECSOD R213G polymorphism and 129-SvEv (wild-type, WT) mice were exposed to forced running on a treadmill for 45 min/day, 5 days/wk, over 8 wk. At the end of the running protocol, knee joint tissue was obtained for histology, immunohistochemistry, and protein analysis. Sedentary Het and WT mice were maintained for comparison. Whole tibias were studied for bone morphometry, finite element analysis, and mechanical testing. Forced running improved joint histology in WT mice. However, when ECSOD levels were reduced, this beneficial effect with running was lost. Het ECSOD runner mice had significantly worse histology scores compared with WT runner mice. Runner mice for both strains had increased bone strength in response to the running protocol, while Het mice showed evidence of a less robust bone structure in both runners and untrained mice. Reduced levels of ECSOD in cartilage produced joint damage when joints were stressed by forced running. The bone tissues responded to increased loading with hypertrophy, regardless of mouse strain. We conclude that ECSOD plays an important role in protecting cartilage from damage caused by mechanical loading. Copyright © 2015 the American Physiological Society.
NASA Astrophysics Data System (ADS)
Zhang, Pei; Barlow, Robert; Masri, Assaad; Wang, Haifeng
2016-11-01
The mixture fraction and progress variable are often used as independent variables for describing turbulent premixed and non-premixed flames. There is a growing interest in using these two variables for describing partially premixed flames. The joint statistical distribution of the mixture fraction and progress variable is of great interest in developing models for partially premixed flames. In this work, we conduct predictive studies of the joint statistics of mixture fraction and progress variable in a series of piloted methane jet flames with inhomogeneous inlet flows. The employed models combine large eddy simulations with the Monte Carlo probability density function (PDF) method. The joint PDFs and marginal PDFs are examined in detail by comparing the model predictions and the measurements. Different presumed shapes of the joint PDFs are also evaluated.
NASA Astrophysics Data System (ADS)
Sun, Guo-Qin; Sun, Feng-Yang; Cao, Fang-Li; Chen, Shu-Jun; Barkey, Mark E.
2015-11-01
The numerical simulation of tensile fracture behavior on Al-Cu alloy friction stir-welded joint was performed with the Gurson-Tvergaard-Needleman (GTN) damage model. The parameters of the GTN model were studied in each region of the friction stir-welded joint by means of inverse identification. Based on the obtained parameters, the finite element model of the welded joint was built to predict the fracture behavior and tension properties. Good agreement can be found between the numerical and experimental results in the location of the tensile fracture and the mechanical properties.
Østergaard, Mikkel; Peterfy, Charles G; Bird, Paul; Gandjbakhch, Frédérique; Glinatsi, Daniel; Eshed, Iris; Haavardsholm, Espen A; Lillegraven, Siri; Bøyesen, Pernille; Ejbjerg, Bo; Foltz, Violaine; Emery, Paul; Genant, Harry K; Conaghan, Philip G
2017-11-01
The Outcome Measures in Rheumatology (OMERACT) Rheumatoid Arthritis (RA) Magnetic Resonance Imaging (MRI) scoring system (RAMRIS), evaluating bone erosion, bone marrow edema/osteitis, and synovitis, was introduced in 2002, and is now the standard method of objectively quantifying inflammation and damage by MRI in RA trials. The objective of this paper was to identify subsequent advances and based on them, to provide updated recommendations for the RAMRIS. MRI studies relevant for RAMRIS and technical and scientific advances were analyzed by the OMERACT MRI in Arthritis Working Group, which used these data to provide updated considerations on image acquisition, RAMRIS definitions, and scoring systems for the original and new RA pathologies. Further, a research agenda was outlined. Since 2002, longitudinal studies and clinical trials have documented RAMRIS variables to have face, construct, and criterion validity; high reliability and sensitivity to change; and the ability to discriminate between therapies. This has enabled RAMRIS to demonstrate inhibition of structural damage progression with fewer patients and shorter followup times than has been possible with conventional radiography. Technical improvements, including higher field strengths and improved pulse sequences, allow higher image resolution and contrast-to-noise ratio. These have facilitated development and validation of scoring methods of new pathologies: joint space narrowing and tenosynovitis. These have high reproducibility and moderate sensitivity to change, and can be added to RAMRIS. Combined scores of inflammation or joint damage may increase sensitivity to change and discriminative power. However, this requires further research. Updated 2016 RAMRIS recommendations and a research agenda were developed.
Zavaleta-Muñiz, S A; Gonzalez-Lopez, L; Murillo-Vazquez, J D; Saldaña-Cruz, A M; Vazquez-Villegas, M L; Martín-Márquez, B T; Vasquez-Jimenez, J C; Sandoval-Garcia, F; Ruiz-Padilla, A J; Fajardo-Robledo, N S; Ponce-Guarneros, J M; Rocha-Muñoz, A D; Alcaraz-Lopez, M F; Cardona-Müller, D; Totsuka-Sutto, S E; Rubio-Arellano, E D; Gamez-Nava, J I
2016-12-19
Several interleukin 6 gene (IL6) polymorphisms are implicated in susceptibility to rheumatoid arthritis (RA). It has not yet been established with certainty if these polymorphisms are associated with the severe radiographic damage observed in some RA patients, particularly those with the development of joint bone ankylosis (JBA). The objective of the present study was to evaluate the association between severe radiographic damage in hands and the -174G/C and -572G/C IL6 polymorphisms in Mexican Mestizo people with RA. Mestizo adults with RA and long disease duration (>5 years) were classified into two groups according to the radiographic damage in their hands: a) severe radiographic damage (JBA and/or joint bone subluxations) and b) mild or moderate radiographic damage. We compared the differences in genotype and allele frequencies of -174G/C and -572G/C IL6 polymorphisms (genotyped using polymerase chain reaction-restriction fragment length polymorphism) between these two groups. Our findings indicated that the -174G/C polymorphism of IL6 is associated with severe joint radiographic damage [maximum likelihood odds ratios (MLE_OR): 8.03; 95%CI 1.22-187.06; P = 0.03], whereas the -572G/C polymorphism of IL6 exhibited no such association (MLE_OR: 1.5; 95%CI 0.52-4.5; P = 0.44). Higher anti-cyclic citrullinated peptide antibody levels were associated with more severe joint radiographic damage (P = 0.04). We conclude that there is a relevant association between the -174G/C IL6 polymorphism and severe radiographic damage. Future studies in other populations are required to confirm our findings.
Geven, Edwin J W; van den Bosch, Martijn H J; Di Ceglie, Irene; Ascone, Giuliana; Abdollahi-Roodsaz, Shahla; Sloetjes, Annet W; Hermann, Sven; Schäfers, Michael; van de Loo, Fons A J; van der Kraan, Peter M; Koenders, Marije I; Foell, Dirk; Roth, Johannes; Vogl, Thomas; van Lent, Peter L E M
2016-10-24
Seronegative joint diseases are characterized by a lack of well-defined biomarkers since autoantibodies are not elevated. Calprotectin (S100A8/A9) is a damage-associated molecular pattern (DAMP) which is released by activated phagocytes, and high levels are found in seronegative arthritides. In this study, we investigated the biomarker potential of systemic and local levels of these S100 proteins to assess joint inflammation and joint destruction in an experimental model for seronegative arthritis. Serum levels of S100A8/A9 and various cytokines were monitored during disease development in interleukin-1 receptor antagonist (IL-1Ra) -/- mice using ELISA and multiplex bead-based immunoassay, and were correlated to macroscopic and microscopic parameters for joint inflammation, bone erosion, and cartilage damage. Local expression of S100A8 and S100A9 and matrix metalloproteinase (MMP)-mediated cartilage damage in the ankle joints were investigated by immunohistochemistry. In addition, local S100A8 and activated MMPs were monitored in vivo by optical imaging using anti-S100A8-Cy7 and AF489-Cy5.5, a specific tracer for activated MMPs. Serum levels of S100A8/A9 were significantly increased in IL-1Ra -/- mice and correlated with macroscopic joint swelling and histological inflammation, while serum levels of pro-inflammatory cytokines did not correlate with joint swelling. In addition, early serum S100A8/A9 levels were prognostic for disease outcome at a later stage. The increased serum S100A8/A9 levels were reflected by an increased expression of S100A8 and S100A9 within the ankle joint, as visualized by molecular imaging. Next to inflammatory processes, serum S100A8/A9 also correlated with histological parameters for bone erosion and cartilage damage. In addition, arthritic IL-1Ra -/- mice with increased synovial S100A8 and S100A9 expression showed increased cartilage damage that coincided with MMP-mediated neoepitope expression and in vivo imaging of activated MMPs. Expression of S100A8 and S100A9 in IL-1Ra -/- mice strongly correlates with synovial inflammation, bone erosion, and cartilage damage, underlining the potential of S100A8/A9 as a systemic and local biomarker in seronegative arthritis not only for assessing inflammation but also for assessing severity of inflammatory joint destruction.
Robust control of multi-jointed arm with a decentralized autonomous control mechanism
NASA Technical Reports Server (NTRS)
Kimura, Shinichi; Miyazaki, Ken; Suzuki, Yoshiaki
1994-01-01
A decentralized autonomous control mechanism applied to the control of three dimensional manipulators and its robustness to partial damage was assessed by computer simulation. Decentralized control structures are believed to be quite robust to time delay between the operator and the target system. A 10-jointed manipulator based on our control mechanism was able to continue its positioning task in three-dimensional space without revision of the control program, even after some of its joints were damaged. These results suggest that this control mechanism can be effectively applied to space telerobots, which are associated with serious time delay between the operator and the target system, and which cannot be easily repaired after being partially damaged.
Laragione, Teresina; Cheng, Kai F; Tanner, Mark R; He, Mingzhu; Beeton, Christine; Al-Abed, Yousef; Gulko, Pércio S
2015-06-01
Little is known about the regulation of arthritis severity and joint damage in rheumatoid arthritis (RA). Fibroblast-like synoviocytes (FLS) have a central role in joint damage and express increased levels of the cation channel Trpv2. We aimed at determining the role of Trpv2 in arthritis. Treatment with Trpv2-specific agonists decreased the in vitro invasiveness of FLS from RA patients and arthritic rats and mice. Trpv2 stimulation suppressed IL-1β-induced expression of MMP-2 and MMP-3. Trpv2 agonists, including the new and more potent LER13, significantly reduced disease severity in KRN serum- and collagen-induced arthritis, and reduced histologic joint damage, synovial inflammation, and synovial blood vessel numbers suggesting anti-angiogenic activity. In this first in vivo use of Trpv2 agonists we discovered a new central role for Trpv2 in arthritis. These new compounds have the potential to become new therapies for RA and other diseases associated with inflammation, invasion, and angiogenesis. Copyright © 2015 Elsevier Inc. All rights reserved.
Laragione, Teresina; Cheng, Kai F.; Tanner, Mark R.; He, Mingzhu; Beeton, Christine; Al-Abed, Yousef; Gulko, Pércio S.
2015-01-01
Little is known about the regulation of arthritis severity and joint damage in rheumatoid arthritis (RA). Fibroblast-like synoviocytes (FLS) have a central role in joint damage and express increased levels of the cation channel Trpv2. We aimed at determining the role of Trpv2 in arthritis. Treatment with Trpv2-specific agonists decreased the in vitro invasiveness of FLS from RA patients and arthritic rats and mice. Trpv2 stimulation suppressed IL-1β-induced expression of MMP-2 and MMP-3. Trpv2 agonists, including the new and more potent LER13, significantly reduced disease severity in KRN serum- and collagen-induced arthritis, and reduced histologic joint damage, synovial inflammation, and synovial blood vessel numbers suggesting anti-angiogenic activity. In this first in vivo use of Trpv2 agonists we discovered a new central role for Trpv2 in arthritis. These new compounds have the potential to become new therapies for RA and other diseases associated with inflammation, invasion and angiogenesis. PMID:25869297
Early detection and progression of decay in L-joints and lap-joints in a moderate decay hazard zone
Carol A. Clausen; Terry L. Highley; Daniel L. Lindner
2006-01-01
Accelerated test methods are needed to evaluate the initiation and progression of decay in wood exposed aboveground. The relationship between test conditions and initiation of decay, however, is poorly understood. Southern pine and maple L-joints and lap-joints were exposed aboveground in a configuration that encouraged water entrapment at the Valley View Experimental...
Therapies for the bone in mucopolysaccharidoses
Tomatsu, Shunji; Alméciga-Díaz, Carlos J.; Montaño, Adriana M.; Yabe, Hiromasa; Tanaka, Akemi; Dung, Vu Chi; Giugliani, Roberto; Kubaski, Francyne; Mason, Robert W.; Yasuda, Eriko; Sawamoto, Kazuki; Mackenzie, William; Suzuki, Yasuyuki; Orii, Kenji E.; Barrera, Luis A.; Sly, William S.; Orii, Tadao
2014-01-01
Patients with mucopolysaccharidoses (MPS) have accumulation of glycosaminoglycans in multiple tissues which may cause coarse facial features, mental retardation, recurrent ear and nose infections, inguinal and umbilical hernias, hepatosplenomegaly, and skeletal deformities. Clinical features related to bone lesions may include marked short stature, cervical stenosis, pectus carinatum, small lungs, joint rigidity (but laxity for MPS IV), kyphoscoliosis, lumbar gibbus, and genu valgum. Patients with MPS are often wheelchair-bound and physical handicaps increase with age as a result of progressive skeletal dysplasia, abnormal joint mobility, and osteoarthritis, leading to 1) stenosis of the upper cervical region, 2) restrictive small lung, 3) hip dysplasia, 4) restriction of joint movement, and 5) surgical complications. Patients often need multiple orthopedic procedures including cervical decompression and fusion, carpal tunnel release, hip reconstruction and replacement, and femoral or tibial osteotomy through their lifetime. Current measures to intervene in bone disease progression are not perfect and palliative, and improved therapies are urgently required. Enzyme replacement therapy (ERT), hematopoietic stem cell transplantation (HSCT), and gene therapy are available or in development for some types of MPS. Delivery of sufficient enzyme to bone, especially avascular cartilage, to prevent or ameliorate the devastating skeletal dysplasias remains an unmet challenge. The use of an anti-inflammatory drug is also under clinical study. Therapies should start at a very early stage prior to irreversible bone lesion, and damage since the severity of skeletal dysplasia is associated with level of activity during daily life. This review illustrates a current overview of therapies and their impact for bone lesions in MPS including ERT, HSCT, gene therapy, and anti-inflammatory drugs. PMID:25537451
Metabolic syndrome-associated osteoarthritis.
Courties, Alice; Sellam, Jérémie; Berenbaum, Francis
2017-03-01
Interest in the metabolic syndrome-associated osteoarthritis phenotype is increasing. Here, we summarize recently published significant findings. Meta-analyses confirmed an association between type 2 diabetes and osteoarthritis and between cardiovascular diseases and osteoarthritis. Recent advances in the study of metabolic syndrome-associated osteoarthritis have focused on a better understanding of the role of metabolic diseases in inducing or aggravating joint damage. In-vivo models of obesity, diabetes, or dyslipidemia have helped to better decipher this association. They give emerging evidence that, beyond the role of common pathogenic mechanisms for metabolic diseases and osteoarthritis (i.e., low-grade inflammation and oxidative stress), metabolic diseases have a direct systemic effect on joints. In addition to the impact of weight, obesity-associated inflammation is associated with osteoarthritis severity and may modulate osteoarthritis progression in mouse models. As well, osteoarthritis synovium from type 2 diabetic patients shows insulin-resistant features, which may participate in joint catabolism. Finally, exciting data are emerging on the association of gut microbiota and circadian rhythm and metabolic syndrome-associated osteoarthritis. The systemic role of metabolic syndrome in osteoarthritis pathophysiology is now better understood, but new avenues of research are being pursued to better decipher the metabolic syndrome-associated osteoarthritis phenotype.
... or have trouble moving around, you might have arthritis. Most kinds of arthritis cause pain and swelling in your joints. Joints ... joint can become severely damaged. Some kinds of arthritis can also cause problems in your organs, such ...
Tam, Lai-Shan
2016-10-01
Since 2011, members of the SPECTRA Collaboration (Study grouP for xtrEme-Computed Tomography in Rheumatoid Arthritis) have investigated the validity, reliability, and responsiveness of high-resolution peripheral quantitative computed tomography (HR-pQCT) as a biomarker for joint damage in inflammatory arthritis. Presented in this series of articles are a systematic review of HR-pQCT-related findings to date, a review of selected images of cortical and subchondral trabecular bone of metacarpophalangeal (MCP) joints, results of a consensus process to standardize the definition of erosions and their quantification, as well as an examination of the effect of joint flexion on width and volume assessment of the joint space.
Progressive Fracture of Fiber Composite Build-Up Structures
NASA Technical Reports Server (NTRS)
Gotsis, Pascal K.; Chamis, C. C.; Minnetyan, Levon
1997-01-01
Damage progression and fracture of built-up composite structures is evaluated by using computational simulation. The objective is to examine the behavior and response of a stiffened composite (0/ +/- 45/90)(sub s6) laminate panel by simulating the damage initiation, growth, accumulation, progression and propagation to structural collapse. An integrated computer code, CODSTRAN, was augmented for the simulation of the progressive damage and fracture of built-up composite structures under mechanical loading. Results show that damage initiation and progression have significant effect on the structural response. Influence of the type of loading is investigated on the damage initiation, propagation and final fracture of the build-up composite panel.
Progressive Fracture of Fiber Composite Build-Up Structures
NASA Technical Reports Server (NTRS)
Minnetyan, Levon; Gotsis, Pascal K.; Chamis, C. C.
1997-01-01
Damage progression and fracture of built-up composite structures is evaluated by using computational simulation. The objective is to examine the behavior and response of a stiffened composite (0 +/-45/90)(sub s6) laminate panel by simulating the damage initiation, growth, accumulation, progression and propagation to structural collapse. An integrated computer code CODSTRAN was augmented for the simulation of the progressive damage and fracture of built-up composite structures under mechanical loading. Results show that damage initiation and progression to have significant effect on the structural response. Influence of the type of loading is investigated on the damage initiation, propagation and final fracture of the build-up composite panel.
Modeling thermal and irradiation-induced swelling effects on the integrity of Ti 3 SiC 2 /SiC joints
DOE Office of Scientific and Technical Information (OSTI.GOV)
Nguyen, Ba Nghiep; Henager, Charles H.; Kurtz, Richard J.
Previously, results for CVD-SiC joints created using solid state displacement reactions to form a dual-phase SiC/MAX phase irradiated at 800°C and 5 dpa indicated some extent of cracking in the joint and along the CVD-SiC/joint interface. This paper elucidates the origin of cracking by thermomechanical modeling combined with irradiation-induced swelling effects using a continuum damage approach with support of micromechanical modeling. Three irradiation temperatures (400°C, 500°C and 800°C) are considered assuming experimental irradiation doses in a range leading to saturation swelling in SiC. The analyses indicate that a SiC/MAX joint heated to 400°C fails during irradiation-induced swelling at this temperaturemore » while it experiences some damage after being heated to 500°C and irradiated at the same temperature. However, it fails during cooling from 500°C to room temperature. The joint experiences minor damage when heated to and irradiated at 800°C but does not fail after cooling. The prediction agrees with the experimental findings available for this case.« less
Spahn, Gunter; Lipfert, Jens Uwe; Maurer, Constance; Hartmann, Bernd; Schiele, Rainer; Klemm, Holm-Torsten; Grifka, Joachim; Hofmann, Gunther O
2017-04-01
This case-control study compares patients with healthy elbows to a group of symptomatic patients with cartilage damage/osteoarthritis. The control group (n = 126) was recruited during routine medical examinations of patients (general medical offices). Included in the case group were a total of 92 patients who were undergoing arthroscopy as a result of chronic elbow discomfort. All patients were questioned with regard to occupational stress and athletic stress. A significantly increased risk of cartilage damage/osteoarthritis was found with subjectively perceived increased stress in occupational settings: OR = 3.8 (95% CI 2.1-6.7); p < 0.001; for the individual stresses of the elbow joint in occupational settings, the following severities in effects were found: Exposure to heavy work OR = 3.9 (95% CI 2.2-6.8); Force OR = 3.7 (95% CI 2.1-6.5); Vibration OR = 4.6 (95% CI 2.5-8.5); Repetition OR = 9.2 (95% CI 3.6-23.3); p < 0.001. Elbow-stressing sport types represent a potential risk factor for the development of cartilage damage/osteoarthritis of the elbow joint: OR = 2.5 (95% CI 1.3-4.7); p = 0.003. Cartilage damage/radiographic osteoarthritis of the elbow joint are rare with respect to the overall prevalence of osteoarthritis. In the large number of patients with cartilage damage/radiographic osteoarthritis of the elbow joint, occupational or athletic stress factors and injuries sustained, in addition to other causes (rheumatism, gout), can prove as possible causes of these as secondary to symptomatic forms of osteoarthritis.
Giannotti, S; Giovannelli, D; Dell'Osso, G; Bottai, V; Bugelli, G; Celli, F; Citarelli, C; Guido, G
2016-04-01
The tibial plateau fractures involve one of the main weight bearing joints of the human body. The goals of surgical treatment are anatomical reduction, articular surface reconstruction and high primary stability. The aim of this study was to evaluate the clinical and functional outcomes after internal plate fixation of this kind of fractures. From January 2009 to December 2012, we treated 75 cases of tibial plateau fracture with angular stable plates. We used Rasmussen Score and the Knee Society Score for the clinical and functional evaluation. Twenty-five cases that underwent hardware removal had arthroscopic and CT evaluation of the joint. No complications occurred. The clinical and functional evaluation, performed by the KSS and Rasmussen Score, highlighted the high percentage of good-to-excellent results (over 90 %). In every case, the range of motion was good with flexion >90°. Arthroscopy showed the presence of chondral damage in 100 % of patients. In all the cases, we found that X-ray images seem better than the CT images. Angular stable plates allow to obtain a good primary stability, permitting an early joint recovery with an excellent range of motion. Avoiding to perform a knee arthrotomy at the time of fracture reduction could prove to be an advantage in terms of functional recovery. The meniscus on the injured bone should be preserved in order to maintain good function of the joint. X-ray images remain the gold standard in checking the progression of post-traumatic osteoarthritis.
Siebelt, Michiel; Groen, Harald C; Koelewijn, Stuart J; de Blois, Erik; Sandker, Marjan; Waarsing, Jan H; Müller, Cristina; van Osch, Gerjo J V M; de Jong, Marion; Weinans, Harrie
2014-01-29
Articular cartilage needs sulfated-glycosaminoglycans (sGAGs) to withstand high pressures while mechanically loaded. Chondrocyte sGAG synthesis is regulated by exposure to compressive forces. Moderate physical exercise is known to improve cartilage sGAG content and might protect against osteoarthritis (OA). This study investigated whether rat knee joints with sGAG depleted articular cartilage through papain injections might benefit from moderate exercise, or whether this increases the susceptibility for cartilage degeneration. sGAGs were depleted from cartilage through intraarticular papain injections in the left knee joints of 40 Wistar rats; their contralateral joints served as healthy controls. Of the 40 rats included in the study, 20 rats remained sedentary, and the other 20 were subjected to a moderately intense running protocol. Animals were longitudinally monitored for 12 weeks with in vivo micro-computed tomography (μCT) to measure subchondral bone changes and single-photon emission computed tomography (SPECT)/CT to determine synovial macrophage activation. Articular cartilage was analyzed at 6 and 12 weeks with ex vivo contrast-enhanced μCT and histology to measure sGAG content and cartilage thickness. All outcome measures were unaffected by moderate exercise in healthy control joints of running animals compared with healthy control joints of sedentary animals. Papain injections in sedentary animals resulted in severe sGAG-depleted cartilage, slight loss of subchondral cortical bone, increased macrophage activation, and osteophyte formation. In running animals, papain-induced sGAG-depleted cartilage showed increased cartilage matrix degradation, sclerotic bone formation, increased macrophage activation, and more osteophyte formation. Moderate exercise enhanced OA progression in papain-injected joints and did not protect against development of the disease. This was not restricted to more-extensive cartilage damage, but also resulted in pronounced subchondral sclerosis, synovial macrophage activation, and osteophyte formation.
Evaluation of the fuselage lap joint fatigue and terminating action repair
NASA Technical Reports Server (NTRS)
Samavedam, Gopal; Thomson, Douglas; Jeong, David Y.
1994-01-01
Terminating action is a remedial repair which entails the replacement of shear head countersunk rivets with universal head rivets which have a larger shank diameter. The procedure was developed to eliminate the risk of widespread fatigue damage (WFD) in the upper rivet row of a fuselage lap joint. A test and evaluation program has been conducted by Foster-Miller, Inc. (FMI) to evaluate the terminating action repair of the upper rivet row of a commercial aircraft fuselage lap splice. Two full scale fatigue tests were conducted on fuselage panels using the growth of fatigue cracks in the lap joint. The second test was performed to evaluate the effectiveness of the terminating action repair. In both tests, cyclic pressurization loading was applied to the panels while crack propagation was recorded at all rivet locations at regular intervals to generate detailed data on conditions of fatigue crack initiation, ligament link-up, and fuselage fracture. This program demonstrated that the terminating action repair substantially increases the fatigue life of a fuselage panel structure and effectively eliminates the occurrence of cracking in the upper rivet row of the lap joint. While high cycle crack growth was recorded in the middle rivet row during the second test, failure was not imminent when the test was terminated after cycling to well beyond the service life. The program also demonstrated that the initiation, propagation, and linkup of WFD in full-scale fuselage structures can be simulated and quantitatively studied in the laboratory. This paper presents an overview of the testing program and provides a detailed discussion of the data analysis and results. Crack distribution and propagation rates and directions as well as frequency of cracking are presented for both tests. The progression of damage to linkup of adjacent cracks and to eventual overall panel failure is discussed. In addition, an assessment of the effectiveness of the terminating action repair and the occurrence of cracking in the middle rivet row is provided, and conclusions of practical interest are drawn.
Structural health management of aerospace hotspots under fatigue loading
NASA Astrophysics Data System (ADS)
Soni, Sunilkumar
Sustainability and life-cycle assessments of aerospace systems, such as aircraft structures and propulsion systems, represent growing challenges in engineering. Hence, there has been an increasing demand in using structural health monitoring (SHM) techniques for continuous monitoring of these systems in an effort to improve safety and reduce maintenance costs. The current research is part of an ongoing multidisciplinary effort to develop a robust SHM framework resulting in improved models for damage-state awareness and life prediction, and enhancing capability of future aircraft systems. Lug joints, a typical structural hotspot, were chosen as the test article for the current study. The thesis focuses on integrated SHM techniques for damage detection and characterization in lug joints. Piezoelectric wafer sensors (PZTs) are used to generate guided Lamb waves as they can be easily used for onboard applications. Sensor placement in certain regions of a structural component is not feasible due to the inaccessibility of the area to be monitored. Therefore, a virtual sensing concept is introduced to acquire sensor data from finite element (FE) models. A full three dimensional FE analysis of lug joints with piezoelectric transducers, accounting for piezoelectrical-mechanical coupling, was performed in Abaqus and the sensor signals were simulated. These modeled sensors are called virtual sensors. A combination of real data from PZTs and virtual sensing data from FE analysis is used to monitor and detect fatigue damage in aluminum lug joints. Experiments were conducted on lug joints under fatigue loads and sensor signals collected were used to validate the simulated sensor response. An optimal sensor placement methodology for lug joints is developed based on a detection theory framework to maximize the detection rate and minimize the false alarm rate. The placement technique is such that the sensor features can be directly correlated to damage. The technique accounts for a number of factors, such as actuation frequency and strength, minimum damage size, damage detection scheme, material damping, signal to noise ratio and sensing radius. Advanced information processing methodologies are discussed for damage diagnosis. A new, instantaneous approach for damage detection, localization and quantification is proposed for applications to practical problems associated with changes in reference states under different environmental and operational conditions. Such an approach improves feature extraction for state awareness, resulting in robust life prediction capabilities.
Progressive Fracture of Fiber Composite Builtup Structures
NASA Technical Reports Server (NTRS)
Gotsis, Pascal K.; Chamis, Christos C.; Minnetyan, Levon
1996-01-01
The damage progression and fracture of builtup composite structures was evaluated by using computational simulation to examine the behavior and response of a stiffened composite (0 +/- 45/90)(sub s6) laminate panel subjected to a bending load. The damage initiation, growth, accumulation, progression, and propagation to structural collapse were simulated. An integrated computer code (CODSTRAN) was augmented for the simulation of the progressive damage and fracture of builtup composite structures under mechanical loading. Results showed that damage initiation and progression have a significant effect on the structural response. Also investigated was the influence of different types of bending load on the damage initiation, propagation, and final fracture of the builtup composite panel.
NASA Astrophysics Data System (ADS)
Marhadi, Kun Saptohartyadi
Structural optimization for damage tolerance under various unforeseen damage scenarios is computationally challenging. It couples non-linear progressive failure analysis with sampling-based stochastic analysis of random damage. The goal of this research was to understand the relationship between alternate load paths available in a structure and its damage tolerance, and to use this information to develop computationally efficient methods for designing damage tolerant structures. Progressive failure of a redundant truss structure subjected to small random variability was investigated to identify features that correlate with robustness and predictability of the structure's progressive failure. The identified features were used to develop numerical surrogate measures that permit computationally efficient deterministic optimization to achieve robustness and predictability of progressive failure. Analysis of damage tolerance on designs with robust progressive failure indicated that robustness and predictability of progressive failure do not guarantee damage tolerance. Damage tolerance requires a structure to redistribute its load to alternate load paths. In order to investigate the load distribution characteristics that lead to damage tolerance in structures, designs with varying degrees of damage tolerance were generated using brute force stochastic optimization. A method based on principal component analysis was used to describe load distributions (alternate load paths) in the structures. Results indicate that a structure that can develop alternate paths is not necessarily damage tolerant. The alternate load paths must have a required minimum load capability. Robustness analysis of damage tolerant optimum designs indicates that designs are tailored to specified damage. A design Optimized under one damage specification can be sensitive to other damages not considered. Effectiveness of existing load path definitions and characterizations were investigated for continuum structures. A load path definition using a relative compliance change measure (U* field) was demonstrated to be the most useful measure of load path. This measure provides quantitative information on load path trajectories and qualitative information on the effectiveness of the load path. The use of the U* description of load paths in optimizing structures for effective load paths was investigated.
The Influence of Sn Orientation on the Electromigration of Idealized Lead-free Interconnects
NASA Astrophysics Data System (ADS)
Linares, Xioranny
As conventional lead solders are being replaced by Pb-free solders in electronic devices, the reliability of solder joints in integrated circuits (ICs) has become a high concern. Due to the miniaturization of ICs and consequently solder joints, the current density through the solder interconnects has increased causing electrical damage known as electromigration. Electromigration, atomic and mass migration due to high electron currents, is one of the most urgent reliability issues delaying the implementation of Pb-free solder materials in electronic devices. The research on Pb-free solders has mainly focused on the qualitative understanding of failure by electromigration. There has been little progress however, on the quantitative analysis of electromigration because of the lack of available material parameters, such as the effective charge, (z*), the driving force for electromigration. The research herein uses idealized interconnects to measure the z* of electromigration of Cu in Sn-3.0Ag-0.5Cu (SAC305) alloy under different experimental conditions. Planar SAC 305 interconnects were sandwiched between two Cu pads and subject to uniaxial current. The crystallographic orientation of Sn in these samples were characterized with electron backscatter diffraction (EBSD) and wavelength dispersive spectroscopy (WDS) before and after electromigration testing. Results indicate that samples with the c-axis aligned perpendicular to current flow, polycrystalline, and those with a diffusion barrier on the cathode side all inhibit the growth of intermetallic compounds (IMC). The effective charge values of Cu in SAC 305 under the different conditions tested were quantified for the first time and included in this dissertation. The following research is expected to help verify and improve the electromigration model and identify the desirable conditions to inhibit damage by electromigration in Pb-free solder joints.
Low dose native type II collagen prevents pain in a rat osteoarthritis model
2013-01-01
Background Osteoarthritis is the most widespread joint-affecting disease. Patients with osteoarthritis experience pain and impaired mobility resulting in marked reduction of quality of life. A progressive cartilage loss is responsible of an evolving disease difficult to treat. The characteristic of chronicity determines the need of new active disease modifying drugs. Aim of the present research is to evaluate the role of low doses of native type II collagen in the rat model of osteoarthritis induced by sodium monoiodoacetate (MIA). Methods 1, 3 and 10 mg kg-1 porcine native type II collagen were daily per os administered for 13 days starting from the day of MIA intra-articular injection. Results On day 14, collagen-treated rats showed a significant prevention of pain threshold alterations induced by MIA. Evaluation were performed on paws using mechanical noxious (Paw pressure test) or non-noxious (Electronic Von Frey test) stimuli, and a decrease of articular pain was directly measured on the damaged joint (PAM test). The efficacy of collagen in reducing pain was as higher as the dose was lowered. Moreover, a reduced postural unbalance, measured as hind limb weight bearing alterations (Incapacitance test), and a general improvement of motor activity (Animex test) were observed. Finally, the decrease of plasma and urine levels of CTX-II (Cross Linked C-Telopeptide of Type II Collagen), a biomarker of cartilage degradation, suggests a collagen-dependent decrease of structural joint damage. Conclusions These results describe the preclinical efficacy of low dosages of native type II collagen as pain reliever by a mechanism that involves a protective effect on cartilage. PMID:23915264
Ko, Frank C.; Dragomir, Cecilia; Plumb, Darren A.; Goldring, Steven R.; Wright, Timothy M.; Goldring, Mary B.; van der Meulen, Marjolein C.H.
2013-01-01
Objectives Alterations in the mechanical loading environment in joints may have both beneficial and detrimental effects on articular cartilage and subchondral bone and subsequently influence the development of osteoarthritis (OA). We used an in vivo tibial loading model to investigate the adaptive responses of cartilage and bone to mechanical loading and to assess the influence of load level and duration. Methods We applied cyclic compression of 4.5 and 9.0N peak loads to the left tibia via the knee joint of adult (26-week-old) C57Bl/6 male mice for 1, 2, and 6 weeks. Only 9.0N loading was utilized in young (10-week-old) mice. The changes in articular cartilage and subchondral bone were analyzed by histology and microcomputed tomography. Results Loading promoted cartilage damage in both age groups, with increased damage severity dependent upon the duration of loading. Metaphyseal bone mass increased in the young mice, but not in the adult mice, whereas epiphyseal cancellous bone mass decreased with loading in both young and adult mice. Articular cartilage thickness decreased, and subchondral cortical bone thickness increased in the posterior tibial plateau in both age groups. Both age groups developed periarticular osteophytes at the tibial plateau in response to the 9.0N load, but no osteophyte formation occurred in adult mice subjected to 4.5N peak loading. Conclusion This non-invasive loading model permits dissection of temporal and topographical changes in cartilage and bone and will enable investigation of the efficacy of treatment interventions targeting joint biomechanics or biological events that promote OA onset and progression. PMID:23436303
Structural behavior of composites with progressive fracture
NASA Technical Reports Server (NTRS)
Minnetyan, L.; Murthy, P. L. N.; Chamis, C. C.
1989-01-01
The objective of the study is to unify several computational tools developed for the prediction of progressive damage and fracture with efforts for the prediction of the overall response of damaged composite structures. In particular, a computational finite element model for the damaged structure is developed using a computer program as a byproduct of the analysis of progressive damage and fracture. Thus, a single computational investigation can predict progressive fracture and the resulting variation in structural properties of angleplied composites.
Distinguishing erosive osteoarthritis and calcium pyrophosphate deposition disease.
Rothschild, Bruce M
2013-04-18
Erosive osteoarthritis is a term utilized to describe a specific inflammatory condition of the interphalangeal and first carpal metacarpal joints of the hands. The term has become a part of medical philosophical semantics and paradigms, but the issue is actually more complicated. Even the term osteoarthritis (non-erosive) has been controversial, with some suggesting osteoarthrosis to be more appropriate in view of the perspective that it is a non-inflammatory process undeserving of the "itis" suffix. The term "erosion" has also been a source of confusion in osteoarthritis, as it has been used to describe cartilage, not bone lesions. Inflammation in individuals with osteoarthritis actually appears to be related to complicating phenomena, such as calcium pyrophosphate and hydroxyapatite crystal deposition producing arthritis. Erosive osteoarthritis is the contentious term. It is used to describe a specific form of joint damage to specific joints. The damage has been termed erosions and the distribution of the damage is to the interphalangeal joints of the hand and first carpal metacarpal joint. Inflammation is recognized by joint redness and warmth, while X-rays reveal alteration of the articular surfaces, producing a smudged appearance. This ill-defined, joint damage has a crumbling appearance and is quite distinct from the sharply defined erosions of rheumatoid arthritis and spondyloarthropathy. The appearance is identical to those found with calcium pyrophosphate deposition disease, both in character and their unique responsiveness to hydroxychloroquine treatment. Low doses of the latter often resolve symptoms within weeks, in contrast to higher doses and the months required for response in other forms of inflammatory arthritis. Reconsidering erosive osteoarthritis as a form of calcium pyrophosphate deposition disease guides physicians to more effective therapeutic intervention.
Distinguishing erosive osteoarthritis and calcium pyrophosphate deposition disease
Rothschild, Bruce M
2013-01-01
Erosive osteoarthritis is a term utilized to describe a specific inflammatory condition of the interphalangeal and first carpal metacarpal joints of the hands. The term has become a part of medical philosophical semantics and paradigms, but the issue is actually more complicated. Even the term osteoarthritis (non-erosive) has been controversial, with some suggesting osteoarthrosis to be more appropriate in view of the perspective that it is a non-inflammatory process undeserving of the “itis” suffix. The term “erosion” has also been a source of confusion in osteoarthritis, as it has been used to describe cartilage, not bone lesions. Inflammation in individuals with osteoarthritis actually appears to be related to complicating phenomena, such as calcium pyrophosphate and hydroxyapatite crystal deposition producing arthritis. Erosive osteoarthritis is the contentious term. It is used to describe a specific form of joint damage to specific joints. The damage has been termed erosions and the distribution of the damage is to the interphalangeal joints of the hand and first carpal metacarpal joint. Inflammation is recognized by joint redness and warmth, while X-rays reveal alteration of the articular surfaces, producing a smudged appearance. This ill-defined, joint damage has a crumbling appearance and is quite distinct from the sharply defined erosions of rheumatoid arthritis and spondyloarthropathy. The appearance is identical to those found with calcium pyrophosphate deposition disease, both in character and their unique responsiveness to hydroxychloroquine treatment. Low doses of the latter often resolve symptoms within weeks, in contrast to higher doses and the months required for response in other forms of inflammatory arthritis. Reconsidering erosive osteoarthritis as a form of calcium pyrophosphate deposition disease guides physicians to more effective therapeutic intervention. PMID:23610748
2011-11-01
elastic range, and with some simple forms of progressing damage . However, a general physics-based methodology to assess the initial and lifetime... damage evolution in the RVE for all possible load histories. Microstructural data on initial configuration and damage progression in CMCs were...the damaged elements will have changed, hence, a progressive damage model. The crack opening for each crack type in each element is stored as a
The Characteristics of Fatigue Damage in the Fuselage Riveted Lap Splice Joint
NASA Technical Reports Server (NTRS)
Piascik, Robert S.; Willard, Scott A.
1997-01-01
An extensive data base has been developed to form the physical basis for new analytical methodology to predict the onset of widespread fatigue damage in the fuselage lap splice joint. The results of detailed destructive examinations have been cataloged to describe the physical nature of MSD in the lap splice joint. ne catalog includes a detailed description, e.g., crack initiation, growth rates, size, location, and fracture morphology, of fatigue damage in the fuselage lap splice joint structure. Detailed examinations were conducted on a lap splice joint panel removed from a full scale fuselage test article after completing a 60,000 cycle pressure test. The panel contained a four bay region that exhibited visible outer skin cracks and regions of crack link-up along the upper rivet row. Destructive examinations revealed undetected fatigue damage in the outer skin, inner skin, and tear strap regions. Outer skin fatigue cracks were found to initiate by fretting damage along the faying surface. The cracks grew along the faying surface to a length equivalent to two to three skin thicknesses before penetrating the outboard surface of the outer skin. Analysis of fracture surface marker bands produced during full scale testing revealed that all upper rivet row fatigue cracks contained in a dim bay region grow at similar rates; this important result suggests that fracture mechanics based methods can be used to predict the growth of outer skin fatigue cracks in lap splice structure. Results are presented showing the affects of MSD and out-of-plane pressure loads on outer skin crack link-up.
Evaluation of Longitudinal Joints of HMA Pavements in Tennessee
DOT National Transportation Integrated Search
2010-05-01
Longitudinal joints between lanes of hot-mix asphalt (HMA) pavements are commonly susceptible to moisture damage and other failures. In 2006, the Tennessee Department of Transportation (TDOT) identified longitudinal joint failure as one of the major ...
Ultrasound in management of rheumatoid arthritis: ARCTIC randomised controlled strategy trial
Aga, Anna-Birgitte; Olsen, Inge Christoffer; Lillegraven, Siri; Hammer, Hilde B; Uhlig, Till; Fremstad, Hallvard; Madland, Tor Magne; Lexberg, Åse Stavland; Haukeland, Hilde; Rødevand, Erik; Høili, Christian; Stray, Hilde; Noraas, Anne; Hansen, Inger Johanne Widding; Bakland, Gunnstein; Nordberg, Lena Bugge; van der Heijde, Désirée; Kvien, Tore K
2016-01-01
Objective To determine whether a treatment strategy based on structured ultrasound assessment would lead to improved outcomes in rheumatoid arthritis, compared with a conventional strategy. Design Multicentre, open label, two arm, parallel group, randomised controlled strategy trial. Setting Ten rheumatology departments and one specialist centre in Norway, from September 2010 to September 2015. Participants 238 patients were recruited between September 2010 and April 2013, of which 230 (141 (61%) female) received the allocated intervention and were analysed for the primary outcome. The main inclusion criteria were age 18-75 years, fulfilment of the 2010 American College of Rheumatology/European League Against Rheumatism classification criteria for rheumatoid arthritis, disease modifying anti-rheumatic drug naivety with indication for disease modifying drug therapy, and time from first patient reported swollen joint less than two years. Patients with abnormal kidney or liver function or major comorbidities were excluded. Interventions 122 patients were randomised to an ultrasound tight control strategy targeting clinical and imaging remission, and 116 patients were randomised to a conventional tight control strategy targeting clinical remission. Patients in both arms were treated according to the same disease modifying anti-rheumatic drug escalation strategy, with 13 visits over two years. Main outcome measures The primary endpoint was the proportion of patients with a combination between 16 and 24 months of clinical remission, no swollen joints, and non-progression of radiographic joint damage. Secondary outcomes included measures of disease activity, radiographic progression, functioning, quality of life, and adverse events. All participants who attended at least one follow-up visit were included in the full analysis set. Results 26 (22%) of the 118 analysed patients in the ultrasound tight control arm and 21 (19%) of the 112 analysed patients in the clinical tight control arm reached the primary endpoint (mean difference 3.3%, 95% confidence interval −7.1% to 13.7%). Secondary endpoints (disease activity, physical function, and joint damage) were similar between the two groups. Six (5%) patients in the ultrasound tight control arm and seven (6%) patients in the conventional arm had serious adverse events. Conclusions The systematic use of ultrasound in the follow-up of patients with early rheumatoid arthritis treated according to current recommendations is not justified on the basis of the ARCTIC results. The findings highlight the need for randomised trials assessing the clinical application of medical technology. Trial registration Clinical trials NCT01205854. PMID:27530741
Histochemistry as a Unique Approach for Investigating Normal and Osteoarthritic Cartilage
Musumeci, G.; Castrogiovanni, P.; Mazzone, V.; Szychlinska, M. A.; Castorina, S.; Loreto, C.
2014-01-01
In this review article, we describe benefits and disadvantages of the established histochemical methods for studying articular cartilage tissue under normal, pathological and experimental conditions. We illustrate the current knowledge on cartilage tissue based on histological and immunohistochemical aspects, and in conclusion we provide a short overview on the degeneration of cartilage, such as osteoarthritis. Adult articular cartilage has low capacity to repair itself, and thus even minor injuries may lead to progressive damage and osteoarthritic joint degeneration, resulting in significant pain and disability. Numerous efforts have been made to implement the knowledge in the study of cartilage in the last years, and histochemistry proved to be an especially powerful tool to this aim. PMID:24998926
Early osteoarthritis of the patellofemoral joint.
Arendt, Elizabeth A; Berruto, Massimo; Filardo, Giuseppe; Ronga, Mario; Zaffagnini, Stefano; Farr, Jack; Ferrua, Paolo; Grassi, Alberto; Condello, Vincenzo
2016-06-01
Patellofemoral joint cartilage lesions are associated with a variety of clinical situations including blunt trauma, lateral patella dislocations, or as a secondary development in the setting of abnormal joint loading. There is a need for more clarity on how to best address these lesions. Most specifically, when is it necessary to surgically treat these lesions of the patella and trochlea and which technique to use? This review will focus on the spectrum of patellofemoral disease/injury and their treatment strategies, with special emphasis on cartilage damage and early osteoarthritis. Chapter sections will review the most common scenarios of cartilage damage in the patellofemoral joint, with an attempt to summarize current treatment, their outcomes, remaining challenges and unanswered questions.
An accurate fatigue damage model for welded joints subjected to variable amplitude loading
NASA Astrophysics Data System (ADS)
Aeran, A.; Siriwardane, S. C.; Mikkelsen, O.; Langen, I.
2017-12-01
Researchers in the past have proposed several fatigue damage models to overcome the shortcomings of the commonly used Miner’s rule. However, requirements of material parameters or S-N curve modifications restricts their practical applications. Also, application of most of these models under variable amplitude loading conditions have not been found. To overcome these restrictions, a new fatigue damage model is proposed in this paper. The proposed model can be applied by practicing engineers using only the S-N curve given in the standard codes of practice. The model is verified with experimentally derived damage evolution curves for C 45 and 16 Mn and gives better agreement compared to previous models. The model predicted fatigue lives are also in better correlation with experimental results compared to previous models as shown in earlier published work by the authors. The proposed model is applied to welded joints subjected to variable amplitude loadings in this paper. The model given around 8% shorter fatigue lives compared to Eurocode given Miner’s rule. This shows the importance of applying accurate fatigue damage models for welded joints.
Prognostics for Ground Support Systems: Case Study on Pneumatic Valves
NASA Technical Reports Server (NTRS)
Daigle, Matthew; Goebel, Kai
2011-01-01
Prognostics technologies determine the health (or damage) state of a component or sub-system, and make end of life (EOL) and remaining useful life (RUL) predictions. Such information enables system operators to make informed maintenance decisions and streamline operational and mission-level activities. We develop a model-based prognostics methodology for pneumatic valves used in ground support equipment for cryogenic propellant loading operations. These valves are used to control the flow of propellant, so failures may have a significant impact on launch availability. Therefore, correctly predicting when valves will fail enables timely maintenance that avoids launch delays and aborts. The approach utilizes mathematical models describing the underlying physics of valve degradation, and, employing the particle filtering algorithm for joint state-parameter estimation, determines the health state of the valve and the rate of damage progression, from which EOL and RUL predictions are made. We develop a prototype user interface for valve prognostics, and demonstrate the prognostics approach using historical pneumatic valve data from the Space Shuttle refueling system.
Harding, Graeme T; Dunbar, Michael J; Hubley-Kozey, Cheryl L; Stanish, William D; Astephen Wilson, Janie L
2016-01-01
Obesity is an important risk factor for knee osteoarthritis initiation and progression. However, it is unclear how obesity may directly affect the mechanical loading environment of the knee joint, initiating or progressing joint degeneration. The objective of this study was to investigate the interacting role of obesity and moderate knee osteoarthritis presence on tibiofemoral contact forces and muscle forces within the knee joint during walking gait. Three-dimensional gait analysis was performed on 80 asymptomatic participants and 115 individuals diagnosed with moderate knee osteoarthritis. Each group was divided into three body mass index categories: healthy weight (body mass index<25), overweight (25≤body mass index≤30), and obese (body mass index>30). Tibiofemoral anterior-posterior shear and compressive forces, as well as quadriceps, hamstrings and gastrocnemius muscle forces, were estimated based on a sagittal plane contact force model. Peak contact and muscle forces during gait were compared between groups, as well as the interaction between disease presence and body mass index category, using a two-factor analysis of variance. There were significant osteoarthritis effects in peak shear, gastrocnemius and quadriceps forces only when they were normalized to body mass, and there were significant BMI effects in peak shear, compression, gastrocnemius and hamstrings forces only in absolute, non-normalized forces. There was a significant interaction effect in peak quadriceps muscle forces, with higher forces in overweight and obese groups compared to asymptomatic healthy weight participants. Body mass index was associated with higher absolute tibiofemoral compression and shear forces as well as posterior muscle forces during gait, regardless of moderate osteoarthritis presence or absence. The differences found may contribute to accelerated joint damage with obesity, but with the osteoarthritic knees less able to accommodate the high loads. Copyright © 2015 Elsevier Ltd. All rights reserved.
NASA Technical Reports Server (NTRS)
Farrokh, Babak; Segal, Kenneth N.; Akkerman, Michael; Glenn, Ronald L.; Rodini, Benjamin T.; Fan, Wei-Ming; Kellas, Sortiris; Pineda, Evan J.
2014-01-01
In this work, an all-bonded out-of-autoclave (OoA) curved longitudinal composite joint concept, intended for use in the next generation of composite heavy lift launch vehicles, was evaluated and verified through finite element (FE) analysis, fabrication, testing, and post-test inspection. The joint was used to connect two curved, segmented, honeycomb sandwich panels representative of a Space Launch System (SLS) fairing design. The overall size of the resultant panel was 1.37 m by 0.74 m (54 in by 29 in), of which the joint comprised a 10.2 cm (4 in) wide longitudinal strip at the center. NASTRAN and ABAQUS were used to perform linear and non-linear analyses of the buckling and strength performance of the jointed panel. Geometric non-uniformities (i.e., surface contour imperfections) were measured and incorporated into the FE model and analysis. In addition, a sensitivity study of the specimens end condition showed that bonding face-sheet doublers to the panel's end, coupled with some stress relief features at corner-edges, can significantly reduce the stress concentrations near the load application points. Ultimately, the jointed panel was subjected to a compressive load. Load application was interrupted at the onset of buckling (at 356 kN 80 kips). A post-test non-destructive evaluation (NDE) showed that, as designed, buckling occurred without introducing any damage into the panel or the joint. The jointed panel was further capable of tolerating an impact damage to the same buckling load with no evidence of damage propagation. The OoA cured all-composite joint shows promise as a low mass factory joint for segmented barrels.
Avouac, Jérôme; Walker, Ulrich A; Hachulla, Eric; Riemekasten, Gabriela; Cuomo, Giovanna; Carreira, Patricia E; Caramaschi, Paola; Ananieva, Lidia P; Matucci-Cerinic, Marco; Czirjak, Laszlo; Denton, Christopher; Ladner, Ulf Müller; Allanore, Yannick
2016-01-01
To determine whether joint synovitis and tendon friction rubs (TFRs) can predict the progression of systemic sclerosis (SSc) over time. We performed a prospective cohort study that included 1301 patients with SSc from the EUSTAR database with disease duration ≤3 years at inclusion and with a follow-up of at least 2 years. Presence or absence at clinical examination of synovitis and TFRs was extracted at baseline. Outcomes were skin, cardiovascular, renal and lung progression. Overall disease progression was defined according to the occurrence of at least one organ progression. Joint synovitis (HR: 1.26, 95% CI 1.01 to 1.59) and TFRs (HR: 1.32, 95% CI 1.03 to 1.70) were independently predictive of overall disease progression, as were also the diffuse cutaneous subset (HR: 1.30, 95% CI 1.05 to 1.61) and positive antitopoisomerase-I antibodies (HR: 1.25, 95% CI 1.02 to 1.53). Regarding skin progression, joint synovitis (HR: 1.67, 95% CI 1.06 to 2.64) and TFRs (HR: 1.69, 95% CI 1.02 to 2.77) were also independently predictive of worsening of the modified Rodnan skin score. For cardiovascular progression, joint synovitis was predictive of the occurrence of new digital ulcer(s) (HR: 1.45, 95% CI 1.08 to 1.96) and decreased left ventricular ejection fraction (HR: 2.20, 95% CI 1.06 to 4.57); TFRs were confirmed to be an independent predictor of scleroderma renal crisis (HR: 2.33, 95% CI 1.03 to 6.19). Joint synovitis and TFRs are independent predictive factors for disease progression in patients with early SSc. These easily detected clinical markers may be useful for the risk stratification of patients with SSc. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/
Osteonecrosis in systemic lupus erythematosus.
Gontero, Romina Patricia; Bedoya, María Eugenia; Benavente, Emilio; Roverano, Susana Graciela; Paira, Sergio Oscar
2015-01-01
To define the proportion of osteonecrosis (ON) in our patient population with lupus and to identify factors associated with the development of ON in systemic lupus erythematosus, as well as to carry out a descriptive analysis of ON cases. Observational retrospective study of 158 patients with SLE (ACR 1982 criteria). Demographic and laboratory data, clinical manifestations, SLICC, SLEDAI, cytotoxic and steroid treatments were compared. In patients with ON, we analyzed time of disease progression and age at ON diagnosis, form of presentation, joints involved, diagnostic methods, Ficat-Arlet classification, and treatment. To compare the means, t-test or Mann-Whitney's test were employed and the cHi-2 test or Fisher's exact test, as appropriate, were used to measure the equality of proportions. ON was present in 15 out 158 patients (9.5%), 13 women and 2 men, with a mean age of 30 (r: 16-66) at diagnosis and 35 months of evolution until diagnosis (r: 1-195). Among the 15 patients, 34 joints presented ON, 23 were symptomatic and 22 were diagnosed by magnetic resonance images. Twenty-six occurred in hips (24 bilateral), 4 in knees and 4 in shoulders. In 13 patients, ON involved 2 or more joints. At onset, 28 joints were in stage i-ii, one in stage iii and 5 had no data and; in the end, 14 were in stage iii-iv, 5 in stage i-ii and 15 had no data. Twenty-nine underwent conservative treatment with rest and 8 hips required joint replacement. ON progression was associated with Cushing's syndrome (P=0.014) OR 4.16 (95% CI 1.4-12.6) and 2nd year SLICC (P=0.042). No relation with clinical manifestations, lab results, cytotoxic treatment, steroid treatment (total accumulated dose, mean daily dose and duration) metilprednisolone pulses, nor activity was found. All patients with ON received antimalarials, in contrast to 77% of those without ON. The proportion of ON was 9.5%, mainly in women, 76% in hips (26) and 92% bilaterally. They were associated significantly with Cushing's syndrome and accumulated damage at second year. Copyright © 2014 Elsevier España, S.L.U. All rights reserved.
Investigating the Effect of Damage Progression Model Choice on Prognostics Performance
NASA Technical Reports Server (NTRS)
Daigle, Matthew; Roychoudhury, Indranil; Narasimhan, Sriram; Saha, Sankalita; Saha, Bhaskar; Goebel, Kai
2011-01-01
The success of model-based approaches to systems health management depends largely on the quality of the underlying models. In model-based prognostics, it is especially the quality of the damage progression models, i.e., the models describing how damage evolves as the system operates, that determines the accuracy and precision of remaining useful life predictions. Several common forms of these models are generally assumed in the literature, but are often not supported by physical evidence or physics-based analysis. In this paper, using a centrifugal pump as a case study, we develop different damage progression models. In simulation, we investigate how model changes influence prognostics performance. Results demonstrate that, in some cases, simple damage progression models are sufficient. But, in general, the results show a clear need for damage progression models that are accurate over long time horizons under varied loading conditions.
Razawy, Wida; van Driel, Marjolein
2018-01-01
Abstract The IL‐23/Th17 axis has been implicated in the development of autoimmune diseases, such as rheumatoid arthritis (RA) and psoriatic arthritis (PsA). RA and PsA are heterogeneous diseases with substantial burden on patients. Increasing evidence suggests that the IL‐23 signaling pathway may be involved in the development of autoimmunity and erosive joint damage. IL‐23 can act either directly or indirectly on bone forming osteoblasts as well as on bone resorbing osteoclasts. As IL‐23 regulates the activity of cells of the bone, it is conceivable that in addition to inflammation‐mediated joint erosion, IL‐23 may play a role in physiological bone remodeling. In this review, we focus on the role of IL‐23 in autoimmune arthritis in patients and murine models, and provide an overview of IL‐23 producing and responding cells in autoimmune arthritic joints. In addition, we discuss the role of IL‐23 on bone forming osteoblasts and bone resorbing osteoclasts regarding inflammation‐mediated joint damage and bone remodeling. At last, we briefly discuss the clinical implications of targeting this pathway for joint damage and systemic bone loss in autoimmune arthritis. PMID:29148561
Smolen, Josef S; Choe, Jung-Yoon; Prodanovic, Nenad; Niebrzydowski, Jaroslaw; Staykov, Ivan; Dokoupilova, Eva; Baranauskaite, Asta; Yatsyshyn, Roman; Mekic, Mevludin; Porawska, Wieskawa; Ciferska, Hana; Jedrychowicz-Rosiak, Krystyna; Zielinska, Agnieszka; Choi, Jasmine; Rho, Young Hee
2017-10-01
SB2 is a biosimilar to the reference infliximab (INF). Similar efficacy, safety and immunogenicity between SB2 and INF up to 30 weeks were previously reported. This report investigates such clinical similarity up to 54 weeks, including structural joint damage. In this phase III, double-blind, parallel-group, multicentre study, patients with moderate to severe RA despite MTX were randomized (1:1) to receive 3 mg/kg of either SB2 or INF at 0, 2, 6 and every 8 weeks thereafter. Dose escalation by 1.5 mg/kg up to a maximum dose of 7.5 mg/kg was allowed after week 30. Efficacy, safety and immunogenicity were measured at each visit up to week 54. Radiographic damage evaluated by modified total Sharp score was measured at baseline and week 54. A total of 584 patients were randomized to receive SB2 (n = 291) or INF (n = 293). The rate of radiographic progression was comparable between SB2 and INF (mean modified total Sharp score difference: SB2, 0.38; INF, 0.37) at 1 year. ACR responses, 28-joint DAS, Clinical Disease Activity Index and Simplified Disease Activity Index were comparable between SB2 and INF up to week 54. The incidence of treatment-emergent adverse events and anti-drug antibodies were comparable between treatment groups. Such comparable trends of efficacy, safety and immunogenicity were consistent from baseline up to 54 weeks. The pattern of dose increment was also comparable between SB2 and INF. SB2 maintained similar efficacy, safety and immunogenicity with INF up to 54 weeks in patients with moderate to severe RA. Radiographic progression was comparable at 1 year. ClinicalTrials.gov (http://clinicaltrials.gov; NCT01936181) and EudraCT (https://www.clinicaltrialsregister.eu; 2012-005733-37). © The Author 2017. Published by Oxford University Press on behalf of the British Society for Rheumatology.
Smolen, Josef S.; Choe, Jung-Yoon; Prodanovic, Nenad; Niebrzydowski, Jaroslaw; Staykov, Ivan; Dokoupilova, Eva; Baranauskaite, Asta; Yatsyshyn, Roman; Mekic, Mevludin; Porawska, Wieskawa; Ciferska, Hana; Jedrychowicz-Rosiak, Krystyna; Zielinska, Agnieszka; Choi, Jasmine; Rho, Young Hee
2017-01-01
Abstract Objectives SB2 is a biosimilar to the reference infliximab (INF). Similar efficacy, safety and immunogenicity between SB2 and INF up to 30 weeks were previously reported. This report investigates such clinical similarity up to 54 weeks, including structural joint damage. Methods In this phase III, double-blind, parallel-group, multicentre study, patients with moderate to severe RA despite MTX were randomized (1:1) to receive 3 mg/kg of either SB2 or INF at 0, 2, 6 and every 8 weeks thereafter. Dose escalation by 1.5 mg/kg up to a maximum dose of 7.5 mg/kg was allowed after week 30. Efficacy, safety and immunogenicity were measured at each visit up to week 54. Radiographic damage evaluated by modified total Sharp score was measured at baseline and week 54. Results A total of 584 patients were randomized to receive SB2 (n = 291) or INF (n = 293). The rate of radiographic progression was comparable between SB2 and INF (mean modified total Sharp score difference: SB2, 0.38; INF, 0.37) at 1 year. ACR responses, 28-joint DAS, Clinical Disease Activity Index and Simplified Disease Activity Index were comparable between SB2 and INF up to week 54. The incidence of treatment-emergent adverse events and anti-drug antibodies were comparable between treatment groups. Such comparable trends of efficacy, safety and immunogenicity were consistent from baseline up to 54 weeks. The pattern of dose increment was also comparable between SB2 and INF. Conclusion SB2 maintained similar efficacy, safety and immunogenicity with INF up to 54 weeks in patients with moderate to severe RA. Radiographic progression was comparable at 1 year. Trial registration ClinicalTrials.gov (http://clinicaltrials.gov; NCT01936181) and EudraCT (https://www.clinicaltrialsregister.eu; 2012-005733-37) PMID:28957563
CSF inflammation and axonal damage are increased and correlate in progressive multiple sclerosis.
Romme Christensen, Jeppe; Börnsen, Lars; Khademi, Mohsen; Olsson, Tomas; Jensen, Poul Erik; Sørensen, Per Soelberg; Sellebjerg, Finn
2013-06-01
The mechanism underlying disease progression in progressive multiple sclerosis (MS) is uncertain. Pathological studies found widespread inflammation in progressive MS brains correlating with disease progression and axonal damage. To study cerebrospinal fluid (CSF) biomarkers and clarify whether inflammation and axonal damage are associated in progressive MS. Using enzyme-linked immunosorbent assay (ELISA), we analysed CSF from 40 secondary progressive (SPMS), 21 primary progressive (PPMS), and 36 relapsing-remitting (RRMS) and 20 non-inflammatory neurological disease (NIND) patients. Twenty-two of the SPMS patients participated in an MBP8298 peptide clinical trial and had CSF follow-up after one year. Compared to NIND patients, inflammatory biomarkers osteopontin and matrix metalloproteinase-9 (MMP9) were increased in all MS patients while CXCL13 was increased in RRMS and SPMS patients. Biomarkers of axonal damage (NFL) and demyelination (MBP) were increased in all MS patients. In progressive MS patients CSF levels of osteopontin and CXCL13 correlated with NFL while osteopontin and MMP9 correlated with MBP. MBP8298 treatment did not affect the levels of the biomarkers after one year of treatment. All biomarkers were continuously increased after one year of follow-up except MBP, which decreased. CSF biomarkers of inflammation, axonal damage and demyelination are continuously increased in progressive MS patients and correlate. These findings parallel pathology studies, emphasise a relationship between inflammation, axonal damage and demyelination and support the use of CSF biomarkers in progressive MS clinical trials.
Kim, Tae-Jong; Sung, Il-Hoon; Lee, Seunghun; Joo, Kyung Bin; Choi, Jung Hyun; Park, Dong-Jin; Park, Yong-Wook; Lee, Shin-Seok; Kim, Tae-Hwan
2013-10-01
To evaluate the influence of homozygosity for HLA-B27 on the radiographic damage in ankylosing spondylitis (AS). A total of 368 AS patients with positive HLA-B27 status from the Observation Study of Korean spondyloArthropathy Registry (OSKAR) cohort were recruited for this study. HLA-B27 positive patients out of all AS patients were assessed for whether they had homozygosity or heterozygosity for HLA-B27. First, all data were stratified in relation to the carrier state of positive HLA-B27 for cross-sectional survey. Then we compared the radiographic damage score between groups. Second, we evaluated collected clinical and radiographic parameters at two different time points. Then we compared radiographic progression between groups. To use the mSASSS, cervical and lumbar spinal radiographs were examined by two experienced bone and joint radiologists (S. Lee, K.B. Joo). The agreement between the two readers regarding mSASSS was very good: ICC coefficient 0.70 (95% CI 0.60-0.81). The mean age (SD) of the AS patients was 37.0 (9.2) years, and the mean disease duration (SD) was 15.6 (9.1) years. Of these patients, 34.5% (127 patients) had HLA-B27 homozygosity. The mean mSASSS unit (SEM) was not significantly different between groups (homozygosity 28.57±4.12 vs heterozygosity 23.34±3.44, P=0.344) on cross-sectional survey. When it comes to radiographic progression between groups over 5 years, there was no significant difference in spite of adjusting for confounding variable (homozygosity 4.98±0.98 vs heterozygosity 4.21±0.82, P=0.562). The carrier state of positive HLA-B27 plays no role in determining the radiographic progression in AS. Copyright © 2013 Société française de rhumatologie. Published by Elsevier SAS. All rights reserved.
Evaluation of subsurface damage in concrete deck joints using impact echo method
Rickard, Larry; Choi, Wonchang
2016-01-01
Many factors can affect the overall performance and longevity of highway bridges, including the integrity of their deck joints. This study focuses on the evaluation of subsurface damage in deteriorated concrete deck joints, which includes the delamination and corrosion of the reinforcement. Impact echo and surface wave technology, mainly a portable seismic property analyzer (PSPA), were employed to evaluate the structural deficiency of concrete joints. Laboratory tests of core samples were conducted to verify the nondestructive test results. As a result, the primary advantage of the PSPA as a bridge assessment tool lies in its ability to assess the concrete’smore » modulus and to detect subsurface defects at a particular point simultaneously.« less
A comparative MRI study of cartilage damage in gout versus rheumatoid arthritis.
Popovich, Ivor; Lee, Arier C L; Doyle, Anthony; McHaffie, Alexandra; Clarke, Andrew; Reeves, Quentin; Dalbeth, Nicola; McQueen, Fiona M
2015-08-01
Magnetic resonance imaging (MRI) is useful for detecting joint inflammation and damage in the inflammatory arthropathies. This study aimed to investigate MRI cartilage damage and its associations with joint inflammation in patients with gout compared with a group with rheumatoid arthritis (RA). Forty patients with gout and 38 with seropositive RA underwent 3T-MRI of the wrist with assessment of cartilage damage at six carpal sites, using established scoring systems. Synovitis and bone oedema (BME) were graded according to Rheumatoid Arthritis MRI Scoring System criteria. Cartilage damage was compared between the groups adjusting for synovitis and disease duration using logistic regression analysis. Compared with RA, there were fewer sites of cartilage damage and lower total damage scores in the gout group (P = 0.02 and 0.003), adjusting for their longer disease duration and lesser degree of synovitis. Cartilage damage was strongly associated with synovitis in both conditions (R = 0.59, P < 0.0001 and R = 0.52, P = 0.0045 respectively) and highly correlated with BME in RA (R = 0.69, P < 0.0001) but not in gout (R = 0.095, P = 0.56). Cartilage damage is less severe in gout than in RA, with fewer sites affected and lower overall scores. It is associated with synovitis in both diseases, likely indicating an effect of pro-inflammatory cytokine production on cartilage integrity. However, the strong association between cartilage damage and BME observed in RA was not identified in gout. This emphasizes differences in the underlying pathophysiology of joint damage in these two conditions. © 2015 The Royal Australian and New Zealand College of Radiologists.
Hudson, C J W; Kim, L S; Hancock, S A; Cunliffe, I A; Wild, J M
2007-05-01
To identify the presence, and origin, of any "dissociating factors" inherent to the techniques for evaluating progression that mask the relationship between structural and functional progression in open-angle glaucoma (OAG). 23 patients (14 with OAG and 9 with ocular hypertension (OHT)) who had received serial Heidelberg Retina Tomograph (HRT II) and Humphrey Field Analyser (HFA) examinations for >or=5 years (mean 78.4 months (SD 9.5), range 60-101 months) were identified. Evidence of progressive disease was retrospectively evaluated in one eye of each patient using the Topographic Change Analysis (TCA) and Glaucoma Progression Analysis (GPA) for the HRT II and HFA, respectively. Six patients were stable by both techniques; four exhibited both structural and functional progression; seven exhibited structural progression, only, and six showed functional progression, only. Three types of dissociating factors were identified. TCA failed to identify progressive structural damage in the presence of advanced optic nerve head damage. GPA failed to identify progressive functional damage at stimulus locations, with sensitivities exhibiting test-retest variability beyond the maximum stimulus luminance of the perimeter, and where a perimetric learning effect was apparent. The three dissociating factors accounted for nine of the 13 patients who exhibited a lack of concordance between structural and functional progressive damage.
Influence of interface ply orientation on fatigue damage of adhesively bonded composite joints
NASA Technical Reports Server (NTRS)
Johnson, W. S.; Mall, S.
1985-01-01
An experimental study of cracked-lap-shear specimens was conducted to determine the influence of adherend stacking sequence on debond initiation and damage growth in a composite-to-composite bonded joint. Specimens consisted of quasi-isotropic graphite/epoxy adherends bonded together with either FM-300 or EC 3445 adhesives. The stacking sequence of the adherends was varied such that 0 deg, 45 deg, or 90 deg plies were present at the adherend-adhesive interfaces. Fatigue damage initiated in the adhesive layer in those specimens with 0 deg nd 45 deg interface plies. Damage initiated in the form of ply cracking in the strap adherend for the specimens with 90 deg interface plies. The fatigue-damage growth was in the form of delamination within the composite adherends for specimens with the 90 deg and 45 deg plies next to the adhesive, while debonding in the adhesive resulted for the specimens with 0 deg plies next to the adhesive. Those joints with the 0 deg and 45 deg plies next to either adhesive has essentially the same fatigue-damage-initiation stress levels. These stress levels were 13 and 71 percent higher, respectively, than those for specimens with 90 deg plies next to the EC 3445 and FM-300 adhesives.
A Biomimetic Structural Health Monitoring Approach Using Carbon Nanotubes
NASA Astrophysics Data System (ADS)
Liu, Yingtao; Rajadas, Abhishek; Chattopadhyay, Aditi
2012-07-01
A self-sensing nanocomposite material has been developed to track the presence of damage in complex composite structures. Multiwalled carbon nanotubes are integrated with polymer matrix to develop a novel bonding material with sensing capabilities. The changes of the piezoresistance in the presence of damage are used to monitor the condition of bonded joints, where the usual bonding material is replaced by the self-sensing nanocomposite. The feasibility of this concept is investigated through experiments conducted on single-lap joints subject to monotonic tensile loading conditions. The results show that the self-sensing nanocomposite is sensitive to crack propagation within the matrix material. An acoustic emission-based sensing technique has been used to validate these results and shows good correlation with damage growth. A digital image correlation system is used to measure the shear strain field in the joint area.
Fully automated joint space width measurement and digital X-ray radiogrammetry in early RA.
Platten, Michael; Kisten, Yogan; Kälvesten, Johan; Arnaud, Laurent; Forslind, Kristina; van Vollenhoven, Ronald
2017-01-01
To study fully automated digital joint space width (JSW) and bone mineral density (BMD) in relation to a conventional radiographic scoring method in early rheumatoid arthritis (eRA). Radiographs scored by the modified Sharp van der Heijde score (SHS) in patients with eRA were acquired from the SWEdish FarmacOTherapy study. Fully automated JSW measurements of bilateral metacarpals 2, 3 and 4 were compared with the joint space narrowing (JSN) score in SHS. Multilevel mixed model statistics were applied to calculate the significance of the association between ΔJSW and ΔBMD over 1 year, and the JSW differences between damaged and undamaged joints as evaluated by the JSN. Based on 576 joints of 96 patients with eRA, a significant reduction from baseline to 1 year was observed in the JSW from 1.69 (±0.19) mm to 1.66 (±0.19) mm (p<0.01), and BMD from 0.583 (±0.068) g/cm 2 to 0.566 (±0.074) g/cm 2 (p<0.01). A significant positive association was observed between ΔJSW and ΔBMD over 1 year (p<0.0001). On an individual joint level, JSWs of undamaged (JSN=0) joints were wider than damaged (JSN>0) joints: 1.68 mm (95% CI 1.70 to 1.67) vs 1.54 mm (95% CI 1.63 to 1.46). Similarly the unadjusted multilevel model showed significant differences in JSW between undamaged (1.68 mm (95% CI 1.72 to 1.64)) and damaged joints (1.63 mm (95% CI 1.68 to 1.58)) (p=0.0048). This difference remained significant in the adjusted model: 1.66 mm (95% CI 1.70 to 1.61) vs 1.62 mm (95% CI 1.68 to 1.56) (p=0.042). To measure the JSW with this fully automated digital tool may be useful as a quick and observer-independent application for evaluating cartilage damage in eRA. NCT00764725.
Chan, Deva D.; Xiao, Wenfeng; Li, Jun; de la Motte, Carol A.; Sandy, John D.; Plaas, Anna
2015-01-01
Objective Articular cartilage defects commonly result from traumatic injury and predispose to degenerative joint diseases. To test the hypothesis that aberrant healing responses and chronic inflammation lead to osteoarthritis, we examined spatiotemporal changes in joint tissues after cartilage injury in murine knees. Since intra-articular injection of hyaluronan (HA) can attenuate injury-induced osteoarthritis in wild-type (WT) mice, we investigated a role for HA in the response to cartilage injury in mice lacking HA synthase 1 (Has1−/−). Design Femoral groove cartilage of WT and Has1−/− mice was debrided to generate a non-bleeding wound. Macroscopic imaging, histology, and gene expression were used to evaluate naïve, sham-operated, and injured joints. Results Acute responses (1–2 weeks) in injured joints from WT mice included synovial hyperplasia with HA deposition and joint-wide increases in expression of genes associated with inflammation, fibrosis, and extracellular matrix (ECM) production. By 4 weeks, some resurfacing of damaged cartilage occurred, and early cell responses were normalized. Cartilage damage in Has1−/− mice also induced early responses; however, at 4 weeks, inflammation and fibrosis genes remained elevated with widespread cartilage degeneration and fibrotic scarring in the synovium and joint capsule. Conclusions We conclude that the ineffective repair of injured cartilage in Has1−/− joints can be at least partly explained by the markedly enhanced expression of particular genes in pathways linked to ECM turnover, IL-17/IL-6 cytokine signaling, and apoptosis. Notably, Has1 ablation does not alter gross HA content in the ECM, suggesting that HAS1 has a unique function in the metabolism of inflammatory HA matrices. PMID:26521733
Have the annual trends of total hip arthroplasty in rheumatoid arthritis patients decreased?
Onuoha, Kemjika O.; Solow, Max; Newman, Jared M.; Sodhi, Nipun; Pivec, Robert; Khlopas, Anton; Sultan, Assem A.; Chughtai, Morad; Shah, Neil V.; George, Jaiben
2017-01-01
Background Rheumatoid arthritis (RA) is characterized by chronic systemic and synovial inflammation, resulting in damage to both cartilage and bone. Medical treatment, which has increasingly relied upon disease modifying anti-rheumatic drugs (DMARDs), may fail to slow disease progression and limit joint damage, ultimately warranting surgical intervention. Up to 25% of RA patients will require lower extremity total joint arthroplasty. Though total hip arthroplasty (THA) is known to improve quality of life and functional measures, clarification is still required with respect to the impact of increased DMARD use on annual rates of THA. Thus, the purpose of this study was to evaluate: (I) the annual trends of THAs due to RA in the United States population; (II) the annual trends in the proportion of THAs due to RA in the United States. Methods This study utilized the Nationwide Inpatient Sample (NIS) to identify all patients who underwent THA between 2002 and 2013 (n=3,135,904). Then, THA patients who had a diagnosis of RA, which was defined by the International Classification of Disease 9th revision diagnosis code 714.0, were identified. The incidence of THAs with a diagnosis of RA in the United States was calculated using the United States population as the denominator. Regression models were used to analyze the annual trends of RA in patients who underwent THA. Results Review of the database identified 90,487 patients who had a diagnosis of RA and underwent THA from 2002 to 2013. The annual prevalence of RA in those who underwent THA slightly decreased over the specified time period, with 28.7 per 1,000 THAs in 2002 and 28.6 per 1,000 THAs in 2013; however, this change was not statistically significant (R2=0.158, P=0.200). Conclusions The annual rates of THA among RA patients did not show any significant change between 2002 and 2013. DMARD use has decreased both disease progression and joint destruction, and DMARDs are now often utilized as primary treatment. The increase in population of the country during the study period may have overestimated THA trends. Moreover, patients may be more likely to opt for surgical management, given the advances in operative techniques as well as peri- and post-operative course. PMID:29299482
Progressive Damage Modeling of Notched Composites
NASA Technical Reports Server (NTRS)
Aitharaju, Venkat; Aashat, Satvir; Kia, Hamid; Satyanarayana, Arunkumar; Bogert, Philip
2016-01-01
There is an increased interest in using non-crimp fabric reinforced composites for primary and secondary structural weight savings in high performance automobile applications. However, one of the main challenges in implementing these composites is the lack of understanding of damage progression under a wide variety of loading conditions for general configurations. Towards that end, researchers at GM and NASA are developing new damage models to predict accurately the progressive failure of these composites. In this investigation, the developed progressive failure analysis model was applied to study damage progression in center-notched and open-hole tension specimens for various laminate schemes. The results of a detailed study with respect to the effect of element size on the analysis outcome are presented.
Yasuda, Tomohiro; Obara, Shu; Hayashi, Junji; Arai, Masayuki; Sato, Kaoru
2017-06-01
Intramedullary nail fixation is a common treatment for tibial-shaft fractures, and it offers a better functional prognosis than other conservative treatments. Currently, the primary approach employed during intramedullary nail insertion is the semiextended position is the suprapatellar approach, which involves a vertical incision of the quadriceps tendon Damage to the patellofemoral joint cartilage has been highlighted as a drawback associated with this approach. To avoid this issue, we perform surgery using the patellar eversion technique and a soft sleeve. This method allows the articular surface to be monitored during intramedullary nail insertion. We arthroscopically assessed the effect of this technique on patellofemoral joint cartilage. The patellar eversion technique allows a direct view and protection of the patellofemoral joint without affecting the patella. Thus, damage to the patellofemoral joint cartilage can be avoided. Copyright © 2017 Elsevier Ltd. All rights reserved.
Nam, Jackie L; Hensor, Elizabeth M A; Hunt, Laura; Conaghan, Philip G; Wakefield, Richard J; Emery, Paul
2016-12-01
To determine whether ultrasound can identify anti-cyclic citrullinated peptide (anti-CCP) antibody-positive patients without clinical synovitis (CS) who progress to inflammatory arthritis (IA). In a prospective study, anti-CCP-positive patients without CS underwent ultrasound imaging of 32 joints (wrists, metacarpophalangeal joints, proximal interphalangeal joints and metatarsophalangeal joints (MTPs)) and were monitored for the development of IA. Associations between baseline ultrasound findings (grey scale (GS), power Doppler (PD) and erosions) and (1) progression to IA and (2) development of CS within an individual joint were measured. Consecutive anti-CCP-positive patients (n=136; mean age 51 years, 100 women) were followed up for median of 18.3 months (range 0.1-79.6). At baseline 96% had GS, 30% had PD and 21% had one or more erosions. IA developed in 57 patients (42%) after median of 8.6 months (range 0.1-52.4). Ultrasound abnormalities (GS ≥2, PD ≥1 or erosion ≥1) were found in 86% at baseline compared with 67% of non-progressors (χ 2 =6.3, p=0.012). Progression to IA was significantly higher in those with ultrasound findings in any joint (excluding MTPs for GS) (GS ≥2: 55% vs 24%, HR (95% CI) 2.3 (1.0 to 4.9), p=0.038; PD ≥2: 75% vs 32%, 3.7 (2.0 to 6.9), p<0.001 and erosion ≥1: 71% vs 34%, 2.9 (1.7 to 5.1), p<0.001). Furthermore, progression occurred earlier with PD ≥2 (median 7.1 vs 52.4 months) and erosion ≥1 (15.4 vs 46.5). At the individual joint level, the trend for progression to CS was more significant for GS and PD (GS ≥2: 26% vs 3%, 9.4 (5.1 to 17.5), p<0.001; PD ≥2: 55% vs 4%, 31.3 (15.6 to 62.9), p<0.001). Ultrasound features of joint inflammation may be detected in anti-CCP-positive patients without CS. Ultrasound findings predict progression (and rate of progression) to IA, with the risk of progression highest in those with PD signal. NCT02012764; Results. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.
DOE Office of Scientific and Technical Information (OSTI.GOV)
Henager, Charles H.; Nguyen, Ba Nghiep; Kurtz, Richard J.
The international fusion community has designed a miniature torsion specimen for neutron irradiation studies of joined SiC and SiC/SiC composite materials. Miniature torsion joints based on this specimen design were fabricated using displacement reactions between Si and TiC to produce Ti3SiC2 + SiC joints with CVD-SiC and tested in torsion-shear prior to and after neutron irradiation. However, many of these miniature torsion specimens fail out-of-plane within the CVD-SiC specimen body, which makes it problematic to assign a shear strength value to the joints and makes it difficult to compare unirradiated and irradiated joint strengths to determine the effects of themore » irradiation. Finite element elastic damage and elastic-plastic damage models of miniature torsion joints are developed that indicate shear fracture is likely to occur within the body of the joined sample and cause out-of-plane failures for miniature torsion specimens when a certain modulus and strength ratio between the joint material and the joined material exists. The model results are compared and discussed with regard to unirradiated and irradiated joint test data for a variety of joint materials. The unirradiated data includes Ti3SiC2 + SiC/CVD-SiC joints with tailored joint moduli, and includes steel/epoxy and CVD-SiC/epoxy joints. The implications for joint data based on this sample design are discussed.« less
Probabilistic Assessment of Fracture Progression in Composite Structures
NASA Technical Reports Server (NTRS)
Chamis, Christos C.; Minnetyan, Levon; Mauget, Bertrand; Huang, Dade; Addi, Frank
1999-01-01
This report describes methods and corresponding computer codes that are used to evaluate progressive damage and fracture and to perform probabilistic assessment in built-up composite structures. Structural response is assessed probabilistically, during progressive fracture. The effects of design variable uncertainties on structural fracture progression are quantified. The fast probability integrator (FPI) is used to assess the response scatter in the composite structure at damage initiation. The sensitivity of the damage response to design variables is computed. The methods are general purpose and are applicable to stitched and unstitched composites in all types of structures and fracture processes starting from damage initiation to unstable propagation and to global structure collapse. The methods are demonstrated for a polymer matrix composite stiffened panel subjected to pressure. The results indicated that composite constituent properties, fabrication parameters, and respective uncertainties have a significant effect on structural durability and reliability. Design implications with regard to damage progression, damage tolerance, and reliability of composite structures are examined.
Cell Therapy and Tissue Engineering Approaches for Cartilage Repair and/or Regeneration
Mardones, Rodrigo; Jofré, Claudio M.; Minguell, José J.
2015-01-01
Articular cartilage injuries caused by traumatic, mechanical and/or by progressive degeneration result in pain, swelling, subsequent loss of joint function and finally osteoarthritis. Due to the peculiar structure of the tissue (no blood supply), chondrocytes, the unique cellular phenotype in cartilage, receive their nutrition through diffusion from the synovial fluid and this limits their intrinsic capacity for healing. The first cellular avenue explored for cartilage repair involved the in situ transplantation of isolated chondrocytes. Latterly, an improved alternative for the above reparative strategy involved the infusion of mesenchymal stem cells (MSC), which in addition to a self-renewal capacity exhibit a differentiation potential to chondrocytes, as well as a capability to produce a vast array of growth factors, cytokines and extracellular matrix compounds involved in cartilage development. In addition to the above and foremost reparative options up till now in use, other therapeutic options have been developed, comprising the design of biomaterial substrates (scaffolds) capable of sustaining MSC attachment, proliferation and differentiation. The implantation of these engineered platforms, closely to the site of cartilage damage, may well facilitate the initiation of an ‘in situ’ cartilage reparation process. In this mini-review, we examined the timely and conceptual development of several cell-based methods, designed to repair/regenerate a damaged cartilage. In addition to the above described cartilage reparative options, other therapeutic alternatives still in progress are portrayed. PMID:26019754
Cell Therapy and Tissue Engineering Approaches for Cartilage Repair and/or Regeneration.
Mardones, Rodrigo; Jofré, Claudio M; Minguell, José J
2015-05-01
Articular cartilage injuries caused by traumatic, mechanical and/or by progressive degeneration result in pain, swelling, subsequent loss of joint function and finally osteoarthritis. Due to the peculiar structure of the tissue (no blood supply), chondrocytes, the unique cellular phenotype in cartilage, receive their nutrition through diffusion from the synovial fluid and this limits their intrinsic capacity for healing. The first cellular avenue explored for cartilage repair involved the in situ transplantation of isolated chondrocytes. Latterly, an improved alternative for the above reparative strategy involved the infusion of mesenchymal stem cells (MSC), which in addition to a self-renewal capacity exhibit a differentiation potential to chondrocytes, as well as a capability to produce a vast array of growth factors, cytokines and extracellular matrix compounds involved in cartilage development. In addition to the above and foremost reparative options up till now in use, other therapeutic options have been developed, comprising the design of biomaterial substrates (scaffolds) capable of sustaining MSC attachment, proliferation and differentiation. The implantation of these engineered platforms, closely to the site of cartilage damage, may well facilitate the initiation of an 'in situ' cartilage reparation process. In this mini-review, we examined the timely and conceptual development of several cell-based methods, designed to repair/regenerate a damaged cartilage. In addition to the above described cartilage reparative options, other therapeutic alternatives still in progress are portrayed.
Yiu, Sean; Farewell, Vernon T; Tom, Brian D M
2018-02-01
In psoriatic arthritis, it is important to understand the joint activity (represented by swelling and pain) and damage processes because both are related to severe physical disability. The paper aims to provide a comprehensive investigation into both processes occurring over time, in particular their relationship, by specifying a joint multistate model at the individual hand joint level, which also accounts for many of their important features. As there are multiple hand joints, such an analysis will be based on the use of clustered multistate models. Here we consider an observation level random-effects structure with dynamic covariates and allow for the possibility that a subpopulation of patients is at minimal risk of damage. Such an analysis is found to provide further understanding of the activity-damage relationship beyond that provided by previous analyses. Consideration is also given to the modelling of mean sojourn times and jump probabilities. In particular, a novel model parameterization which allows easily interpretable covariate effects to act on these quantities is proposed.
Damage progression in Composite Structures
NASA Technical Reports Server (NTRS)
Minnetyan, Levon
1996-01-01
A computational simulation tool is used to evaluate the various stages of damage progression in composite materials during Iosipescu sheat testing. Unidirectional composite specimens with either the major or minor material axis in the load direction are considered. Damage progression characteristics are described for each specimen using two types of boundary conditions. A procedure is outlined regarding the use of computational simulation in composites testing. Iosipescu shear testing using the V-notched beam specimen is a convenient method to measure both shear strength and shear stiffness simultaneously. The evaluation of composite test response can be made more productive and informative via computational simulation of progressive damage and fracture. Computational simulation performs a complete evaluation of laminated composite fracture via assessment of ply and subply level damage/fracture processes.
Popovich, I; Dalbeth, N; Doyle, A; Reeves, Q; McQueen, F M
2014-07-01
Few imaging studies have investigated cartilage in gout. Magnetic resonance imaging (MRI) can image cartilage damage and also reveals other features of gouty arthropathy. The objective was to develop and validate a system for quantifying cartilage damage in gout. 3-T MRI scans of the wrist were obtained in 40 gout patients. MRI cartilage damage was quantified using an adaptation of the radiographic Sharp van der Heijde score. Two readers scored cartilage loss at 7 wrist joints: 0 (normal), 1 (partial narrowing), 2 (complete narrowing) and concomitant osteoarthritis was recorded. Bone erosion, bone oedema and synovitis were scored (RAMRIS) and tophi were assessed. Correlations between radiographic and MRI cartilage scores were investigated, as was the reliability of the MRI cartilage score and its associations. The GOut MRI Cartilage Score (GOMRICS) was highly correlated with the total Sharp van der Heijde (SvdH) score and the joint space narrowing component (R = 0.8 and 0.71 respectively, p < 0.001). Reliability was high (intraobserver, interobserver ICCs = 0.87 [0.57-0.97], 0.64 [0.41-0.79] respectively), and improved on unenhanced scans; interobserver ICC = 0.82 [0.49-0.95]. Cartilage damage was predominantly focal (82% of lesions) and identified in 40 out of 280 (14%) of joints. Cartilage scores correlated with bone erosion (R = 0.57), tophus size (R = 0.52), and synovitis (R = 0.55), but not bone oedema scores. Magnetic resonance imaging can be used to investigate cartilage in gout. Cartilage damage was relatively uncommon, focal, and associated with bone erosions, tophi and synovitis, but not bone oedema. This emphasises the unique pathophysiology of gout.
DOE Office of Scientific and Technical Information (OSTI.GOV)
Henager, Charles H.; Nguyen, Ba Nghiep; Kurtz, Richard J.
2016-03-31
Finite element continuum damage models (FE-CDM) have been developed to simulate and model dual-phase joints and cracked joints for improved analysis of SiC materials in nuclear environments. This report extends the analysis from the last reporting cycle by including results from dual-phase models and from cracked joint models.
Chilibeck, Philip D; Vatanparast, Hassanali; Cornish, Stephen M; Abeysekara, Saman; Charlesworth, Sarah
2011-07-01
We systematically reviewed the safety of physical activity (PA) for people with arthritis, osteoporosis, and low back pain. We searched PubMed, MEDLINE, Sport Discus, and the Cochrane Central Register of Controlled Trials (1966 through March 2008) for relevant articles on PA and adverse events. A total of 111 articles met our inclusion criteria. The incidence for adverse events during PA was 3.4%-11% (0.06%-2.4% serious adverse events) and included increased joint pain, fracture, and back pain for those with arthritis, osteoporosis, and low back pain, respectively. Recommendations were based on the Appraisal of Guidelines for Research and Evaluation, which applies Levels of Evidence based on type of study ranging from high-quality randomized controlled trials (Level 1) to anecdotal evidence (Level 4) and Grades from A (strong) to C (weak). Our main recommendations are that (i) arthritic patients with highly progressed forms of disease should avoid heavy load-bearing activities, but should participate in non-weight-bearing activities (Level 2, Grade A); and (ii) patients with osteoporosis should avoid trunk flexion (Level 2, Grade A) and powerful twisting of the trunk (Level 3, Grade C); (iii) patients with acute low back pain can safely do preference-based PA (i.e., PA that does not induce pain), including low back extension and flexion (Level 2, Grade B); (iv) arthritic patients with stable disease without progressive joint damage and patients with stable osteoporosis or low back pain can safely perform a variety of progressive aerobic or resistance-training PAs (Level 2, Grades A and B). Overall, the adverse event incidence from reviewed studies was low. PA can safely be done by most individuals with musculoskeletal conditions.
Talar Fractures in Children: A Possible Injury After Go-Karting Accidents.
Kamphuis, Saskia J M; Meijs, Claartje M E M; Kleinveld, Sanne; Diekerhof, Carel H; van der Heijden, Frank H W M
2015-01-01
Go-karting is an increasingly popular high-energy sport enjoyed by both children and adults. Because of the speeds involved, accidents involving go-karts can lead to serious injury. We describe 6 talar fractures in 4 patients that resulted from go-karting accidents. Talar fractures can cause severe damage to the tibiotalar joint, talocalcaneal or subtalar joint, and the talonavicular joint. This damage can, in turn, lead to complications such as avascular necrosis, arthritis, nonunion, delayed union, and neuropraxia, which have the potential to cause long-term disability in a child. Copyright © 2015 American College of Foot and Ankle Surgeons. Published by Elsevier Inc. All rights reserved.
NASA Technical Reports Server (NTRS)
Castelli, Michael G.
1994-01-01
A detailed experimental investigation was performed at a single maximum cyclic stress (sigma max) level to physically characterize the progression of thermomechanical fatigue (lW) damage in continuously reinforced (0 deg) SCS-6/Timetal 21S, a titanium matrix composite. In-phase (IP) and out of-phase (OP) loadings were investigated at sigma max = 1000 MPa with a temperature cycle from 150 to 6500 C. Damage progression, in terms of macroscopic property degradation, was experimentally quantified through an advanced TMF test methodology which incorporates explicit measurements of the isothermal static moduli at the TMF temperature extremes and the coefficient of thermal expansion (CTE) as functions of the TMF cycles. Detailed characterization of the physical damage progression at the microstructural level was performed by interrupting multiple TMF tests at various stages of mechanical property degradation and analyzing the microstructure through extensive destructive metallography. Further, the extent of damage was also quantified through residual static strength measurements. Results indicated that damage initiation occurred very early in cyclic life (N less than 0.1Nf) for both the IP and OP TMF loadings. IP TMF damage was found to be dominated by fiber breakage with a physical damage progression in the microstructure which was difficult to quantify. OP TMF loadings produced matrix cracking exclusively associated with surface initiations. Here, damage progression was easily distinguished in terms of both the number of cracks and their relative inward progressions toward the outer fiber rows with increased cycling. The point at which the leading cracks reached the outer fiber rows (when localized fiber/matrix de-bonding and matrix crack bridging occurred) appeared to be reflected in the macroscopic property degradation curves.
Cell-based cartilage repair strategies in the horse.
Ortved, Kyla F; Nixon, Alan J
2016-02-01
Damage to the articular cartilage surface is common in the equine athlete and, due to the poor intrinsic healing capabilities of cartilage, can lead to osteoarthritis (OA). Joint disease and OA are the leading cause of retirement in equine athletes and currently there are no effective treatments to stop the progression of OA. Several different cell-based strategies have been investigated to bolster the weak regenerative response of chondrocytes. Such techniques aim to restore the articular surface and prevent further joint degradation. Cell-based cartilage repair strategies include enhancement of endogenous repair mechanisms by recruitment of stem cells from the bone marrow following perforation of the subchondral bone plate; osteochondral implantation; implantation of chondrocytes that are maintained in defects by either a membrane cover or scaffold, and transplantation of mesenchymal stem cells into cartilage lesions. More recently, bioengineered cartilage and scaffoldless cartilage have been investigated for enhancing repair. This review article focuses on the multitude of cell-based repair techniques for cartilage repair across several species, with special attention paid to the horse. Copyright © 2015 Elsevier Ltd. All rights reserved.
Subchondral bone in osteoarthritis: insight into risk factors and microstructural changes
2013-01-01
Osteoarthritis (OA) is a major cause of disability in the adult population. As a progressive degenerative joint disorder, OA is characterized by cartilage damage, changes in the subchondral bone, osteophyte formation, muscle weakness, and inflammation of the synovium tissue and tendon. Although OA has long been viewed as a primary disorder of articular cartilage, subchondral bone is attracting increasing attention. It is commonly reported to play a vital role in the pathogenesis of OA. Subchondral bone sclerosis, together with progressive cartilage degradation, is widely considered as a hallmark of OA. Despite the increase in bone volume fraction, subchondral bone is hypomineralized, due to abnormal bone remodeling. Some histopathological changes in the subchondral bone have also been detected, including microdamage, bone marrow edema-like lesions and bone cysts. This review summarizes basic features of the osteochondral junction, which comprises subchondral bone and articular cartilage. Importantly, we discuss risk factors influencing subchondral bone integrity. We also focus on the microarchitectural and histopathological changes of subchondral bone in OA, and provide an overview of their potential contribution to the progression of OA. A hypothetical model for the pathogenesis of OA is proposed. PMID:24321104
Subchondral bone in osteoarthritis: insight into risk factors and microstructural changes.
Li, Guangyi; Yin, Jimin; Gao, Junjie; Cheng, Tak S; Pavlos, Nathan J; Zhang, Changqing; Zheng, Ming H
2013-01-01
Osteoarthritis (OA) is a major cause of disability in the adult population. As a progressive degenerative joint disorder, OA is characterized by cartilage damage, changes in the subchondral bone, osteophyte formation, muscle weakness, and inflammation of the synovium tissue and tendon. Although OA has long been viewed as a primary disorder of articular cartilage, subchondral bone is attracting increasing attention. It is commonly reported to play a vital role in the pathogenesis of OA. Subchondral bone sclerosis, together with progressive cartilage degradation, is widely considered as a hallmark of OA. Despite the increase in bone volume fraction, subchondral bone is hypomineralized, due to abnormal bone remodeling. Some histopathological changes in the subchondral bone have also been detected, including microdamage, bone marrow edema-like lesions and bone cysts. This review summarizes basic features of the osteochondral junction, which comprises subchondral bone and articular cartilage. Importantly, we discuss risk factors influencing subchondral bone integrity. We also focus on the microarchitectural and histopathological changes of subchondral bone in OA, and provide an overview of their potential contribution to the progression of OA. A hypothetical model for the pathogenesis of OA is proposed.
A Fiber Optic Doppler Sensor and Its Application in Debonding Detection for Composite Structures
Li, Fucai; Murayama, Hideaki; Kageyama, Kazuro; Meng, Guang; Ohsawa, Isamu; Shirai, Takehiro
2010-01-01
Debonding is one of the most important damage forms in fiber-reinforced composite structures. This work was devoted to the debonding damage detection of lap splice joints in carbon fiber reinforced plastic (CFRP) structures, which is based on guided ultrasonic wave signals captured by using fiber optic Doppler (FOD) sensor with spiral shape. Interferometers based on two types of laser sources, namely the He-Ne laser and the infrared semiconductor laser, are proposed and compared in this study for the purpose of measuring Doppler frequency shift of the FOD sensor. Locations of the FOD sensors are optimized based on mechanical characteristics of lap splice joint. The FOD sensors are subsequently used to detect the guided ultrasonic waves propagating in the CFRP structures. By taking advantage of signal processing approaches, features of the guided wave signals can be revealed. The results demonstrate that debonding in the lap splice joint results in arrival time delay of the first package in the guided wave signals, which can be the characteristic for debonding damage inspection and damage extent estimation. PMID:22219698
A fiber optic Doppler sensor and its application in debonding detection for composite structures.
Li, Fucai; Murayama, Hideaki; Kageyama, Kazuro; Meng, Guang; Ohsawa, Isamu; Shirai, Takehiro
2010-01-01
Debonding is one of the most important damage forms in fiber-reinforced composite structures. This work was devoted to the debonding damage detection of lap splice joints in carbon fiber reinforced plastic (CFRP) structures, which is based on guided ultrasonic wave signals captured by using fiber optic Doppler (FOD) sensor with spiral shape. Interferometers based on two types of laser sources, namely the He-Ne laser and the infrared semiconductor laser, are proposed and compared in this study for the purpose of measuring Doppler frequency shift of the FOD sensor. Locations of the FOD sensors are optimized based on mechanical characteristics of lap splice joint. The FOD sensors are subsequently used to detect the guided ultrasonic waves propagating in the CFRP structures. By taking advantage of signal processing approaches, features of the guided wave signals can be revealed. The results demonstrate that debonding in the lap splice joint results in arrival time delay of the first package in the guided wave signals, which can be the characteristic for debonding damage inspection and damage extent estimation.
NASA Astrophysics Data System (ADS)
Nguyen Van Do, Vuong
2018-04-01
In this study, a development of nonlinear continuum damage mechanics (CDM) model for multiaxial high cycle fatigue is proposed in which the cyclic plasticity constitutive model has been incorporated in the finite element (FE) framework. T-joint FE simulation of fillet welding is implemented to characterize sequentially coupled three-dimensional (3-D) of thermo-mechanical FE formulation and simulate the welding residual stresses. The high cycle fatigue damage model is then taken account into the fillet weld joints under the various cyclic fatigue load types to calculate the fatigue life considering the residual stresses. The fatigue crack initiation and the propagation in the present model estimated for the total fatigue is compared with the experimental results. The FE results illustrated that the proposed high cycle fatigue damage model in this study could become a powerful tool to effectively predict the fatigue life of the welds. Parametric studies in this work are also demonstrated that the welding residual stresses cannot be ignored in the computation of the fatigue life of welded structures.
Razawy, Wida; van Driel, Marjolein; Lubberts, Erik
2018-02-01
The IL-23/Th17 axis has been implicated in the development of autoimmune diseases, such as rheumatoid arthritis (RA) and psoriatic arthritis (PsA). RA and PsA are heterogeneous diseases with substantial burden on patients. Increasing evidence suggests that the IL-23 signaling pathway may be involved in the development of autoimmunity and erosive joint damage. IL-23 can act either directly or indirectly on bone forming osteoblasts as well as on bone resorbing osteoclasts. As IL-23 regulates the activity of cells of the bone, it is conceivable that in addition to inflammation-mediated joint erosion, IL-23 may play a role in physiological bone remodeling. In this review, we focus on the role of IL-23 in autoimmune arthritis in patients and murine models, and provide an overview of IL-23 producing and responding cells in autoimmune arthritic joints. In addition, we discuss the role of IL-23 on bone forming osteoblasts and bone resorbing osteoclasts regarding inflammation-mediated joint damage and bone remodeling. At last, we briefly discuss the clinical implications of targeting this pathway for joint damage and systemic bone loss in autoimmune arthritis. © 2017 The Authors. European Journal of Immunology published by WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.
2014-01-01
Introduction Articular cartilage needs sulfated-glycosaminoglycans (sGAGs) to withstand high pressures while mechanically loaded. Chondrocyte sGAG synthesis is regulated by exposure to compressive forces. Moderate physical exercise is known to improve cartilage sGAG content and might protect against osteoarthritis (OA). This study investigated whether rat knee joints with sGAG depleted articular cartilage through papain injections might benefit from moderate exercise, or whether this increases the susceptibility for cartilage degeneration. Methods sGAGs were depleted from cartilage through intraarticular papain injections in the left knee joints of 40 Wistar rats; their contralateral joints served as healthy controls. Of the 40 rats included in the study, 20 rats remained sedentary, and the other 20 were subjected to a moderately intense running protocol. Animals were longitudinally monitored for 12 weeks with in vivo micro-computed tomography (μCT) to measure subchondral bone changes and single-photon emission computed tomography (SPECT)/CT to determine synovial macrophage activation. Articular cartilage was analyzed at 6 and 12 weeks with ex vivo contrast-enhanced μCT and histology to measure sGAG content and cartilage thickness. Results All outcome measures were unaffected by moderate exercise in healthy control joints of running animals compared with healthy control joints of sedentary animals. Papain injections in sedentary animals resulted in severe sGAG-depleted cartilage, slight loss of subchondral cortical bone, increased macrophage activation, and osteophyte formation. In running animals, papain-induced sGAG-depleted cartilage showed increased cartilage matrix degradation, sclerotic bone formation, increased macrophage activation, and more osteophyte formation. Conclusions Moderate exercise enhanced OA progression in papain-injected joints and did not protect against development of the disease. This was not restricted to more-extensive cartilage damage, but also resulted in pronounced subchondral sclerosis, synovial macrophage activation, and osteophyte formation. PMID:24472689
[Arthroscopy-guided fracture management. Ankle joint and calcaneus].
Schoepp, C; Rixen, D
2013-04-01
Arthroscopic fracture management of the ankle and calcaneus requires a differentiated approach. The aim is to minimize surgical soft tissue damage and to visualize anatomical fracture reduction arthroscopically. Moreover, additional cartilage damage can be detected and treated. The arthroscopic approach is limited by deep impressions of the joint surface needing cancellous bone grafting, by multiple fracture lines on the articular side and by high-grade soft tissue damage. An alternative to the minimally invasive arthroscopic approach is open arthroscopic reduction in conventional osteosynthesis. This facilitates correct assessment of surgical reduction of complex calcaneal fractures, otherwise remaining non-anatomical reduction might not be fluoroscopically detected during surgery.
Progressive damage and rupture in polymers
NASA Astrophysics Data System (ADS)
Talamini, Brandon; Mao, Yunwei; Anand, Lallit
2018-02-01
Progressive damage, which eventually leads to failure, is ubiquitous in biological and synthetic polymers. The simplest case to consider is that of elastomeric materials which can undergo large reversible deformations with negligible rate dependence. In this paper we develop a theory for modeling progressive damage and rupture of such materials. We extend the phase-field method, which is widely used to describe the damage and fracture of brittle materials, to elastomeric materials undergoing large deformations. A central feature of our theory is the recognition that the free energy of elastomers is not entirely entropic in nature - there is also an energetic contribution from the deformation of the bonds in the chains. It is the energetic part in the free energy which is the driving force for progressive damage and fracture.
Simulating Progressive Damage of Notched Composite Laminates with Various Lamination Schemes
NASA Astrophysics Data System (ADS)
Mandal, B.; Chakrabarti, A.
2017-05-01
A three dimensional finite element based progressive damage model has been developed for the failure analysis of notched composite laminates. The material constitutive relations and the progressive damage algorithms are implemented into finite element code ABAQUS using user-defined subroutine UMAT. The existing failure criteria for the composite laminates are modified by including the failure criteria for fiber/matrix shear damage and delamination effects. The proposed numerical model is quite efficient and simple compared to other progressive damage models available in the literature. The efficiency of the present constitutive model and the computational scheme is verified by comparing the simulated results with the results available in the literature. A parametric study has been carried out to investigate the effect of change in lamination scheme on the failure behaviour of notched composite laminates.
Henriksen, Marius; Creaby, Mark W; Lund, Hans; Juhl, Carsten; Christensen, Robin
2014-01-01
Objective We performed a systematic review, meta-analysis and assessed the evidence supporting a causal link between knee joint loading during walking and structural knee osteoarthritis (OA) progression. Design Systematic review, meta-analysis and application of Bradford Hill's considerations on causation. Data sources We searched MEDLINE, Scopus, AMED, CINAHL and SportsDiscus for prospective cohort studies and randomised controlled trials (RCTs) from 1950 through October 2013. Study eligibility criteria We selected cohort studies and RCTs in which estimates of knee joint loading during walking were used to predict structural knee OA progression assessed by X-ray or MRI. Data analyses Meta-analysis was performed to estimate the combined OR for structural disease progression with higher baseline loading. The likelihood of a causal link between knee joint loading and OA progression was assessed from cohort studies using the Bradford Hill guidelines to derive a 0–4 causation score based on four criteria and examined for confirmation in RCTs. Results Of the 1078 potentially eligible articles, 5 prospective cohort studies were included. The studies included a total of 452 patients relating joint loading to disease progression over 12–72 months. There were very serious limitations associated with the methodological quality of the included studies. The combined OR for disease progression was 1.90 (95% CI 0.85 to 4.25; I2=77%) for each one-unit increment in baseline knee loading. The combined causation score was 0, indicating no causal association between knee loading and knee OA progression. No RCTs were found to confirm or refute the findings from the cohort studies. Conclusions There is very limited and low-quality evidence to support for a causal link between knee joint loading during walking and structural progression of knee OA. Trial registration number CRD42012003253 PMID:25031196
Henriksen, Marius; Creaby, Mark W; Lund, Hans; Juhl, Carsten; Christensen, Robin
2014-07-15
We performed a systematic review, meta-analysis and assessed the evidence supporting a causal link between knee joint loading during walking and structural knee osteoarthritis (OA) progression. Systematic review, meta-analysis and application of Bradford Hill's considerations on causation. We searched MEDLINE, Scopus, AMED, CINAHL and SportsDiscus for prospective cohort studies and randomised controlled trials (RCTs) from 1950 through October 2013. We selected cohort studies and RCTs in which estimates of knee joint loading during walking were used to predict structural knee OA progression assessed by X-ray or MRI. Meta-analysis was performed to estimate the combined OR for structural disease progression with higher baseline loading. The likelihood of a causal link between knee joint loading and OA progression was assessed from cohort studies using the Bradford Hill guidelines to derive a 0-4 causation score based on four criteria and examined for confirmation in RCTs. Of the 1078 potentially eligible articles, 5 prospective cohort studies were included. The studies included a total of 452 patients relating joint loading to disease progression over 12-72 months. There were very serious limitations associated with the methodological quality of the included studies. The combined OR for disease progression was 1.90 (95% CI 0.85 to 4.25; I(2)=77%) for each one-unit increment in baseline knee loading. The combined causation score was 0, indicating no causal association between knee loading and knee OA progression. No RCTs were found to confirm or refute the findings from the cohort studies. There is very limited and low-quality evidence to support for a causal link between knee joint loading during walking and structural progression of knee OA. CRD42012003253. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.
In situ damage detection in frame structures through coupled response measurements
NASA Astrophysics Data System (ADS)
Liu, D.; Gurgenci, H.; Veidt, M.
2004-05-01
Due to the existence of global modes and local modes of the neighbouring members, damage detection on a structure is more challenging than damage on isolated beams. Detection of an artificial circumferential crack on a joint in a frame-like welded structure is studied in this paper using coupled response measurements. Similarity to real engineering structures is maintained in the fabrication of the test frame. Both the chords and the branch members have hollow sections and the branch members have smaller sizes. The crack is created by a hacksaw on a joint where a branch meets the chord. The methodology is first demonstrated on a single hollow section beam. The test results are then presented for the damaged and undamaged frame. The existence of the damage is clearly observable from the experimental results. It is suggested that this approach offers the potential to detect damage in welded structures such as cranes, mining equipment, steel-frame bridges, naval and offshore structures.
Design for inadvertent damage in composite laminates
NASA Technical Reports Server (NTRS)
Singhal, Surendra N.; Chamis, Christos C.
1992-01-01
Simplified predictive methods and models to computationally simulate durability and damage in polymer matrix composite materials/structures are described. The models include (1) progressive fracture, (2) progressively damaged structural behavior, (3) progressive fracture in aggressive environments, (4) stress concentrations, and (5) impact resistance. Several examples are included to illustrate applications of the models and to identify significant parameters and sensitivities. Comparisons with limited experimental data are made.
NASA Astrophysics Data System (ADS)
Mahin Shirazi, Sam
Accelerated thermal cycling (ATC) tests are the most commonly used tests for the thermo-mechanical performance assessment of microelectronics assemblies. Currently used reliability models have failed to incorporate the microstructural dependency of lead free solder joint behavior and its microstructure evolution during cycling. Thus, it is essential to have a mechanistic understanding of the effect of cycling parameters on damage evolution and failure of lead free solder joints in ATC. Recrystallization has been identified as the damage rate controlling mechanism in ATC. Usually it takes 1/3 of life for completion of recrystallization regardless of cycling parameters. Thus, the life of the solder joints can be predicted by estimating global recrystallization. The objective of the first part of the study was to examine whether the damage scenario applies in service is the same as the harsh thermal cycling tests (i.e. 0/100 °C and -40/125 °C) commonly used in industry. Microstructure analysis results on a variety of lead free solder SnAgCu assemblies subjected to the both harsh (0/100 °C) and mild (20/80 °C) ATC confirmed similar failure mechanism under the both testing conditions. Sn grain morphology (interlaced versus beach ball) has a significant effect on the thermo-mechanical performance (and thus the model) of the lead free solder joints. The longer thermal cycling lifetime observed in the interlaced solder joints subjected to the ATC compared to the beach ball structure was correlated to the different initial microstructure and the microstructure evolution during cycling. For the modeling proposes, the present study was focused on Sn-Ag-Cu solder joints with either a single Sn grain or beach ball structure. Microstructural analysis results of the simulated thermal cycling experiment revealed that, the life can be approximated as determined by the accumulation of a certain amount of work during the high temperature dwells. Finally the effect of precipitates spacing on acceleration factor was investigated. Results indicated that a smaller initial precipitate spacing would tend to result in a longer life in mild thermal cycling/service (where there is lower stresses). Accordingly, it is essential to incorporate the dependence of damage rate (i.e. recrystallization) on precipitate coarsening in any predictions.
DOE Office of Scientific and Technical Information (OSTI.GOV)
Henager, Jr., C. H.; Nguyen, Ba N.; Kurtz, Richard J.
The international fusion community has designed a miniature torsion specimen for neutron irradiation studies of joined SiC and SiC/SiC composite materials. For this research, miniature torsion joints based on this specimen design were fabricated using displacement reactions between Si and TiC to produce Ti 3SiC 2 + SiC joints with SiC and tested in torsion-shear prior to and after neutron irradiation. However, many miniature torsion specimens fail out-of-plane within the SiC specimen body, which makes it problematic to assign a shear strength value to the joints and makes it difficult to compare unirradiated and irradiated strengths to determine irradiation effects.more » Finite element elastic damage and elastic–plastic damage models of miniature torsion joints are developed that indicate shear fracture is more likely to occur within the body of the joined sample and cause out-of-plane failures for miniature torsion specimens when a certain modulus and strength ratio between the joint material and the joined material exists. The model results are compared and discussed with regard to unirradiated and irradiated test data for a variety of joint materials. The unirradiated data includes Ti 3SiC 2 + SiC/CVD-SiC joints with tailored joint moduli, and includes steel/epoxy and CVD-SiC/epoxy joints. Finally, the implications for joint data based on this sample design are discussed.« less
Influence of interface ply orientation on fatigue damage of adhesively bonded composite joints
NASA Technical Reports Server (NTRS)
Johnson, W. S.; Mall, S.
1986-01-01
An experimental study of cracked-lap-shear specimens was conducted to determine the influence of adherend stacking sequence on debond initiation and damage growth in a composite-to-composite bonded joint. Specimens consisted of quasi-isotropic graphite/epoxy adherends bonded together with either FM-300 or EC 3445 adhesives. The stacking sequence of the adherends was varied such that 0 deg, 45 deg, or 90 deg plies were present at the adherend-adhesive interfaces. Fatigue damage initiated in the adhesive layer in those specimens with 0 deg and 45 deg interface plies. Damaage initiated in the form of ply cracking in the strap adherend for the specimens with 90 deg interface plies. The fatigue-damage growth was in the form of delamination within the composite adherends for specimens with the 90 deg and 45 deg plies next to the adhesive, while debonding in the adhesive resulted for the specimens with 0 deg plies next to the adhesive. Those joints with the 0 deg and 45 deg plies next to either adhesive has essentially the same fatigue-damage-initiation stress levels. These stress levels were 13 and 71 percent higher, respectively, than those for specimens with 90 deg plies next to the EC 3445 and FM-300 adhesives.
Estrogens and progression of diabetic kidney damage.
Doublier, Sophie; Lupia, Enrico; Catanuto, Paola; Elliot, Sharon J
2011-01-01
It is generally accepted that estrogens affect and modulate the development and progression of chronic kidney diseases (CKD) not related to diabetes. Clinical studies have indeed demonstrated that the severity and rate of progression of renal damage tends to be greater among men, compared with women. Experimental studies also support the notion that female sex is protective and male sex permissive, for the development of CKD in non-diabetics, through the opposing actions of estrogens and testosterone. However, when we consider diabetes-induced kidney damage, in the setting of either type 1 or type 2 diabetes, the contribution of gender to the progression of renal disease is somewhat uncertain. Previous studies on the effects of estrogens in the pathogenesis of progressive kidney damage have primarily focused on mesangial cells. More recently, data on the effects of estrogens on podocytes, the cell type whose role may include initiation of progressive diabetic renal disease, became available. The aim of this review will be to summarize the main clinical and experimental data on the effects of estrogens on the progression of diabetes-induced kidney injury. In particular, we will highlight the possible biological effects of estrogens on podocytes, especially considering those critical for the pathogenesis of diabetic kidney damage.
Progression of white matter damage in progressive supranuclear palsy with predominant parkinsonism.
Caso, Francesca; Agosta, Federica; Ječmenica-Lukić, Milica; Petrović, Igor; Meani, Alessandro; Kostic, Vladimir S; Filippi, Massimo
2018-04-01
Progressive supranuclear palsy with predominant parkinsonism (PSP-P) accounts for 14-35% of all PSP cases. A few cross-sectional MRI studies in PSP-P showed a remarkable white matter (WM) damage. Progression of brain structural damage in these patients remains unknown. Longitudinal clinical, cognitive and diffusion tensor (DT) MRI data were obtained over a mean 1.6 year follow up in 10 PSP-P patients. At study entry, patients were compared with 36 healthy controls. Voxelwise statistical analysis of white matter DT MRI data (mean, axial and radial diffusivity, and fractional anisotropy) was carried out using tract-based spatial statistics. During the 1.6 year follow up, PSP-P patients showed significant decline of motor, cognitive and mood disturbances. DT MRI analysis revealed at baseline a widespread pattern of WM alterations. Over time, PSP-P patients exhibited progression of WM damage in supratentorial tracts compared to baseline. No WM changes were detected in cerebellar WM. In PSP-P patients, WM damage significantly progressed over time. Longitudinal DT MRI measures are a potential in vivo marker of disease progression in PSP-P. Copyright © 2018 Elsevier Ltd. All rights reserved.
Basic radiological assessment of synovial diseases: a pictorial essay
Turan, Aynur; Çeltikçi, Pınar; Tufan, Abdurrahman; Öztürk, Mehmet Akif
2017-01-01
The synovium is a specialized tissue lining the synovial joints, bursae, and tendon sheaths of the body. It is affected by various localized or systemic disorders. Synovial diseases can be classified as inflammatory, infectious, degenerative, traumatic, hemorrhagic, and neoplastic. Damage in other intraarticular structures, particularly cartilages, generally occurs as a part of pathologic processes involving the synovium, leading to irreversible joint destruction. Imaging has an essential role in the early detection of synovial diseases prior to irreversible joint damage. Obtaining and understanding characteristic imaging findings of synovial diseases enables a proper diagnosis for early treatment. This article focuses on the recent literature that is related with the role of imaging in synovial disease. PMID:28638696
Stock, Greg M.; Martel, Stephen J.; Collins, Brian D.; Harp, Edwin L.
2012-01-01
Progressive rock-fall failures in natural rock slopes are common in many environments, but often elude detailed quantitative documentation and analysis. Here we present high-resolution photography, video, and laser scanning data that document spatial and temporal patterns of a 15-month-long sequence of at least 14 rock falls from the Rhombus Wall, a sheeted granitic cliff in Yosemite Valley, California. The rock-fall sequence began on 26 August 2009 with a small failure at the tip of an overhanging rock slab. Several hours later, a series of five rock falls totaling 736 m3progressed upward along a sheeting joint behind the overhanging slab. Over the next 3 weeks, audible cracking occurred on the Rhombus Wall, suggesting crack propagation, while visual monitoring revealed opening of a sheeting joint adjacent to the previous failure surface. On 14 September 2009 a 110 m3 slab detached along this sheeting joint. Additional rock falls between 30 August and 20 November 2010, totaling 187 m3, radiated outward from the initial failure area along cliff (sub)parallel sheeting joints. We suggest that these progressive failures might have been related to stress redistributions accompanying propagation of sheeting joints behind the cliff face. Mechanical analyses indicate that tensile stresses should occur perpendicular to the cliff face and open sheeting joints, and that sheeting joints should propagate parallel to a cliff face from areas of stress concentrations. The analyses also account for how sheeting joints can propagate to lengths many times greater than their depths behind cliff faces. We posit that as a region of failure spreads across a cliff face, stress concentrations along its margin will spread with it, promoting further crack propagation and rock falls.
DOT National Transportation Integrated Search
2010-09-01
Most of the damage to concrete pavement results from poor drainage, which can lead to increased freeze-thaw damage, and when combined with heavy loading can contribute to cracking, spalling and surface damage that causes driver discomfort from increa...
Detection of fastener loosening in simple lap joint based on ultrasonic wavefield imaging
NASA Astrophysics Data System (ADS)
Gooda Sahib, M. I.; Leong, S. J.; Chia, C. C.; Mustapha, F.
2017-12-01
Joints in aero-mechanical structures are critical elements that ensure the structural integrity but they are prone to damages. Inspection of such joints that have no prior baseline data is really challenging but it can be possibly done using the Ultrasonic Propagation Imager (UPI). The feasibility of applying UPI for detection of loosened fastener is investigated in this study. A simple lap joint specimen made by connecting two pieces of 2.5mm thick SAE304 stainless steel plates using five M6 screws and nuts has been used in this study. All fasteners are tightened to 10Nm but one of them is completely loosened to simulate the damage. The wavefield data is processed into ultrasonic wavefield propagation video and a series of spectral amplitude images. The spectral images showed noticeable amplitude difference at the loosened fastener, hence confirmed the feasibility of using UPI for structural joints inspection. A simple contrast maximization method is also introduced to improve the result.
Damage Progression in Buckle-Resistant Notched Composite Plates Loaded in Uniaxial Compression
NASA Technical Reports Server (NTRS)
McGowan, David M.; Davila, Carlos G.; Ambur, Damodar R.
2001-01-01
Results of an experimental and analytical evaluation of damage progression in three stitched composite plates containing an angled central notch and subjected to compression loading are presented. Parametric studies were conducted systematically to identify the relative effects of the material strength parameters on damage initiation and growth. Comparisons with experiments were conducted to determine the appropriate in situ values of strengths for progressive failure analysis. These parametric studies indicated that the in situ value of the fiber buckling strength is the most important parameter in the prediction of damage initiation and growth in these notched composite plates. Analyses of the damage progression in the notched, compression-loaded plates were conducted using in situ material strengths. Comparisons of results obtained from these analyses with experimental results for displacements and axial strains show good agreement.
Progressive Damage and Fracture in Composites Under Dynamic Loading
NASA Technical Reports Server (NTRS)
Minnetyan, Levon
1994-01-01
A computational simulation tool is used to evaluate the various stages of damage progression in composite materials during losipescu shear testing. Unidirectional composite specimens with either the major or minor material axis in the load direction are considered. Damage progression characteristics are described for each specimen using two types of boundary conditions. A procedure is outlined regarding the use of computational simulation in the testing of composite materials.
Zamli, Zaitunnatakhin; Adams, Michael A; Tarlton, John F; Sharif, Mohammed
2013-08-29
Osteoarthritis (OA) is the most common joint disease characterised by degradation of articular cartilage and bone remodelling. For almost a decade chondrocyte apoptosis has been investigated as a possible mechanism of cartilage damage in OA, but its precise role in initiation and/or progression of OA remains to the determined. The aim of this study is to determine the role of chondrocyte apoptosis in spontaneous animal models of OA. Right tibias from six male Dunkin Hartley (DH) and Bristol Strain 2 (BS2) guinea pigs were collected at 10, 16, 24 and 30 weeks of age. Fresh-frozen sections of tibial epiphysis were microscopically scored for OA, and immunostained with caspase-3 and TUNEL for apoptotic chondrocytes. The DH strain had more pronounced cartilage damage than BS2, especially at 30 weeks. At this time point, the apoptotic chondrocytes were largely confined to the deep zone of articular cartilage (AC) with a greater percentage in the medial side of DH than BS2 (DH: 5.7%, 95% CI: 4.2-7.2), BS2: 4.8%, 95% CI: 3.8-5.8), p > 0.05). DH had a significant progression of chondrocyte death between 24 to 30 weeks during which time significant changes were observed in AC fibrillation, proteoglycan depletion and overall microscopic OA score. A strong correlation (p ≤ 0.01) was found between chondrocyte apoptosis and AC fibrillation (r = 0.3), cellularity (r = 0.4) and overall microscopic OA scores (r = 0.4). Overall, the rate of progression in OA and apoptosis over the study period was greater in the DH (versus BS2) and the medial AC (versus lateral). Chondrocyte apoptosis was higher at the later stage of OA development when the cartilage matrix was hypocellular and highly fibrillated, suggesting that chondrocyte apoptosis is a late event in OA.
The effect of fatigue cracks on fastener flexibility, load distribution, and fatigue crack growth
NASA Astrophysics Data System (ADS)
Whitman, Zachary Layne
Fatigue cracks typically occur at stress risers such as geometry changes and holes. This type of failure has serious safety and economic repercussions affecting structures such as aircraft. The need to prevent catastrophic failure due to fatigue cracks and other discontinuities has led to durability and damage tolerant methodologies influencing the design of aircraft structures. Holes in a plate or sheet filled with a fastener are common fatigue critical locations in aircraft structure requiring damage tolerance analysis (DTA). Often, the fastener is transferring load which leads to a loading condition involving both far-field stresses such as tension and bending, and localized bearing at the hole. The difference between the bearing stress and the tensile field at the hole is known as load transfer. The ratio of load transfer as well as the magnitude of the stresses plays a significant part in how quickly a crack will progress to failure. Unfortunately, the determination of load transfer in a complex joint is far from trivial. Many methods exist in the open literature regarding the analysis of splices, doublers and attachment joints to determine individual fastener loads. These methods work well for static analyses but greater refinement is needed for crack growth analysis. The first fastener in a splice or joint is typically the most critical but different fastener flexibility equations will all give different results. The constraint of the fastener head and shop end, along with the type of fastener, affects the stiffness or flexibility of the fastener. This in turn will determine the load that the fastener will transfer within a given fastener pattern. However, current methods do not account for the change in flexibility at a fastener as the crack develops. It is put forth that a crack does indeed reduce the stiffness of a fastener by changing its constraint, thus lessening the load transfer. A crack growth analysis utilizing reduced load transfer will result in a slower growing crack versus an analysis that ignores the effect.
Wakitani, S; Imoto, K; Saito, M; Yamamoto, T; Kawabata, H
2002-05-01
Reconstruction of a knee damaged by cement packed to cure a giant-cell tumor is sometimes difficult. We reconstructed such a knee by removal of the cement, autologous bone transplantation and distraction osteogenesis using the Ilizarov apparatus. In this paper the results 29 months after the salvage surgery are given. We saw a 31-year-old woman's knee joint that showed osteoarthritic change after curettage, cryosurgery and cementation performed 4 years previously for a giant-cell tumor of the proximal tibia. We reconstructed the knee joint. This procedure included cement removal, alignment correction by tibial osteotomy, subchondral bone reconstruction by autologous bone transplantation, and filling the defect after removing the bone cement by elongating the diaphysis using the Ilizarov apparatus. Distraction was terminated 4 months later when 54 mm of elongation was performed. All devices were removed 12 months after the surgery. Seventeen months after the removal of the apparatus, the range of motion of the right knee was 0 degrees extension and 110 degrees flexion, and the patient was able to walk without pain. Although the treatment period is long and there may be some complications of Ilizarov lengthening and distraction osteogenesis, this procedure has numerous benefits. Bony defects can be soundly reconstructed and, at the same time, the alignment of the knee can be corrected. Also it is not necessary to reconstruct the ligaments because the insertions are intact. If osteoarthritis progresses, a surface type total knee replacement can be performed, not constrained type prosthesis, which would be used if the bony structure had not been reconstructed. This procedure may be one of the candidates for reconstructing such knee joints destroyed by bone cement. Copyright 2002 OsteoArthritis Research Society International. Published by Elsevier Science Ltd. All rights reserved.
Goetzen, Michael; Hofmann-Fliri, Ladina; Arens, Daniel; Zeiter, Stephan; Stadelmann, Vincent; Nehrbass, Dirk; Richards, R Geoff; Blauth, Michael
2015-01-01
Augmentation of implants with polymethylmethacrylate (PMMA) bone cement in osteoporotic fractures is a promising approach to increase implant purchase. Side effects of PMMA for the metaphyseal bone, particularly for the adjacent subchondral bone plate and joint cartilage, have not yet been studied. The following experimental study investigates whether subchondral PMMA injection compromises the homeostasis of the subchondral bone and/or the joint cartilage.Ten mature sheep were used to simulate subchondral PMMA injection. Follow-ups of 2 (4 animals) and 4 (6 animals) months were chosen to investigate possible cartilage damage and subchondral plate alterations in the knee. Evaluation was completed by means of high-resolution peripheral quantitative computed tomography (HRpQCT) imaging, histopathological osteoarthritis scoring, and determination of glycosaminoglycan content in the joint cartilage. Results were compared with the untreated contralateral knee and statistically analyzed using nonparametric tests.Evaluation of the histological osteoarthritis score revealed no obvious cartilage damage for the treated knee; median histological score after 2 months 0 (range 4), after 4 months 1 (range 5). There was no significant difference when compared with the untreated control site after 2 and 4 months (P = 0.23 and 0.76, respectively). HRpQCT imaging showed no damage to the metaphyseal trabeculae. Glycosaminoglycan measurements of the treated joint cartilage after 4 months revealed no significant difference compared with the untreated cartilage (P = 0.24).The findings of this study support initial clinical observation that PMMA implant augmentation of metaphyseal fractures appears to be a safe procedure for fixation without harming the subchondral bone plate and adjacent joint cartilage.
NASA Technical Reports Server (NTRS)
Pearlman, Michael R.; Carter, David (Technical Monitor)
2004-01-01
This progress report discusses the status and progress made in joint international programs including: 1) WEGENER; 2) Arabian Peninsula program; 3) Asia-Pacific Space Geodynamics (APSG) program; 4) the Fourteenth International Workshop on Laser Ranging; 5) the International Laser Ranging Service; and 6) current support for the NASA network.
Saltzherr, Michael S; Coert, J Henk; Selles, Ruud W; van Neck, Johan W; Jaquet, Jean-Bart; van Osch, Gerjo J V M; Oei, Edwin H G; Luime, Jolanda J; Muradin, Galied S R
2017-03-14
Magnetic resonance imaging (MRI) is increasingly used for research in hand osteoarthritis, but imaging the thin cartilage layers in the hand joints remains challenging. We therefore assessed the accuracy of MRI in detecting cartilage loss in patients with symptomatic osteoarthritis of the first carpometacarpal (CMC1) joint. Twelve patients scheduled for trapeziectomy to treat severe symptomatic osteoarthritis of the CMC1 joint underwent a preoperative high resolution 3D spoiled gradient (SPGR) MRI scan. Subsequently, the resected trapezium was evaluated histologically. The sections were scored for cartilage damage severity (Osteoarthritis Research Society International (OARSI) score), and extent of damage (percentage surface area). Each MRI scan was scored for the area of normal cartilage, partial cartilage loss and full cartilage loss. The percentages of the total surface area with any cartilage loss and full-thickness cartilage loss were calculated using MRI and histological evaluation. MRI and histological evaluation both identified large areas of overall cartilage loss. The median (IQR) surface area of any cartilage loss on MRI was 98% (82-100%), and on histological assessment 96% (87-98%). However, MRI underestimated the extent of full-thickness cartilage loss. The median (IQR) surface area of full-thickness cartilage loss on MRI was 43% (22-70%), and on histological evaluation 79% (67-85%). The difference was caused by a thin layer of high signal on the articulating surface, which was interpreted as damaged cartilage on MRI but which was not identified on histological evaluation. Three-dimensional SPGR MRI of the CMC1 joint demonstrates overall cartilage damage, but underestimates full-thickness cartilage loss in patients with advanced osteoarthritis.
Combination of Polymeric Supports and Drug Delivery Systems for Osteochondral Regeneration.
Rojo, Luis
2018-01-01
Musculoskeletal conditions have been defined by European National Health systems as one of the key themes which should be featured during the present decade as a consequence of the significant healthcare and social support costs. Among others, articular cartilage degeneration due to traumatic and degenerative lesion injury or other pathologies commonly results in the development of musculoskeletal disorders such as osteoarthritis and arthritis rheumatoid, eventually leading to progressive articular cartilage and joint destruction especially at osteochondral interphase, that account for more disability among the elderly than any other diseases constituting a global social challenge that needs a multidisciplinary response from the scientific community. Current treatments for damaged osteoarthritic joint cartilage include the use of disease-modifying drugs and ultimately joint arthroplasty as unavoidable surgical intervention due to the limited ability of articular cartilage to self-regenerate. However, potential future regenerative therapies based on tissue engineering strategies are likely to become more important to facilitate the recruitment of repairing cells and improve musculoskeletal metabolism. In addition, emerging bioprinting technologies in combination with implemented manufacturing techniques such electrospinning or cryogelation processes have permitted the development of new tissue substitutes with precise control of sizes and shapes to recreate the complex physiological, biomechanical and hieratical microstructure of osteochondral interphases. Thus, this chapter will provide an upgrade on the state of the art focusing the most relevant developments on polymer scaffolds and drug delivery systems for osteochondral regeneration.
NASA Technical Reports Server (NTRS)
Coats, Timothy William
1994-01-01
Progressive failure is a crucial concern when using laminated composites in structural design. Therefore the ability to model damage and predict the life of laminated composites is vital. The purpose of this research was to experimentally verify the application of the continuum damage model, a progressive failure theory utilizing continuum damage mechanics, to a toughened material system. Damage due to tension-tension fatigue was documented for the IM7/5260 composite laminates. Crack density and delamination surface area were used to calculate matrix cracking and delamination internal state variables, respectively, to predict stiffness loss. A damage dependent finite element code qualitatively predicted trends in transverse matrix cracking, axial splits and local stress-strain distributions for notched quasi-isotropic laminates. The predictions were similar to the experimental data and it was concluded that the continuum damage model provided a good prediction of stiffness loss while qualitatively predicting damage growth in notched laminates.
NASA Technical Reports Server (NTRS)
Coats, Timothy W.; Harris, Charles E.
1995-01-01
The durability and damage tolerance of laminated composites are critical design considerations for airframe composite structures. Therefore, the ability to model damage initiation and growth and predict the life of laminated composites is necessary to achieve structurally efficient and economical designs. The purpose of this research is to experimentally verify the application of a continuum damage model to predict progressive damage development in a toughened material system. Damage due to monotonic and tension-tension fatigue was documented for IM7/5260 graphite/bismaleimide laminates. Crack density and delamination surface area were used to calculate matrix cracking and delamination internal state variables to predict stiffness loss in unnotched laminates. A damage dependent finite element code predicted the stiffness loss for notched laminates with good agreement to experimental data. It was concluded that the continuum damage model can adequately predict matrix damage progression in notched and unnotched laminates as a function of loading history and laminate stacking sequence.
Hip Replacement: MedlinePlus Health Topic
... damage. The most common cause of damage is osteoarthritis . Osteoarthritis causes pain, swelling, and reduced motion in your ... Food and Drug Administration) Genetics Genetics Home Reference: osteoarthritis (National Library of Medicine) Images Hip joint replacement - ...
Recent progress in the joint velocity-scalar PDF method
NASA Technical Reports Server (NTRS)
Anand, M. S.
1995-01-01
This viewgraph presentation discusses joint velocity-scalar PDF method; turbulent combustion modeling issues for gas turbine combustors; PDF calculations for a recirculating flow; stochastic dissipation model; joint PDF calculations for swirling flows; spray calculations; reduced kinetics/manifold methods; parallel processing; and joint PDF focus areas.
Three-Dimensional Geometric Nonlinear Contact Stress Analysis of Riveted Joints
NASA Technical Reports Server (NTRS)
Shivakumar, Kunigal N.; Ramanujapuram, Vivek
1998-01-01
The problems associated with fatigue were brought into the forefront of research by the explosive decompression and structural failure of the Aloha Airlines Flight 243 in 1988. The structural failure of this airplane has been attributed to debonding and multiple cracking along the longitudinal lap splice riveted joint in the fuselage. This crash created what may be termed as a minor "Structural Integrity Revolution" in the commercial transport industry. Major steps have been taken by the manufacturers, operators and authorities to improve the structural airworthiness of the aging fleet of airplanes. Notwithstanding, this considerable effort there are still outstanding issues and concerns related to the formulation of Widespread Fatigue Damage which is believed to have been a contributing factor in the probable cause of the Aloha accident. The lesson from this accident was that Multiple-Site Damage (MSD) in "aging" aircraft can lead to extensive aircraft damage. A strong candidate in which MSD is highly probable to occur is the riveted lap joint.
Lowe, Jason A; Routh, Lucas K; Leary, Jeffrey T; Buzhardt, Paul C
2016-01-01
Recent published data have suggested successful union of subtalar and tibiotalar joints without formal debridement during tibiotalocalcaneal (TTC) fusion procedures. Although previous studies have reported on the importance of the proper guidewire starting point and trajectory to obtain appropriate hindfoot alignment for successful fusion, to our knowledge, no studies have quantified the amount of articular damage to the subtalar joint with retrograde reaming. We hypothesized that reaming would destroy >50% of the posterior facet of the subtalar joint. The bilateral lower extremities of 5 cadavers were obtained and the subtalar joints exposed. Retrograde TTC nail guidewires were inserted, and a 12-mm reamer was passed through the subtalar and ankle joints. Pre- and postreaming images of the subtalar joint were obtained to compare the amount of joint destruction after reaming. We found an average of 5.89% articular destruction of the talar posterior facet and an average of 4.01% articular destruction of the posterior facet of the calcaneus. No damage to the middle facets of the subtalar joint was observed. TTC nailing is a successful procedure for ankle and subtalar joint fusion. Published studies have reported successful subtalar union using TTC nailing without formal open debridement of the subtalar joint, preserving the soft tissue envelope. TTC nail insertion using a 12-mm reamer will destroy 5.89% and 4.01% of the respective talar and calcaneal posterior facets of the subtalar joint. Copyright © 2016 American College of Foot and Ankle Surgeons. Published by Elsevier Inc. All rights reserved.
Silva Rodrigues, João Francisco; Silva E Silva, Cristiane; França Muniz, Thayanne; de Aquino, Alana Fernanda; Neuza da Silva Nina, Larissa; Fialho Sousa, Nagila Caroline; Nascimento da Silva, Luis Claudio; de Souza, Breno Glaessner Gomes Fernandes; da Penha, Tatiana Aranha; Abreu-Silva, Ana Lúcia; de Sá, Joicy Cortez; Soares Fernandes, Elizabeth; Grisotto, Marcos Augusto Grigolin
2018-04-24
Rheumatoid arthritis (RA) is characterized by inflammation of one or more joints, and affects ~1% of the adult population worldwide. Sulforaphane (SFN) is a natural compound that has been suggested as an antioxidant. Here, SFN’s effects were evaluated in a murine mono-arthritis model. Mono-arthritis was induced in mice by a single intra-articular injection of Complete Freund’s Adjuvant (CFA-10 µg/joint, in 10 µL) into the ipsilateral joint. The contralateral joint received an equal volume of PBS. On the 4th day post-joint inflammation induction, animals received either SFN (10 mg/kg) or vehicle (3% DMSO in saline), intraperitoneally (i.p.), twice a day for 3 days. Joint swelling and secondary mechanical allodynia and hyperalgesia were evaluated over 7 days post-CFA. After this period, animals were culled and their blood and synovial fluid samples were collected for analysis of cell populations, cytokine release and thioredoxin reductase (TrxR) activity. Knee joint samples were also collected for histology. SFN reduced joint swelling and damage whilst increasing the recruitment of Ly6C⁺ and Ly6G⁺ cells to CFA-injected joints. SFN-treated animals presented down-regulation of CD11b and CD62L on synovial fluid Ly6G⁺ cells. Synovial fluid samples obtained from CFA-injected joints and plasma samples of SFN-treated mice presented higher levels of IL-6 and increased activity of TrxR, in comparison with controls. These results indicate that SFN reduces knee joint damage by modulating cell activation/migration to the joints, cytokine production and increasing the activity of TrxR, and therefore, may represent an alternative treatment to joint inflammation.
Nickerson, John M.; Gao, Feng-juan; Sun, Zhongmou; Chen, Xin-ya; Zhang, Shu-jie; Gao, Feng; Chen, Jun-yi; Luo, Yi; Wang, Yan; Sun, Xing-huai
2015-01-01
Glaucoma is a chronic neurodegenerative disease characterized by the progressive loss of retinal ganglion cells (RGCs). Mitochondrial DNA (mtDNA) alterations have been documented as a key component of many neurodegenerative disorders. However, whether mtDNA alterations contribute to the progressive loss of RGCs and the mechanism whereby this phenomenon could occur are poorly understood. We investigated mtDNA alterations in RGCs using a rat model of chronic intraocular hypertension and explored the mechanisms underlying progressive RGC loss. We demonstrate that the mtDNA damage and mutations triggered by intraocular pressure (IOP) elevation are initiating, crucial events in a cascade leading to progressive RGC loss. Damage to and mutation of mtDNA, mitochondrial dysfunction, reduced levels of mtDNA repair/replication enzymes, and elevated reactive oxygen species form a positive feedback loop that produces irreversible mtDNA damage and mutation and contributes to progressive RGC loss, which occurs even after a return to normal IOP. Furthermore, we demonstrate that mtDNA damage and mutations increase the vulnerability of RGCs to elevated IOP and glutamate levels, which are among the most common glaucoma insults. This study suggests that therapeutic approaches that target mtDNA maintenance and repair and that promote energy production may prevent the progressive death of RGCs. PMID:25478814
New insights into the epidemiology of gout.
Doherty, Michael
2009-05-01
Gout is a true crystal deposition disease caused by formation of monosodium urate crystals in joints and other tissues. It is a common inflammatory arthritis that has increased in prevalence in recent decades. Gout normally results from the interaction of genetic, constitutional and environmental risk factors. It is more common in men and strongly age related. A major determinant is the degree of elevation of uric acid levels above the saturation point for urate crystal formation, principally caused by inefficient renal urate excretion. Local joint tissue factors may influence the topography and extent of crystal deposition. Recent studies have provided information on dietary risk factors for gout: higher intakes of red meat, fructose and beer are independently associated with increased risk, whereas higher intakes of coffee, low-fat dairy products and vitamin C are associated with lower risk. Several renal urate transporters have been identified including URAT1 and SLC2A9 (GLUT9) and polymorphisms in these genes are associated with an increased risk of hyperuricaemia and gout. Many drugs influence serum uric acid levels through an effect on renal urate transport. Comorbidities, including the metabolic syndrome and impaired renal function are common in gout patients. The usual initial presentation of gout is with rapidly developing acute inflammatory monoarthritis, typically affecting the first MTP joint. If left untreated it may progress with recurrent acute attacks and eventual development of chronic symptoms and joint damage. New knowledge of the modifiable risk factors for gout can be integrated into the management strategy to optimize long-term patient outcomes.
Lawrence, Alexandra; Xu, Xin; Bible, Melissa D.; Calve, Sarah; Neu, Corey P.; Panitch, Alyssa
2015-01-01
The lubricating proteoglycan, lubricin, facilitates the remarkable low friction and wear properties of articular cartilage in the synovial joints of the body. Lubricin lines the joint surfaces and plays a protective role as a boundary lubricant in sliding contact; decreased expression of lubricin is associated with cartilage degradation and the pathogenesis of osteoarthritis. An unmet need for early osteoarthritis treatment is the development of therapeutic molecules that mimic lubricin function and yet are also resistant to enzymatic degradation common in the damaged joint. Here, we engineered a lubricin mimic (mLub) that is less susceptible to enzymatic degradation and binds to the articular surface to reduce friction. mLub was synthesized using a chondroitin sulfate backbone with type II collagen and hyaluronic acid (HA) binding peptides to promote interaction with the articular surface and synovial fluid constituents. In vitro and in vivo characterization confirmed the binding ability of mLub to isolated type II collagen and HA, and to the cartilage surface. Following trypsin treatment to the cartilage surface, application of mLub, in combination with purified or commercially available hyaluronan, reduced the coefficient of friction, and adhesion, to control levels as assessed over macro- to micro-scales by rheometry and atomic force microscopy. In vivo studies demonstrate an mLub residency time of less than 1 week. Enhanced lubrication by mLub reduces surface friction and adhesion, which may suppress the progression of degradation and cartilage loss in the joint. mLub therefore shows potential for treatment in early osteoarthritis following injury. PMID:26398308
Modeling Progressive Failure of Bonded Joints Using a Single Joint Finite Element
NASA Technical Reports Server (NTRS)
Stapleton, Scott E.; Waas, Anthony M.; Bednarcyk, Brett A.
2010-01-01
Enhanced finite elements are elements with an embedded analytical solution which can capture detailed local fields, enabling more efficient, mesh-independent finite element analysis. In the present study, an enhanced finite element is applied to generate a general framework capable of modeling an array of joint types. The joint field equations are derived using the principle of minimum potential energy, and the resulting solutions for the displacement fields are used to generate shape functions and a stiffness matrix for a single joint finite element. This single finite element thus captures the detailed stress and strain fields within the bonded joint, but it can function within a broader structural finite element model. The costs associated with a fine mesh of the joint can thus be avoided while still obtaining a detailed solution for the joint. Additionally, the capability to model non-linear adhesive constitutive behavior has been included within the method, and progressive failure of the adhesive can be modeled by using a strain-based failure criteria and re-sizing the joint as the adhesive fails. Results of the model compare favorably with experimental and finite element results.
Modeling and testing miniature torsion specimens for SiC joining development studies for fusion
Henager, Jr., C. H.; Nguyen, Ba N.; Kurtz, Richard J.; ...
2015-08-05
The international fusion community has designed a miniature torsion specimen for neutron irradiation studies of joined SiC and SiC/SiC composite materials. For this research, miniature torsion joints based on this specimen design were fabricated using displacement reactions between Si and TiC to produce Ti 3SiC 2 + SiC joints with SiC and tested in torsion-shear prior to and after neutron irradiation. However, many miniature torsion specimens fail out-of-plane within the SiC specimen body, which makes it problematic to assign a shear strength value to the joints and makes it difficult to compare unirradiated and irradiated strengths to determine irradiation effects.more » Finite element elastic damage and elastic–plastic damage models of miniature torsion joints are developed that indicate shear fracture is more likely to occur within the body of the joined sample and cause out-of-plane failures for miniature torsion specimens when a certain modulus and strength ratio between the joint material and the joined material exists. The model results are compared and discussed with regard to unirradiated and irradiated test data for a variety of joint materials. The unirradiated data includes Ti 3SiC 2 + SiC/CVD-SiC joints with tailored joint moduli, and includes steel/epoxy and CVD-SiC/epoxy joints. Finally, the implications for joint data based on this sample design are discussed.« less
NASA Technical Reports Server (NTRS)
Wilkinson, J. P.
1990-01-01
The performance of the thermal protection system, field joint protection system, and systems tunnel components of Flight Set 360L006, are documented, as evaluated by postflight hardware inspection. The condition of both motors was similar to previous flights. Sixteen aft edge hits were noted on the ground environment instrumentation thermal protection system. Each hit left a clean substrate, indicating that the damage was caused by nozzle severance debris and/or water impact. No National Space and Transporation System debris criteria for missing thermal protection system were violated. One 5.0 by 1.0 in. unbond was observed on the left hand center field joint K5NA closeout and was elevated to an in-flight anomaly (STS-34-M-4) by the NASA Ice/Debris team. Aft edge damage to the K5NA and an associated black streak indicate that burning debris from the nozzle severance system was the likely cause of the damage. Minor divots caused by debris were seen on previous flights, but this is the first occurrence of a K5NA unbond. Since the unbond occurred after booster separation there is no impact on flight safety and no corrective actions was taken. The right hand center field joint primary heater failed the dielectric withstanding voltage test after joint closeout. The heater was then disabled by opening the circuit breaker, and the redundant heater was used. The redundant heater performed nominally during the launch countdown. A similar condition occurred on Flight 4 when a secondary joint heater failed the dielectric withstanding voltage test.
Test and Analysis Correlation for a Y-Joint Specimen for a Composite Cryotank
NASA Technical Reports Server (NTRS)
Mason, Brian H.; Sleight, David W.; Grenoble, Ray
2015-01-01
The Composite Cryotank Technology Demonstration (CCTD) project under NASA's Game Changing Development Program (GCDP) developed space technologies using advanced composite materials. Under CCTD, NASA funded the Boeing Company to design and test a number of element-level joint specimens as a precursor to a 2.4-m diameter composite cryotank. Preliminary analyses indicated that the y-joint in the cryotank had low margins of safety; hence the y-joint was considered to be a critical design region. The y-joint design includes a softening strip wedge to reduce localized shear stresses at the skirt/dome interface. In this paper, NASA-developed analytical models will be correlated with the experimental results of a series of positive-peel y-joint specimens from Boeing tests. Initial analytical models over-predicted the experimental strain gage readings in the far-field region by approximately 10%. The over-prediction was attributed to uncertainty in the elastic properties of the laminate and a mismatch between the thermal expansion of the strain gages and the laminate. The elastic properties of the analytical model were adjusted to account for the strain gage differences. The experimental strain gages also indicated a large non-linear effect in the softening strip region that was not predicted by the analytical model. This non-linear effect was attributed to delamination initiating in the softening strip region at below 20% of the failure load for the specimen. Because the specimen was contained in a thermally insulated box during cryogenic testing to failure, delamination initiation and progression was not visualized during the test. Several possible failure initiation locations were investigated, and a most likely failure scenario was determined that correlated well with the experimental data. The most likely failure scenario corresponded to damage initiating in the softening strip and delamination extending to the grips at final failure.
[Pulmonary involvement in connective tissue disease].
Bartosiewicz, Małgorzata
2016-01-01
The connective tissue diseases are a variable group of autoimmune mediated disorders characterized by multiorgan damage. Pulmonary complications are common, usually occur after the onset of joint symptoms, but can also be initially presenting complaint. The respiratory system may be involved in all its component: airways, vessels, parenchyma, pleura and respiratory muscles. Lung involvement is an increasing cause of morbidity and mortality in the connective tissue diseases. Clinical course is highly variable - can range from mild to rapidly progressive, some processes are reversible, while others are irreversible. Thus, the identification of reversible disease , and separately progressive disease, are important clinical issues. The frequency, clinical presentation, prognosis and responce to therapy are different, depending on the pattern of involvement as well as on specyfic diagnostic method used to identify it. High- resolution computed tompography plays an important role in identifying patients with respiratory involvement. Pulmonary function tests are a sensitive tool detecting interstitial lung disease. In this article, pulmonary lung involvement accompanying most frequently apperaing connective tissue diseases - rheumatoid arthritis, systemic sclerosis, lupus erythematosus, polymyositis/dermatomyositis, Sjögrens syndrome and mixed connective tissue disaese are reviewed.
30 CFR 220.011 - Schedule of allowable direct and allocable joint costs and credits.
Code of Federal Regulations, 2010 CFR
2010-07-01
... household applicances, and purchases of insurance against damages to or loss of personal property are... approval. (h) Damages and losses to NPSL property. All costs necessary for the repair or replacement of NPSL property made necessary because of damages or losses incurred by fire, flood, storm, theft...
Damage Tolerance of Large Shell Structures
NASA Technical Reports Server (NTRS)
Minnetyan, L.; Chamis, C. C.
1999-01-01
Progressive damage and fracture of large shell structures is investigated. A computer model is used for the assessment of structural response, progressive fracture resistance, and defect/damage tolerance characteristics. Critical locations of a stiffened conical shell segment are identified. Defective and defect-free computer models are simulated to evaluate structural damage/defect tolerance. Safe pressurization levels are assessed for the retention of structural integrity at the presence of damage/ defects. Damage initiation, growth, accumulation, and propagation to fracture are included in the simulations. Damage propagation and burst pressures for defective and defect-free shells are compared to evaluate damage tolerance. Design implications with regard to defect and damage tolerance of a large steel pressure vessel are examined.
Demonstrating damage tolerance of composite airframes
NASA Technical Reports Server (NTRS)
Poe, Clarence C., Jr.
1993-01-01
Commercial transport aircraft operating in the United States are certified by the Federal Aviation Authority to be damage tolerant. On 28 April 1988, Aloha Airlines Flight 243, a Boeing 727-200 airplane, suffered an explosive decompression of the fuselage but landed safely. This event provides very strong justification for the damage tolerant design criteria. The likely cause of the explosive decompression was the linkup of numerous small fatigue cracks that initiated at adjacent fastener holes in the lap splice joint at the side of the body. Actually, the design should have limited the damage size to less than two frame spacings (about 40 inches), but this type of 'multi-site damage' was not originally taken into account. This cracking pattern developed only in the high-time airplanes (many flights). After discovery in the fleet, a stringent inspection program using eddy current techniques was inaugurated to discover these cracks before they linked up. Because of concerns about safety and the maintenance burden, the lap-splice joints of these high-time airplanes are being modified to remove cracks and prevent new cracking; newer designs account for 'multi-site damage'.
Glomerular and tubular damage markers in individuals with progressive albuminuria.
Nauta, Ferdau L; Scheven, Lieneke; Meijer, Esther; van Oeveren, Wim; de Jong, Paul E; Bakker, Stephan J L; Gansevoort, Ron T
2013-07-01
Albuminuria is associated with risk for renal and cardiovascular disease. It is difficult to predict which persons will progress in albuminuria. This study investigated whether assessment of urinary markers associated with damage to different parts of the nephron may help identify individuals that will progress in albuminuria. Individuals were selected from a prospective community-based cohort study with serial follow-up and defined as "progressors" if they belonged to the quintile of participants with the most rapid annual increase in albuminuria, and reached an albuminuria ≥150 mg/d during follow-up. Patients with known renal disease or macroalbuminuria at baseline were excluded. Each progressor was matched to two control participants, based on baseline albuminuria, age, and sex. Furthermore, damage markers were measured in a separate set of healthy individuals. After a median follow-up of 8.6 years, 183 of 8394 participants met the criteria for progressive albuminuria. Baseline clinical characteristics were comparable between progressors and matched controls (n=366). Both had higher baseline albuminuria than the overall population. Urinary excretion of the glomerular damage marker IgG was significantly higher in progressors, whereas urinary excretion of proximal tubular damage markers and inflammatory markers was lower in these individuals compared with controls. Healthy individuals (n=109) had the lowest values for all urinary damage markers measured. These data suggest that albuminuria associated with markers of glomerular damage is more likely to progress, whereas albuminuria associated with markers of tubulointerstitial damage is more likely to remain stable.
Akdemir, Gülşah; Heimans, Lotte; Bergstra, Sytske Anne; Goekoop, Robbert J; van Oosterhout, Maikel; van Groenendael, Johannes H L M; Peeters, André J; Steup-Beekman, Gerda M; Lard, Leroy R; de Sonnaville, Peter B J; Grillet, Bernard A M; Huizinga, Tom W J; Allaart, Cornelia F
2018-01-01
To determine the 5-year outcomes of early remission induction therapy followed by targeted treatment aimed at drug-free remission (DFR) in patients with early arthritis. In 12 hospitals, 610 patients with early (<2 years) rheumatoid arthritis (RA) or undifferentiated arthritis (UA) started on methotrexate (MTX) 25 mg/week and prednisone (60 mg/day tapered to 7.5 mg/day). Patients not in early remission (Disease Activity Score <1.6 after 4 months) were randomised (single blind) to arm 1, adding hydroxychloroquine 400 mg/day and sulfasalazine 2000 mg/day, or arm 2, switching to MTX plus adalimumab 40 mg/2 weeks. Treatment adjustments over time aimed at DFR. Outcomes were remission percentages, functional ability, toxicity and radiological damage progression after 5 years. After 4 months, 387 patients were in early remission, 83 were randomised to arm 1 and 78 to arm 2. After 5 years, 295/610 (48%) patients were in remission, 26% in sustained DFR (SDFR) (≥1 year) (220/387 (57%) remission and 135/387 (35%) SDFR in the early remission group, 50% remission, 11% SDFR in the randomisation arms without differences between the arms). More patients with UA (37% vs 23% RA, p=0.001) and more anticitrullinated protein antibody (ACPA)-negative patients (37% vs 18% ACPA-positive, p<0.001) achieved SDFR.Overall, mean Health Assessment Questionnaire was 0.6 (0.5), and median (IQR) damage progression was 0.5 (0-2.7) Sharp/van der Heijde points, with only five patients showing progression >25 points in 5 years. Five years of DFR-steered treatment in patients with early RA resulted in almost normal functional ability without clinically relevant joint damage across treatment groups. Patients who achieved early remission had the best clinical outcomes. There were no differences between the randomisation arms. SDFR is a realistic treatment goal. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.
Exercise may decrease further destruction in the adult haemophilic joint.
Harris, S; Boggio, L N
2006-05-01
The effect of exercise on adult haemophilic joints was investigated. Forty-six subjects with existing joint disease were evaluated and range of motion (ROM) in joints was measured. The effect of exercise of large joint ROM in haemophilia was evaluated by comparing the ranges of motion in subjects who exercised at least three times weekly against those subjects who did not exercise. The exercise group showed improvement in the majority of joint ranges of motion compared with the non-exercise group (P = 0.003). Thus regular exercise may help reduce further destruction in haemophilic joints by strengthening muscle ligaments and tendons surrounding the joint thereby protecting them from damage caused by recurrent haemarthrotic events.
Use of Acoustic Emission to Monitor Progressive Damage Accumulation in KEVLAR® 49 Composites
NASA Astrophysics Data System (ADS)
Waller, J. M.; Andrade, E.; Saulsberry, R. L.
2010-02-01
Acoustic emission (AE) data acquired during intermittent load hold tensile testing of epoxy impregnated Kevlar® 49 (K/Ep) composite strands were analyzed to monitor progressive damage during the approach to tensile failure. Insight into the progressive damage of K/Ep strands was gained by monitoring AE event rate and energy. Source location based on energy attenuation and arrival time data was used to discern between significant AE attributable to microstructural damage and spurious AE attributable to noise. One of the significant findings was the observation of increasing violation of the Kaiser effect (Felicity ratio <1.0) with damage accumulation. The efficacy of three different intermittent load hold stress schedules that allowed the Felicity ratio to be determined analytically is discussed.
Detection of damage in welded structure using experimental modal data
NASA Astrophysics Data System (ADS)
Abu Husain, N.; Ouyang, H.
2011-07-01
A typical automotive structure could contain thousands of spot weld joints that contribute significantly to the vehicle's structural stiffness and dynamic characteristics. However, some of these joints may be imperfect or even absent during the manufacturing process and they are also highly susceptible to damage due to operational and environmental conditions during the vehicle lifetime. Therefore, early detection and estimation of damage are important so necessary actions can be taken to avoid further problems. Changes in physical parameters due to existence of damage in a structure often leads to alteration of vibration modes; thus demonstrating the dependency between the vibration characteristics and the physical properties of structures. A sensitivity-based model updating method, performed using a combination of MATLAB and NASTRAN, has been selected for the purpose of this work. The updating procedure is regarded as parameter identification which aims to bring the numerical prediction to be as closely as possible to the measured natural frequencies and mode shapes data of the damaged structure in order to identify the damage parameters (characterised by the reductions in the Young's modulus of the weld patches to indicate the loss of material/stiffness at the damage region).
Simple geometry tribological study of osteochondral graft implantation in the knee.
Bowland, Philippa; Ingham, Eileen; Fisher, John; Jennings, Louise M
2018-03-01
Robust preclinical test methods involving tribological simulations are required to investigate and understand the tribological function of osteochondral repair interventions in natural knee tissues. The aim of this study was to investigate the effects of osteochondral allograft implantation on the local tribology (friction, surface damage, wear and deformation) of the tissues in the natural knee joint using a simple geometry, reciprocating pin-on-plate friction simulator. In addition, the study aimed to assess the ability of osteochondral grafts to restore a low surface damage, deformation and wear articulation when compared to the native state. A method was developed to characterise and quantify surface damage wear and deformation of the opposing cartilage-bone pin surface using a non-contacting optical profiler (Alicona Infinite Focus). Porcine 12 mm diameter cartilage-bone pins were reciprocated against bovine cartilage-bone plates that had 6 mm diameter osteochondral allografts, cartilage defects or stainless steel pins (positive controls) inserted centrally. Increased levels of surface damage with changes in geometry were not associated with significant increases in the coefficient of dynamic friction. Significant damage to the opposing cartilage surface was observed in the positive control groups. Cartilage damage, deformation and wear (as measured by change in geometry) in the xenograft (2.4 mm 3 ) and cartilage defect (0.99 mm 3 ) groups were low and not significantly different (p > 0.05) compared to the negative control in either group. The study demonstrated the potential of osteochondral grafts to restore the congruent articular surface and biphasic tribology of the natural joint. An optical method has been developed to characterise cartilage wear, damage and deformation that can be applied to the tribological assessment of osteochondral grafts in a whole natural knee joint simulation model.
Simple geometry tribological study of osteochondral graft implantation in the knee
Bowland, Philippa; Ingham, Eileen; Fisher, John; Jennings, Louise M
2018-01-01
Robust preclinical test methods involving tribological simulations are required to investigate and understand the tribological function of osteochondral repair interventions in natural knee tissues. The aim of this study was to investigate the effects of osteochondral allograft implantation on the local tribology (friction, surface damage, wear and deformation) of the tissues in the natural knee joint using a simple geometry, reciprocating pin-on-plate friction simulator. In addition, the study aimed to assess the ability of osteochondral grafts to restore a low surface damage, deformation and wear articulation when compared to the native state. A method was developed to characterise and quantify surface damage wear and deformation of the opposing cartilage-bone pin surface using a non-contacting optical profiler (Alicona Infinite Focus). Porcine 12 mm diameter cartilage-bone pins were reciprocated against bovine cartilage-bone plates that had 6 mm diameter osteochondral allografts, cartilage defects or stainless steel pins (positive controls) inserted centrally. Increased levels of surface damage with changes in geometry were not associated with significant increases in the coefficient of dynamic friction. Significant damage to the opposing cartilage surface was observed in the positive control groups. Cartilage damage, deformation and wear (as measured by change in geometry) in the xenograft (2.4 mm3) and cartilage defect (0.99 mm3) groups were low and not significantly different (p > 0.05) compared to the negative control in either group. The study demonstrated the potential of osteochondral grafts to restore the congruent articular surface and biphasic tribology of the natural joint. An optical method has been developed to characterise cartilage wear, damage and deformation that can be applied to the tribological assessment of osteochondral grafts in a whole natural knee joint simulation model. PMID:29375001
Numerical damage models using a structural approach: application in bones and ligaments
NASA Astrophysics Data System (ADS)
Arnoux, P. J.; Bonnoit, J.; Chabrand, P.; Jean, M.; Pithioux, M.
2002-01-01
The purpose of the present study was to apply knowledge of structural properties to perform numerical simulations with models of bones and knee ligaments exposed to dynamic tensile loading leading to tissue damage. Compact bones and knee ligaments exhibit the same geometrical pattern in their different levels of structural hierarchy from the tropocollagen molecule to the fibre. Nevertheless, their mechanical behaviours differ considerably at the fibril level. These differences are due to the contribution of the joints in the microfibril-fibril-fibre assembly and to the mechanical properties of the structural components. Two finite element models of the fibrous bone and ligament structure were used to describe damage in terms of elastoplastic laws or joint decohesion processes.
Articular cartilage. Part II. The osteoarthritic joint.
Muehleman, C; Arsenis, C H
1995-05-01
Articular hyaline cartilage, though a metabolically active tissue, has limited capacity for repair. Though the integrity of the cartilage is dependent upon a certain level of force placed upon it, excessive force leads to damage. It is when the breakdown of the cartilage exceeds the capacity of the cartilage for repair that osteoarthritis results. At present, pharmacologic treatment of osteoarthritis is focused toward the control of pain and stiffness. This treatment, however, masks the symptoms of the disease and effectively allows the patient to do further damage to the joint.
NEUTRON RADIATION DAMAGE IN CCD CAMERAS AT JOINT EUROPEAN TORUS (JET).
Milocco, Alberto; Conroy, Sean; Popovichev, Sergey; Sergienko, Gennady; Huber, Alexander
2017-10-26
The neutron and gamma radiations in large fusion reactors are responsible for damage to charged couple device (CCD) cameras deployed for applied diagnostics. Based on the ASTM guide E722-09, the 'equivalent 1 MeV neutron fluence in silicon' was calculated for a set of CCD cameras at the Joint European Torus. Such evaluations would be useful to good practice in the operation of the video systems. © The Author 2017. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.
Wu, Ji-Hong; Zhang, Sheng-Hai; Nickerson, John M; Gao, Feng-Juan; Sun, Zhongmou; Chen, Xin-Ya; Zhang, Shu-Jie; Gao, Feng; Chen, Jun-Yi; Luo, Yi; Wang, Yan; Sun, Xing-Huai
2015-02-01
Glaucoma is a chronic neurodegenerative disease characterized by the progressive loss of retinal ganglion cells (RGCs). Mitochondrial DNA (mtDNA) alterations have been documented as a key component of many neurodegenerative disorders. However, whether mtDNA alterations contribute to the progressive loss of RGCs and the mechanism whereby this phenomenon could occur are poorly understood. We investigated mtDNA alterations in RGCs using a rat model of chronic intraocular hypertension and explored the mechanisms underlying progressive RGC loss. We demonstrate that the mtDNA damage and mutations triggered by intraocular pressure (IOP) elevation are initiating, crucial events in a cascade leading to progressive RGC loss. Damage to and mutation of mtDNA, mitochondrial dysfunction, reduced levels of mtDNA repair/replication enzymes, and elevated reactive oxygen species form a positive feedback loop that produces irreversible mtDNA damage and mutation and contributes to progressive RGC loss, which occurs even after a return to normal IOP. Furthermore, we demonstrate that mtDNA damage and mutations increase the vulnerability of RGCs to elevated IOP and glutamate levels, which are among the most common glaucoma insults. This study suggests that therapeutic approaches that target mtDNA maintenance and repair and that promote energy production may prevent the progressive death of RGCs. Copyright © 2014 Elsevier Inc. All rights reserved.
NASA Astrophysics Data System (ADS)
He, Jingjing; Guan, Xuefei; Peng, Tishun; Liu, Yongming; Saxena, Abhinav; Celaya, Jose; Goebel, Kai
2013-10-01
This paper presents an experimental study of damage detection and quantification in riveted lap joints. Embedded lead zirconate titanate piezoelectric (PZT) ceramic wafer-type sensors are employed to perform in situ non-destructive evaluation (NDE) during fatigue cyclical loading. PZT wafers are used to monitor the wave reflection from the boundaries of the fatigue crack at the edge of bolt joints. The group velocity of the guided wave is calculated to select a proper time window in which the received signal contains the damage information. It is found that the fatigue crack lengths are correlated with three main features of the signal, i.e., correlation coefficient, amplitude change, and phase change. It was also observed that a single feature cannot be used to quantify the damage among different specimens since a considerable variability was observed in the response from different specimens. A multi-feature integration method based on a second-order multivariate regression analysis is proposed for the prediction of fatigue crack lengths using sensor measurements. The model parameters are obtained using training datasets from five specimens. The effectiveness of the proposed methodology is demonstrated using several lap joint specimens from different manufactures and under different loading conditions.
The Effects of Progressive Taxation on Labor Supply when Hours and Wages Are Jointly Determined
ERIC Educational Resources Information Center
Aaronson, Daniel; French, Eric
2009-01-01
This paper extends a standard intertemporal labor supply model to account for progressive taxation as well as the joint determination of hourly wages and hours worked. We show that these two factors can have implications for both estimating labor supply elasticities as well as for using these elasticities in tax analysis. Failure to account for…
An enhancement to the NA4 gear vibration diagnostic parameter
NASA Technical Reports Server (NTRS)
Decker, Harry J.; Handschuh, Robert F.; Zakrajsek, James J.
1994-01-01
A new vibration diagnostic parameter for health monitoring of gears, NA4*, is proposed and tested. A recently developed gear vibration diagnostic parameter NA4 outperformed other fault detection methods at indicating the start and initial progression of damage. However, in some cases, as the damage progressed, the sensitivity of the NA4 and FM4 parameters tended to decrease and no longer indicated damage. A new parameter, NA4* was developed by enhancing NA4 to improve the trending of the parameter. This allows for the indication of damage both at initiation and also as the damage progresses. The NA4* parameter was verified and compared to the NA4 and FM4 parameters using experimental data from single mesh spur and spiral bevel gear fatigue rigs. The primary failure mode for the test cases was naturally occurring tooth surface pitting. The NA4* parameter is shown to be a more robust indicator of damage.
Use of Acoustic Emission to Monitor Progressive Damage Accumulation in Kevlar (R) 49 Composites
NASA Technical Reports Server (NTRS)
Waller, Jess M.; Saulsberry, Regor L.; Andrade, Eduardo
2009-01-01
Acoustic emission (AE) data acquired during intermittent load hold tensile testing of epoxy impregnated Kevlar(Registeres TradeMark) 49 (K/Ep) composite strands were analyzed to monitor progressive damage during the approach to tensile failure. Insight into the progressive damage of K/Ep strands was gained by monitoring AE event rate and energy. Source location based on energy attenuation and arrival time data was used to discern between significant AE attributable to microstructural damage and spurious AE attributable to noise. One of the significant findings was the observation of increasing violation of the Kaiser effect (Felicity ratio < 1.0) with damage accumulation. The efficacy of three different intermittent load hold stress schedules that allowed the Felicity ratio to be determined analytically is discussed.
Joint Instability and Osteoarthritis
Blalock, Darryl; Miller, Andrew; Tilley, Michael; Wang, Jinxi
2015-01-01
Joint instability creates a clinical and economic burden in the health care system. Injuries and disorders that directly damage the joint structure or lead to joint instability are highly associated with osteoarthritis (OA). Thus, understanding the physiology of joint stability and the mechanisms of joint instability-induced OA is of clinical significance. The first section of this review discusses the structure and function of major joint tissues, including periarticular muscles, which play a significant role in joint stability. Because the knee, ankle, and shoulder joints demonstrate a high incidence of ligament injury and joint instability, the second section summarizes the mechanisms of ligament injury-associated joint instability of these joints. The final section highlights the recent advances in the understanding of the mechanical and biological mechanisms of joint instability-induced OA. These advances may lead to new opportunities for clinical intervention in the prevention and early treatment of OA. PMID:25741184
Joint instability and osteoarthritis.
Blalock, Darryl; Miller, Andrew; Tilley, Michael; Wang, Jinxi
2015-01-01
Joint instability creates a clinical and economic burden in the health care system. Injuries and disorders that directly damage the joint structure or lead to joint instability are highly associated with osteoarthritis (OA). Thus, understanding the physiology of joint stability and the mechanisms of joint instability-induced OA is of clinical significance. The first section of this review discusses the structure and function of major joint tissues, including periarticular muscles, which play a significant role in joint stability. Because the knee, ankle, and shoulder joints demonstrate a high incidence of ligament injury and joint instability, the second section summarizes the mechanisms of ligament injury-associated joint instability of these joints. The final section highlights the recent advances in the understanding of the mechanical and biological mechanisms of joint instability-induced OA. These advances may lead to new opportunities for clinical intervention in the prevention and early treatment of OA.
Glomerular and Tubular Damage Markers in Individuals with Progressive Albuminuria
Nauta, Ferdau L.; Scheven, Lieneke; Meijer, Esther; van Oeveren, Wim; de Jong, Paul E.; Bakker, Stephan J.L.
2013-01-01
Summary Background and objectives Albuminuria is associated with risk for renal and cardiovascular disease. It is difficult to predict which persons will progress in albuminuria. This study investigated whether assessment of urinary markers associated with damage to different parts of the nephron may help identify individuals that will progress in albuminuria. Design, setting, participants, & measurements Individuals were selected from a prospective community-based cohort study with serial follow-up and defined as “progressors” if they belonged to the quintile of participants with the most rapid annual increase in albuminuria, and reached an albuminuria ≥150 mg/d during follow-up. Patients with known renal disease or macroalbuminuria at baseline were excluded. Each progressor was matched to two control participants, based on baseline albuminuria, age, and sex. Furthermore, damage markers were measured in a separate set of healthy individuals. Results After a median follow-up of 8.6 years, 183 of 8394 participants met the criteria for progressive albuminuria. Baseline clinical characteristics were comparable between progressors and matched controls (n=366). Both had higher baseline albuminuria than the overall population. Urinary excretion of the glomerular damage marker IgG was significantly higher in progressors, whereas urinary excretion of proximal tubular damage markers and inflammatory markers was lower in these individuals compared with controls. Healthy individuals (n=109) had the lowest values for all urinary damage markers measured. Conclusions These data suggest that albuminuria associated with markers of glomerular damage is more likely to progress, whereas albuminuria associated with markers of tubulointerstitial damage is more likely to remain stable. PMID:23539232
NASA Astrophysics Data System (ADS)
Dansereau, V.; Got, J. L.
2017-12-01
Before a volcanic eruption, the pressurization of the volcanic edifice by a magma reservoir induces earthquakes and damage in the edifice; damage lowers the strength of the edifice and decreases its elastic properties. Anelastic deformations cumulate and lead to rupture and eruption. These deformations translate into surface displacements, measurable via GPS or InSAR (e.g., Kilauea, southern flank, or Piton de la Fournaise, eastern flank).Attempts to represent these processes are usually based on a linear-elastic rheology. More recently, linear elastic-perfectly plastic or elastic-brittle damage approaches were used to explain the time evolution of the surface displacements in basaltic volcanoes before an eruption. However these models are non-linear elastic, and can not account for the anelastic deformation that occurs during the pre-eruptive process. Therefore, they can not be used to represent the complete eruptive cycle, comprising loading and unloading phases. Here we present a new rheological approach for modelling the eruptive cycle called Maxwell-Elasto-Brittle, which incorporates a viscous-like relaxation of the stresses in an elastic-brittle damage framework. This mechanism allows accounting for the anelastic deformations that cumulate and lead to rupture and eruption. The inclusion of healing processes in this model is another step towards a complete spatio-temporal representation of the eruptive cycle. Plane-strain Maxwell-EB modelling of the deformation of a magma reservoir and volcanic edifice will be presented. The model represents the propagation of damage towards the surface and the progressive localization of the deformation along faults under the pressurization of the magma reservoir. This model allows a complete spatio-temporal representation of the rupture process. We will also discuss how available seismicity records and time series of surface displacements could be used jointly to constrain the model.
Waller, Kimberly A.; Chin, Kaitlyn E.; Jay, Gregory D.; Zhang, Ling X.; Teeple, Erin; McAllister, Scott; Badger, Gary J.; Schmidt, Tannin A.; Fleming, Braden C.
2016-01-01
Background Lubricin, or proteoglycan 4 (PRG4), is a glycoprotein responsible for joint boundary lubrication. PRG4 has been previously shown to be down-regulated following traumatic joint injury such as a meniscal tear. There is preliminary evidence suggesting that intra-articular injection of PRG4 post-injury will reduce cartilage damage in rat models of surgically-induced post-traumatic osteoarthritis. Objective To determine the efficacy of intra-articular injection of full length recombinant human lubricin (rhPRG4) for reducing cartilage damage after medial meniscus destabilization (DMM) in a pre-clinical large animal model. Study Design Controlled laboratory study Methods Unilateral DMM was performed in 29 Yucutan minipigs. One week post-DMM, animals received 3 weekly intra-articular injections (3cc/injection): 1) rhPRG4 [1.3mg/ml; n=10], 2) rhPRG4+hyaluronan [1.3mg/ml rhPRG4 and 3mg/ml hyaluronan (~950 kDA); n=10], and 3) phosphate buffered saline [PBS; n=9]. Hind limbs were harvested 26 weeks post-surgery. Cartilage integrity was evaluated using macroscopic (India Ink) and microscopic (Safranin O-fast green and hematoxylin & eosin) scoring systems. Secondary outcomes evaluated using ELISA included PRG4 levels in synovial fluid, CTX-II concentrations in urine and serum, and IL-1β levels in synovial fluid and serum. Results The rhPRG4 group had significantly less macroscopic cartilage damage in the medial tibial plateau compared to the PBS group (p=.002). No difference was found between the rhPRG4+hyaluronan and PBS groups (p=.23). However, no differences in microscopic damage scores were observed between the three groups (p=.70). PRG4 production was elevated in the rhPRG4 group synovial fluid compared to the PBS group (p=.033). The rhPRG4 group presented significantly lower urinary CTX-II levels, but not serum levels, when compared to the PBS (p=.013) and rhPRG4+hyaluronan (p=.011) groups. In serum and synovial fluid, both rhPRG4 (p=.006; p=.017) and rhPRG4+hyaluronan groups (p=.009; p=.03) presented decreased IL-1β levels. Conclusion All groups exhibited significant cartilage degeneration following DMM surgery. However, animals treated with rhPRG4 had the least amount of cartilage damage and less inflammation, providing evidence that intra-articular injections of rhPRG4 may slow the progression of post-traumatic osteoarthritis. Clinical Relevance Patients with meniscal trauma are at high risk for post-traumatic osteoarthritis. This study demonstrates that an intra-articular injection regimen of rhPRG4 may attenuate cartilage damage following meniscal injury. PMID:28129516
Al Kaissi, Ali; Klaushofer, Klaus; Grill, Franz
2008-08-19
Contracture is a condition of abnormal shortening or shrinkage of a muscle, and or a tendon often with persistent flexion or distortion at a joint. Careful documentation of the kind of contractures encountered in different paediatric disorders is important in distinguishing a specific subtype. Achondroplasia has been considered as the most common short-limbed dwarfism syndrome, but there are a variety of other syndromes within this category, and other types of limb shortening. We report on a 5-year-old boy of Austrian origin who manifests progressive joint limitations in connection with a dysplastic form of short-limbed dwarfism namely chondrodysplasia punctata-tibial-metacarpal-type. Progressive joint limitations of maximal intensity over the hip, and the ankle joints were the main presenting features. Osteochondrodysplasias involve abnormal bone or cartilage growth leading to skeletal maldevelopment, often short-limbed dwarfism. Diagnosis is by physical examination, radiographic documentation, and, in some cases, genetic testing. In patients with chondrodysplasia punctata, early life radiographic examination is fundamental, since resolution of the punctate calcifications leaving abnormal epiphyses and flared and irregular metaphyses after age one to three years seems to be characteristic.
Al Kaissi, Ali; Klaushofer, Klaus; Grill, Franz
2008-01-01
Introduction Contracture is a condition of abnormal shortening or shrinkage of a muscle, and or a tendon often with persistent flexion or distortion at a joint. Careful documentation of the kind of contractures encountered in different paediatric disorders is important in distinguishing a specific subtype. Achondroplasia has been considered as the most common short-limbed dwarfism syndrome, but there are a variety of other syndromes within this category, and other types of limb shortening. Case presentation We report on a 5-year-old boy of Austrian origin who manifests progressive joint limitations in connection with a dysplastic form of short-limbed dwarfism namely chondrodysplasia punctata-tibial-metacarpal-type. Progressive joint limitations of maximal intensity over the hip, and the ankle joints were the main presenting features. Conclusion Osteochondrodysplasias involve abnormal bone or cartilage growth leading to skeletal maldevelopment, often short-limbed dwarfism. Diagnosis is by physical examination, radiographic documentation, and, in some cases, genetic testing. In patients with chondrodysplasia punctata, early life radiographic examination is fundamental, since resolution of the punctate calcifications leaving abnormal epiphyses and flared and irregular metaphyses after age one to three years seems to be characteristic. PMID:18713450
Full-scale testing and progressive damage modeling of sandwich composite aircraft fuselage structure
NASA Astrophysics Data System (ADS)
Leone, Frank A., Jr.
A comprehensive experimental and computational investigation was conducted to characterize the fracture behavior and structural response of large sandwich composite aircraft fuselage panels containing artificial damage in the form of holes and notches. Full-scale tests were conducted where panels were subjected to quasi-static combined pressure, hoop, and axial loading up to failure. The panels were constructed using plain-weave carbon/epoxy prepreg face sheets and a Nomex honeycomb core. Panel deformation and notch tip damage development were monitored during the tests using several techniques, including optical observations, strain gages, digital image correlation (DIC), acoustic emission (AE), and frequency response (FR). Additional pretest and posttest inspections were performed via thermography, computer-aided tap tests, ultrasound, x-radiography, and scanning electron microscopy. The framework to simulate damage progression and to predict residual strength through use of the finite element (FE) method was developed. The DIC provided local and full-field strain fields corresponding to changes in the state-of-damage and identified the strain components driving damage progression. AE was monitored during loading of all panels and data analysis methodologies were developed to enable real-time determination of damage initiation, progression, and severity in large composite structures. The FR technique has been developed, evaluating its potential as a real-time nondestructive inspection technique applicable to large composite structures. Due to the large disparity in scale between the fuselage panels and the artificial damage, a global/local analysis was performed. The global FE models fully represented the specific geometries, composite lay-ups, and loading mechanisms of the full-scale tests. A progressive damage model was implemented in the local FE models, allowing the gradual failure of elements in the vicinity of the artificial damage. A set of modifications to the definitions of the local FE model boundary conditions is proposed and developed to address several issues related to the scalability of progressive damage modeling concepts, especially in regards to full-scale fuselage structures. Notable improvements were observed in the ability of the FE models to predict the strength of damaged composite fuselage structures. Excellent agreement has been established between the FE model predictions and the experimental results recorded by DIC, AE, FR, and visual observations.
Recognizing systemic sclerosis: comparative analysis of various sets of classification criteria
Romanowska-Próchnicka, Katarzyna; Olesińska, Marzena
2016-01-01
Systemic sclerosis is a complex disease characterized by autoimmunity, vasculopathy and tissue fibrosis. Although most patients present with some degree of skin sclerosis, which is a distinguishing hallmark, the clinical presentation vary greatly complicating the diagnosis. In this regard, new classification criteria were jointly published in 2013 by American College of Rheumatology (ACR) and European League Against Rheumatism (EULAR). A recent major development in the classification criteria is improved sensitivity, particularly for detecting early disease. The new criteria allow more cases to be classified as having systemic sclerosis (SSc), which leads to earlier treatment. Moreover it is clinically beneficial in preventing the disease progression with its irreversible fibrosis and organ damage. The aim of this review is to give insight into new classification criteria and current trends in the diagnosis of systemic sclerosis. PMID:28115780
Drewniak, Elizabeth I; Jay, Gregory D; Fleming, Braden C; Zhang, Ling; Warman, Matthew L; Crisco, Joseph J
2012-01-01
Objective To investigate the effects of lubricin gene dosage and cyclic loading on whole joint coefficient of friction and articular cartilage surface integrity in mouse knee joints. Methods Joints from mice with 2 (Prg4+/+), 1 (Prg4+/−), or no (Prg4−/−) functioning lubricin alleles were subjected to 26 hours of cyclic loading using a custom-built pendulum. Coefficient of friction values were measured at multiple time points. Contralateral control joints were left unloaded. Following testing, joints were examined for histologic evidence of damage and cell viability. Results At baseline, the coefficient of friction values in Prg4−/− mice were significantly higher than those in Prg4+/+ and Prg4+/− mice (P < 0.001). Cyclic loading continuously increased the coefficient of friction in Prg4−/− mouse joints. In contrast, Prg4+/− and Prg4+/+ mouse joints had no coefficient of friction increases during the first 4 hours of loading. After 26 hours of loading, joints from all genotypes had increased coefficient of friction values compared to baseline and unloaded controls. Significantly greater increases occurred in Prg4−/− and Prg4+/− mouse joints compared to Prg4+/+ mouse joints. The coefficient of friction values were not significantly associated with histologic evidence of damage or loss of cell viability. Conclusion Our findings indicate that mice lacking lubricin have increased baseline coefficient of friction values and are not protected against further increases caused by loading. Prg4+/− mice are indistinguishable from Prg4+/+ mice at baseline, but have significantly greater coefficient of friction values following 26 hours of loading. Lubricin dosage affects joint properties during loading, and may have clinical implications in patients for whom injury or illness alters lubricin abundance. PMID:21905020
Philpott, Holly T.; O'Brien, Melissa; McDougall, Jason J.
2017-01-01
Abstract Osteoarthritis (OA) is a multifactorial joint disease, which includes joint degeneration, intermittent inflammation, and peripheral neuropathy. Cannabidiol (CBD) is a noneuphoria producing constituent of cannabis that has the potential to relieve pain. The aim of this study was to determine whether CBD is anti-nociceptive in OA, and whether inhibition of inflammation by CBD could prevent the development of OA pain and joint neuropathy. Osteoarthritis was induced in male Wistar rats (150-175 g) by intra-articular injection of sodium monoiodoacetate (MIA; 3 mg). On day 14 (end-stage OA), joint afferent mechanosensitivity was assessed using in vivo electrophysiology, whereas pain behaviour was measured by von Frey hair algesiometry and dynamic incapacitance. To investigate acute joint inflammation, blood flow and leukocyte trafficking were measured on day 1 after MIA. Joint nerve myelination was calculated by G-ratio analysis. The therapeutic and prophylactic effects of peripheral CBD (100-300 μg) were assessed. In end-stage OA, CBD dose-dependently decreased joint afferent firing rate, and increased withdrawal threshold and weight bearing (P < 0.0001; n = 8). Acute, transient joint inflammation was reduced by local CBD treatment (P < 0.0001; n = 6). Prophylactic administration of CBD prevented the development of MIA-induced joint pain at later time points (P < 0.0001; n = 8), and was also found to be neuroprotective (P < 0.05; n = 6-8). The data presented here indicate that local administration of CBD blocked OA pain. Prophylactic CBD treatment prevented the later development of pain and nerve damage in these OA joints. These findings suggest that CBD may be a safe, useful therapeutic for treating OA joint neuropathic pain. PMID:28885454
Philpott, Holly T; OʼBrien, Melissa; McDougall, Jason J
2017-12-01
Osteoarthritis (OA) is a multifactorial joint disease, which includes joint degeneration, intermittent inflammation, and peripheral neuropathy. Cannabidiol (CBD) is a noneuphoria producing constituent of cannabis that has the potential to relieve pain. The aim of this study was to determine whether CBD is anti-nociceptive in OA, and whether inhibition of inflammation by CBD could prevent the development of OA pain and joint neuropathy. Osteoarthritis was induced in male Wistar rats (150-175 g) by intra-articular injection of sodium monoiodoacetate (MIA; 3 mg). On day 14 (end-stage OA), joint afferent mechanosensitivity was assessed using in vivo electrophysiology, whereas pain behaviour was measured by von Frey hair algesiometry and dynamic incapacitance. To investigate acute joint inflammation, blood flow and leukocyte trafficking were measured on day 1 after MIA. Joint nerve myelination was calculated by G-ratio analysis. The therapeutic and prophylactic effects of peripheral CBD (100-300 μg) were assessed. In end-stage OA, CBD dose-dependently decreased joint afferent firing rate, and increased withdrawal threshold and weight bearing (P < 0.0001; n = 8). Acute, transient joint inflammation was reduced by local CBD treatment (P < 0.0001; n = 6). Prophylactic administration of CBD prevented the development of MIA-induced joint pain at later time points (P < 0.0001; n = 8), and was also found to be neuroprotective (P < 0.05; n = 6-8). The data presented here indicate that local administration of CBD blocked OA pain. Prophylactic CBD treatment prevented the later development of pain and nerve damage in these OA joints. These findings suggest that CBD may be a safe, useful therapeutic for treating OA joint neuropathic pain.
Code of Federal Regulations, 2010 CFR
2010-01-01
... AND ATMOSPHERIC ADMINISTRATION, DEPARTMENT OF COMMERCE OIL POLLUTION ACT REGULATIONS NATURAL RESOURCE... restoration is achieved without double recovery of damages. For joint assessments, trustees must designate one... there is no double recovery of damages. (3) Trustees may develop pre-incident or incident-specific...
Analysis Concerning the Inspection Threshold for Multi-Site Damage.
DOT National Transportation Integrated Search
1993-12-01
Periodic inspections, at a prescribed interval, for Multi-Site Damage (MS) in longitudinal fuselage lap-joints start when the aircraft has accumulated a certain number of flights, the inspection threshold. The work reported here was an attempt to obt...
Micro-Energy Rates for Damage Tolerance and Durability of Composite Structures
NASA Technical Reports Server (NTRS)
Chamis, Christos C.; Minnetyan, Levon
2006-01-01
In this paper, the adhesive bond strength of lap-jointed graphite/aluminum composites is examined by computational simulation. Computed micro-stress level energy release rates are used to identify the damage mechanisms associated with the corresponding acoustic emission (AE) signals. Computed damage regions are similarly correlated with ultrasonically scanned damage regions. Results show that computational simulation can be used with suitable NDE methods for credible in-service monitoring of composites.
Investigation of Sideband Index Response to Prototype Gear Tooth Damage
NASA Technical Reports Server (NTRS)
Dempsey, Paula J.
2013-01-01
The objective of this analysis was to evaluate the ability of gear condition indicators (CI) to detect contact fatigue damage on spiral bevel gear teeth. Tests were performed in the NASA Glenn Spiral Bevel Gear Fatigue Rig on eight prototype gear sets (pinion/gear). Damage was initiated and progressed on the gear and pinion teeth. Vibration data was measured during damage progression at varying torque values while varying damage modes to the gear teeth were observed and documented with inspection photos. Sideband indexes (SI) and root mean square (RMS) CIs were calculated from the time synchronous averaged vibration data. Results found that both CIs respond differently to varying torque levels, damage levels and damage modes
Skoffer, Birgit; Dalgas, Ulrik; Maribo, Thomas; Søballe, Kjeld; Mechlenburg, Inger
2017-11-09
Preoperative progressive resistance training (PRT) is controversial in patients scheduled for total knee arthroplasty (TKA), because of the concern that it may exacerbate knee joint pain and effusion. To examine whether preoperative PRT initiated 5 weeks prior to TKA would exacerbate pain and knee effusion, and would allow a progressively increased training load throughout the training period that would subsequently increase muscle strength. Secondary analyses from a randomized controlled trial. University Hospital and a Regional Hospital. A total of 30 patients who were scheduled for TKA due to osteoarthritis and assigned as the intervention group. Patients underwent unilateral PRT (3 sessions per week). Exercise loading was 12 repetitions maximum (RM) with progression toward 8 RM. The training program consisted of 6 exercises performed unilaterally. Before and after each training session, knee joint pain was rated on an 11-point scale, effusion was assessed by measuring the knee joint circumference, and training load was recorded. The first and last training sessions were initiated by 1 RM testing of unilateral leg press, unilateral knee extension, and unilateral knee flexion. The median pain change score from before to after each training session was 0 at all training sessions. The average increase in knee joint effusion across the 12 training sessions was a mean 0.16 cm ± 0.23 cm. No consistent increase in knee joint effusion after training sessions during the training period was found (P = .21). Training load generally increased, and maximal muscle strength improved as follows: unilateral leg press: 18% ± 30% (P = .03); unilateral knee extension: 81% ± 156% (P < .001); and unilateral knee flexion: 53% ± 57% (P < .001). PRT of the affected leg initiated shortly before TKA does not exacerbate knee joint pain and effusion, despite a substantial progression in loading and increased muscle strength. Concerns for side effects such as pain and effusion after PRT seem unfounded. To be determined. Copyright © 2017. Published by Elsevier Inc.
Effects of radiofrequency probe application on irrigation fluid temperature in the wrist joint.
Sotereanos, Dean G; Darlis, Nickolaos A; Kokkalis, Zinon T; Zanaros, George; Altman, Gregory T; Miller, Mark Carl
2009-12-01
Radiofrequency (RF) probes used in wrist arthroscopy may raise joint fluid temperature, increasing the risk of capsular and ligamentous damage. The purposes of the current study were to measure joint fluid temperature during wrist arthroscopy with the use of RF probes, and to determine whether using an outlet portal will reduce the maximum temperature. We performed wrist arthroscopy on 8 cadaveric arms. Ablation and coagulation cycles using RF probe were performed at documented locations within the joint. This was done for 60-second intervals on both the radial and ulnar side of the wrist, to mimic clinical practice. We used 4 fiberoptic phosphorescent probes to measure temperature (radial, ulnar, inflow-tube, and outflow-tube probes) and measured joint fluid temperature with and without outflow. There was a significant difference between wrists with and without outflow when examining maximum ablation temperatures (p < .002). All specimens showed higher maximum and average ablation temperatures without outflow. Maximum joint temperatures, greater than 60 degrees C, were observed in only no-outflow conditions. In performing RF ablation during wrist arthroscopy, the use of an outlet portal reduces the joint fluid temperature. Without an outlet portal, maximum temperatures can exceed desirable levels when using ablation; such temperatures have the potential to damage adjacent tissues. It is useful to maintain adequate outflow when using the radiofrequency probes during wrist arthroscopy.
NASA Astrophysics Data System (ADS)
Li, Xiao-kang; Liu, Zhen-guo; Hu, Long; Wang, Yi-bo; Lei, Bing; Huang, Xiang
2017-02-01
Numerical studied on T-joints with three-dimensional four directional (3D4D) braided composite fillers was presented in this article. Compared with conventional unidirectional prepreg fillers, the 3D braided composite fillers have excellent ability to prevent crack from penetrating trigone fillers, which constantly occurred in the conventional fillers. Meanwhile, the 3D braided composite fillers had higher fiber volume fraction and eliminated the fiber folding problem in unidirectional prepreg fillers. The braiding technology and mechanical performance of 3D4D braided fillers were studied. The numerical model of carbon fiber T-joints with 3D4D braided composite fillers was built by finite element analysis software. The damage formation, extension and failing process of T-joints with 3D4D braided fillers under tensile load were investigated. Further investigation was extended to the effect of 3D4D braided fillers with different braiding angles on mechanical behavior of the T-joints. The study results revealed that the filling area was the weakest part of the T-joints where the damage first appeared and the crack then rapidly spread to the glue film around the filling area and the interface between over-laminate and soleplate. The 3D4D braided fillers were undamaged and the braiding angle change induced a little effect on the bearing capacity of T-joints.
Keenan, Robert T
2017-02-01
This article outlines several important issues regarding the management of patients with gout. The topics discussed include best practices for gout based on the most current guidelines, opportunities for improving gout management, and current and emerging therapies for gout. [PubMed and Google Scholar databases] were search for all articles and trials published before 2016, using the key terms [hyperuricemia, gout, tophi, joint erosion, joint damage, treatment guidelines, American College of Rheumatology (ACR), European League Against Rheumatism (EULAR), flare, comorbidity, epidemiology, adherence, serum uric acid (sUA), monosodium urate (MSU), <6 mg/dL, MSU crystal formation, as well as individual drug names and classes of treatments of interest (allopurinol, febuxostat, colchicine, non-steroidal anti-inflammatories (NSAIDs)]. Studies were selected that presented data on gout treatment, including drugs under development, and on the management of gout from both the physician and patient perspectives. The reference lists of identified articles were searched manually for additional publications. Gout, a progressive debilitating form of inflammatory arthritis, is caused by factors that elevate serum uric acid (sUA) levels, leading to hyperuricemia. Continued elevated sUA can result in monosodium urate crystal deposition in joints and soft tissues, causing acute and chronic inflammation. Crystal deposition can lead to chronic gout, with an increased number of flares, tophi development, and structural joint damage. The aims of gout treatment are to reduce the sUA level to <6 mg/dL, to inhibit the formation of new crystals, and to promote the dissolution of existing crystals. Gout is often poorly managed for several reasons, including a lack of adherence to treatment guidelines by health care providers, patients' poor adherence to therapy, and differences between a provider's and patient's perspectives regarding treatment. Patients need to be educated about their diagnosis and management of the disease, such as the importance of compliance with long-term treatment. Gout treatment may also confounded by contraindications to current standards of therapy and the limitations of current treatment paradigms. Recently approved medications, as well as drugs under development, may provide new ways for reaching the sUA target and also "curing" the disease. Copyright © 2017 The Authors. Published by Elsevier Inc. All rights reserved.
Dougados, Maxime; Maksymowych, Walter P; Landewé, Robert B M; Moltó, Anna; Claudepierre, Pascal; de Hooge, Manouk; Lambert, Robert G; Bonin, Randi; Bukowski, Jack F; Jones, Heather E; Logeart, Isabelle; Pedersen, Ron; Szumski, Annette; Vlahos, Bonnie; van der Heijde, Désirée
2018-02-01
To compare 2 years of radiographic sacroiliac joint (SIJ) changes in patients with recent onset axial spondyloarthritis (axSpA) receiving etanercept in a clinical trial (EMBARK) to similar patients not receiving biologics in a cohort study (DESIR). Endpoints were changes at week 104 per the modified New York (mNY) grading system in total SIJ score (primary endpoint) and net percentage of patients with progression defined three ways. Treatment effect was analysed with and without adjustment for baseline covariates. At 104 weeks, total SIJ score improved in the etanercept group (n=154, adjusted least-squares mean change: -0.14) and worsened in the control group (n=182, change: 0.08). The adjusted difference between groups (etanercept minus control) was -0.22 (95% CI -0.38 to -0.06), p=0.008. The net percentage of patients with progression was significantly lower in the etanercept versus the control group for two of three binary endpoints: -1.9% versus 1.6% (adjusted difference for etanercept minus control: -4.7%,95% CI -9.9 to 0.5, p=0.07) for change in mNY criteria; -1.9% versus 7.8% (adjusted difference: -18.2%,95% CI -30.9 to -5.6, p=0.005) for change ≥1 grade in ≥1 SIJ; and -0.6% versus 6.7% (adjusted difference: -16.4%,95% CI -27.9 to -5.0, p=0.005) for change ≥1 grade in ≥1 SIJ, with shift from 0 to 1 or 1 to 0 considered no change. Despite the slow radiographic SIJ progression rate over 2 years in axSpA, this study suggests a lower rate of progression in the SIJ with etanercept than without anti-tumour necrosis factor therapy. NCT01258738, NCT01648907; Post-results. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.
Dougados, Maxime; Maksymowych, Walter P; Landewé, Robert B M; Moltó, Anna; Claudepierre, Pascal; de Hooge, Manouk; Lambert, Robert G; Bonin, Randi; Bukowski, Jack F; Jones, Heather E; Logeart, Isabelle; Pedersen, Ron; Szumski, Annette; Vlahos, Bonnie
2018-01-01
Objective To compare 2 years of radiographic sacroiliac joint (SIJ) changes in patients with recent onset axial spondyloarthritis (axSpA) receiving etanercept in a clinical trial (EMBARK) to similar patients not receiving biologics in a cohort study (DESIR). Methods Endpoints were changes at week 104 per the modified New York (mNY) grading system in total SIJ score (primary endpoint) and net percentage of patients with progression defined three ways. Treatment effect was analysed with and without adjustment for baseline covariates. Results At 104 weeks, total SIJ score improved in the etanercept group (n=154, adjusted least-squares mean change: –0.14) and worsened in the control group (n=182, change: 0.08). The adjusted difference between groups (etanercept minus control) was –0.22 (95% CI –0.38 to –0.06), p=0.008. The net percentage of patients with progression was significantly lower in the etanercept versus the control group for two of three binary endpoints: –1.9% versus 1.6% (adjusted difference for etanercept minus control: –4.7%,95% CI –9.9 to 0.5, p=0.07) for change in mNY criteria; –1.9% versus 7.8% (adjusted difference: –18.2%,95% CI –30.9 to –5.6, p=0.005) for change ≥1 grade in ≥1 SIJ; and –0.6% versus 6.7% (adjusted difference: –16.4%,95% CI –27.9 to –5.0, p=0.005) for change ≥1 grade in ≥1 SIJ, with shift from 0 to 1 or 1 to 0 considered no change. Conclusion Despite the slow radiographic SIJ progression rate over 2 years in axSpA, this study suggests a lower rate of progression in the SIJ with etanercept than without anti-tumour necrosis factor therapy. Trial registration numbers NCT01258738, NCT01648907; Post-results. PMID:28970213
Lawrence, Alexandra; Xu, Xin; Bible, Melissa D; Calve, Sarah; Neu, Corey P; Panitch, Alyssa
2015-12-01
The lubricating proteoglycan, lubricin, facilitates the remarkable low friction and wear properties of articular cartilage in the synovial joints of the body. Lubricin lines the joint surfaces and plays a protective role as a boundary lubricant in sliding contact; decreased expression of lubricin is associated with cartilage degradation and the pathogenesis of osteoarthritis. An unmet need for early osteoarthritis treatment is the development of therapeutic molecules that mimic lubricin function and yet are also resistant to enzymatic degradation common in the damaged joint. Here, we engineered a lubricin mimic (mLub) that is less susceptible to enzymatic degradation and binds to the articular surface to reduce friction. mLub was synthesized using a chondroitin sulfate backbone with type II collagen and hyaluronic acid (HA) binding peptides to promote interaction with the articular surface and synovial fluid constituents. In vitro and in vivo characterization confirmed the binding ability of mLub to isolated type II collagen and HA, and to the cartilage surface. Following trypsin treatment to the cartilage surface, application of mLub, in combination with purified or commercially available hyaluronan, reduced the coefficient of friction, and adhesion, to control levels as assessed over macro-to micro-scales by rheometry and atomic force microscopy. In vivo studies demonstrate an mLub residency time of less than 1 week. Enhanced lubrication by mLub reduces surface friction and adhesion, which may suppress the progression of degradation and cartilage loss in the joint. mLub therefore shows potential for treatment in early osteoarthritis following injury. Copyright © 2015 Elsevier Ltd. All rights reserved.
Damaging effects of visible light. Comprehensive progress report
DOE Office of Scientific and Technical Information (OSTI.GOV)
None
1981-01-01
Research progress is reported on studies of retinal light damage. A myriad of variables effect the production of light damage. These include age, prior light history, body temperature, vitamin A status, intensity, wavelength and duration of light. The intensity-duration function and the age function have been studied in detail in rats. Studies have been begun on the wavelength variable. (ACR)
Hirabayashi, Yasuhiko; Munakata, Yasuhiko; Miyata, Masayuki; Urata, Yukitomo; Saito, Koichi; Okuno, Hiroshi; Yoshida, Masaaki; Kodera, Takao; Watanabe, Ryu; Miyamoto, Seiya; Ishii, Tomonori; Nakazawa, Shigeshi; Takemori, Hiromitsu; Ando, Takanobu; Kanno, Takashi; Komagamine, Masataka; Kato, Ichiro; Takahashi, Yuichi; Komatsuda, Atsushi; Endo, Kojiro; Murai, Chihiro; Takakubo, Yuya; Miura, Takao; Sato, Yukio; Ichikawa, Kazunobu; Konta, Tsuneo; Chiba, Noriyuki; Muryoi, Tai; Kobayashi, Hiroko; Fujii, Hiroshi; Sekiguchi, Yukio; Hatakeyama, Akira; Ogura, Ken; Sakuraba, Hirotake; Asano, Tomoyuki; Kanazawa, Hiroshi; Suzuki, Eiji; Takasaki, Satoshi; Asakura, Kenichi; Sugisaki, Kota; Suzuki, Yoko; Takagi, Michiaki; Nakayama, Takahiro; Watanabe, Hiroshi; Miura, Keiki; Mori, Yu
2016-11-01
To evaluate the clinical and structural efficacy of tocilizumab (TCZ) during its long-term administration in patients with rheumatoid arthritis (RA). In total, 693 patients with RA who started TCZ therapy were followed for 3 years. Clinical efficacy was evaluated by DAS28-ESR and Boolean remission rates in 544 patients. Joint damage was assessed by calculating the modified total Sharp score (mTSS) in 50 patients. When the reason for discontinuation was limited to inadequate response or adverse events, the 1-, 2-, and 3-year continuation rates were 84.0%, 76.8%, and 72.2%, respectively. The mean DAS28-ESR was initially 5.1 and decreased to 2.5 at 6 months and to 2.2 at 36 months. The Boolean remission rate was initially 0.9% and increased to 21.7% at 6 months and to 32.2% at 36 months. The structural remission rates (ΔmTSS/year ≤ 0.5) were 68.8%, 78.6%, and 88.9% within the first, second, and third years, respectively. The structural remission rate at 3 years (ΔmTSS ≤ 1.5) was 66.0%, and earlier achievement of swollen joint count (SJC) of 1 or less resulted in better outcomes. TCZ was highly efficacious, and bone destruction was strongly prevented. SJC was an easy-to-use indicator of joint destruction.
Tapered Roller Bearing Damage Detection Using Decision Fusion Analysis
NASA Technical Reports Server (NTRS)
Dempsey, Paula J.; Kreider, Gary; Fichter, Thomas
2006-01-01
A diagnostic tool was developed for detecting fatigue damage of tapered roller bearings. Tapered roller bearings are used in helicopter transmissions and have potential for use in high bypass advanced gas turbine aircraft engines. A diagnostic tool was developed and evaluated experimentally by collecting oil debris data from failure progression tests conducted using health monitoring hardware. Failure progression tests were performed with tapered roller bearings under simulated engine load conditions. Tests were performed on one healthy bearing and three pre-damaged bearings. During each test, data from an on-line, in-line, inductance type oil debris sensor and three accelerometers were monitored and recorded for the occurrence of bearing failure. The bearing was removed and inspected periodically for damage progression throughout testing. Using data fusion techniques, two different monitoring technologies, oil debris analysis and vibration, were integrated into a health monitoring system for detecting bearing surface fatigue pitting damage. The data fusion diagnostic tool was evaluated during bearing failure progression tests under simulated engine load conditions. This integrated system showed improved detection of fatigue damage and health assessment of the tapered roller bearings as compared to using individual health monitoring technologies.
Resistance welding graphite-fiber composites
NASA Technical Reports Server (NTRS)
Lamoureux, R. T.
1980-01-01
High-strength joints are welded in seconds in carbon-reinfored thermoplastic beams. Resistance-welding electrode applies heat and pressure to joint and is spring-loaded to follow softening material to maintain contact; it also holds parts together for cooling and hardening. Both transverse and longitudinal configurations can be welded. Adhesive bonding and encapsulation are more time consuming methods and introduce additional material into joint, while ultrasonic heating can damage graphite fibers in composite.
Treatment of TMJDS with helium-neon laser beam irradiation on the acupoints
NASA Astrophysics Data System (ADS)
Li, Ping
1993-03-01
Through He-NE laser stimulation of acupuncture points, we treated and observed 50 cases of Temporomandibular Joint Dysfunction Syndrome (TMJDS). The results proved that this treatment was very effective for relieving the patient's pain. In cases which had structural disturbances and organic damage such as limitation of mouth-opening and joint clink, there was less improvement of symptoms and no relief for joint clink.
DOE Office of Scientific and Technical Information (OSTI.GOV)
Muehleman,C.; Li, J.; Zhong, Z.
2006-01-01
Objective: To demonstrate the ability of a novel radiographic technique, Diffraction Enhanced Radiographic Imaging (DEI), to render high contrast images of canine knee joints for identification of cartilage lesions in situ. Methods: DEI was carried out at the X-15A beamline at Brookhaven National Laboratory on intact canine knee joints with varying levels of cartilage damage. Two independent observers graded the DE images for lesions and these grades were correlated to the gross morphological grade. Results: The correlation of gross visual grades with DEI grades for the 18 canine knee joints as determined by observer 1 (r2=0.8856, P=0.001) and observer 2more » (r2=0.8818, P=0.001) was high. The overall weighted ? value for inter-observer agreement was 0.93, thus considered high agreement. Conclusion: The present study is the first study for the efficacy of DEI for cartilage lesions in an animal joint, from very early signs through erosion down to subchondral bone, representing the spectrum of cartilage changes occurring in human osteoarthritis (OA). Here we show that DEI allows the visualization of cartilage lesions in intact canine knee joints with good accuracy. Hence, DEI may be applicable for following joint degeneration in animal models of OA.« less
Total-Body Irradiation Produces Late Degenerative Joint Damage in Rats
Hutchinson, Ian D.; Olson, John; Lindburg, Carl A.; Payne, Valerie; Collins, Boyce; Smith, Thomas L.; Munley, Michael T.; Wheeler, Kenneth T.; Willey, Jeffrey S.
2014-01-01
Purpose Premature musculoskeletal joint failure is a major source of morbidity among childhood cancer survivors. Radiation effects on synovial joint tissues of the skeleton are poorly understood. Our goal was to assess long-term changes in the knee joint from skeletally mature rats that received total-body irradiation while skeletal growth was ongoing. Materials and Methods 14 week-old rats were irradiated with 1, 3 or 7 Gy total-body doses of 18 MV x-rays. At 53 weeks of age, structural and compositional changes in knee joint tissues (articular cartilage, subchondral bone, and trabecular bone) were characterized using 7T MRI, nanocomputed tomography (nanoCT), microcomputed tomography (microCT), and histology. Results T2 relaxation times of the articular cartilage were lower after exposure to all doses. Likewise, calcifications were observed in the articular cartilage. Trabecular bone microarchitecture was compromised in the tibial metaphysis at 7 Gy. Mild to moderate cartilage erosion was scored in the 3 and 7 Gy rats. Conclusions Late degenerative changes in articular cartilage and bone were observed after total body irradiation in adult rats exposed prior to skeletal maturity. 7T MRI, microCT, nanoCT, and histology identified potential prognostic indicators of late radiation-induced joint damage. PMID:24885745
Fanconi anemia proteins in telomere maintenance.
Sarkar, Jaya; Liu, Yie
2016-07-01
Mammalian chromosome ends are protected by nucleoprotein structures called telomeres. Telomeres ensure genome stability by preventing chromosome termini from being recognized as DNA damage. Telomere length homeostasis is inevitable for telomere maintenance because critical shortening or over-lengthening of telomeres may lead to DNA damage response or delay in DNA replication, and hence genome instability. Due to their repetitive DNA sequence, unique architecture, bound shelterin proteins, and high propensity to form alternate/secondary DNA structures, telomeres are like common fragile sites and pose an inherent challenge to the progression of DNA replication, repair, and recombination apparatus. It is conceivable that longer the telomeres are, greater is the severity of such challenges. Recent studies have linked excessively long telomeres with increased tumorigenesis. Here we discuss telomere abnormalities in a rare recessive chromosomal instability disorder called Fanconi Anemia and the role of the Fanconi Anemia pathway in telomere biology. Reports suggest that Fanconi Anemia proteins play a role in maintaining long telomeres, including processing telomeric joint molecule intermediates. We speculate that ablation of the Fanconi Anemia pathway would lead to inadequate aberrant structural barrier resolution at excessively long telomeres, thereby causing replicative burden on the cell. Published by Elsevier B.V.
Plating To Reinforce Welded Joints
NASA Technical Reports Server (NTRS)
Otousa, J. E.
1982-01-01
Electrodeposition used to strengthen welded joints gouged, nicked, or suffered other mechanical damage. Plating cell, typically of acrylic plastic such as poly (Methylmetacrylate), is assembled around part to be plated. Areas not to be plated are masked with plater's tape. Weld area is plated in standard nickel-plating process.
Joint Group on Pollution Prevention: Partnering for Progress
NASA Technical Reports Server (NTRS)
Hill, R.
2001-01-01
This viewgraph presentation outlines the Joint Group on Pollution Prevention (JG-PP) partnership. Details are given on what groups comprise JG-PP, the proven methodology for what JG-PP can accomplish, the common problems, joint solutions, and shared efforts, and some of the JG-PP projects.
Simplified Radiographic Damage Index for Affected Joints in Chronic Gouty Arthritis
2016-01-01
The aim of this study was to develop and validate a new radiographic damage scoring method (DAmagE index of GoUt; DAEGU) in chronic gout using plain radiography. Two independent observers scored foot x-rays from 15 patients with chronic gout according to the DAEGU method and the modified Sharp/van der Heijde (SvdH) method. The 10 metatarsophalangeal (MTP) and 2 interphalangeal (IP) joints of the first toes of both feet were scored to assess the degrees of erosion and joint space narrowing (JSN). The intraobserver and interobserver reliabilities were analyzed by calculating the intraclass correlation coefficient (ICC) and minimal detectable change (MDC). The correlation between the DAEGU and SvdH methods was analyzed by calculating the Spearman's rho correlation coefficients and Kappa coefficients. The DAEGU method was found to be highly reproducible (0.945–0.987 for the intraobserver and 0.993–0.996 for the interobserver ICC values). The erosion, JSN, and total scores exhibited strong positive correlations between the DAEGU and SvdH methods and also within each method (r = 0.860–0.969, P < 0.001 for all parameters). The DAEGU and SvdH methods were in very good agreement as determined by Kappa coefficient analysis [0.732 (0.387–1.000) for erosion and 1.000 (1.000–1.000) for JSN]. In conclusion, this study revealed that DAEGU method was a reliable and feasible tool in the assessment of radiographic damage in chronic gout. The DAEGU method may provide a more easy assessment of structural damage in chronic gout in the real clinical practice. PMID:26955246
Transcriptomic analysis of synovial extracellular RNA following knee trauma: A pilot study.
Griswold, Anthony J; Perez, Jose; Nuytemans, Karen; Strong, Thomas A; Wang, Liyong; Vance, Danica D; Ennis, Hayley; Smith, Marvin K; Best, Thomas M; Vance, Jeffery M; Pericak-Vance, Margaret A; Kaplan, Lee D
2018-06-01
Traumatic knee injuries often result in damage to articular cartilage and other joint structures. Such trauma is a strong risk factor for the future development and progression of osteoarthritis (OA). The molecular mechanisms and signaling pathways modulating response to knee joint trauma remain unclear. Moreover, investigations of biomarkers influencing responses have been targeted rather than broad, unbiased discovery studies. Herein, we characterize the complete complement of extracellular RNA (exRNA) in the synovial fluid of 14 subjects following knee injury. Fluid was collected during surgery from the injured knees, and from the contralateral knee in a subset, undergoing surgical repair of the ACL and/or meniscal repair/debridement. Arthroscopic grading of chondral damage in four knee compartments was performed using the Outerbridge classification. exRNA was extracted and subjected to massively parallel total RNA sequencing. Differential abundance of RNA was calculated between the subject cohorts of injured and non-injured knee, average Outerbridge score ≥0.5 and less, and chronic and acute injury duration defined as ≤4 months till surgery or longer. Overall, expression of several thousand genes was identified in the synovial fluid. Furthermore, differential expression analysis suggests a role of exRNA fragments of matrix metalloproteinases and skeletal muscle fiber genes in the response to traumatic injury. Together, these data suggest that high-throughput approaches can indicate exRNA molecular signatures following knee trauma. Future studies are required to more fully characterize the biological roles of these exRNA and the cadence of their respective release that may lead to translational treatment options for post-traumatic OA. © 2017 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 36:1659-1665, 2018. © 2017 Orthopaedic Research Society. Published by Wiley Periodicals, Inc.
Constitutive Modeling of the Thermomechanical Behavior of Rock Salt
NASA Astrophysics Data System (ADS)
Hampel, A.
2016-12-01
For the safe disposal of heat-generating high-level radioactive waste in rock salt formations, highly reliable numerical simulations of the thermomechanical and hydraulic behavior of the host rock have to be performed. Today, the huge progress in computer technology has enabled experts to calculate large and detailed computer models of underground repositories. However, the big advances in computer technology are only beneficial when the applied material models and modeling procedures also meet very high demands. They result from the fact that the evaluation of the long-term integrity of the geological barrier requires an extrapolation of a highly nonlinear deformation behavior to up to 1 million years, while the underlying experimental investigations in the laboratory or in situ have a duration of only days, weeks or at most some years. Several advanced constitutive models were developed and continuously improved to describe the dependences of various deformation phenomena in rock salt on in-situ relevant boundary conditions: transient and steady-state creep, evolution of damage and dilatancy in the DRZ, failure, post-failure behavior, residual strength, damage and dilatancy reduction, and healing. In a joint project series between 2004 and 2016, fundamental features of the advanced models were investigated and compared in detail with benchmark calculations. The study included procedures for the determination of characteristic salt-type-specific model parameter values and for the performance of numerical calculations of underground structures. Based on the results of this work and on specific laboratory investigations, the rock mechanical modeling is currently developed further in a common research project of experts from Germany and the United States. In this presentation, an overview about the work and results of the project series is given and the current joint research project WEIMOS is introduced.
NASA Astrophysics Data System (ADS)
He, Jingjing; Wang, Dengjiang; Zhang, Weifang
2015-03-01
This study presents an experimental and modeling study for damage detection and quantification in riveted lap joints. Embedded lead zirconate titanate piezoelectric (PZT) ceramic wafer-type sensors are employed to perform in-situ non-destructive testing during fatigue cyclical loading. A multi-feature integration method is developed to quantify the crack size using signal features of correlation coefficient, amplitude change, and phase change. In addition, probability of detection (POD) model is constructed to quantify the reliability of the developed sizing method. Using the developed crack size quantification method and the resulting POD curve, probabilistic fatigue life prediction can be performed to provide comprehensive information for decision-making. The effectiveness of the overall methodology is demonstrated and validated using several aircraft lap joint specimens from different manufactures and under different loading conditions.
Oldenburg, J; Zimmermann, R; Katsarou, O; Theodossiades, G; Zanon, E; Niemann, B; Kellermann, E; Lundin, B
2015-01-01
In patients with haemophilia A, factor VIII (FVIII) prophylaxis reduces bleeding frequency and joint damage compared with on-demand therapy. To assess the effect of prophylaxis initiation age, magnetic resonance imaging (MRI) was used to evaluate bone and cartilage damage in patients with severe haemophilia A. In this cross-sectional, multinational investigation, patients aged 12–35 years were assigned to 1 of 5 groups: primary prophylaxis started at age <2 years (group 1); secondary prophylaxis started at age 2 to <6 years (group 2), 6 to <12 years (group 3), or 12−18 years (group 4); or on-demand treatment (group 5). Joint status at ankles and knees was assessed using Compatible Additive MRI scoring (maximum and mean ankle; maximum and mean of all 4 joints) and Gilbert scores in the per-protocol population (n = 118). All prophylaxis groups had better MRI joint scores than the on-demand group. MRI scores generally increased with current patient age and later start of prophylaxis. Ankles were the most affected joints. In group 1 patients currently aged 27−35 years, the median of maximum ankle scores was 0.0; corresponding values in groups 4 and 5 were 17.0 and 18.0, respectively [medians of mean index joint scores: 0.0 (group 1), 8.1 (group 2) and 13.8 (group 4)]. Gilbert scores revealed outcomes less pronounced than MRI scores. MRI scores identified pathologic joint status with high sensitivity. Prophylaxis groups had lower annualized joint bleeds and MRI scores vs. the on-demand group. Primary prophylaxis demonstrated protective effects against joint deterioration compared with secondary prophylaxis. PMID:25470205
Adaptive measurement selection for progressive damage estimation
NASA Astrophysics Data System (ADS)
Zhou, Wenfan; Kovvali, Narayan; Papandreou-Suppappola, Antonia; Chattopadhyay, Aditi; Peralta, Pedro
2011-04-01
Noise and interference in sensor measurements degrade the quality of data and have a negative impact on the performance of structural damage diagnosis systems. In this paper, a novel adaptive measurement screening approach is presented to automatically select the most informative measurements and use them intelligently for structural damage estimation. The method is implemented efficiently in a sequential Monte Carlo (SMC) setting using particle filtering. The noise suppression and improved damage estimation capability of the proposed method is demonstrated by an application to the problem of estimating progressive fatigue damage in an aluminum compact-tension (CT) sample using noisy PZT sensor measurements.
A joint frailty-copula model between tumour progression and death for meta-analysis.
Emura, Takeshi; Nakatochi, Masahiro; Murotani, Kenta; Rondeau, Virginie
2017-12-01
Dependent censoring often arises in biomedical studies when time to tumour progression (e.g., relapse of cancer) is censored by an informative terminal event (e.g., death). For meta-analysis combining existing studies, a joint survival model between tumour progression and death has been considered under semicompeting risks, which induces dependence through the study-specific frailty. Our paper here utilizes copulas to generalize the joint frailty model by introducing additional source of dependence arising from intra-subject association between tumour progression and death. The practical value of the new model is particularly evident for meta-analyses in which only a few covariates are consistently measured across studies and hence there exist residual dependence. The covariate effects are formulated through the Cox proportional hazards model, and the baseline hazards are nonparametrically modeled on a basis of splines. The estimator is then obtained by maximizing a penalized log-likelihood function. We also show that the present methodologies are easily modified for the competing risks or recurrent event data, and are generalized to accommodate left-truncation. Simulations are performed to examine the performance of the proposed estimator. The method is applied to a meta-analysis for assessing a recently suggested biomarker CXCL12 for survival in ovarian cancer patients. We implement our proposed methods in R joint.Cox package.
Davatzes, N.C.; Aydin, A.
2005-01-01
We examined the distribution of fault rock and damage zone structures in sandstone and shale along the Moab fault, a basin-scale normal fault with nearly 1 km (0.62 mi) of throw, in southeast Utah. We find that fault rock and damage zone structures vary along strike and dip. Variations are related to changes in fault geometry, faulted slip, lithology, and the mechanism of faulting. In sandstone, we differentiated two structural assemblages: (1) deformation bands, zones of deformation bands, and polished slip surfaces and (2) joints, sheared joints, and breccia. These structural assemblages result from the deformation band-based mechanism and the joint-based mechanism, respectively. Along the Moab fault, where both types of structures are present, joint-based deformation is always younger. Where shale is juxtaposed against the fault, a third faulting mechanism, smearing of shale by ductile deformation and associated shale fault rocks, occurs. Based on the knowledge of these three mechanisms, we projected the distribution of their structural products in three dimensions along idealized fault surfaces and evaluated the potential effect on fluid and hydrocarbon flow. We contend that these mechanisms could be used to facilitate predictions of fault and damage zone structures and their permeability from limited data sets. Copyright ?? 2005 by The American Association of Petroleum Geologists.
NASA Astrophysics Data System (ADS)
Baur, Jeffery W.; Slinker, Keith; Kondash, Corey
2017-04-01
Understanding the shear strain, viscoelastic response, and onset of damage within bonded composites is critical to their design, processing, and reliability. This presentation will discuss the multidisciplinary research conducted which led to the conception, development, and demonstration of two methods for measuring the shear within a bonded joint - dualplane digital image correlation (DIC) and a micro-cantilever shear sensor. The dual plane DIC method was developed to measure the strain field on opposing sides of a transparent single-lap joint in order to spatially quantify the joint shear strain. The sensor consists of a single glass fiber cantilever beam with a radially-grown forest of carbon nanotubes (CNTs) within a capillary pore. When the fiber is deflected, the internal radial CNT array is compressed against an electrode within the pore and the corresponding decrease in electrical resistance is correlated with the external loading. When this small, simple, and low-cost sensor was integrated within a composite bonded joint and cycled in tension, the onset of damage prior to joint failure was observed. In a second sample configuration, both the dual plane DIC and the hair sensor detected viscoplastic changes in the strain of the sample in response to continued loading.
Ankle rehabilitation device with two degrees of freedom and compliant joint
NASA Astrophysics Data System (ADS)
Racu (Cazacu, C.-M.; Doroftei, I.
2015-11-01
We propose a rehabilitation device that we intend to be low cost and easy to manufacture. The system will ensure functionality but also have a small dimensions and low mass, considering the physiological dimensions of the foot and lower leg. To avoid injure of the ankle joint, this device is equipped with a compliant joint between the motor and mechanical transmission. The torque of this joint is intended to be adjustable, according to the degree of ankle joint damage. To choose the material and the dimensions of this compliant joint, in this paper we perform the first stress simulation. The minimum torque is calculated, while the maximum torque is given by the preliminary chosen actuator.
Urinary tract infection in small children: the evolution of renal damage over time.
Swerkersson, Svante; Jodal, Ulf; Sixt, Rune; Stokland, Eira; Hansson, Sverker
2017-10-01
Our objective was to analyze the evolution of kidney damage over time in small children with urinary tract infection (UTI) and factors associated with progression of renal damage. From a cohort of 1003 children <2 years of age with first-time UTI, a retrospective analysis of 103 children was done. Children were selected because of renal damage at index 99m Tc-dimercaptosuccinic acid (DMSA) scintigraphy at least 3 months after UTI, and a late DMSA scan was performed after at least 2 years. Damage was classified as progression when there was a decline in differential renal function (DRF) by ≥4%, as regression when there was complete or partial resolution of uptake defects. Of 103 children, 20 showed progression, 20 regression, and 63 remained unchanged. There were no differences between groups regarding gender or age. In the progression group, 16/20 (80%) children had vesicoureteral reflux (VUR) grade III-V and 13 (65%) had recurrent UTI. In multivariable regression analysis, both VUR grade III-V and recurrent UTI were associated with progression. In the regression group, 16/20 (80%) had no VUR or grade I-II, and two (10%) had recurrent UTI. Most small children with febrile UTI do not develop renal damage and if they do the majority remain unchanged or regress over time. However, up to one-fifth of children with renal damage diagnosed after UTI are at risk of renal deterioration. These children are characterized by the presence of VUR grades III-V and recurrent febrile UTI and may benefit from follow-up.
Joint modelling of longitudinal CEA tumour marker progression and survival data on breast cancer
NASA Astrophysics Data System (ADS)
Borges, Ana; Sousa, Inês; Castro, Luis
2017-06-01
This work proposes the use of Biostatistics methods to study breast cancer in patients of Braga's Hospital Senology Unit, located in Portugal. The primary motivation is to contribute to the understanding of the progression of breast cancer, within the Portuguese population, using a more complex statistical model assumptions than the traditional analysis that take into account a possible existence of a serial correlation structure within a same subject observations. We aim to infer which risk factors aect the survival of Braga's Hospital patients, diagnosed with breast tumour. Whilst analysing risk factors that aect a tumour markers used on the surveillance of disease progression the Carcinoembryonic antigen (CEA). As survival and longitudinal processes may be associated, it is important to model these two processes together. Hence, a joint modelling of these two processes to infer on the association of these was conducted. A data set of 540 patients, along with 50 variables, was collected from medical records of the Hospital. A joint model approach was used to analyse these data. Two dierent joint models were applied to the same data set, with dierent parameterizations which give dierent interpretations to model parameters. These were used by convenience as the ones implemented in R software. Results from the two models were compared. Results from joint models, showed that the longitudinal CEA values were signicantly associated with the survival probability of these patients. A comparison between parameter estimates obtained in this analysis and previous independent survival[4] and longitudinal analysis[5][6], lead us to conclude that independent analysis brings up bias parameter estimates. Hence, an assumption of association between the two processes in a joint model of breast cancer data is necessary. Results indicate that the longitudinal progression of CEA is signicantly associated with the probability of survival of these patients. Hence, an assumption of association between the two processes in a joint model of breast cancer data is necessary.
Joint Kinetics and Kinematics During Common Lower Limb Rehabilitation Exercises.
Comfort, Paul; Jones, Paul Anthony; Smith, Laura Constance; Herrington, Lee
2015-10-01
Unilateral body-weight exercises are commonly used to strengthen the lower limbs during rehabilitation after injury, but data comparing the loading of the limbs during these tasks are limited. To compare joint kinetics and kinematics during 3 commonly used rehabilitation exercises. Descriptive laboratory study. Laboratory. A total of 9 men (age = 22.1 ± 1.3 years, height = 1.76 ± 0.08 m, mass = 80.1 ± 12.2 kg) participated. Participants performed the single-legged squat, forward lunge, and reverse lunge with kinetic data captured via 2 force plates and 3-dimensional kinematic data collected using a motion-capture system. Peak ground reaction forces, maximum joint angles, and peak sagittal-joint moments. We observed greater eccentric and concentric peak vertical ground reaction forces during the single-legged squat than during both lunge variations (P ≤ .001). Both lunge variations demonstrated greater knee and hip angles than did the single-legged squat (P < .001), but we observed no differences between lunges (P > .05). Greater dorsiflexion occurred during the single-legged squat than during both lunge variations (P < .05), but we noted no differences between lunge variations (P = .70). Hip-joint moments were greater during the forward lunge than during the reverse lunge (P = .003) and the single-legged squat (P = .011). Knee-joint moments were greater in the single-legged squat than in the reverse lunge (P < .001) but not greater in the single-legged squat than in the forward lunge (P = .41). Ankle-joint moments were greater during the single-legged squat than during the forward lunge (P = .002) and reverse lunge (P < .001). Appropriate loading progressions for the hip should begin with the single-legged squat and progress to the reverse lunge and then the forward lunge. In contrast, loading progressions for the knee and ankle should begin with the reverse lunge and progress to the forward lunge and then the single-legged squat.
Structural Damage Detection Using Changes in Natural Frequencies: Theory and Applications
NASA Astrophysics Data System (ADS)
He, K.; Zhu, W. D.
2011-07-01
A vibration-based method that uses changes in natural frequencies of a structure to detect damage has advantages over conventional nondestructive tests in detecting various types of damage, including loosening of bolted joints, using minimum measurement data. Two major challenges associated with applications of the vibration-based damage detection method to engineering structures are addressed: accurate modeling of structures and the development of a robust inverse algorithm to detect damage, which are defined as the forward and inverse problems, respectively. To resolve the forward problem, new physics-based finite element modeling techniques are developed for fillets in thin-walled beams and for bolted joints, so that complex structures can be accurately modeled with a reasonable model size. To resolve the inverse problem, a logistical function transformation is introduced to convert the constrained optimization problem to an unconstrained one, and a robust iterative algorithm using a trust-region method, called the Levenberg-Marquardt method, is developed to accurately detect the locations and extent of damage. The new methodology can ensure global convergence of the iterative algorithm in solving under-determined system equations and deal with damage detection problems with relatively large modeling error and measurement noise. The vibration-based damage detection method is applied to various structures including lightning masts, a space frame structure and one of its components, and a pipeline. The exact locations and extent of damage can be detected in the numerical simulation where there is no modeling error and measurement noise. The locations and extent of damage can be successfully detected in experimental damage detection.
NASA Technical Reports Server (NTRS)
Gotsis, Pascal K.; Chamis, Christos C.; Minnetyan, Levon
1996-01-01
Graphite/epoxy composite thin shell structures were simulated to investigate damage and fracture progression due to internal pressure and axial loading. Defective and defect-free structures (thin cylinders) were examined. The three different laminates examined had fiber orientations of (90/0/+/-0)(sub s), where 0 is 45, 60, and 75 deg. CODSTRAN, an integrated computer code that scales up constituent level properties to the structural level and accounts for all possible failure modes, was used to simulate composite degradation under loading. Damage initiation, growth, accumulation, and propagation to fracture were included in the simulation. Burst pressures for defective and defect-free shells were compared to evaluate damage tolerance. The results showed that damage initiation began with matrix failure whereas damage and/or fracture progression occurred as a result of additional matrix failure and fiber fracture. In both thin cylinder cases examined (defective and defect-free), the optimum layup configuration was (90/0/+/-60)(sub s) because it had the best damage tolerance with respect to the burst pressure.
A model for the progressive failure of laminated composite structural components
NASA Technical Reports Server (NTRS)
Allen, D. H.; Lo, D. C.
1991-01-01
Laminated continuous fiber polymeric composites are capable of sustaining substantial load induced microstructural damage prior to component failure. Because this damage eventually leads to catastrophic failure, it is essential to capture the mechanics of progressive damage in any cogent life prediction model. For the past several years the authors have been developing one solution approach to this problem. In this approach the mechanics of matrix cracking and delamination are accounted for via locally averaged internal variables which account for the kinematics of microcracking. Damage progression is predicted by using phenomenologically based damage evolution laws which depend on the load history. The result is a nonlinear and path dependent constitutive model which has previously been implemented to a finite element computer code for analysis of structural components. Using an appropriate failure model, this algorithm can be used to predict component life. In this paper the model will be utilized to demonstrate the ability to predict the load path dependence of the damage and stresses in plates subjected to fatigue loading.
Tolboom, Tanja C A; van der Helm-Van Mil, Annette H M; Nelissen, Rob G H H; Breedveld, Ferdinand C; Toes, René E M; Huizinga, Tom W J
2005-07-01
Rheumatoid arthritis (RA) is characterized by inflammation and destruction of synovial joints. Fibroblast-like synoviocytes (FLS) harvested from synovial tissue of patients with RA can invade normal human cartilage in severe combined immunodeficient (SCID) mice and Matrigel basement membrane matrix in vitro. This study was undertaken to investigate the association of these in vitro characteristics with disease characteristics in patients with RA. Synovial tissue samples from 72 RA and 49 osteoarthritis (OA) patients were obtained. Samples of different joints were collected from 7 patients with RA. The FLS invasiveness in Matrigel was studied, and the intraindividual and interindividual differences were compared. From the patients with FLS who exhibited the most extreme differences in in vitro ingrowth (most and least invasive FLS), radiographs of the hands and feet were collected and scored according to the Sharp/van der Heijde method to determine the relationship between in vitro invasion data and estimated yearly joint damage progression. FLS from patients with RA were more invasive than FLS from patients with OA (P < 0.001). The mean intraindividual variation in FLS invasion was much less than the mean interindividual variation (mean +/- SD 1,067 +/- 926 and 3,845 +/- 2,367 for intraindividual and interindividual variation, respectively; P = 0.035), which shows that the level of FLS invasion is a patient characteristic. The mean +/- SEM Sharp score on radiographs of the hands or feet divided by the disease duration was 4.4 +/- 1.1 units per year of disease duration in patients with the least invasive FLS (n = 9), which was much lower compared with the 21.8 +/- 3.1 units per year of disease duration in patients with the most invasive FLS (n = 9) (P < 0.001). The ex vivo invasive behavior of FLS from RA patients is associated with the rate of joint destruction and is a patient characteristic, given the much smaller intraindividual than interindividual FLS variation.
Clinical characteristics of RA patients with secondary SS and association with joint damage.
Brown, Lindsay E; Frits, Michelle L; Iannaccone, Christine K; Weinblatt, Michael E; Shadick, Nancy A; Liao, Katherine P
2015-05-01
Secondary SS (sSS) is a common extra-articular manifestation of RA. There are conflicting data regarding the association of sSS with worse joint damage. This study aims to characterize sSS patients in an RA cohort and study the association between sSS and joint damage. We conducted a cross-sectional study of RA patients with ≥1 year of follow-up at a large academic centre. Subjects with co-morbid diseases that can also result in sicca symptoms were excluded from the analysis. Subjects were considered to have sSS if they were reported as having sSS by their rheumatologist at recruitment into the cohort and had the diagnosis confirmed by chart review. The primary outcome was Sharp score using bilateral hand radiographs at recruitment. We constructed a linear regression model to determine the association of sSS status and Sharp score adjusted by age, gender, disease duration and ACPA and RF status. We studied 829 RA subjects, mean age 57 years, 83% female, mean RA duration 13 years, 74% seropositive; 85 subjects (10.3%) had sSS. We observed a female predominance (95.3%), longer mean disease duration (16.9 years) and higher frequency of RF or ACPA positive among patients with sSS and RA. Having sSS at baseline was associated with higher Sharp scores (P = 0.03), independent of age, gender, RA disease duration and seropositive disease. In our RA cohort, RA subjects with sSS had worse joint damage, suggesting that sSS is a marker of more aggressive disease. © The Author 2014. Published by Oxford University Press on behalf of the British Society for Rheumatology. All rights reserved. For Permissions, please email: journals.permissions@oup.com.
20 CFR 10.712 - How much of any settlement or judgment must be paid to the United States?
Code of Federal Regulations, 2014 CFR
2014-04-01
... entire amount of the award; (ii) Subtract the amount of award representing damage to real or personal... Damage $0.00 (iii) Subtotal A (Line a minus Line b) $100,000.00 (iv) Amount Allocated for Loss of... which is permitted under the state law and for damage to her vehicle (documented at $50,000.00). A joint...
20 CFR 10.712 - How much of any settlement or judgment must be paid to the United States?
Code of Federal Regulations, 2013 CFR
2013-04-01
... entire amount of the award; (ii) Subtract the amount of award representing damage to real or personal... Damage $0.00 (iii) Subtotal A (Line a minus Line b) $100,000.00 (iv) Amount Allocated for Loss of... which is permitted under the state law and for damage to her vehicle (documented at $50,000.00). A joint...
20 CFR 10.712 - How much of any settlement or judgment must be paid to the United States?
Code of Federal Regulations, 2012 CFR
2012-04-01
... entire amount of the award; (ii) Subtract the amount of award representing damage to real or personal... Damage $0.00 (iii) Subtotal A (Line a minus Line b) $100,000.00 (iv) Amount Allocated for Loss of... which is permitted under the state law and for damage to her vehicle (documented at $50,000.00). A joint...
NASA Technical Reports Server (NTRS)
Gotsis, P. K.; Chamis, C. C.; Minnetyan, L.
1996-01-01
Defect-free and defected composite thin shells with ply orientation (90/0/+/-75) made of graphite/epoxy are simulated for damage progression and fracture due to internal pressure and axial loading. The thin shells have a cylindrical geometry with one end fixed and the other free. The applied load consists of an internal pressure in conjunction with an axial load at the free end, the cure temperature was 177 C (350 F) and the operational temperature was 21 C (70 F). The residual stresses due to the processing are taken into account. Shells with defect and without defects were examined by using CODSTRAN an integrated computer code that couples composite mechanics, finite element and account for all possible failure modes inherent in composites. CODSTRAN traces damage initiation, growth, accumulation, damage propagation and the final fracture of the structure. The results show that damage initiation started with matrix failure while damage/fracture progression occurred due to additional matrix failure and fiber fracture. The burst pressure of the (90/0/+/- 75) defected shell was 0.092% of that of the free defect. Finally the results of the damage progression of the (90/0/+/- 75), defective composite shell was compared with the (90/0/+/- theta, where theta = 45 and 60, layup configurations. It was shown that the examined laminate (90/0/+/- 75) has the least damage tolerant of the two compared defective shells with the (90/0/+/- theta), theta = 45 and 60 laminates.
Progressive Fracture of [0/90/ + or - Theta]s Composite Structure Under Uniform Pressure Load
NASA Technical Reports Server (NTRS)
Gotsis, Pascalis K.; Chamis, Christos C.; Gotsis, Christos K.; Mouratidis, Ericos
2007-01-01
S-Glass/epoxy [0/90/plus or minus theta]s for theta =45 deg., 60 deg., and 75 deg. laminated fiber-reinforced composite stiffened plate was simulated to investigated for damage and fracture progression under uniform pressure. An integrated computer code was augmented for the simulation of the damage initiation, growth, accumulation, and propagation to fracture and to structural collapse. Results show in detail the damage progression sequence and structural fracture resistance during different degradation stages. Damage through the thickness of the laminate initiated first at [0/90/plus or minus 45]s at 15.168 MPa (2200 psi), followed by [0/90/plus or minus 60]s at 16.96 MPa (2460 psi) and finally by [0/90/plus or minus 75]s at 19.3 MPa (2800 psi). After damage initiation happened the cracks propagate rapidly to structural fracture.
NASA Technical Reports Server (NTRS)
Satyanarayana, Arunkumar; Bogert, Philip B.; Chunchu, Prasad B.
2007-01-01
The influence of delamination on the progressing damage path and initial failure load in composite laminates is investigated. Results are presented from a numerical and an experimental study of center-notched tensile-loaded coupons. The numerical study includes two approaches. The first approach considers only intralaminar (fiber breakage and matrix cracking) damage modes in calculating the progression of the damage path. In the second approach, the model is extended to consider the effect of interlaminar (delamination) damage modes in addition to the intralaminar damage modes. The intralaminar damage is modeled using progressive damage analysis (PDA) methodology implemented with the VUMAT subroutine in the ABAQUS finite element code. The interlaminar damage mode has been simulated using cohesive elements in ABAQUS. In the experimental study, 2-3 specimens each of two different stacking sequences of center-notched laminates are tensile loaded. The numerical results from the two different modeling approaches are compared with each other and the experimentally observed results for both laminate types. The comparisons reveal that the second modeling approach, where the delamination damage mode is included together with the intralaminar damage modes, better simulates the experimentally observed damage modes and damage paths, which were characterized by splitting failures perpendicular to the notch tips in one or more layers. Additionally, the inclusion of the delamination mode resulted in a better prediction of the loads at which the failure took place, which were higher than those predicted by the first modeling approach which did not include delaminations.
Screening Adhesively Bonded Single-Lap-Joint Testing Results Using Nonlinear Calculation Parameters
2012-03-01
versus displacement response for single-lap-joints bonded with damage-tolerant adhe- sives, such the polyurea adhesive plotted in Figure 2, is much...displacement response for a single-lap-joint bonded with a polyurea adhesive. Complex x-y plots are commonly fitted using the Levenberg-Marquardt...expected decrease in maximum strength for the polyurea in compar- ison to the epoxy, which could have been obtained using a traditional analysis approach
Experimental Verification of Computational Models for Laminated Composites
NASA Technical Reports Server (NTRS)
Harris, Charles E.; Coats, Timothy W.; Glaessgen, Edward H.
1999-01-01
The objective of the research reported herein is to develop a progressive damage methodology capable of predicting the residual strength of continuous fiber-reinforced, laminated, polymer matrix composites with through-penetration damage. The fracture behavior of center-notch tension panels with thin crack-like slits was studied. Since fibers are the major load-carrying constituent in polymer matrix composites, predicting the residual strength of a laminate requires a criterion for fiber fracture. The effects on fiber strain due to other damage mechanisms such as matrix cracking and delaminations must also be modeled. Therefore, the research herein examines the damage mechanisms involved in translaminate fracture and identifies the toughening mechanisms responsible for damage growth resistance in brittle epoxy matrix systems. The mechanics of matrix cracking and fiber fracture are discussed as is the mathematical framework for the progressive damage model developed by the authors. The progressive damage analysis algorithms have been implemented into a general purpose finite element code developed by NASA, the Computational Structural Mechanics Testbed (COMET). Damage growth is numerically simulated and the analytical residual strength predictions are compared to experimental results for a variety of notched panel configurations and materials systems.
Osteoarthritis screening using Raman spectroscopy of dried human synovial fluid drops
NASA Astrophysics Data System (ADS)
Esmonde-White, Karen A.; Mandair, Gurjit S.; Esmonde-White, Francis W. L.; Raaii, Farhang; Roessler, Blake J.; Morris, Michael D.
2009-02-01
We describe the use of Raman spectroscopy to investigate synovial fluid drops deposited onto fused silica microscope slides. This spectral information can be used to identify chemical changes in synovial fluid associated with osteoarthritis (OA) damage to knee joints. The chemical composition of synovial fluid is predominately proteins (enzymes, cytokines, or collagen fragments), glycosaminoglycans, and a mixture of minor components such as inorganic phosphate crystals. During osteoarthritis, the chemical, viscoelastic and biological properties of synovial fluid are altered. A pilot study was conducted to determine if Raman spectra of synovial fluid correlated with radiological scoring of knee joint damage. After informed consent, synovial fluid was drawn and x-rays were collected from the knee joints of 40 patients. Raman spectra and microscope images were obtained from the dried synovial fluid drops using a Raman microprobe and indicate a coarse separation of synovial fluid components. Individual protein signatures could not be identified; Raman spectra were useful as a general marker of overall protein content and secondary structure. Band intensity ratios used to describe protein and glycosaminoglycan structure were used in synovial fluid spectra. Band intensity ratios of Raman spectra indicate that there is less ordered protein secondary structure in synovial fluid from the damage group. Combination of drop deposition with Raman spectroscopy is a powerful approach to examining synovial fluid for the purposes of assessing osteoarthritis damage.
Joint-specific risk of impaired function in fibrodysplasia ossificans progressiva (FOP).
Pignolo, Robert J; Durbin-Johnson, Blythe P; Rocke, David M; Kaplan, Frederick S
2018-04-01
Fibrodysplasia ossificans progressiva (FOP) causes progressive disability due to heterotopic ossification from episodic flare-ups. Using data from 500 FOP patients (representing 63% of all known patients world-wide), age- and joint-specific risks of new joint involvement were estimated using parametric and nonparametric statistical methods. Compared to data from a 1994 survey of 44 individuals with FOP, our current estimates of age- and joint-specific risks of new joint involvement are more accurate (narrower confidence limits), based on a wider range of ages, and have less bias due to its greater comprehensiveness (captures over three-fifths of the known FOP patients worldwide). For the neck, chest, abdomen, and upper back, the estimated hazard decreases over time. For the jaw, lower back, shoulder, elbow, wrist, fingers, hip, knee, ankle, and foot, the estimated hazard increases initially then either plateaus or decreases. At any given time and for any anatomic site, the data indicate which joints are at risk. This study of approximately 63% of the world's known population of FOP patients provides a refined estimate of risk for new involvement at any joint at any age, as well as the proportion of patients with uninvolved joints at any age. Importantly, these joint-specific survival curves can be used to facilitate clinical trial design and to determine if potential treatments can modify the predicted trajectory of progressive joint dysfunction. Copyright © 2017 Elsevier Inc. All rights reserved.
The role of tissue damage in whiplash associated disorders: Discussion paper 1
Bogduk, Nikolai; Ivancic, Paul C.; McLean, Samuel A.; Siegmund, Gunter P.; Winkelstein, Beth
2011-01-01
STUDY DESIGN Non-systematic review of cervical spine lesions in whiplash-associated disorders (WAD). OBJECTIVE To describe whiplash injury models in terms of basic and clinical science, to summarize what can and cannot be explained by injury models, and to highlight future research areas to better understand the role of tissue damage in WAD. SUMMARY OF BACKGROUND DATA The frequent lack of detectable tissue damage has raised questions about whether tissue damage is necessary for WAD and what role it plays in the clinical context of WAD. METHODS Non-systematic review. RESULTS Lesions of various tissues have been documented by numerous investigations conducted in animals, cadavers, healthy volunteers and patients. Most lesions are undetected by imaging techniques. For zygapophysial (facet) joints, lesions have been predicted by bioengineering studies and validated through animal studies; for zygapophysial joint pain, a valid diagnostic test and a proven treatment are available. Lesions of dorsal root ganglia, discs, ligaments, muscles and vertebral artery have been documented in biomechanical and autopsy studies, but no valid diagnostic test is available to assess their clinical relevance. The proportion of WAD patients in whom a persistent lesion is the major determinant of ongoing symptoms is unknown. Psychosocial factors, stress reactions and generalized hyperalgesia have also been shown to predict WAD outcomes. CONCLUSION There is evidence supporting a lesion-based model in WAD. Lack of macroscopically identifiable tissue damage does not rule out the presence of painful lesions. The best available evidence concerns zygapophysial joint pain. The clinical relevance of other lesions needs to be addressed by future research. PMID:22020601
NASA Technical Reports Server (NTRS)
Waller, J. M.; Nichols, C. T.; Wentzel, D. J.; Saulsberry R. L.
2010-01-01
Broad-band modal acoustic emission (AE) data was used to characterize micromechanical damage progression in uniaxial IM7 and T1000 carbon fiber-epoxy tows and an IM7 composite overwrapped pressure vessel (COPV) subjected to an intermittent load hold tensile stress profile known to activate the Felicity ratio (FR). Damage progression was followed by inspecting the Fast Fourier Transforms (FFTs) associated with acoustic emission events. FFT analysis revealed the occurrence of cooperative micromechanical damage events in a frequency range between 100 kHz and 1 MHz. Evidence was found for the existence of a universal damage parameter, referred to here as the critical Felicity ratio, or Felicity ratio at rupture (FR*), which had a value close to 0.96 for the tows and the COPV tested. The implications of using FR* to predict failure in carbon/epoxy composite materials and related composite components such as COPVs are discussed. Trends in the FFT data are also discussed; namely, the difference between the low and high energy events, the difference between early and late-life events, comparison of IM7 and T1000 damage progression, and lastly, the similarity of events occurring at the onset of significant acoustic emission used to calculate the FR.
NASA Astrophysics Data System (ADS)
Larimer, J. E.; Yanites, B.
2017-12-01
River morphology reflects the interaction between the driving forces of erosion and the resisting properties of bedrock that limit erosion. Changes in energy dissipation at the riverbed are indicated by differences in channel geometry. To erode at the same rate, stronger rocks require more energy, and thus, an adjustment in river slope or width is necessary to accomplish this work. Therefore, morphological changes should reflect differences in the rock strength properties most relevant to the dominant erosion process. We investigate this hypothesis by comparing river morphology and rock-strength properties of reaches subject to different processes. Streams in Prescott National Forest, AZ expose bedrock through a variety of lithologies, which provides a natural testing ground. Measurements include channel geometry, surface P-wave velocity, fracture spacing, and bedload grain size distribution of 150 individual reaches, as well as 260 tensile and compressive-strength tests and P-wave velocity of cores up to depths of 20 cm. Based on observations, we infer that fluvial erosion processes in this region generally fall into three domains: (1) grain by grain abrasion, (2) progressive failure by damage accumulation due to bedload impacts or `macro-abrasion', and (3) `plucking' of jointed rocks. We focus analyses on the accumulation of damage from sub-critical stresses that weakens the surface of the bedrock, potentially leading to macroscopic fractures, fatigue, and rock failure. This plays a dual role facilitating the ease with which abrasion removes material and increasing the rate of production of pluck-able particles. We estimate the `damage potential' of saltating bedload using water discharge time-series, sediment transport models and grain size distribution. To determine the resistance to damage accumulation among different rocks, we measure the evolution of damage in core samples under uniaxial loading using strain energy and inherent flaw theory. Preliminary results suggest that tensile strength is a good predictor of channel morphology in abrasion dominated reaches, morphology is better predicted through a damage perspective in macro-abrasion dominated reaches, and reduction in P-wave velocity near the surface correlates with damage susceptibility.
GENOA-PFA: Progressive Fracture in Composites Simulated Computationally
NASA Technical Reports Server (NTRS)
Murthy, Pappu L. N.
2000-01-01
GENOA-PFA is a commercial version of the Composite Durability Structural Analysis (CODSTRAN) computer program that simulates the progression of damage ultimately leading to fracture in polymer-matrix-composite (PMC) material structures under various loading and environmental conditions. GENOA-PFA offers several capabilities not available in other programs developed for this purpose, making it preferable for use in analyzing the durability and damage tolerance of complex PMC structures in which the fiber reinforcements occur in two- and three-dimensional weaves and braids. GENOA-PFA implements a progressive-fracture methodology based on the idea that a structure fails when flaws that may initially be small (even microscopic) grow and/or coalesce to a critical dimension where the structure no longer has an adequate safety margin to avoid catastrophic global fracture. Damage is considered to progress through five stages: (1) initiation, (2) growth, (3) accumulation (coalescence of propagating flaws), (4) stable propagation (up to the critical dimension), and (5) unstable or very rapid propagation (beyond the critical dimension) to catastrophic failure. The computational simulation of progressive failure involves formal procedures for identifying the five different stages of damage and for relating the amount of damage at each stage to the overall behavior of the deteriorating structure. In GENOA-PFA, mathematical modeling of the composite physical behavior involves an integration of simulations at multiple, hierarchical scales ranging from the macroscopic (lamina, laminate, and structure) to the microscopic (fiber, matrix, and fiber/matrix interface), as shown in the figure. The code includes algorithms to simulate the progression of damage from various source defects, including (1) through-the-thickness cracks and (2) voids with edge, pocket, internal, or mixed-mode delaminations.
Progressive failure methodologies for predicting residual strength and life of laminated composites
NASA Technical Reports Server (NTRS)
Harris, Charles E.; Allen, David H.; Obrien, T. Kevin
1991-01-01
Two progressive failure methodologies currently under development by the Mechanics of Materials Branch at NASA Langley Research Center are discussed. The damage tolerance/fail safety methodology developed by O'Brien is an engineering approach to ensuring adequate durability and damage tolerance by treating only delamination onset and the subsequent delamination accumulation through the laminate thickness. The continuum damage model developed by Allen and Harris employs continuum damage laws to predict laminate strength and life. The philosophy, mechanics framework, and current implementation status of each methodology are presented.
Intema, Femke; Van Roermund, Peter M; Marijnissen, Anne C A; Cotofana, Sebastian; Eckstein, Felix; Castelein, Rene M; Bijlsma, Johannes W J; Mastbergen, Simon C; Lafeber, Floris P J G
2011-01-01
Background Modification of joint tissue damage is challenging in late-stage osteoarthritis (OA). Few options are available for treating end-stage knee OA other than joint replacement. Objectives To examine whether joint distraction can effectively modify knee joint tissue damage and has the potential to delay prosthesis surgery. Methods 20 patients (<60 years) with tibiofemoral OA were treated surgically using joint distraction. Distraction (∼5 mm) was applied for 2 months using an external fixation frame. Tissue structure modification at 1 year of follow-up was evaluated radiographically (joint space width (JSW)), by MRI (segmentation of cartilage morphology) and by biochemical markers of collagen type II turnover, with operators blinded to time points. Clinical improvement was evaluated by Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) and Visual Analogue Scale (VAS) pain score. Results Radiography demonstrated an increase in mean and minimum JSW (2.7 to 3.6 mm and 1.0 to 1.9 mm; p<0.05 and <0.01). MRI revealed an increase in cartilage thickness (2.4 to 3.0 mm; p<0.001) and a decrease of denuded bone areas (22% to 5%; p<0.001). Collagen type II levels showed a trend towards increased synthesis (+103%; p<0.06) and decreased breakdown (−11%; p<0.08). The WOMAC index increased from 45 to 77 points, and VAS pain decreased from 73 to 31 mm (both p<0.001). Conclusions Joint distraction can induce tissue structure modification in knee OA and could result in clinical benefit. No current treatment is able to induce such changes. Larger, longer and randomised studies on joint distraction are warranted. PMID:21565898
Progressive Fracture of Laminated Fiber-Reinforced Composite Stiffened Plate Under Pressure
NASA Technical Reports Server (NTRS)
Gotsis, Pascalis K.; Abdi, Frank; Chamis, Christos C.; Tsouros, Konstantinos
2007-01-01
S-Glass/epoxy laminated fiber-reinforced composite stiffened plate structure with laminate configuration (0/90)5 was simulated to investigate damage and fracture progression, under uniform pressure. For comparison reasons a simple plate was examined, in addition with the stiffened plate. An integrated computer code was used for the simulation. The damage initiation began with matrix failure in tension, continuous with damage and/or fracture progression as a result of additional matrix failure and fiber fracture and followed by additional interply delamination. Fracture through the thickness began when the damage accumulation was 90%. After that stage, the cracks propagate rapidly and the structures collapse. The collapse load for the simple plate is 21.57 MPa (3120 psi) and for the stiffened plate 25.24 MPa (3660 psi).
An Enriched Shell Finite Element for Progressive Damage Simulation in Composite Laminates
NASA Technical Reports Server (NTRS)
McElroy, Mark W.
2016-01-01
A formulation is presented for an enriched shell nite element capable of progressive damage simulation in composite laminates. The element uses a discrete adaptive splitting approach for damage representation that allows for a straightforward model creation procedure based on an initially low delity mesh. The enriched element is veri ed for Mode I, Mode II, and mixed Mode I/II delamination simulation using numerical benchmark data. Experimental validation is performed using test data from a delamination-migration experiment. Good correlation was found between the enriched shell element model results and the numerical and experimental data sets. The work presented in this paper is meant to serve as a rst milestone in the enriched element's development with an ultimate goal of simulating three-dimensional progressive damage processes in multidirectional laminates.
Cervical spondylosis anatomy: pathophysiology and biomechanics.
Shedid, Daniel; Benzel, Edward C
2007-01-01
Cervical spondylosis is the most common progressive disorder in the aging cervical spine. It results from the process of degeneration of the intervertebral discs and facet joints of the cervical spine. Biomechanically, the disc and the facets are the connecting structures between the vertebrae for the transmission of external forces. They also facilitate cervical spine mobility. Symptoms related to myelopathy and radiculopathy are caused by the formation of osteophytes, which compromise the diameter of the spinal canal. This compromise may also be partially developmental. The developmental process, together with the degenerative process, may cause mechanical pressure on the spinal cord at one or multiple levels. This pressure may produce direct neurological damage or ischemic changes and, thus, lead to spinal cord disturbances. A thorough understanding of the biomechanics, the pathology, the clinical presentation, the radiological evaluation, as well as the surgical indications of cervical spondylosis, is essential for the management of patients with cervical spondylosis.
Mesenchymal stem-cell potential in cartilage repair: an update
Mazor, M; Lespessailles, E; Coursier, R; Daniellou, R; Best, T M; Toumi, H
2014-01-01
Articular cartilage damage and subsequent degeneration are a frequent occurrence in synovial joints. Treatment of these lesions is a challenge because this tissue is incapable of quality repair and/or regeneration to its native state. Non-operative treatments endeavour to control symptoms and include anti-inflammatory medications, viscosupplementation, bracing, orthotics and activity modification. Classical surgical techniques for articular cartilage lesions are frequently insufficient in restoring normal anatomy and function and in many cases, it has not been possible to achieve the desired results. Consequently, researchers and clinicians are focusing on alternative methods for cartilage preservation and repair. Recently, cell-based therapy has become a key focus of tissue engineering research to achieve functional replacement of articular cartilage. The present manuscript is a brief review of stem cells and their potential in the treatment of early OA (i.e. articular cartilage pathology) and recent progress in the field. PMID:25353372
An Orthopedic Perspective. Does Running Cause Osteoarthritis?
ERIC Educational Resources Information Center
Pascale, Mark; Grana, William A.
1989-01-01
Discusses the development of osteoarthritis and whether running and other impact loading sports promote it. Although these sports do not cause arthritis in normal weight bearing limbs, they can accelerate it in damaged joints. It is important to identify people with preeexisting joint disease so they can choose nonimpact-loading aerobic exercise.…
A Dual Role for NOTCH Signaling in Joint Cartilage Maintenance and Osteoarthritis
Liu, Zhaoyang; Chen, Jianquan; Mirando, Anthony; Wang, Cuicui; Zuscik, Michael J.; O’Keefe, Regis J.; Hilton, Matthew J.
2015-01-01
Loss of NOTCH signaling in postnatal murine joints results in osteoarthritis (OA), indicating a requirement for NOTCH during joint cartilage maintenance. Unexpectedly, NOTCH components are significantly up-regulated in human and murine post-traumatic OA, suggesting either a reparative or pathological role for NOTCH activation in OA. Here we investigated the potential dual role for NOTCH in joint maintenance and OA by generating two mouse models overexpressing the NOTCH1 intracellular domain within postnatal joint cartilage; one with sustained NOTCH activation that likely resembles pathological NOTCH signaling and one with transient NOTCH activation that more closely reflects physiological NOTCH signaling. Sustained NOTCH signaling in joint cartilage leads to an early and progressive OA pathology, while on the contrary, transient NOTCH activation enhances cartilage matrix synthesis and promotes joint maintenance under normal physiological conditions. Using RNA-seq, immunohistochemical, and biochemical approaches we identified several novel targets potentially responsible for NOTCH-mediated cartilage degradation, fibrosis, and OA progression, including components of the IL6/STAT3 and ERK/p38 MAPK pathways; factors that may also contribute to post-traumatic OA development. Collectively, these data demonstrate a dual role for the NOTCH pathway in joint cartilage and identify important downstream NOTCH effectors as potential targets for disease modifying osteoarthritis drugs (DMOADs). PMID:26198357
McCann, Matthew R; Veras, Matthew A; Yeung, Cynthia; Lalli, Gurkeet; Patel, Priya; Leitch, Kristyn M; Holdsworth, David W; Dixon, S Jeffrey; Séguin, Cheryle A
2017-05-01
Whole-body vibration (WBV) is a popular fitness trend based on claims of increased muscle mass, weight loss and reduced joint pain. Following its original implementation as a treatment to increase bone mass in patients with osteoporosis, WBV has been incorporated into clinical practice for musculoskeletal disorders, including back pain. However, our recent studies revealed damaging effects of WBV on joint health in a murine model. In this report, we examined potential mechanisms underlying disc degeneration following exposure of mice to WBV. Ten-week-old male mice were exposed to WBV (45 Hz, 0.3 g peak acceleration, 30 min/day, 5 days/week) for 4 weeks, 8 weeks, or 4 weeks WBV followed by 4 weeks recovery. Micro-computed tomography (micro-CT), histological, and gene expression analyses were used to assess the effects of WBV on spinal tissues. Exposure of mice to 4 or 8 weeks of WBV did not alter total body composition or induce significant changes in vertebral bone density. On the other hand, WBV-induced intervertebral disc (IVD) degeneration, associated with decreased disc height and degenerative changes in the annulus fibrosus (AF) that did not recover within 4 weeks after cessation of WBV. Gene expression analysis showed that WBV for 8 weeks induced expression of Mmp3, Mmp13, and Adamts5 in IVD tissues, changes preceded by increased expression of Il-1β. Progressive IVD degeneration induced by WBV was associated with increased expression of Il-1β within the IVD that preceded Mmp and Adamts gene induction. Moreover, WBV-induced IVD degeneration is not reversed following cessation of vibration. Copyright © 2017 Osteoarthritis Research Society International. Published by Elsevier Ltd. All rights reserved.
Baseline 24-2 Central Visual Field Damage Is Predictive of Global Progressive Field Loss.
Garg, Aakriti; De Moraes, C Gustavo; Cioffi, George A; Girkin, Christopher A; Medeiros, Felipe A; Weinreb, Robert N; Zangwill, Linda M; Liebmann, Jeffrey M
2018-03-01
Central visual field (VF) damage in glaucoma patients can significantly hinder daily activities. The present study investigates whether the presence of localized baseline damage to the central 10 degrees of the VF is predictive of faster global mean deviation (MD) progression. Prospective cohort study. Eyes from the multicenter African Descent and Glaucoma Evaluation Study (ADAGES) with established glaucoma and VF loss and a minimum of 5 24-2 VFs were eligible. Baseline central 24-2 damage was defined as any of the 12 central-most points with total deviation (TD) values at P < 0.5% on 2 consecutive examinations. Progression was determined using trend-based and event-based criteria: (1) rates of MD change significantly faster than zero and (2) >-5 dB MD loss over the entire follow-up. A total of 827 eyes of 584 patients were studied. Mean rate of MD change of the entire sample was -0.15 dB/year (95% CI: -0.19 to -0.12, P < .001). Eyes with baseline central damage progressed faster than those without (difference: β central = -0.07 dB/year, 95% CI: -0.11 to -0.01, P = .011) and were more likely to experience MD loss greater than 5 dB (hazard ratio = 3.0 [95% CI: 2.1-4.1, P < .001]). These differences remained significant after adjusting for confounders. The presence of central VF damage at baseline is significantly associated with more rapid global progression. Detection of central VF damage aids in stratification of high-risk patients who may need intensive surveillance and aggressive treatment. Copyright © 2018 Elsevier Inc. All rights reserved.
Characterizing flow pathways in a sandstone aquifer at multiple depths
NASA Astrophysics Data System (ADS)
Medici, Giacomo; West, Jared; Mountney, Nigel
2017-04-01
Sandstone aquifers are commonly assumed to represent porous media characterized by a permeable matrix. However, such aquifers may be heavily fractured where rock properties and timing of deformation favour brittle failure and crack opening. In many aquifer types, fractures associated with faults, bedding planes and stratabound joints represent preferential pathways for fluids and contaminants. This presentation reports well-test results and outcrop-scale studies that reveal how strongly lithified siliciclastic rocks may be entirely dominated by fracture flow at shallow depths (≤ 150 m), similar to limestone and crystalline aquifers. The Triassic St Bees Sandstone Formation of the UK East Irish Sea Basin represents an optimum succession for study of the influence of both sedimentary and tectonic aquifer heterogeneities in a strongly lithified sandstone aquifer-type. This sedimentary succession of fluvial origin accumulated in rapidly subsiding basins, which typically favour preservation of complete depositional cycles, including fine-grained mudstone and silty sandstone layers of floodplain origin interbedded with sandstone-dominated fluvial channel deposits. Vertical joints in the St Bees Sandstone Formation form a pervasive stratabound system whereby joints terminate at bedding-parallel discontinuities. Additionally, normal faults are present through the succession and record development of open-fractures in their damage zones. Here, the shallow aquifer (depth ≤150 m BGL) was characterized in outcrop and well tests. Fluid temperature, conductivity and flow-velocity logs record inflows and outflows from normal faults, as well as from pervasive bed-parallel fractures. Quantitative flow logging analyses in boreholes that cut fault planes indicate that zones of fault-related open fractures typically represent ˜ 50% of well transmissivity. The remaining flow component is dominated by bed-parallel fractures. However, such sub-horizontal fractures become the principal flow conduits in wells that penetrate the exterior parts of fault damage zones, as well as in non-faulted areas. Optical televiewer logs show development of karst-like conduits in correspondence of bedding fractures and faults up to 150 m below the ground surface, where recharge water containing dissolved carbonic acid enlarges fractures; these features may be responsible for the relatively high field-scale permeability (K˜0.1-1 m/day) of the phreatic zone at these depths. Below this 'karstifed' zone, field-scale permeability progressively decreases from K˜10-2 to 10-4 m/day from 150 m to 1100 m depth. Notably, differences between plug and field-scale permeability, and frequency of well in-flows seen in temperature and conductivity logs, also decrease between intermediate (150 to 450 m) and elevated (450 to 1100 m) depths. This confirms how fracture closure leads to a progressively more important matrix contribution to flow with increasing lithostatic stress, leading to intergranular flow dominance at ˜ 1 km depth.
Moon, Su-Jin; Park, Jin-Sil; Jeong, Jeong-Hee; Yang, Eun-Ji; Park, Mi-Kyung; Kim, Eun-Kyung; Park, Sung-Hwan; Kim, Ho-Youn; Cho, Mi-La; Min, Jun-Ki
2013-01-01
Osteoarthritis (OA) is a degenerative joint disease characterized by the progressive loss of articular cartilage and chronic pain. Although cyclooxygenase-2 (COX-2) inhibitors such as celecoxib are recommended to patients at high risk of gastrointestinal (GI) adverse events, COX-2 inhibitors do not completely prevent GI adverse events. Rebamipide, a gastroprotective agent, has anti-inflammatory properties and acts as an oxygen radical scavenger. The aim of this study was to investigate the in vivo effects of coadministration of rebamipide and celecoxib in an OA rat model. OA was induced by intra-articular injection of monosodium iodoacetate. Oral administration of rebamipide was initiated on the day of OA induction. In this study, rebamipide showed antinociceptive properties and attenuated cartilage degeneration. Rebamipide reduced the expression of matrix metalloproteinase 13, interleukin-1β, inducible nitric oxide synthase, and nitrotyrosine in OA cartilage. OA rats treated with celecoxib in combination with rebamipide demonstrated a higher pain threshold than those treated with monotherapy. Histological examination also showed that the joints from OA animals treated with combination therapy demonstrated less cartilage damage than those of animals treated with monotherapy. We showed that the potential benefit of combination therapy with celecoxib and rebamipide on pain and cartilage degeneration in OA.
Startzman, Ashley; Collins, Devin; Carreira, Dominic
2016-11-01
Benign synovial diseases of the hip including Synovial Chondromatosis (SC) and Pigmented Villonodular Synovitis (PVNS) are devastating diseases. Initially, patients present with hip pain unrelieved by conservative measures. The diagnosis of PVNS and SC are often delayed, leading to progression of joint damage. The purpose of this review is to present the latest on the diagnosis, management, and prognosis of SC and PVNS of the hip. An extensive systematic search of MEDLINE and PUBMED Databases was performed. Data parameters were set from 2005 to present day with set inclusion criteria. Systematic reviews were excluded. 427 abstracts were identified, with 12 articles meeting all inclusion criteria. Eight studies focused on SC, and 5 on PVNS. 233 patients with SC of the hip and 98 patients with PVNS of the hip were identified, a total of 331 patients. Benign Synovial disorders of the hip are rare. In patients with chronic hip pain secondary to benign synovial disorders, early diagnosis and surgical intervention demonstrate good outcomes, and patients may benefit due to prevention of morbidity from further joint destruction. There is no clear consensus between higher successes through open versus arthroscopic surgical debridement. In the final phase of benign synovial disorders of the hip, THA of different types based on the patient's age should be considered.
Wu, Vincent W C; Lam, Ying-Na
2016-06-01
Nasopharyngeal carcinoma (NPC) is endemic in southern China, and its incidence in Hong Kong is relatively high. Radiotherapy is the mainstay treatment for NPC due to its relatively high radiosensitivity and deep-seated anatomical position, which is not readily accessible by surgery. Although the technique of radiotherapy in NPC has been advancing and offers promising treatment outcome, complications around the irradiation areas are inevitable and the quality of life of the post-radiotherapy patients is often compromised. Trismus, which is defined as the restricted mouth opening or jaw movement due to the disorder of temporo-mandibular joint (TMJ), is one of the possible late complications for radiotherapy of NPC and is found in 5-17% of the post-radiotherapy (post-RT) patients. Trismus at early stage may only affect the speech, but in severe cases nutritional intake and oral hygiene condition may deteriorate seriously. This article reviewed the possible causes of radiation-induced TMJ damage, the various assessments including imaging modalities and possible treatments. The conclusion is that the availability of simple, yet effective examinations for trismus is essential for delaying the progression and restoring TMJ functions. Although there is no absolutely effective treatment for trismus, many supportive, restorative and palliative management are possible under different clinical situations.
NASA Technical Reports Server (NTRS)
Sanchez, Christopher M.
2011-01-01
NASA White Sands Test Facility (WSTF) is leading an evaluation effort in advanced destructive and nondestructive testing of composite pressure vessels and structures. WSTF is using progressive finite element analysis methods for test design and for confirmation of composite pressure vessel performance. Using composite finite element analysis models and failure theories tested in the World-Wide Failure Exercise, WSTF is able to estimate the static strength of composite pressure vessels. Additionally, test and evaluation on composites that have been impact damaged is in progress so that models can be developed to estimate damage tolerance and the degradation in static strength.
Fatigue damage assessment of high-usage in-service aircraft fuselage structure
NASA Astrophysics Data System (ADS)
Mosinyi, Bao Rasebolai
As the commercial and military aircraft fleets continue to age, there is a growing concern that multiple-site damage (MSD) can compromise structural integrity. Multiple site damage is the simultaneous occurrence of many small cracks at independent structural locations, and is the natural result of fatigue, corrosion, fretting and other possible damage mechanisms. These MSD cracks may linkup and form a fatigue lead crack of critical length. The presence of MSD also reduces the structure's ability to withstand longer cracks. The objective of the current study is to assess, both experimentally and analytically, MSD formation and growth in the lap joint of curved panels removed from a retired aircraft. A Boeing 727-232 airplane owned and operated by Delta Air Lines, and retired at its design service goal, was selected for the study. Two panels removed from the left-hand side of the fuselage crown, near stringer 4L, were subjected to extended fatigue testing using the Full-Scale Aircraft Structural Test Evaluation and Research (FASTER) facility located at the Federal Aviation Administration (FAA) William J. Hughes Technical Center. The state of MSD was continuously assessed using several nondestructive inspection (NDI) methods. Damage to the load attachment points of the first panel resulted in termination of the fatigue test at 43,500 fatigue cycles, before cracks had developed in the lap joint. The fatigue test for the second panel was initially conducted under simulated in-service loading conditions for 120,000 cycles, and no cracks were detected in the skin of the panel test section. Artificial damage was then introduced into the panel at selected rivets in the critical (lower) rivet row, and the fatigue loads were increased. Visually detectable crack growth from the artificial notches was first seen after 133,000 cycles. The resulting lead crack grew along the lower rivet row, eventually forming an 11.8" long unstable crack after 141,771 cycles, at which point the test was terminated. Posttest fractograpic examinations of the crack surfaces were conducted, revealing the presence of subsurface MSD at the critical rivet row of the lap joint. Special attention was also given to the stringer clips that attach the fuselage frames to the stringers, since they also experienced cracking during the fatigue tests. The performance of the different conventional and emerging NDI methods was also assessed, and some of the emerging NDI methods were quite effective in detecting and measuring the length of subsurface cracks. Delta Air Lines conducted a separate destructive investigation on the state of damage along the right-hand side of the fuselage, near stringer 4R. A comparison of these two studies showed that the lap joint on the left hand-side of the aircraft, along stringer 4L, had better fatigue life than the one on the opposite side, along stringer 4R. The cause of the difference in fatigue life was investigated by close examination of the rivet installation qualities, and was found to be a result of better rivet installation along the lap joint at stringer 4L. Finite element models for both the skin and substructures of the panels were developed and geometrically nonlinear finite element analyses were conducted to verify the loading conditions and to determine near-field parameters governing MSD initiation and growth. Fatigue crack growth predictions based on the NASGRO equation were in good agreement with the experimental crack growth data for through-the-thickness cracks. For subsurface cracks, simulation of crack growth was found to correlate better with fractography data when an empirical crack growth model was used. The results of the study contribute to the understanding of the initiation and growth of MSD in the inner skin layer of a lap joint, and provide valuable data for the evaluation and validation of analytical methodologies to predict MSD initiation and growth and a better understanding on the effect of manufacturing quality on damage accumulation along the lap joint.
[Meniscal lesion. A pre-osteoarthritic condition of the knee joint].
Goebel, L; Reinhard, J; Madry, H
2017-10-01
A close relationship between meniscal damage and articular cartilage exist. Likewise, (partial) meniscectomy may lead to the development of osteoarthritis (OA). With a special emphasis on therapeutic consequences for orthopaedic surgeons, the structural and functional relationship between meniscal tears/extrusion and cartilage loss, and/or the effect of meniscectomy or meniscal repair on the development of OA, are emphasized. A selective literature review with implementation of own research findings. The close topographical and functional interplay between the menisci and the tibiofemoral cartilage is the basis for the clinically important relationship between meniscal damage and cartilage degeneration. In particular, due to its close connection to tibiofemoral OA, a degenerative meniscal lesion represents a pre-osteoarthritic condition. Meniscus extrusion is also often associated with tibiofemoral OA. Even large cartilage defects can cause meniscus lesions. Partial meniscectomy is strongly associated with the incidence and risk of progression of OA. Clinical results are particularly problematic after partial resection of the lateral meniscus. Although the use of arthroscopic partial resection for degenerative meniscal lesions has been controversially discussed, no long-term studies are available. A large number of studies emphasize the medium-term value of meniscus reconstruction compared to partial meniscus resection. Combined meniscus and cartilage damage are complex cases, and the value of a simultaneous therapy remains unclear. Preserving the meniscus is the first step towards cartilage repair. Randomized and controlled studies will provide better information on the long-term outcomes of meniscal resection and repair with regard to OA development.
Singh, Namrata; Vogelgesang, Scott A
2017-05-01
Monoarticular arthritis is inflammation characterized by joint pain, swelling, and sometimes periarticular erythema. Although chronic causes are seen, the onset is often acute. An infected joint can quickly lead to permanent damage, making it a medical emergency. However, acute gout presenting as monoarticular arthritis is often so uncomfortable it requires urgent attention. Monoarticular crystalline arthritis is common and a septic joint is a medical emergency so it is no surprise that these diagnoses come to mind with complaint of inflammation in 1 joint. However, there are many causes of monoarticular arthritis that clinicians must consider. Copyright © 2016 Elsevier Inc. All rights reserved.
The role of knee alignment in disease progression and functional decline in knee osteoarthritis.
Sharma, L; Song, J; Felson, D T; Cahue, S; Shamiyeh, E; Dunlop, D D
2001-07-11
Knee osteoarthritis (OA) is a leading cause of disability in older persons. Few risk factors for disease progression or functional decline have been identified. Hip-knee-ankle alignment influences load distribution at the knee; varus and valgus alignment increase medial and lateral load, respectively. To test the hypotheses that (1) varus alignment increases risk of medial knee OA progression during the subsequent 18 months, (2) valgus alignment increases risk of subsequent lateral knee OA progression, (3) greater severity of malalignment is associated with greater subsequent loss of joint space, and (4) greater burden of malalignment is associated with greater subsequent decline in physical function. Prospective longitudinal cohort study conducted March 1997 to March 2000 at an academic medical center in Chicago, Ill. A total of 237 persons recruited from the community with primary knee OA, defined by presence of definite tibiofemoral osteophytes and at least some difficulty with knee-requiring activity; 230 (97%) completed the study. Progression of OA, defined as a 1-grade increase in severity of joint space narrowing on semiflexed, fluoroscopically confirmed knee radiographs; change in narrowest joint space width; and change in physical function between baseline and 18 months, compared by knee alignment at baseline. Varus alignment at baseline was associated with a 4-fold increase in the odds of medial progression, adjusting for age, sex, and body mass index (adjusted odds ratio [OR], 4.09; 95% confidence interval [CI], 2.20-7.62). Valgus alignment at baseline was associated with a nearly 5-fold increase in the odds of lateral progression (adjusted OR, 4.89; 95% CI, 2.13-11.20). Severity of varus correlated with greater medial joint space loss during the subsequent 18 months (R = 0.52; 95% CI, 0.40-0.62 in dominant knees), and severity of valgus correlated with greater subsequent lateral joint space loss (R = 0.35; 95% CI, 0.21-0.47 in dominant knees). Having alignment of more than 5 degrees (in either direction) in both knees at baseline was associated with significantly greater functional deterioration during the 18 months than having alignment of 5 degrees or less in both knees, after adjusting for age, sex, body mass index, and pain. This is, to our knowledge, the first demonstration that in primary knee OA varus alignment increases risk of medial OA progression, that valgus alignment increases risk of lateral OA progression, that burden of malalignment predicts decline in physical function, and that these effects can be detected after as little as 18 months of observation.
... Progress, June 2016 issue, explores The Joint Commission’s internal Robust Process Improvement ® program. Read the ... cry for improving our services. It has provided a pulpit from which we structure quality and safety activities and get buy-in from ...
NASA Technical Reports Server (NTRS)
Slater, Richard
1996-01-01
A joint U.S./Russian film test was conducted during MIR Mission 18 to evaluate the effects of radiation on photographic film during long-duration space flights. Two duplicate sets of film were flown on this MIR mission: one set was processed and evaluated by the NASA/JSC Photographic Laboratory, and the other by the RKK Energia's Photographic Laboratory in Moscow. This preliminary report includes only the results of the JSC evaluation (excluding the SN-10 film which was not available for evaluation at the time this report was written). The final report will include an evaluation by JSC of the SN-10 film and an evaluation of the test data by the RKK Energia. ISC's evaluation of the test data showed the positive film flown was damaged very little when exposed to approximately 8 rads of radiation. Two of the three negative films were significantly damaged and the third film was damaged only moderately.
DOE Office of Scientific and Technical Information (OSTI.GOV)
Slater, R.
1996-04-01
A joint U.S./Russian film test was conducted during MIR Mission 18 to evaluate the effects of radiation on photographic film during long-duration space flights. Two duplicate sets of film were flown on this MIR mission: one set was processed and evaluated by the NASA/JSC Photographic Laboratory, and the other by the RKK Energia`s Photographic Laboratory in Moscow. This preliminary report includes only the results of the JSC evaluation (excluding the SN-10 film which was not available for evaluation at the time this report was written). The final report will include an evaluation by JSC of the SN-10 film and anmore » evaluation of the test data by the RKK Energia. ISC`s evaluation of the test data showed the positive film flown was damaged very little when exposed to approximately 8 rads of radiation. Two of the three negative films were significantly damaged and the third film was damaged only moderately.« less
Micromechanics Modeling of Composites Subjected to Multiaxial Progressive Damage in the Constituents
NASA Technical Reports Server (NTRS)
Bednarcyk, Brett A.; Aboudi, Jacob; Amold, Steven M.
2010-01-01
The high-fidelity generalized method of cells composite micromechanics model is extended to include constituent-scale progressive damage via a proposed damage model. The damage model assumes that all material nonlinearity is due to damage in the form of reduced stiffness, and it uses six scalar damage variables (three for tension and three for compression) to track the damage. Damage strains are introduced that account for interaction among the strain components and that also allow the development of the damage evolution equations based on the constituent material uniaxial stress strain response. Local final-failure criteria are also proposed based on mode-specific strain energy release rates and total dissipated strain energy. The coupled micromechanics-damage model described herein is applied to a unidirectional E-glass/epoxy composite and a proprietary polymer matrix composite. Results illustrate the capability of the coupled model to capture the vastly different character of the monolithic (neat) resin matrix and the composite in response to far-field tension, compression, and shear loading.
Radiologic changes of ankle joint after total knee arthroplasty.
Lee, Jung Hee; Jeong, Bi O
2012-12-01
The authors noticed that ankle joint osteoarthritis was not uncommon when lower extremity malalignment, such as a knee varus deformity, was present as a result of severe osteoarthritis of the knee. The purpose of this study was to analyze radiologic changes of the ankle joint after total knee arthroplasty. This study included 142 cases in 110 patients who underwent total knee arthroplasty and were followed for at least 3 years. The varus knee group included 128 cases and the valgus knee group included 14 cases. On anteroposterior standing lower extremity radiographs, varus and valgus angles of the knee were measured preoperatively and at the last follow-up. The angle between the ground surface and the distal tibial plafond as well as the upper talus was also measured. In addition, tibial anterior surface angle, talar tilt, space between the medial malleolar distal tip and the medial articular surface of the talus, and medial tibiotalar joint space of the ankle joint were measured. Out of 142 cases, 50 (35.2%) had arthritis in the ankle before total knee arthroplasty and 31 (21.8%) had newly developed or progressive arthritis after surgery. In particular, the varus knee group demonstrated statistically significant differences in preoperative varus deformity, preoperative talar tilt, and postoperative correction angle between the cases that developed or had progressive arthritis and those that did not show any changes (p < .05). After total knee arthroplasty, arthritis developed or progressed in the ankle of many cases radiographically. In particular, when the preoperative talar tilt increased medial to the ankle or the postoperative correction angle was large, the incidence of arthritis in the ankle joint increased. The authors recommend more cautious follow-up on the symptoms of the ankle joint after total knee arthroplasty.
Osteoligamentous injuries of the medial ankle joint.
Lötscher, P; Lang, T H; Zwicky, L; Hintermann, B; Knupp, M
2015-12-01
Injuries of the ankle joint have a high incidence in daily life and sports, thus, playing an important socioeconomic role. Therefore, proper diagnosis and adequate treatment are mandatory. While most of the ligament injuries around the ankle joint are treated conservatively, great controversy exists on how to treat deltoid ligament injuries in ankle fractures. Missed injuries and inadequate treatment of the medial ankle lead to inferior outcome with instability, progressive deformity, and ankle joint osteoarthritis.
Blom, M; Creemers, M C W; Kievit, W; Lemmens, J A M; van Riel, P L C M
2013-01-01
To investigate the prevalence of cervical spine damage due to rheumatoid arthritis (RA) in the long term and to investigate which disease-specific factors are related to this damage. Patients with early RA from the Nijmegen inception cohort with 6 to 12 years of follow-up were included. Conventional radiographs of the cervical spine were obtained at baseline, 3, 6, 9, and 12 years and scored for erosions of C1 and C2, anterior atlantoaxial subluxation (AAS) and atlantoaxial impaction (AAI). Disease-specific factors, such as disease activity, functionality, and peripheral joint damage, at baseline, 3, 6, and 9 years, were compared between patients with and without cervical spine damage at 9 years. A total of 196 patients were included, of whom 134 had radiographs at 9 years. Cervical spine damage was present in 16% (22/134) of the patients at 9 years. During the total 12 years of follow-up, AAS and erosions of C2 were observed most frequently. Erosions of C1 and AAI were very rare. Patients with cervical spine damage at 9 years had a higher number of erosions of the peripheral joints and failed more disease-modifying anti-rheumatic drugs (DMARDs) at 3, 6, and 9 years. Patients without peripheral erosive disease at 3 years were unlikely to develop cervical spine damage within 9 years of disease duration. The prevalence of cervical spine damage due to RA was 16% at 9 years. Patients without peripheral erosive disease at 3 years were unlikely to develop cervical spine damage at 9 years.
Amanatullah, D F; Masini, M A; Roger, D J; Pagnano, M W
2016-08-01
We wished to quantify the extent of soft-tissue damage sustained during minimally invasive total hip arthroplasty through the direct anterior (DA) and direct superior (DS) approaches. In eight cadavers, the DA approach was performed on one side, and the DS approach on the other, a single brand of uncemented hip prosthesis was implanted by two surgeons, considered expert in their surgical approaches. Subsequent reflection of the gluteus maximus allowed the extent of muscle and tendon damage to be measured and the percentage damage to each anatomical structure to be calculated. The DA approach caused substantially greater damage to the gluteus minimus muscle and tendon when compared with the DS approach (t-test, p = 0.049 and 0.003, respectively). The tensor fascia lata and rectus femoris muscles were damaged only in the DA approach. There was no difference in the amount of damage to the gluteus medius muscle and tendon, piriformis tendon, obturator internus tendon, obturator externus tendon or quadratus femoris muscle between approaches. The posterior soft-tissue releases of the DA approach damaged the gluteus minimus muscle and tendon, piriformis tendon and obturator internus tendon. The DS approach caused less soft-tissue damage than the DA approach. However the clinical relevance is unknown. Further clinical outcome studies, radiographic evaluation of component position, gait analyses and serum biomarker levels are necessary to evaluate and corroborate the safety and efficacy of the DS approach. Cite this article: Bone Joint J 2016;98-B1036-42. ©2016 The British Editorial Society of Bone & Joint Surgery.
Wang, Dan Min; Lin, Ling; Peng, Jian Hua; Gong, Yao; Hou, Zhi Duo; Chen, Su Biao; Xiao, Zheng Yu
2018-06-08
The pathogenesis of sacroiliitis is unclear; therefore, we aimed to systematically study the immunopathology of sacroiliitis in patients with axial spondyloarthritis (axSpA), and explore the relationship between pannus formation, inflammation, and the structural damage caused by sacroiliitis. Fine needle aspiration biopsy of the sacroiliac joint (SIJ) was performed in 193 patients with axSpA. Clinical, laboratory, and imaging data were collected at baseline and during the follow up. Immunohistochemistry analysis was performed to detect CD34+ microvessels, CD68+ osteoclasts/macrophages, vascular endothelial growth factor (VEGF), metalloproteinase-3 (MMP-3), tumor necrosis factor-α (TNF-α), and caspase-3. Autopsy subjects were used as controls. In early sacroiliitis (grade 0-1) all pathological features could be observed, with the most common being subchondral pannus formation. Among the 193 patients, 98 were followed up for 1-13 years (mean 3.6 years); 63.3% had radiological progression at the endpoint. Multiple regression analysis showed that cartilage pannus invasion (OR 2.99, P = 0.010) and endochondral ossification (OR 3.97, P = 0.049) at baseline were risk factors for radiological structural damage. Compared to SIJ controls, the subchondral microvessel density, number of CD68+ multinuclear osteoclasts, and the levels of VEGF, caspase-3, MMP-3, and TNF-α expressed at the interface of the bone and cartilage were significantly higher in patients with sacroiliitis. Subchondral fibrovascular tissue formation is the most important pathological feature in early sacroiliitis. The existence of cartilage pannus invasion or endochondral ossification at baseline can predict radiological structural damage during the follow up.
Computational Simulation of Composite Structural Fatigue
NASA Technical Reports Server (NTRS)
Minnetyan, Levon; Chamis, Christos C. (Technical Monitor)
2005-01-01
Progressive damage and fracture of composite structures subjected to monotonically increasing static, tension-tension cyclic, pressurization, and flexural cyclic loading are evaluated via computational simulation. Constituent material properties, stress and strain limits are scaled up to the structure level to evaluate the overall damage and fracture propagation for composites. Damage initiation, growth, accumulation, and propagation to fracture due to monotonically increasing static and cyclic loads are included in the simulations. Results show the number of cycles to failure at different temperatures and the damage progression sequence during different degradation stages. A procedure is outlined for use of computational simulation data in the assessment of damage tolerance, determination of sensitive parameters affecting fracture, and interpretation of results with insight for design decisions.
Computational Simulation of Composite Structural Fatigue
NASA Technical Reports Server (NTRS)
Minnetyan, Levon
2004-01-01
Progressive damage and fracture of composite structures subjected to monotonically increasing static, tension-tension cyclic, pressurization, and flexural cyclic loading are evaluated via computational simulation. Constituent material properties, stress and strain limits are scaled up to the structure level to evaluate the overall damage and fracture propagation for composites. Damage initiation, growth, accumulation, and propagation to fracture due to monotonically increasing static and cyclic loads are included in the simulations. Results show the number of cycles to failure at different temperatures and the damage progression sequence during different degradation stages. A procedure is outlined for use of computational simulation data in the assessment of damage tolerance, determination of sensitive parameters affecting fracture, and interpretation of results with insight for design decisions.
NASA Technical Reports Server (NTRS)
Waller, Jess M.; Saulsberry, Regor L.
2009-01-01
This project is a subtask of a multi-center project to advance the state-of-the-art by developing NDE techniques that are capable of evaluating stress rupture (SR) degradation in Kevlar/epoxy (K/Ep) composite overwrapped pressure vessels (COPVs), and damage progression in carbon/epoxy (C/Ep) COPVs. In this subtask, acoustic emission (AE) data acquired during intermittent load hold tensile testing of K/Ep and C/Ep composite tow materials-of-construction used in COPV fabrication were analyzed to monitor progressive damage during the approach to tensile failure. Insight into the progressive damage of composite tow was gained by monitoring AE event rate, energy, source location, and frequency. Source location based on arrival time data was used to discern between significant AE attributable to microstructural damage and spurious AE attributable to background and grip noise. One of the significant findings was the observation of increasing violation of the Kaiser effect (Felicity ratio < 1.0) with damage accumulation.
A thermodynamic approach to nonlinear ultrasonics for material state awareness and prognosis
NASA Astrophysics Data System (ADS)
Chillara, Vamshi Krishna
2017-11-01
We develop a thermodynamic framework for modeling nonlinear ultrasonic damage sensing and prognosis in materials undergoing progressive damage. The framework is based on the internal variable approach and relies on the construction of a pseudo-elastic strain energy function that captures the energetics associated with the damage progression. The pseudo-elastic strain energy function is composed of two energy functions—one that describes how a material stores energy in an elastic fashion and the other describes how material dissipates energy or stores it in an inelastic fashion. Experimental motivation for the choice of the above two functionals is discussed and some specific choices pertaining to damage progression during fatigue and creep are presented. The thermodynamic framework is employed to model the nonlinear response of material undergoing stress relaxation and creep-like degradation. For each of the above cases, evolution of the nonlinearity parameter with damage as well as with macroscopic measurables like accumulated plastic strain is obtained.
Improvement of Progressive Damage Model to Predicting Crashworthy Composite Corrugated Plate
NASA Astrophysics Data System (ADS)
Ren, Yiru; Jiang, Hongyong; Ji, Wenyuan; Zhang, Hanyu; Xiang, Jinwu; Yuan, Fuh-Gwo
2018-02-01
To predict the crashworthy composite corrugated plate, different single and stacked shell models are evaluated and compared, and a stacked shell progressive damage model combined with continuum damage mechanics is proposed and investigated. To simulate and predict the failure behavior, both of the intra- and inter- laminar failure behavior are considered. The tiebreak contact method, 1D spot weld element and cohesive element are adopted in stacked shell model, and a surface-based cohesive behavior is used to capture delamination in the proposed model. The impact load and failure behavior of purposed and conventional progressive damage models are demonstrated. Results show that the single shell could simulate the impact load curve without the delamination simulation ability. The general stacked shell model could simulate the interlaminar failure behavior. The improved stacked shell model with continuum damage mechanics and cohesive element not only agree well with the impact load, but also capture the fiber, matrix debonding, and interlaminar failure of composite structure.
2013-03-01
framework of orientation distribution functions and crack-induced texture o Quantify effects of temperature on damage behavior and damage monitoring...measurement model was obtained from hidden Markov modeling (HMM) of joint time-frequency (TF) features extracted from the PZT sensor signals using the...considered PZT sensor signals recorded from a bolted aluminum plate. About only 20% of the samples of a signal were first randomly selected as
Prediction of functional loss in glaucoma from progressive optic disc damage.
Medeiros, Felipe A; Alencar, Luciana M; Zangwill, Linda M; Bowd, Christopher; Sample, Pamela A; Weinreb, Robert N
2009-10-01
To evaluate the ability of progressive optic disc damage detected by assessment of longitudinal stereophotographs to predict future development of functional loss in those with suspected glaucoma. The study included 639 eyes of 407 patients with suspected glaucoma followed up for an average of 8.0 years with annual standard automated perimetry visual field and optic disc stereophotographs. All patients had normal and reliable standard automated perimetry results at baseline. Conversion to glaucoma was defined as development of 3 consecutive abnormal visual fields during follow-up. Presence of progressive optic disc damage was evaluated by grading longitudinally acquired simultaneous stereophotographs. Other predictive factors included age, intraocular pressure, central corneal thickness, pattern standard deviation, and baseline stereophotograph grading. Hazard ratios for predicting visual field loss were obtained by extended Cox models, with optic disc progression as a time-dependent covariate. Predictive accuracy was evaluated using a modified R(2) index. Progressive optic disc damage had a hazard ratio of 25.8 (95% confidence interval, 16.0-41.7) and was the most important risk factor for development of visual field loss with an R(2) of 79%. The R(2)s for other predictive factors ranged from 6% to 26%. Presence of progressive optic disc damage on stereophotographs was a highly predictive factor for future development of functional loss in glaucoma. These findings suggest the importance of careful monitoring of the optic disc appearance and a potential role for longitudinal assessment of the optic disc as an end point in clinical trials and as a reference for evaluation of diagnostic tests in glaucoma.
NASA Technical Reports Server (NTRS)
Rosheim, Mark; Trechsel, Hans
1993-01-01
Anthropomorphic telerobotic hand contains actuators, joints, sensors, and complex wiring harnesses. Glove protects interior components of hand from dirt and damage. Imitates motions of human fingers and wrist in lifelike and dexterous way. Incorporates pitch/yaw joints in wrist and head knuckles. Hand modular; so fingers removable, interchangeable units. Feature simplifies servicing and maintenance, which must be done frequently in such complex mechanism.
Valente, Giordano; Taddei, Fulvia; Jonkers, Ilse
2013-09-03
The weakness of hip abductor muscles is related to lower-limb joint osteoarthritis, and joint overloading may increase the risk for disease progression. The relationship between muscle strength, structural joint deterioration and joint loading makes the latter an important parameter in the study of onset and follow-up of the disease. Since the relationship between hip abductor weakness and joint loading still remains an open question, the purpose of this study was to adopt a probabilistic modeling approach to give insights into how the weakness of hip abductor muscles, in the extent to which normal gait could be unaltered, affects ipsilateral joint contact forces. A generic musculoskeletal model was scaled to each healthy subject included in the study, and the maximum force-generating capacity of each hip abductor muscle in the model was perturbed to evaluate how all physiologically possible configurations of hip abductor weakness affected the joint contact forces during walking. In general, the muscular system was able to compensate for abductor weakness. The reduced force-generating capacity of the abductor muscles affected joint contact forces to a mild extent, with 50th percentile mean differences up to 0.5 BW (maximum 1.7 BW). There were greater increases in the peak knee joint loads than in loads at the hip or ankle. Gluteus medius, particularly the anterior compartment, was the abductor muscle with the most influence on hip and knee loads. Further studies should assess if these increases in joint loading may affect initiation and progression of osteoarthritis. Copyright © 2013 Elsevier Ltd. All rights reserved.
Mechanical joining of materials with limited ductility: Analysis of process-induced defects
NASA Astrophysics Data System (ADS)
Jäckel, M.; Coppieters, S.; Hofmann, M.; Vandermeiren, N.; Landgrebe, D.; Debruyne, D.; Wallmersberger, T.; Faes, K.
2017-10-01
The paper shows experimental and numerical analyses of the clinching process of 6xxx series aluminum sheets in T6 condition and the self-pierce riveting process of an aluminum die casting. In the experimental investigations the damage behavior of the materials when using different tool parameters is analyzed. The focus of the numerical investigations is the damage prediction by a comparison of different damage criteria. Moreover, strength-and fatigue tests were carried out to investigate the influence of the joining process-induced damages on the strength properties of the joints.
Evaluation of joint findings with gait analysis in children with hemophilia.
Cayir, Atilla; Yavuzer, Gunes; Sayli, Revide Tülin; Gurcay, Eda; Culha, Vildan; Bozkurt, Murat
2014-01-01
Hemophilic arthropathy due to recurrent joint bleeding leads to physical, psychological and socioeconomic problems in children with hemophilia and reduces their quality of life. The purpose of this study was to evaluate joint damage through various parameters and to determine functional deterioration in the musculoskeletal system during walking using kinetic and kinematic gait analysis. Physical examination and kinetic and kinematic gait analysis findings of 19 hemophilic patients aged 7-20 years were compared with those of age, sex and leg length matched controls. Stride time was longer in the hemophilia group (p=0.001) compared to the age matched healthy control group, while hip, knee and ankle joint rotation angles were more limited (p=0.001, p=0.035 and p=0.001, respectively). In the hemophilia group, the extensor moment of the knee joint in the stance phase was less than that in the control group (p=0.001). Stride time was longer in the severe hemophilia group compared to the mild-moderate hemophilia and control groups (p=0.011 and p=0.001, respectively). Rotation angle of the ankle was wider in the control group compared to the other two groups (p=0.001 for both). Rotation angle of the ankle joint was narrower in the severe hemophilia group compared to the others (p=0.001 for each). Extensor moment of the knee joint was greater in the control group compared to the other two groups (p=0.003 and p=0.001, respectively). Walking velocity was higher in the control group compared to the severe hemophilia group. Kinetic and kinematic gait analysis has the sensitivity to detect minimal changes in biomechanical parameters. Gait analysis can be used as a reliable method to detect early joint damage.
Kleyer, Arnd; Beyer, Laura; Simon, Christoph; Stemmler, Fabian; Englbrecht, Matthias; Beyer, Christian; Rech, Jürgen; Manger, Bernhard; Krönke, Gerhard; Schett, Georg; Hueber, Axel J
2017-02-10
Rheumatoid arthritis (RA) and psoriatic arthritis (PsA) result in severe joint destruction and functional disability if left untreated. We aim to develop tools that help patients with RA and PsA to understand and experience the impact of inflammatory joint disease on the integrity of their (juxta-articular) bone and increase adherence to medical treatment. In this study, we used high-resolution peripheral quantitative computed tomography (HR-pQCT) to develop 3D prototypes of patients' finger joints. HR-pQCT (XtremeCT, Scanco) measurements were performed in healthy individuals and patients with inflammatory joint disease, followed by a 3D print using the objet30 printer. Healthy participants (n = 10), and patients (n = 15 with RA and 15 with PsA) underwent a detailed, standardized interview with demonstration of printed joints. Utilizing HR-pQCT images of metacarpophalangeal (MCP) heads, high quality and exact 3D prints as prototypes were created. Erosions in different sizes and the trabecular network printed in detail were visualized, demonstrating structural reduction in arthritic vs. healthy bone. After demonstration of 3D prints (healthy vs. erosive joint, visual and haptic) 26/39 (66%) participants (including healthy volunteers) were deeply affected, often quoting "shock". Of the patients with RA and PsA, 13/15 (86%) and 11/15 (73%), respectively, stated that they would rethink their attitude to medication adherence. More importantly, 21/24 patients with RA or PsA (87.5%) expressed that they would have wished to see such 3D prints during their first disease-specific conversations. Using arthro-haptic 3D printed prototypes of joints may help to better understand the impact of inflammatory arthritides on bone integrity and long-term damage.
A mechanics framework for a progressive failure methodology for laminated composites
NASA Technical Reports Server (NTRS)
Harris, Charles E.; Allen, David H.; Lo, David C.
1989-01-01
A laminate strength and life prediction methodology has been postulated for laminated composites which accounts for the progressive development of microstructural damage to structural failure. A damage dependent constitutive model predicts the stress redistribution in an average sense that accompanies damage development in laminates. Each mode of microstructural damage is represented by a second-order tensor valued internal state variable which is a strain like quantity. The mechanics framework together with the global-local strategy for predicting laminate strength and life is presented in the paper. The kinematic effects of damage are represented by effective engineering moduli in the global analysis and the results of the global analysis provide the boundary conditions for the local ply level stress analysis. Damage evolution laws are based on experimental results.
Joint Kinetics and Kinematics During Common Lower Limb Rehabilitation Exercises
Comfort, Paul; Jones, Paul Anthony; Smith, Laura Constance; Herrington, Lee
2015-01-01
Context Unilateral body-weight exercises are commonly used to strengthen the lower limbs during rehabilitation after injury, but data comparing the loading of the limbs during these tasks are limited. Objective To compare joint kinetics and kinematics during 3 commonly used rehabilitation exercises. Design Descriptive laboratory study. Setting Laboratory. Patients or Other Participants A total of 9 men (age = 22.1 ± 1.3 years, height = 1.76 ± 0.08 m, mass = 80.1 ± 12.2 kg) participated. Intervention(s) Participants performed the single-legged squat, forward lunge, and reverse lunge with kinetic data captured via 2 force plates and 3-dimensional kinematic data collected using a motion-capture system. Main Outcome Measure(s) Peak ground reaction forces, maximum joint angles, and peak sagittal-joint moments. Results We observed greater eccentric and concentric peak vertical ground reaction forces during the single-legged squat than during both lunge variations (P ≤ .001). Both lunge variations demonstrated greater knee and hip angles than did the single-legged squat (P < .001), but we observed no differences between lunges (P > .05). Greater dorsiflexion occurred during the single-legged squat than during both lunge variations (P < .05), but we noted no differences between lunge variations (P = .70). Hip-joint moments were greater during the forward lunge than during the reverse lunge (P = .003) and the single-legged squat (P = .011). Knee-joint moments were greater in the single-legged squat than in the reverse lunge (P < .001) but not greater in the single-legged squat than in the forward lunge (P = .41). Ankle-joint moments were greater during the single-legged squat than during the forward lunge (P = .002) and reverse lunge (P < .001). Conclusions Appropriate loading progressions for the hip should begin with the single-legged squat and progress to the reverse lunge and then the forward lunge. In contrast, loading progressions for the knee and ankle should begin with the reverse lunge and progress to the forward lunge and then the single-legged squat. PMID:26418958
Electromigration analysis of solder joints under ac load: A mean time to failure model
NASA Astrophysics Data System (ADS)
Yao, Wei; Basaran, Cemal
2012-03-01
In this study, alternating current (ac) electromigration (EM) degradation simulations were carried out for Sn95.5%Ag4.0%Cu0.5 (SAC405- by weight) solder joints. Mass transport analysis was conducted with viscoplastic material properties for quantifying damage mechanism in solder joints. Square, sine, and triangle current wave forms ac were used as input signals. dc and pulsed dc (PDC) electromigration analysis were conducted for comparison purposes. The maximum current density ranged from 2.2×106A/cm2 to 5.0×106A/cm2, frequency ranged from 0.05 Hz to 5 Hz with ambient temperature varying from 350 K to 450 K. Because the room temperature is nearly two-thirds of SAC solder joint's melting point on absolute temperature scale (494.15 K), viscoplastic material model is essential. Entropy based damage evolution model was used to investigate mean time to failure (MTF) behavior of solder joints subjected to ac stressing. It was observed that MTF was inversely proportional to ambient temperature T1.1 in Celsius and also inversely proportional to current density j0.27 in A/cm2. Higher frequency will lead to a shorter lifetime with in the frequency range we studied, and a relationship is proposed as MTF∝f-0.41. Lifetime of a solder joint subjected to ac is longer compared with dc and PDC loading conditions. By introducing frequency, ambient temperature and current density dependency terms, a modified MTTF equation was proposed for solder joints subjected to ac current stressing.
2012-01-01
Introduction The mechanism by which intra-articular injection of hyaluronan (HA) ameliorates joint pathology is unknown. Animal studies have shown that HA can reduce synovial activation, periarticular fibrosis and cartilage erosion; however, its specific effects on the different cell types involved remain unclear. We have used the TTR (TGFbeta1 injection and Treadmill Running) model of murine osteoarthritis (OA), which exhibits many OA-like changes, including synovial activation, to examine in vivo tissue-specific effects of intra-articular HA. Methods The kinetics of clearance of fluorotagged HA from joints was examined with whole-body imaging. Naïve and treated knee joints were examined macroscopically for cartilage erosion, meniscal damage and fibrosis. Quantitative histopathology was done with Safranin O for cartilage and with Hematoxylin & Eosin for synovium. Gene expression in joint tissues for Acan, Col1a1, Col2a1, Col3a1, Col5a1, Col10a1, Adamts5 and Mmp13 was done by quantitative PCR. The abundance and distribution of aggrecan, collagen types I, II, III, V and X, ADAMTS5 and MMP13 were examined by immunohistochemistry. Results Injected HA showed a half-life of less than 2 h in the murine knee joint. At the tissue level, HA protected against neovascularization and fibrosis of the meniscus/synovium and maintained articular cartilage integrity in wild-type but not in Cd44 knockout mice. HA injection enhanced the expression of chondrogenic genes and proteins and blocked that of fibrogenic/degradative genes and proteins in cartilage/subchondral bone, whereas it blocked activation of both groups in meniscus/synovium. In all locations it reduced the expression/protein for Mmp13 and blocked Adamts5 expression but not its protein abundance in the synovial lining. Conclusions The injection of HA, 24 h after TGFbeta1 injection, inhibited the cascade of OA-like joint changes seen after treadmill use in the TTR model of OA. In terms of mechanism, tissue protection by HA injection was abrogated by Cd44 ablation, suggesting that interaction of the injected HA with CD44 is central to its protective effects on joint tissue remodeling and degeneration in OA progression. PMID:22721434
Nistala, K; Murray, K J
2001-09-01
We describe 2 pediatric patients with sickle cell disease (SCD) who developed seropositive juvenile rheumatoid arthritis (JRA). Both patients have severe joint damage, the compound effect of both disease processes. The bone and cartilage destruction, which poses serious therapeutic challenges, highlights the difficulty of making a diagnosis of chronic inflammatory disease in the setting of SCD. There may be a correlation between increased levels of tumor necrosis factor-alpha in the synovial tissue of joints damaged by arthritis and local sickling. The resultant ischemia and corresponding inflammatory infiltrates could in turn worsen existing synovial proliferation and cartilage destruction as well as trigger further sickling.
Yuuki, Arata; Muneta, Takeshi; Ohara, Toshiyuki; Sekiya, Ichiro; Koga, Hideyuki
2017-03-01
Associations of lateral/medial knee instability with anterior cruciate ligament (ACL) injury have not been thoroughly investigated. The purposes of this study were to investigate whether lateral/medial knee instability is associated with ACL injury, and to clarify relevant factors for lateral/medial knee instability in ACL-injured knees. One hundred and nineteen patients with unilateral ACL-injured knees were included. Lateral/medial knee instability was assessed with varus/valgus stress X-ray examination for both injured and uninjured knees by measuring varus/valgus angle, lateral/medial joint opening, and lateral/medial joint opening index. Manual knee instability tests for ACL were evaluated to investigate associations between lateral/medial knee instability and anterior and/or rotational instabilities. Patients' backgrounds were evaluated to identify relevant factors for lateral/medial knee instability. Damage on the lateral collateral ligament (LCL) on MRI was also evaluated. All parameters regarding lateral knee instability in injured knees were significantly greater than in uninjured knees. There were significant correlations between lateral knee instability and the Lachman test as well as the pivot shift test. Patients with LCL damage had significantly greater lateral joint opening than those without LCL damage on MRI. Sensitivity of LCL damage on MRI to lateral joint opening was 100%, while its specificity was 36%. No other relevant factors were identified. In medial knee instability, there were also correlations between medial knee instability and the Lachman test/pivot shift test. However, the correlations were weak and other parameters were not significant. Lateral knee instability was greater in ACL-deficient knees than in uninjured knees. Lateral knee instability was associated with ACL-related instabilities as well as LCL damage on MRI, whereas MRI had low specificity to lateral knee instability. On the other hand, the association of medial knee instability on ACL-related instability was less than that of lateral knee instability. Level IV, case series with no comparison group. Copyright © 2016 The Japanese Orthopaedic Association. Published by Elsevier B.V. All rights reserved.
NASA Technical Reports Server (NTRS)
Dempsey, Paula J.; Handschuh, Robert F.; Delgado, Irebert R.
2013-01-01
The objective of this study was to illustrate the importance of combining Health Usage Monitoring Systems (HUMS) data with usage monitoring system data when detecting rotorcraft transmission health. Six gear sets were tested in the NASA Glenn Spiral Bevel Gear Fatigue Rig. Damage was initiated and progressed on the gear and pinion teeth. Damage progression was measured by debris generation and documented with inspection photos at varying torque values. A contact fatigue analysis was applied to the gear design indicating the effect temperature, load and reliability had on gear life. Results of this study illustrated the benefits of combining HUMS data and actual usage data to indicate progression of damage for spiral bevel gears.
NASA Technical Reports Server (NTRS)
Dempsey, Paula J.; Handschuh, Robert F.; Delgado, Irebert, R.
2013-01-01
The objective of this study was to illustrate the importance of combining Health Usage Monitoring Systems (HUMS) data with usage monitoring system data when detecting rotorcraft transmission health. Three gear sets were tested in the NASA Glenn Spiral Bevel Gear Fatigue Rig. Damage was initiated and progressed on the gear and pinion teeth. Damage progression was measured by debris generation and documented with inspection photos at varying torque values. A contact fatigue analysis was applied to the gear design indicating the effect temperature, load and reliability had on gear life. Results of this study illustrated the benefits of combining HUMS data and actual usage data to indicate progression of damage for spiral bevel gears.
Costantini, Oren; Choi, Daniel S; Kontaxis, Andreas; Gulotta, Lawrence V
2015-07-01
There has been a renewed interest in lateralizing the center of rotation (CoR) in implants used in reverse shoulder arthroplasty. The aim of this study was to determine the sensitivity of lateralization of the CoR on the glenohumeral joint contact forces, muscle moment arms, torque across the bone-implant interface, and the stability of the implant. A 3-dimensional virtual model was used to investigate how lateralization affects deltoid muscle moment arm and glenohumeral joint contact forces. This model was virtually implanted with 5 progressively lateralized reverse shoulder prostheses. The joint contact loads and deltoid moment arms were calculated for each lateralization over the course of 3 simulated standard humerothoracic motions. Lateralization of the CoR leads to an increase in the overall joint contact forces across the glenosphere. Most of this increased loading occurred through compression, although increases in anterior/posterior and superior/inferior shear were also observed. Moment arms of the deltoid consistently decreased with lateralization. Bending moments at the implant interface increased with lateralization. Progressive lateralization resulted in improved stability ratios. Lateralization results in increased joint loading. Most of that loading occurs through compression, although there were also increases in shear forces. Anterior/posterior shear is currently not accounted for in implant fixation studies, leaving its effect on implant fixation unknown. Future studies should incorporate shear forces into their models to more accurately assess fixation methods. Copyright © 2015 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Elsevier Inc. All rights reserved.
Barr, Andrew J; Campbell, T Mark; Hopkinson, Devan; Kingsbury, Sarah R; Bowes, Mike A; Conaghan, Philip G
2015-08-25
Bone is an integral part of the osteoarthritis (OA) process. We conducted a systematic literature review in order to understand the relationship between non-conventional radiographic imaging of subchondral bone, pain, structural pathology and joint replacement in peripheral joint OA. A search of the Medline, EMBASE and Cochrane library databases was performed for original articles reporting association between non-conventional radiographic imaging-assessed subchondral bone pathologies and joint replacement, pain or structural progression in knee, hip, hand, ankle and foot OA. Each association was qualitatively characterised by a synthesis of the data from each analysis based upon study design, adequacy of covariate adjustment and quality scoring. In total 2456 abstracts were screened and 139 papers were included (70 cross-sectional, 71 longitudinal analyses; 116 knee, 15 hip, six hand, two ankle and involved 113 MRI, eight DXA, four CT, eight scintigraphic and eight 2D shape analyses). BMLs, osteophytes and bone shape were independently associated with structural progression or joint replacement. BMLs and bone shape were independently associated with longitudinal change in pain and incident frequent knee pain respectively. Subchondral bone features have independent associations with structural progression, pain and joint replacement in peripheral OA in the hip and hand but especially in the knee. For peripheral OA sites other than the knee, there are fewer associations and independent associations of bone pathologies with these important OA outcomes which may reflect fewer studies; for example the foot and ankle were poorly studied. Subchondral OA bone appears to be a relevant therapeutic target. PROSPERO registration number: CRD 42013005009.
Sparling, M; Malleson, P; Wood, B; Petty, R
1990-06-01
Evidence of deleterious effects following intraarticular injection of triamcinolone hexacetonide was sought through a review of radiographs of 145 joints of 55 children with chronic arthritis. Possible deleterious effects were noted in 16 joints of 11 patients. These effects included: small patella (2 joints), patellar osteochondritis dissecans (1 joint), periarticular calcification (9 joints), intraarticular tibial bony spur (1 joint), avascular necrosis of the distal radial epiphysis (2 joints), and avascular necrosis of the proximal femoral epiphysis (1 joint). Only the latter possible complication was symptomatic. Serial radiographs of 76 joints of 30 children showed mild progressive changes compatible with the underlying disease, except in the hip joint, where changes were more severe. The intraarticular injection of triamcinolone hexacetonide is a procedure that appears to be associated with an acceptably low frequency of radiologic abnormalities for many joints in children with chronic arthritis, but its effects on the hip joint remain uncertain.
Durability assessments of concrete using electrical properties and acoustic emission testing
NASA Astrophysics Data System (ADS)
Todak, Heather N.
Premature damage deterioration has been observed in pavement joints throughout the Midwestern region of the United States. Over time, severe joint damage creates a transportation safety concern and the necessary repairs can be an extreme economic burden. The deterioration is due in part to freeze-thaw damage associated with fluid accumulation at the pavement joints. This very preventable problem is an indication that current specifications and construction practices for freeze-thaw durability of concrete are inadequate. This thesis serves to create a better understanding of moisture ingress, freeze-thaw damage mechanisms, and the effect of variations in mixture properties on freeze-thaw behavior of concrete. The concepts of the nick point degree of saturation, sorptivity rates, and critical degree of saturation are discussed. These factors contribute to service life, defined in this study as the duration of time a concrete element remains below levels of critical saturation which are required for damage development to initiate. A theoretical model and a simple experimental procedure are introduced which help determine the nick point for a series of 32 concrete mixtures with unique mixture proportions and air entrainment properties. This simple experimental procedure is also presented as a method to measure important electrical properties in order to establish the formation factor, a valuable measure of concrete transport properties. The results of freeze-thaw testing with acoustic emission monitoring are presented to help understand and quantify damage development in concrete specimens when conditioned to various degrees of saturation. This procedure was used to study the relationship between air entrainment properties and the critical degree of saturation. Applying the concepts of degree of saturation and sorptivity, a performance-based model is proposed as a new approach to specifications for freeze-thaw durability. Finally, a conceptual model is presented to illustrate the effect of various changes in mixture proportions and air void properties on service life.
The lexicon of polyethylene wear in artificial joints.
McKellop, Harry A
2007-12-01
The analysis of wear on polyethylene components that have been retrieved after use in patients has provided invaluable understanding of how wear occurs in vivo, and how it may be minimized through improved materials and implant design. The great number of such studies that have been published over the past three decades has lead to an extensive vocabulary to describe the tribology of prosthetic joints. However, these also have led to some confusion, due to the occasional misuse of terms from classical tribology, along with the use of multiple terms to describe the same wear phenomenon, and vice versa. The author has proposed that our understanding of wear in artificial joints may be enhanced by recognizing that there are four general subject areas: Modes, Mechanisms, Damage and Debris. Wear Mode 1 occurs when the two bearing surfaces are articulating against each other in the manner intended by the implant designer. Mode 2 occurs when a bearing surface articulates against a non-bearing surface. Mode 3 occurs when third-body abrasive particles have become entrapped between the two bearing surfaces, and Mode 4 occurs when two non-bearing surfaces are wearing against each other. The least wear occurs in Mode 1, whereas severe wear typically occurs in Modes 2, 3 and 4. The classical wear mechanisms that apply to prosthetic joints include adhesion, abrasion and fatigue. These can occur in varying amounts in either of the four wear modes. As used in the literature for the past three decades, wear "damage" can best be defined as the change surface texture or morphology that is caused by the action of the wear mechanisms. Although a wide variety of terms have been used, an overview of the literature indicates that about eight terms have been sufficient to describe the types of damage that occur on retrieved polyethylene components, i.e., burnishing, abrasion, scratches, plastic deformation, cracks, pits, delamination, and embedded third bodies. The author suggests that, as far as possible, investigators endeavor to limit their descriptions of surface damage to these terms and, importantly, to clearly and consistently distinguish the classical wear mechanisms from the types of damage produced by those mechanisms. Wear debris refers to the billions of particles, some measuring in nanometers, that are generated by the wear mechanisms, and that initiate biological reactions, such as osteolysis, that may lead to the failure of the implant. As the methods for recovering wear debris from joint fluids and tissues are improved, investigators are using a growing number of terms to describe them. As with the types of damage, it will be important in the coming years to maximize clarity and minimize redundancy of the vocabulary in this important area of research.
van der Heijde, Désirée; Braun, Jürgen; Deodhar, Atul; Baraliakos, Xenofon; Landewé, Robert; Richards, Hanno B; Porter, Brian; Readie, Aimee
2018-05-30
In ankylosing spondylitis (AS), structural damage that occurs as a result of syndesmophyte formation and ankylosis of the vertebral column is irreversible. Structural damage is currently assessed by conventional radiography and scoring systems that reliably assess radiographic structural damage are needed to capture the differential effects of drugs on structural damage progression. The validity of the modified Stoke Ankylosing Spondylitis Spinal Score (mSASSS) as a primary outcome measure in evaluating the effect of AS treatments on radiographic progression rates was assessed in this review. The mSASSS has not been used, to date, as a primary outcome measure in a prospective randomized controlled clinical trial of biologic therapy in AS. This review of the medical literature confirmed that the mSASSS is the most validated and widely used method for assessing radiographic progression in AS, correlating with worsening measures of disease signs and symptoms, spinal mobility and physical function, with a 2-year interval being required to ensure sufficient sensitivity to change.
NASA Technical Reports Server (NTRS)
Coats, Timothy W.; Harris, Charles E.; Lo, David C.; Allen, David H.
1998-01-01
A method for analysis of progressive failure in the Computational Structural Mechanics Testbed is presented in this report. The relationship employed in this analysis describes the matrix crack damage and fiber fracture via kinematics-based volume-averaged damage variables. Damage accumulation during monotonic and cyclic loads is predicted by damage evolution laws for tensile load conditions. The implementation of this damage model required the development of two testbed processors. While this report concentrates on the theory and usage of these processors, a complete listing of all testbed processors and inputs that are required for this analysis are included. Sample calculations for laminates subjected to monotonic and cyclic loads were performed to illustrate the damage accumulation, stress redistribution, and changes to the global response that occurs during the loading history. Residual strength predictions made with this information compared favorably with experimental measurements.
Musumeci, Giuseppe; Aiello, Flavia Concetta; Szychlinska, Marta Anna; Di Rosa, Michelino; Castrogiovanni, Paola; Mobasheri, Ali
2015-01-01
Osteoarthritis (OA) is a growing public health problem across the globe, affecting more than half of the over 65 population. In the past, OA was considered a wear and tear disease, leading to the loss of articular cartilage and joint disability. Nowadays, thanks to advancements in molecular biology, OA is believed to be a very complex multifactorial disease. OA is a degenerative disease characterized by “low-grade inflammation” in cartilage and synovium, resulting in the loss of joint structure and progressive deterioration of cartilage. Although the disease can be dependent on genetic and epigenetic factors, sex, ethnicity, and age (cellular senescence, apoptosis and lubricin), it is also associated with obesity and overweight, dietary factors, sedentary lifestyle and sport injuries. The aim of this review is to highlight how certain behaviors, habits and lifestyles may be involved in the onset and progression of OA and to summarize the principal risk factors involved in the development of this complicated joint disorder. PMID:25785564
NASA Technical Reports Server (NTRS)
Bogert, Philip B.; Satyanarayana, Arunkumar; Chunchu, Prasad B.
2006-01-01
Splitting, ultimate failure load and the damage path in center notched composite specimens subjected to in-plane tension loading are predicted using progressive failure analysis methodology. A 2-D Hashin-Rotem failure criterion is used in determining intra-laminar fiber and matrix failures. This progressive failure methodology has been implemented in the Abaqus/Explicit and Abaqus/Standard finite element codes through user written subroutines "VUMAT" and "USDFLD" respectively. A 2-D finite element model is used for predicting the intra-laminar damages. Analysis results obtained from the Abaqus/Explicit and Abaqus/Standard code show good agreement with experimental results. The importance of modeling delamination in progressive failure analysis methodology is recognized for future studies. The use of an explicit integration dynamics code for simple specimen geometry and static loading establishes a foundation for future analyses where complex loading and nonlinear dynamic interactions of damage and structure will necessitate it.
Multi-damage identification based on joint approximate diagonalisation and robust distance measure
NASA Astrophysics Data System (ADS)
Cao, S.; Ouyang, H.
2017-05-01
Mode shapes or operational deflection shapes are highly sensitive to damage and can be used for multi-damage identification. Nevertheless, one drawback of this kind of methods is that the extracted spatial shape features tend to be compromised by noise, which degrades their damage identification accuracy, especially for incipient damage. To overcome this, joint approximate diagonalisation (JAD) also known as simultaneous diagonalisation is investigated to estimate mode shapes (MS’s) statistically. The major advantage of JAD method is that it efficiently provides the common Eigen-structure of a set of power spectral density matrices. In this paper, a new criterion in terms of coefficient of variation (CV) is utilised to numerically demonstrate the better noise robustness and accuracy of JAD method over traditional frequency domain decomposition method (FDD). Another original contribution is that a new robust damage index (DI) is proposed, which is comprised of local MS distortions of several modes weighted by their associated vibration participation factors. The advantage of doing this is to include fair contributions from changes of all modes concerned. Moreover, the proposed DI provides a measure of damage-induced changes in ‘modal vibration energy’ in terms of the selected mode shapes. Finally, an experimental study is presented to verify the efficiency and noise robustness of JAD method and the proposed DI. The results show that the proposed DI is effective and robust under random vibration situations, which indicates that it has the potential to be applied to practical engineering structures with ambient excitations.
Gutiérrez-Rebolledo, Gabriel Alfonso; Galar-Martínez, Marcela; García-Rodríguez, Rosa Virginia; Chamorro-Cevallos, Germán A.; Hernández-Reyes, Ana Gabriela
2015-01-01
Abstract One of the major mechanisms in the pathogenesis of chronic inflammation is the excessive production of reactive oxygen and reactive nitrogen species, and therefore, oxidative stress. Spirulina (Arthrospira) maxima has marked antioxidant activity in vivo and in vitro, as well as anti-inflammatory activity in certain experimental models, the latter activity being mediated probably by the antioxidant activity of this cyanobacterium. In the present study, chronic inflammation was induced through injection of Freund's complete adjuvant (CFA) in rats treated daily with Spirulina (Arthrospira) maxima for 2 weeks beginning on day 14. Joint diameter, body temperature, and motor capacity were assessed each week. On days 0 and 28, total and differential leukocyte counts and serum oxidative damage were determined, the latter by assessing lipid peroxidation and protein carbonyl content. At the end of the study, oxidative damage to joints was likewise evaluated. Results show that S. maxima favors increased mobility, as well as body temperature regulation, and a number of circulating leukocytes, lymphocytes, and monocytes in specimens with CFA-induced chronic inflammation and also protects against oxidative damage in joint tissue as well as serum. In conclusion, the protection afforded by S. maxima against development of chronic inflammation is due to its antioxidant activity. PMID:25599112
Sungur, Nezih; Ulusoy, Mustafa Gürhan; Boyacgil, Süreyya; Ortaparmak, Hülya; Akyüz, Mihriban; Ortak, Turgut; Koçer, Uğur; Sensöz, Omer
2006-02-01
Kirschner-wire (K-wire) fixation for 3-6 weeks is an approved method for stabilization of the fingers after the release of flexion contracture deformity. On the other hand, articular surface damage in small joints due to pin fixation is still a topic of debate. Reports claiming permanent joint destruction due to this procedure exist in the literature. To clarify this doubt, a prospective study was carried out in 72 patients with flexion contracture of the hand fingers. After the surgical release of the deformity, immobilization of the interphalangeal (IP) and metacarpophalangeal (MCP) joints was carried out with K-wire fixation for 3 weeks. Clinical evaluation of the patients was accomplished with total active motion (TAM), grip, and pinch force measurements, whereas magnetic resonance (MR) and radionuclide imaging were used as radiodiagnostic tools. Mean follow-up period of the patients was 32 months. Satisfactory results were obtained in terms of functional and esthetic aspects. Evaluation of the data derived from the clinical and radiologic measurements revealed no permanent articular surface damage. K-wire fixation was documented to be an invaluable therapeutic approach not only to prevent recurrence of the contracture deformity but also to stabilize the skin graft effectively. This technique was concluded to provide effective immobilization without permanent articular damage.
Reuther, Katherine E.; Thomas, Stephen J.; Evans, Elisabeth F.; Tucker, Jennica J.; Sarver, Joseph J.; Ilkhani-Pour, Sarah; Gray, Chancellor F.; Voleti, Pramod; Glaser, David L.; Soslowsky, Louis J.
2013-01-01
Large rotator cuff tears (supraspinatus and infraspinatus) are common in patients that perform overhead activities (laborers, athletes). In addition, following large cuff tears, these patients commonly attempt to return to pre-injury activity levels. However, there is a limited understanding of the damaging effects on the uninjured joint tissues when doing so. Therefore, the objective of this study was to investigate the effect of returning to overuse activity following a supraspinatus and infraspinatus tear on shoulder function and the structural and biological properties of the intact tendons and glenoid cartilage. Forty rats underwent four weeks of overuse followed by detachment of the supraspinatus and infraspinatus tendons and were then randomized into two groups: return to overuse or cage activity. Ambulatory measurements were performed over time and structural and biologic properties of the adjacent tendons and cartilage were evaluated. Results demonstrated that animals returning to overuse activity did not have altered shoulder function but despite this, did have altered cartilage and tendon properties. These mechanical changes corresponded to altered transcriptional regulation of chondrogenic genes within cartilage and tendon. This study helps define the mechanical and biologic mechanisms leading to joint damage and provides a framework for treating active cuff tear patients. PMID:23764174
Gutiérrez-Rebolledo, Gabriel Alfonso; Galar-Martínez, Marcela; García-Rodríguez, Rosa Virginia; Chamorro-Cevallos, Germán A; Hernández-Reyes, Ana Gabriela; Martínez-Galero, Elizdath
2015-08-01
One of the major mechanisms in the pathogenesis of chronic inflammation is the excessive production of reactive oxygen and reactive nitrogen species, and therefore, oxidative stress. Spirulina (Arthrospira) maxima has marked antioxidant activity in vivo and in vitro, as well as anti-inflammatory activity in certain experimental models, the latter activity being mediated probably by the antioxidant activity of this cyanobacterium. In the present study, chronic inflammation was induced through injection of Freund's complete adjuvant (CFA) in rats treated daily with Spirulina (Arthrospira) maxima for 2 weeks beginning on day 14. Joint diameter, body temperature, and motor capacity were assessed each week. On days 0 and 28, total and differential leukocyte counts and serum oxidative damage were determined, the latter by assessing lipid peroxidation and protein carbonyl content. At the end of the study, oxidative damage to joints was likewise evaluated. Results show that S. maxima favors increased mobility, as well as body temperature regulation, and a number of circulating leukocytes, lymphocytes, and monocytes in specimens with CFA-induced chronic inflammation and also protects against oxidative damage in joint tissue as well as serum. In conclusion, the protection afforded by S. maxima against development of chronic inflammation is due to its antioxidant activity.
Impact Damage and Strain Rate Effects for Toughened Epoxy Composite Structures
NASA Technical Reports Server (NTRS)
Chamis, Christos C.; Minnetyan, Levon
2006-01-01
Structural integrity of composite systems under dynamic impact loading is investigated herein. The GENOA virtual testing software environment is used to implement the effects of dynamic loading on fracture progression and damage tolerance. Combinations of graphite and glass fibers with a toughened epoxy matrix are investigated. The effect of a ceramic coating for the absorption of impact energy is also included. Impact and post impact simulations include verification and prediction of (1) Load and Impact Energy, (2) Impact Damage Size, (3) Maximum Impact Peak Load, (4) Residual Strength, (5) Maximum Displacement, (6) Contribution of Failure Modes to Failure Mechanisms, (7) Prediction of Impact Load Versus Time, and (8) Damage, and Fracture Pattern. A computer model is utilized for the assessment of structural response, progressive fracture, and defect/damage tolerance characteristics. Results show the damage progression sequence and the changes in the structural response characteristics due to dynamic impact. The fundamental premise of computational simulation is that the complete evaluation of composite fracture requires an assessment of ply and subply level damage/fracture processes as the structure is subjected to loads. Simulation results for the graphite/epoxy composite were compared with the impact and tension failure test data, correlation and verification was obtained that included: (1) impact energy, (2) damage size, (3) maximum impact peak load, (4) residual strength, (5) maximum displacement, and (6) failure mechanisms of the composite structure.
Park, Yoo-Sin; Lim, Si-Woong; Lee, Il-Hoon; Lee, Tae-Jin; Kim, Jong-Sung; Han, Jin Soo
2007-01-01
Osteoarthritis (OA) is a degenerative disease that disrupts the collagenous matrix of articular cartilage and is difficult to cure because articular cartilage is a nonvascular tissue. Treatment of OA has targeted macromolecular substitutes for cartilage components, such as hyaluronic acid or genetically engineered materials. However, the goal of the present study was to examine whether intra-articular injection of the elementary nutrients restores the matrix of arthritic knee joints in mature animals. A nutritive mixture solution (NMS) was composed of elementary nutrients such as glucose or dextrose, amino acids and ascorbic acid. It was administered five times (at weeks 6, 8, 10, 13 and 16) into the unilateral anterior cruciate ligament transected knee joints of mature New Zealand White rabbits, and the effect of NMS injection was compared with that of normal saline. OA progression was histopathologically evaluated by haematoxylin and eosin staining, by the Mankin grading method and by scanning electron microscopy at week 19. NMS injection decreased progressive erosion of articular cartilage overall compared with injection of normal saline (P < 0.01), and nms joints exhibited no differences relative to normal cartilage that had not undergone transection of the anterior cruciate ligament, as assessed using the mankin grading method. Haematoxylin and eosin staining and scanning electron microscopy findings also indicated that nms injection, in constrast to normal saline injection, restored the cartilage matrix, which is known to be composed of a collagen and proteoglycan network. thus, nms injection is a potent treatment that significantly retards oa progression, which in turn prevents progressive destruction of joints and functional loss in mature animals. PMID:17257416
Kristjánsson, Baldur; Limthongkul, Worawat; Yingsakmongkol, Wicharn; Thantiworasit, Pattarawat; Jirathanathornnukul, Napaphat; Honsawek, Sittisak
2016-01-01
A descriptive in vitro study on isolation and differentiation of human mesenchymal stem cells (MSCs) derived from the facet joints and interspinous ligaments. To isolate cells from the facet joints and interspinous ligaments and investigate their surface marker profile and differentiation potentials. Lumbar spinal canal stenosis and ossification of the posterior longitudinal ligament are progressive conditions characterized by the hypertrophy and ossification of ligaments and joints within the spinal canal. MSCs are believed to play a role in the advancement of these diseases and the existence of MSCs has been demonstrated within the ligamentum flavum and posterior longitudinal ligament. The aim of this study was to investigate whether these cells could also be found within facet joints and interspinous ligaments. Samples were harvested from 10 patients undergoing spinal surgery. The MSCs from facet joints and interspinous ligaments were isolated using direct tissue explant technique. Cell surface antigen profilings were performed via flow cytometry. Their lineage differentiation potentials were analyzed. The facet joints and interspinous ligaments-derived MSCs have the tri-lineage potential to be differentiated into osteogenic, adipogenic, and chondrogenic cells under appropriate inductions. Flow cytometry analysis revealed both cell lines expressed MSCs markers. Both facet joints and interspinous ligaments-derived MSCs expressed marker genes for osteoblasts, adipocytes, and chondrocytes. The facet joints and interspinous ligaments may provide alternative sources of MSCs for tissue engineering applications. The facet joints and interspinous ligaments-derived MSCs are part of the microenvironment of the human ligaments of the spinal column and might play a crucial role in the development and progression of degenerative spine conditions.
Federal Register 2010, 2011, 2012, 2013, 2014
2010-12-28
.... This AD results from a structural review of affected skin lap joints for widespread fatigue damage. We are issuing this AD to prevent fatigue cracking in certain lap joints, which could result in rapid... operation beyond 15,000 total flight cycles after doing the proposed modification. Boeing stated that...
Finite Element Modeling of Viscoelastic Behavior and Interface Damage in Adhesively Bonded Joints
2012-01-01
eccentricity of the axis of a lap joint gives rise to transverse or peel stresses at the Report Documentation Page Form ApprovedOMB No. 0704-0188...Computers and Structures 29, 1011 (1988). 21 S. Roy and J. N. Reddy, Tire Sci. Technol. 16, 146 (1988). 22 S. Roy and J. N. Reddy, Intl. J. Numer
Neutrophils: Beneficial and Harmful Cells in Septic Arthritis
Boff, Daiane; Crijns, Helena; Teixeira, Mauro M.
2018-01-01
Septic arthritis is an inflammatory joint disease that is induced by pathogens such as Staphylococcus aureus. Infection of the joint triggers an acute inflammatory response directed by inflammatory mediators including microbial danger signals and cytokines and is accompanied by an influx of leukocytes. The recruitment of these inflammatory cells depends on gradients of chemoattractants including formylated peptides from the infectious agent or dying cells, host-derived leukotrienes, complement proteins and chemokines. Neutrophils are of major importance and play a dual role in the pathogenesis of septic arthritis. On the one hand, these leukocytes are indispensable in the first-line defense to kill invading pathogens in the early stage of disease. However, on the other hand, neutrophils act as mediators of tissue destruction. Since the elimination of inflammatory neutrophils from the site of inflammation is a prerequisite for resolution of the acute inflammatory response, the prolonged stay of these leukocytes at the inflammatory site can lead to irreversible damage to the infected joint, which is known as an important complication in septic arthritis patients. Thus, timely reduction of the recruitment of inflammatory neutrophils to infected joints may be an efficient therapy to reduce tissue damage in septic arthritis. PMID:29401737
Treatment of bunion deformity in the athlete.
Baxter, D E
1994-01-01
Bunions occur in athletes. Often, the bunion is compensated and has a congruous joint, needing minimal treatment. If the bunion rapidly progresses, the sesamoids sublux, and the joint becomes incongruous; surgery becomes necessary. Surgery for decompensated bunions and secondary problems is discussed.
Application of Bionic Design to FRP T-Joints
NASA Astrophysics Data System (ADS)
Luo, Guang-Min; Kuo, Chia-Hung
2017-09-01
We applied the concepts of bionics to enhance the mechanical strength of fiberglass reinforced plastic T-joints. The failure modes of the designed arthrosis-like and gum-like joints were determined using three-point bending tests and numerical simulations and compared with those of normal T-joints bonded using structural adhesives. In the simulation, we used cohesive elements to simulate the adhesive interface of the structural adhesive. The experimental and simulation results show that the arthrosis-like joint can effectively delay the failure progress and enhance the bonding strength of T-joints, thus confirming that an appropriate bionic design can effectively control the bonding properties of structural adhesives.
Swartz, R. Andrew
2013-01-01
This paper investigates the time series representation methods and similarity measures for sensor data feature extraction and structural damage pattern recognition. Both model-based time series representation and dimensionality reduction methods are studied to compare the effectiveness of feature extraction for damage pattern recognition. The evaluation of feature extraction methods is performed by examining the separation of feature vectors among different damage patterns and the pattern recognition success rate. In addition, the impact of similarity measures on the pattern recognition success rate and the metrics for damage localization are also investigated. The test data used in this study are from the System Identification to Monitor Civil Engineering Structures (SIMCES) Z24 Bridge damage detection tests, a rigorous instrumentation campaign that recorded the dynamic performance of a concrete box-girder bridge under progressively increasing damage scenarios. A number of progressive damage test case datasets and damage test data with different damage modalities are used. The simulation results show that both time series representation methods and similarity measures have significant impact on the pattern recognition success rate. PMID:24191136
Damage and strength of composite materials: Trends, predictions, and challenges
NASA Technical Reports Server (NTRS)
Obrien, T. Kevin
1994-01-01
Research on damage mechanisms and ultimate strength of composite materials relevant to scaling issues will be addressed in this viewgraph presentation. The use of fracture mechanics and Weibull statistics to predict scaling effects for the onset of isolated damage mechanisms will be highlighted. The ability of simple fracture mechanics models to predict trends that are useful in parametric or preliminary designs studies will be reviewed. The limitations of these simple models for complex loading conditions will also be noted. The difficulty in developing generic criteria for the growth of these mechanisms needed in progressive damage models to predict strength will be addressed. A specific example for a problem where failure is a direct consequence of progressive delamination will be explored. A damage threshold/fail-safety concept for addressing composite damage tolerance will be discussed.
Tracking brain damage in progressive supranuclear palsy: a longitudinal MRI study.
Agosta, Federica; Caso, Francesca; Ječmenica-Lukić, Milica; Petrović, Igor N; Valsasina, Paola; Meani, Alessandro; Copetti, Massimiliano; Kostić, Vladimir S; Filippi, Massimo
2018-01-18
In this prospective, longitudinal, multiparametric MRI study, we investigated clinical as well as brain grey matter and white matter (WM) regional changes in patients with progressive supranuclear palsy-Richardson's syndrome (PSP-RS). Twenty-one patients with PSP-RS were evaluated at baseline relative to 36 healthy controls and after a mean follow-up of 1.4 years with clinical rating scales, neuropsychological tests and MRI scans. Relative to controls, patients with PSP-RS showed at baseline a typical pattern of brain damage, including midbrain atrophy, frontal cortical thinning and widespread WM involvement of the main infratentorial and supratentorial tracts that exceeded cortical damage. Longitudinal study showed that PSP-RS exhibited no further changes in cortical thinning, which remained relatively focal, while midbrain atrophy and WM damage significantly progressed. Corpus callosum and frontal WM tract changes correlated with the progression of both disease severity and behavioural dysfunction. This study demonstrated the feasibility of carrying out longitudinal diffusion tensor MRI in patients with PSP-RS and its sensitivity to identifying the progression of pathology. Longitudinal midbrain volume loss and WM changes are associated with PSP disease course. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.
Romme Christensen, Jeppe; Komori, Mika; von Essen, Marina Rode; Ratzer, Rikke; Börnsen, Lars; Bielekova, Bibi; Sellebjerg, Finn
2018-05-01
Development of treatments for progressive multiple sclerosis (MS) is challenged by the lack of sensitive and treatment-responsive biomarkers of intrathecal inflammation. To validate the responsiveness of cerebrospinal fluid (CSF) inflammatory biomarkers to treatment with natalizumab and methylprednisolone in progressive MS and to examine the relationship between CSF inflammatory and tissue damage biomarkers. CSF samples from two open-label phase II trials of natalizumab and methylprednisolone in primary and secondary progressive MS. CSF concentrations of 20 inflammatory biomarkers and CSF biomarkers of axonal damage (neurofilament light chain (NFL)) and demyelination were analysed using electrochemiluminescent assay and enzyme-linked immunosorbent assay (ELISA). In all, 17 natalizumab- and 23 methylprednisolone-treated patients had paired CSF samples. CSF sCD27 displayed superior standardised response means and highly significant decreases during both natalizumab and methylprednisolone treatment; however, post-treatment levels remained above healthy donor reference levels. Correlation analyses of CSF inflammatory biomarkers and NFL before, during and after treatment demonstrated that CSF sCD27 consistently correlates with NFL. These findings validate CSF sCD27 as a responsive and sensitive biomarker of intrathecal inflammation in progressive MS, capturing residual inflammation after treatment. Importantly, CSF sCD27 correlates with NFL, consistent with residual inflammation after anti-inflammatory treatment being associated with axonal damage.
Firkins, P; Hailey, J L; Fisher, J; Lettington, A H; Butter, R
1998-10-01
The wear of ultra-high molecular weight polyethylene (UHMWPE) in artificial joints and the resulting wear debris-induced osteolysis remains a major clinical concern in the orthopaedic sector. Third-body damage of metallic femoral heads is often cited as a cause of accelerated polyethylene wear, and the use of ceramic femoral heads in the hip is gaining increasing favour. In the knee prostheses and for smaller diameter femoral heads, the application of hard surface coatings, such as diamond-like carbon, is receiving considerable attention. However, to date, there has been little or no investigation of the tribology of these coatings in simulated biological environments. In this study, diamond-like carbon (DLC) has been compared to stainless steel in its undamaged form and following simulated third-body damage. The wear of UHMWPE was found to be similar when sliding against undamaged DLC and stainless steel counterfaces. DLC was found to be much more damage resistant than DLC. Under test conditions that simulate third-body damage to the femoral head, the wear of UHMWPE was seven times lower against DLC than against stainless steel (P < 0.05). The study shows DLC has considerable potential as a femoral bearing surface in artificial joints.
NASA Technical Reports Server (NTRS)
Ricks, Glen A.
1988-01-01
The assembly test article (ATA) consisted of two live loaded redesigned solid rocket motor (RSRM) segments which were assembled and disassembled to simulate the actual flight segment stacking process. The test assembly joint was flight RSRM design, which included the J-joint insulation design and metal capture feature. The ATA test was performed mid-November through 24 December 1987, at Kennedy Space Center (KSC), Florida. The purpose of the test was: certification that vertical RSRM segment mating and separation could be accomplished without any damage; verification and modification of the procedures in the segment stacking/destacking documents; and certification of various GSE to be used for flight assembly and inspection. The RSRM vertical segment assembly/disassembly is possible without any damage to the insulation, metal parts, or seals. The insulation J-joint contact area was very close to the predicted values. Numerous deviations and changes to the planning documents were made to ensure the flight segments are effectively and correctly stacked. Various GSE were also certified for use on flight segments, and are discussed in detail.
Innate Immunity Sensors Participating in Pathophysiology of Joint Diseases: A Brief Overview
Gallo, Jiri; Raska, Milan; Konttinen, Yrjö T.; Nich, Christophe; Goodman, Stuart B.
2015-01-01
The innate immune system consists of functionally specialized “modules” that are activated in response to a particular set of stimuli via sensors located on the surface or inside the tissue cells. These cells screen tissues for a wide range of exogenous and endogenous danger/damage-induced signals with the aim to reject or tolerate them and maintain tissue integrity. In this line of thinking, inflammation evolved as an adaptive tool for restoring tissue homeostasis. A number of diseases are mediated by a maladaptation of the innate immune response, perpetuating chronic inflammation and tissue damage. Here, we review recent evidence on the cross talk between innate immune sensors and development of rheumatoid arthritis, osteoarthritis, and aseptic loosening of total joint replacements. In relation to the latter topic, there is a growing body of evidence that aseptic loosening and periprosthetic osteolysis results from long-term maladaptation of periprosthetic tissues to the presence of by-products continuously released from an artificial joint. PMID:25747032
NASA Technical Reports Server (NTRS)
Taylor, Deneen; Enriquez, Carlos; McCann, David; McFatter, Justin
2010-01-01
The Solar Alpha Rotary Joint (SARJ) is a single-axis pointing mechanism used to orient the solar power generating arrays relative to the sun for the International Space Station (ISS). Approximately 83 days after its on-orbit installation, one of the two SARJ mechanisms aboard the ISS began to exhibit high current draw. Later inspections via Extravehicular Activity (EVA) discovered that the case hardened steel race ring on the outboard side of the joint had extensive damage to one of its three rolling surfaces. A far-reaching investigation of the anomaly was undertaken, comprising metallurgical inspections, coupon tests, traction kinematics tests, detailed bearing measurements, and thermal and structural analyses. The investigation found that the race ring damage had been caused by high bearing edge stresses that resulted from inadequate lubrication of the rolling contact. The profile of the roller bearings and the metallurgical properties of the race ring were also found to be significant contributing factors.
Micromechanics Based Failure Analysis of Heterogeneous Materials
NASA Astrophysics Data System (ADS)
Sertse, Hamsasew M.
In recent decades, heterogeneous materials are extensively used in various industries such as aerospace, defense, automotive and others due to their desirable specific properties and excellent capability of accumulating damage. Despite their wide use, there are numerous challenges associated with the application of these materials. One of the main challenges is lack of accurate tools to predict the initiation, progression and final failure of these materials under various thermomechanical loading conditions. Although failure is usually treated at the macro and meso-scale level, the initiation and growth of failure is a complex phenomena across multiple scales. The objective of this work is to enable the mechanics of structure genome (MSG) and its companion code SwiftComp to analyze the initial failure (also called static failure), progressive failure, and fatigue failure of heterogeneous materials using micromechanics approach. The initial failure is evaluated at each numerical integration point using pointwise and nonlocal approach for each constituent of the heterogeneous materials. The effects of imperfect interfaces among constituents of heterogeneous materials are also investigated using a linear traction-displacement model. Moreover, the progressive and fatigue damage analyses are conducted using continuum damage mechanics (CDM) approach. The various failure criteria are also applied at a material point to analyze progressive damage in each constituent. The constitutive equation of a damaged material is formulated based on a consistent irreversible thermodynamics approach. The overall tangent modulus of uncoupled elastoplastic damage for negligible back stress effect is derived. The initiation of plasticity and damage in each constituent is evaluated at each numerical integration point using a nonlocal approach. The accumulated plastic strain and anisotropic damage evolution variables are iteratively solved using an incremental algorithm. The damage analyses are performed for both brittle failure/high cycle fatigue (HCF) for negligible plastic strain and ductile failure/low cycle fatigue (LCF) for large plastic strain. The proposed approach is incorporated in SwiftComp and used to predict the initial failure envelope, stress-strain curve for various loading conditions, and fatigue life of heterogeneous materials. The combined effects of strain hardening and progressive fatigue damage on the effective properties of heterogeneous materials are also studied. The capability of the current approach is validated using several representative examples of heterogeneous materials including binary composites, continuous fiber-reinforced composites, particle-reinforced composites, discontinuous fiber-reinforced composites, and woven composites. The predictions of MSG are also compared with the predictions obtained using various micromechanics approaches such as Generalized Methods of Cells (GMC), Mori-Tanaka (MT), and Double Inclusions (DI) and Representative Volume Element (RVE) Analysis (called as 3-dimensional finite element analysis (3D FEA) in this document). This study demonstrates that a micromechanics based failure analysis has a great potential to rigorously and more accurately analyze initiation and progression of damage in heterogeneous materials. However, this approach requires material properties specific to damage analysis, which are needed to be independently calibrated for each constituent.
TRAIP promotes DNA damage response during genome replication and is mutated in primordial dwarfism.
Harley, Margaret E; Murina, Olga; Leitch, Andrea; Higgs, Martin R; Bicknell, Louise S; Yigit, Gökhan; Blackford, Andrew N; Zlatanou, Anastasia; Mackenzie, Karen J; Reddy, Kaalak; Halachev, Mihail; McGlasson, Sarah; Reijns, Martin A M; Fluteau, Adeline; Martin, Carol-Anne; Sabbioneda, Simone; Elcioglu, Nursel H; Altmüller, Janine; Thiele, Holger; Greenhalgh, Lynn; Chessa, Luciana; Maghnie, Mohamad; Salim, Mahmoud; Bober, Michael B; Nürnberg, Peter; Jackson, Stephen P; Hurles, Matthew E; Wollnik, Bernd; Stewart, Grant S; Jackson, Andrew P
2016-01-01
DNA lesions encountered by replicative polymerases threaten genome stability and cell cycle progression. Here we report the identification of mutations in TRAIP, encoding an E3 RING ubiquitin ligase, in patients with microcephalic primordial dwarfism. We establish that TRAIP relocalizes to sites of DNA damage, where it is required for optimal phosphorylation of H2AX and RPA2 during S-phase in response to ultraviolet (UV) irradiation, as well as fork progression through UV-induced DNA lesions. TRAIP is necessary for efficient cell cycle progression and mutations in TRAIP therefore limit cellular proliferation, providing a potential mechanism for microcephaly and dwarfism phenotypes. Human genetics thus identifies TRAIP as a component of the DNA damage response to replication-blocking DNA lesions.
Giant Cells Osseous Tumor in the Tarsal Canal after Lateral Ankle Sprain
Lughi, Marcello
2018-01-01
Ankle sprain can cause injuries to the anatomic structures surrounding the tibiotarsal joint. A possible extra-articular pathology is to be hypothesized and diagnosed as early as possible. The subtalar joint, for anatomical and functional reasons, is one of the most damaged joints following an ankle sprain. In spite of this, its involvement is often underestimated. The clinical case presented in the present article is referred to a giant cells osseous tumor in the tarsal canal that was diagnosed 2 months after an inversion ankle sprain. PMID:29675509
[Comparative evolution surgical accesses to temporo-mandibular joint].
Sysoliatin, P G; Novikov, A I; Sysoliatin, S P; Bobylev, N G; Brega, I N
2007-01-01
In experiment on 30 corpses of adult people criteria of an operational wound (depth of a wound, a corner of operational action, an axis of operational action, a corner of an inclination of operational action) were studied at preauricularis, intrauricularis, intrauriculo-temporalis and posterior mandibullaris access to temporo-mandibular joint (TMJ). New surgical intrauriculo-temporalis access to the joint is substantrated. On the basis of the analysis of 289 operations at 268 patients the indications to a choice of surgical access were developed at various diseases and damages of TMJ.
Quantitative metal magnetic memory reliability modeling for welded joints
NASA Astrophysics Data System (ADS)
Xing, Haiyan; Dang, Yongbin; Wang, Ben; Leng, Jiancheng
2016-03-01
Metal magnetic memory(MMM) testing has been widely used to detect welded joints. However, load levels, environmental magnetic field, and measurement noises make the MMM data dispersive and bring difficulty to quantitative evaluation. In order to promote the development of quantitative MMM reliability assessment, a new MMM model is presented for welded joints. Steel Q235 welded specimens are tested along the longitudinal and horizontal lines by TSC-2M-8 instrument in the tensile fatigue experiments. The X-ray testing is carried out synchronously to verify the MMM results. It is found that MMM testing can detect the hidden crack earlier than X-ray testing. Moreover, the MMM gradient vector sum K vs is sensitive to the damage degree, especially at early and hidden damage stages. Considering the dispersion of MMM data, the K vs statistical law is investigated, which shows that K vs obeys Gaussian distribution. So K vs is the suitable MMM parameter to establish reliability model of welded joints. At last, the original quantitative MMM reliability model is first presented based on the improved stress strength interference theory. It is shown that the reliability degree R gradually decreases with the decreasing of the residual life ratio T, and the maximal error between prediction reliability degree R 1 and verification reliability degree R 2 is 9.15%. This presented method provides a novel tool of reliability testing and evaluating in practical engineering for welded joints.
Kim, Y G; Song, J B; Kim, J C; Kim, J M; Yoo, B H; Yun, S B; Hwang, D Y; Lee, H G
2017-08-01
This note presents a superconducting joint technique for the development of MgB 2 magnetic resonance imaging (MRI) magnets. The MgB 2 superconducting joint was fabricated by a powder processing method using Mg and B powders to establish a wire-bulk-wire connection. The joint resistance measured using a field-decay method was <10 -14 Ω, demonstrating that the proposed joint technique could be employed for developing "next-generation" MgB 2 MRI magnets operating in the persistent current mode.
Charcot Neuroarthropathy of the Foot and Ankle.
Burson, Lisa K; Schank, Christopher H
2016-03-01
Charcot neuropathy is a painless, progressive, degeneration most notably of the ankle or midfoot joints, seen in patients with diabetes and neuropathy. This article will describe the etiology, diagnosis, and treatment of this potentially debilitating joint disease and provide implications for home care clinicians.
F-35 Joint Strike Fighter (JSF) Program: Background, Status, and Issues
2007-07-19
Buy ‘Hundreds’ of STOVL Joint Strike Fighters,” Inside the Air Force. September 17, 2004. 6 Marc Selinger. “Jumper Confirms Air Force Plans to Cut...concluded that some 230 of the Navy’s projected buy of 480 JSFs could instead be F/A-18E/Fs, depending on the progress of the JSF program and the price of...18E/F Buy Depends on JSF Progress,’Cohen Tells SASC,” Aerospace Daily, May 21, 1997: 285, 288. See also CRS Issue Brief IB93041, C- 17 Cargo
Marra, Carlo A; Bansback, Nick; Anis, Aslam H; Shojania, Kamran
2011-03-01
Rheumatoid arthritis (RA) is a chronic, debilitating inflammatory, progressive musculoskeletal disease that affects 0.5-1.0% of the adult population in Western countries. The joint destruction and progressive functional disability associated with uncontrolled RA result in tremendous impacts on health-related quality of life, ability to work, and mortality. In addition, the treatment of the disease and associated complications exact a substantial economic burden to the patients, their families, and society. In the last decade, several biological agents (biologics) have been approved for use in RA, revolutionizing treatment. These biologics, which target cytokines such as tumor necrosis factor or lymphocytes such as B or T cells, reduce functional disability and substantially slow the progression of joint damage. However, because these agents typically cost ten to 100 times more than existing available older drug therapies, there has been worldwide concern regarding their impact on healthcare budgets. As such, there has been increased attention towards economic evaluation as a means to determine whether, and in which subgroup of patients, these newer, more expensive agents confer appropriate value for their additional cost. Indeed, evaluations have guided coverage decisions for both private and public health insurance agencies such as the National Institute for Health and Clinical Excellence in the UK. The use of economic evaluations to determine value for money for these agents has attracted both debate and controversy. Some of the controversy is related to the appropriateness of the structure of, and assumptions underlying, the decision models employed to estimate the long-term costs and benefits of these agents over existing therapies. To fully appreciate the debate, one must first understand the basic principles of economic evaluation and the necessity for using decision models to evaluate cost effectiveness. To understand the basic principles of economic evaluation, we refer the reader to an introductory article aimed at clinical rheumatologists. This paper attempts to explain the rationale for the use of economic modeling approaches to assess the value of biologics for RA using specific examples from the literature.
Fischenich, Kristine M.; Button, Keith D.; Coatney, Garrett A.; Fajardo, Ryan S.; Leikert, Kevin M.; Haut, Roger C.; Haut Donahue, Tammy L.
2014-01-01
The objective of this study was to induce anterior cruciate ligament (ACL) and meniscal damage, via a single tibiofemoral compressive impact, in order to document articular cartilage and meniscal changes post impact. Tibiofemoral joints of Flemish Giant rabbits were subjected to a single blunt impact that ruptured the ACL and produced acute meniscal damage. Animals were allowed unrestricted cage activity for 12 weeks before euthanasia. India ink analysis of the articular cartilage revealed higher degrees of surface damage on the impacted tibias (p=0.018) and femurs (p<0.0001) compared to controls. Chronic meniscal damage was most prevalent in the medial central and medial posterior regions. Mechanical tests revealed an overall 19.4% increase in tibial plateau cartilage thickness (p=0.026), 34.8% increase in tibial plateau permeability (p=0.054), 40.8% increase in femoral condyle permeability (p=0.029), and 20.1% decrease in femoral condyle matrix modulus (p=0.012) in impacted joints compared to controls. Both the instantaneous and equilibrium moduli of the lateral and medial menisci were decreased compared to control (p<0.02). Histological analyses revealed significantly increased presence of fissures in the medial femur (p = 0.036). In both the meniscus and cartilage there was a significant decrease in GAG coverage for the impacted limbs. Based on these results it is clear that an unattended combined meniscal and ACL injury results in significant changes to the soft tissues in this experimental joint 12 weeks post injury. Such changes are consistent with a clinical description of mid to late stage PTOA of the knee. PMID:25523754
de Rooster, H; Cox, E; van Bree, H
2000-11-01
To measure and compare synovial fluid antibody titers to type-I and -II collagen in stifle joints with instability caused by complete or partial cranial cruciate ligament (CCL) rupture and joints with osteoarthrosis secondary to other pathologic changes in dogs. 82 dogs with diseased stifle joints. Synovial fluid samples were collected from 7 dogs with clinically normal stifles (control group) and 82 dogs with diseased joints (50 stifle joints with complete rupture of the CCL, 20 with partial damage of the CCL, and 12 joints with radiographic signs of osteoarthritis secondary to other arthropathies). Synovial fluid samples were tested for autoantibodies to type-I and -II collagen by an ELISA. In dogs with complete and partial CCL rupture, synovial fluid antibody titers to type-I and -II collagen were significantly increased, compared with control dogs. Forty-eight percent (24/50) of samples from dogs with complete CCL rupture and 35% (7/20) of samples from dogs with partial CCL rupture had antibody titers to type-I collagen that were greater than the mean plus 2 standard deviations of the control group titers. Synovial fluid antibody titers to type-II collagen were high in 40% of the dogs with partial or (8/20) complete (20/50) CCL rupture. Dogs with osteoarthrosis secondary to other pathologic changes had significantly increased synovial fluid antibodies to type-I and -II collagen, compared with control dogs. Increases in autoantibodies to collagen in synovial fluid are not specific for the type of joint disorder. It is unlikely that the anticollagen antibodies play an active role in the initiation of weakening of the CCL.
Halls, Serena; Law, Rebecca-Jane; Jones, Jeremy G; Markland, David A; Maddison, Peter J; Thom, Jeanette M
2017-09-01
Although exercise is an important factor in the management of rheumatoid arthritis (RA), research indicates that patients perceive that health professionals (HPs) are uncertain about the place of exercise in treatment and its relationship with joint damage. The present study investigated the perceptions of HPs regarding the effects of exercise on joint health in RA patients. A questionnaire investigating perceptions of exercise and joint health was distributed via professional networks and websites. Confirmatory factor analysis (CFA) was used to analyse questionnaire data and develop a focus group interview guide. Focus groups were conducted with multidisciplinary teams (MDTs) of rheumatology HPs and analysed using framework analysis. A total of 137 rheumatology HPs (95 female; 27-65 years of age) completed questionnaires. CFA showed that a four-factor model provided a marginally acceptable fit. Analysis of four focus groups (n = 24; 19 female; 30-60 years of age) identified five themes relating to HPs' perceptions of exercise and joint health in RA patients: 'Exercise is beneficial', 'Concerns about damage to joints', 'Patients have barriers to exercise', 'HP knowledge differs' and 'Patients may think service delivery is vague'. HPs were highly aware of the benefits and importance of exercise for RA patients. However, to remove the patient perception that HPs lack certainty and clarity regarding exercise it is important to ensure: (i) consistent promotion of exercise across the whole MDT; (ii) clear provision of information regarding rest, joint protection and exercise; (iii) HP education to ensure consistent, accurate knowledge, and understanding of the potential for conflicting advice when promoting exercise as part of an MDT. Copy © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.
DOE Office of Scientific and Technical Information (OSTI.GOV)
Chase, A.R.
When Congress enacted the Comprehensive Environmental Response, Compensation, and Liability Act of 1980 (CERCLA), it ushered in a sweeping approach to controlling the environmental effects of improper hazardous waste disposal. CERCLA`s cleanup provisions, which focus on removal and remediation of hazardous substances from inactive hazardous waste sites, have progressed through more than a decade of litigation and a great deal of public debate. However, CERCLA`s natural resource damage provisions have not shared this same degree of progress.
[RESEARCH PROGRESS OF BIOMECHANICS OF PROXIMAL ROW CARPAL INSTABILITY].
Guo, Jinhai; Huang, Fuguo
2015-01-01
To review the research progress of the biomechanics of proximal row carpal instability (IPRC). The related literature concerning IPRC was extensively reviewed. The biomechanical mechanism of the surrounding soft tissue in maintaining the stability of the proximal row carpal (PRC) was analyzed, and the methods to repair or reconstruct the stability and function of the PRC were summarized from two aspects including basic biomechanics and clinical biomechanics. The muscles and ligaments of the PRC are critical to its stability. Most scholars have reached a consensus about biomechanical mechanism of the PRC, but there are still controversial conclusions on the biomechanics mechanism of the surrounding soft tissue to stability of distal radioulnar joint when the triangular fibrocartilage complex are damaged and the biomechanics mechanism of the scapholunate ligament. At present, there is no unified standard about the methods to repair or reconstruct the stability and function of the PRC. So, it is difficult for clinical practice. Some strides have been made in the basic biomechanical study on muscle and ligament and clinical biomechanical study on the methods to repair or reconstruct the stability and function of PRC, but it will be needed to further study the morphology of carpal articular surface and the adjacent articular surface, the pressure of distal carpals to proximal carpal and so on.
Creating Defense Excellence: Defense Addendum to Road Map for National Security
2001-05-15
occasionally distrust political appointees—many of whom can be young , inexperienced academics—as “interlopers” who can severely damage well-established...centralization, lost managerial competence, and the loss of Service esprit de corps. The centralized approach may instill greater efficiency toward a...This is necessary because the evolution of joint warfighting and defense economics has shifted many past roles and responsibilities to joint and
Federal Register 2010, 2011, 2012, 2013, 2014
2010-03-18
.... This proposed AD results from a structural review of affected skin lap joints for widespread fatigue damage. We are proposing this AD to prevent fatigue cracking in certain lap joints, which could result in...., Washington, DC 20590, between 9 a.m. and 5 p.m., Monday through Friday, except Federal holidays. For service...
NASA Technical Reports Server (NTRS)
Lo, David C.; Coats, Timothy W.; Harris, Charles E.; Allen, David H.
1996-01-01
A method for analysis of progressive failure in the Computational Structural Mechanics Testbed is presented in this report. The relationship employed in this analysis describes the matrix crack damage and fiber fracture via kinematics-based volume-averaged variables. Damage accumulation during monotonic and cyclic loads is predicted by damage evolution laws for tensile load conditions. The implementation of this damage model required the development of two testbed processors. While this report concentrates on the theory and usage of these processors, a complete list of all testbed processors and inputs that are required for this analysis are included. Sample calculations for laminates subjected to monotonic and cyclic loads were performed to illustrate the damage accumulation, stress redistribution, and changes to the global response that occur during the load history. Residual strength predictions made with this information compared favorably with experimental measurements.
Investigation of Micro-Scale Architectural Effects on Damage of Composites
NASA Technical Reports Server (NTRS)
Stier, Bertram; Bednarcyk, Brett A.; Simon, Jaan W.; Reese, Stefanie
2015-01-01
This paper presents a three-dimensional, energy based, anisotropic, stiffness reduction, progressive damage model for composite materials and composite material constituents. The model has been implemented as a user-defined constitutive model within the Abaqus finite element software package and applied to simulate the nonlinear behavior of a damaging epoxy matrix within a unidirectional composite material. Three different composite microstructures were considered as finite element repeating unit cells, with appropriate periodicity conditions applied at the boundaries. Results representing predicted transverse tensile, longitudinal shear, and transverse shear stress-strain curves are presented, along with plots of the local fields indicating the damage progression within the microstructure. It is demonstrated that the damage model functions appropriately at the matrix scale, enabling localization of the damage to simulate failure of the composite material. The influence of the repeating unit cell geometry and the effect of the directionality of the applied loading are investigated and discussed.
de Sisternes, Luis; Hu, Julia; Rubin, Daniel L; Marmor, Michael F
2015-05-01
To evaluate the relative involvement of inner and outer retina in hydroxychloroquine (HCQ) retinopathy while on the drug, and after drug cessation, using data from spectral-domain optical coherence tomography (SD-OCT). A total of 102 SD-OCT scans were obtained from 11 patients (classified as having early, moderate, or severe stages of toxicity) over a period of 4 years after cessation of HCQ. The inner and outer retina boundaries were identified automatically to measure thickness and characterize progression topographically. The segmentation of retinal layers was verified in SD-OCT cross-sections for all eyes and scans included in this study (a total of 102 scans). Topographic analysis showed that inner retina was not involved in HCQ toxicity to any meaningful degree, either between stages of retinopathy or after the drug is stopped. The characteristic bull's eye pattern of outer macula thinning appears when comparing moderate retinopathy (before any RPE damage) to the early stage. Later damage, as toxicity evolved to a severe stage, was diffuse across most of the macula. If the drug was stopped at an early or moderate stage, progression was limited to the first year and occurred diffusely without parafoveal localization. Hydroxychloroquine retinopathy primarily involves outer retina (photoreceptors). Outer retinal thinning while using HCQ initially involves the parafovea, but becomes diffuse across the macula as damage progresses or after drug cessation. When HCQ is stopped at an early or moderate stage (before RPE damage), progression seems to be limited to the first year.
... are important for motion and standing. Playing sports, running, falling, or having an accident can damage your legs. Common leg injuries include sprains and strains, joint dislocations, and fractures. ...
Damage Control Surgery and the Joint Solution
2017-06-01
IV. THE SERVICES ’ OPERATE, TRAIN AND EQUIP FOR DEPLOYMENT OF DCS 13 V. COURSES OF ACTION 20 VI. CONCLUSION...Figure 14: Notional Service Enlisted Specialty Training Timeline 25 Figure 15: Timeline of Events for Base Hospital #28...implications for casualty care. Lastly, a short excerpt on how each Service organizes, trains and equips their personnel for the delivery of damage control
Overcoming Barriers to Firewise Actions by Residents. Final Report to Joint Fire Science Program
James D. Absher; Jerry J. Vaske; Katie M. Lyon
2013-01-01
Encouraging the public to take action (e.g., creating defensible space) that can reduce the likelihood of wildfire damage and decrease the likelihood of injury is a common approach to increasing wildfire safety and damage mitigation. This study was designed to improve our understanding of both individual and community actions that homeowners currently do or might take...
Arthroscopic Management of Scaphoid-Trapezium-Trapezoid Joint Arthritis.
Pegoli, Loris; Pozzi, Alessandro
2017-11-01
Scaphoid-trapezium-trapezoid (STT) joint arthritis is a common condition consisting of pain on the radial side of the wrist and base of the thumb, swelling, and tenderness over the STT joint. Common symptoms are loss of grip strength and thumb function. There are several treatments, from symptomatic conservative treatment to surgical solutions, such as arthrodesis, arthroplasties, and prosthesis implant. The role of arthroscopy has grown and is probably the best treatment of this condition. Advantages of arthroscopic management of STT arthritis are faster recovery, better view of the joint during surgery, and possibility of creating less damage to the capsular and ligamentous structures. Copyright © 2017 Elsevier Inc. All rights reserved.
Bay-Jensen, Anne C; Slagboom, Eline; Chen-An, Pingping; Alexandersen, Peter; Qvist, Per; Christiansen, Claus; Meulenbelt, Ingrid; Karsdal, Morten A
2013-05-01
Joint health is affected by local and systemic hormones. It is well accepted that systemic factors regulate the metabolism of joint tissues, and that substantial cross-talk between tissues actively contributes to homeostasis. In the current review, we try to define a subtype of osteoarthritis (OA), metabolic OA, which is dependent on an unhealthy phenotype. Peer-reviewed research articles and reviews were reviewed and summarized. Only literature readily available online, either by download or by purchase order, was included. OA is the most common joint disease and is more common in women after menopause. OA is a disease that affects the whole joint, including cartilage, subchondral bone, synovium, tendons, and muscles. The clinical endpoints of OA are pain and joint space narrowing, which is characterized by cartilage erosion and subchondral sclerosis, suggesting that cartilage is a central tissue of joint health. Thus, the joint, more specifically the cartilage, may be considered a target of endocrine function in addition to the well-described traditional risk factors of disease initiation and progression such as long-term loading of the joint due to obesity. Metabolic syndrome affects a range of tissues and may in part be molecularly described as a dysregulation of cytokines, adipokines, and hormones (e.g., estrogen and thyroid hormone). Consequently, metabolic imbalance may both directly and indirectly influence joint health and cartilage turnover, altering the progression of diseases such as OA. There is substantial evidence for a connection between metabolic health and development of OA. We propose that more focus be directed to understanding this connection to improve the management of menopausal health and associated comorbidities.
Further Simplification of the Simple Erosion Narrowing Score With Item Response Theory Methodology.
Oude Voshaar, Martijn A H; Schenk, Olga; Ten Klooster, Peter M; Vonkeman, Harald E; Bernelot Moens, Hein J; Boers, Maarten; van de Laar, Mart A F J
2016-08-01
To further simplify the simple erosion narrowing score (SENS) by removing scored areas that contribute the least to its measurement precision according to analysis based on item response theory (IRT) and to compare the measurement performance of the simplified version to the original. Baseline and 18-month data of the Combinatietherapie Bij Reumatoide Artritis (COBRA) trial were modeled using longitudinal IRT methodology. Measurement precision was evaluated across different levels of structural damage. SENS was further simplified by omitting the least reliably scored areas. Discriminant validity of SENS and its simplification were studied by comparing their ability to differentiate between the COBRA and sulfasalazine arms. Responsiveness was studied by comparing standardized change scores between versions. SENS data showed good fit to the IRT model. Carpal and feet joints contributed the least statistical information to both erosion and joint space narrowing scores. Omitting the joints of the foot reduced measurement precision for the erosion score in cases with below-average levels of structural damage (relative efficiency compared with the original version ranged 35-59%). Omitting the carpal joints had minimal effect on precision (relative efficiency range 77-88%). Responsiveness of a simplified SENS without carpal joints closely approximated the original version (i.e., all Δ standardized change scores were ≤0.06). Discriminant validity was also similar between versions for both the erosion score (relative efficiency = 97%) and the SENS total score (relative efficiency = 84%). Our results show that the carpal joints may be omitted from the SENS without notable repercussion for its measurement performance. © 2016, American College of Rheumatology.
Talaván-Serna, J; Montiel-Company, J M; Bellot-Arcís, C; Almerich-Silla, J M
2017-02-01
The purpose of this study was to conduct a systematic review of the literature on temporomandibular joint damage directly related to general anaesthesia and sedation. We searched MEDLINE, SCOPUS and the COCHRANE Library for titles and abstracts containing terms related to the subject. The search delimiters were analytical and descriptive studies with abstracts in Spanish, German, English or French, with no time limit. The search was updated in January 2015. Of the 398 articles found, 89 were duplicates and only 28 were of interest. Of these, 23 (82.14%) were case and case series reports, 4 (14.28%) were longitudinal studies and 1 (3.57%) was a cross-sectional study. General anaesthesia and sedation are risk factors for temporomandibular joint damage because of the drop in muscle tone caused by the drugs employed and because of airway management manoeuvres involving the joint. Joint complications have been described with spontaneous ventilation as well as with ventilation assisted by a face or laryngeal mask and with intubation. They are more frequent in women and/or patients with previous temporomandibular problems. Proper assessment is required both before and after anaesthesia or sedation in order to foresee and avoid or minimize temporomandibular complications. The data should be treated with caution, as the evidence of case and case series reports is not of a high standard and the small number of analytical studies is not entirely comparable. General anaesthesia and sedation techniques can influence the onset of temporomandibular joint disorders. More studies are needed to provide better clinical evidence. Copyright © 2016 Elsevier Masson SAS. All rights reserved.
Neidel, J; Schroers, B; Sintermann, F
1998-01-01
To determine whether systemic administration of methotrexate (MTX) can prevent joint destruction in experimental osteoarthrosis (OA) in rabbits, the disorder was induced unilaterally in the knee joints of 40 rabbits by partial medial meniscectomy and sectioning of the medial collateral and both cruciate ligaments. A sham operation (arthrotomy only) was performed in another four animals. Effects on the cartilage of the femoral condyles were studied after 6 and 12 weeks. Twelve weeks after induction, femoral and tibial osteophyte formation was demonstrated on radiographs in all cases. Marked cartilage damage was found histologically (median Mankin score 10 vs 1 for non-operated controls; P < 0.05, Wilcoxon test). Cartilage proteoglycan (GAG) content (dye binding assay) was reduced in operated joints [63 +/- 8 (mean +/- SEM) vs 75 +/- 6 micrograms chondroitin sulfate/mg cartilage wet weight], and the leukocyte count in the joints was elevated (226 +/- 14 vs 7 +/- 3 leukocytes per microliter joint aspirate after injection of 0.5 ml saline solution; both P < 0.05, Wilcoxon test). The rate of GAG synthesis was unchanged (ex vivo labelling with 35S-sulfate). Treatment with MTX (30 mg x kg body weight-1 x week-1 i.m., starting 12 h postoperatively) reduced cartilage damage (median Mankin score 8 vs 10 for placebo, P < 0.05, Mann-Whitney U-test), but had no significant effect on the other parameters tested. No significant MTX effects were observed on cartilage from nonoperated joints. Our data indicate that MTX may have a limited therapeutic effect in experimental OA in the rabbit.
Paradowski, P T; Lohmander, L S; Englund, M
2016-05-01
To determine prevalence, incidence and progression of radiographic knee osteoarthritis (OA) in a cohort of subjects with previous meniscectomy. We assessed 221 subjects (177 men and 44 women) with weight bearing knee radiography twice (assessment A and B) with a follow-up time ranging from 4 to 10 years. All subjects had undergone meniscectomy 15-22 years before assessment A. At assessment B the mean (SD) age was 60 (11) years. We assessed prevalence and incidence of OA, as well as progression of radiographic features over time. Radiographic OA was defined as approximating Kellgren and Lawrence grade 2 or worse. At assessment A, we found tibiofemoral radiographic OA in 107 subjects' index knee (48%) of which 41 subjects (38%) had bilateral tibiofemoral OA. At assessment B, the corresponding figures were 151 (68%) and 71 (32%). At assessment A, we found patellofemoral OA in 32 subjects' index knee (14%) of which 11 (34%) had bilateral patellofemoral OA. At assessment B, the corresponding figures were 51 (23%) and 19 (37%). There was an increase of the sum of joint space narrowing (JSN) and osteophyte grades in the tibiofemoral joint of 144 subjects' index knee (64%) and in the contralateral tibiofemoral joints of 79 subjects (36%). The corresponding progression in the patellofemoral joint was observed in 66 index knees (30%) and in 41 (19%) contralateral knees. Overall, some 20-30 years after meniscectomy nearly three out of four persons had developed radiographic tibiofemoral OA and one out of four had developed patellofemoral OA. Copyright © 2015 Osteoarthritis Research Society International. Published by Elsevier Ltd. All rights reserved.
Donate, Paula B; Cunha, Thiago M; Verri, Waldiceu A; Junta, Cristina M; Lima, Flavia O; Vieira, Silvio M; Peres, Rafael S; Bombonato-Prado, Karina F; Louzada, Paulo; Ferreira, Sergio H; Donadi, Eduardo A; Passos, Geraldo A S; Cunha, Fernando Q
2012-04-01
Endothelins (ETs) are involved in several inflammatory events. The present study investigated the efficacy of bosentan, a dual ETA/ETB receptor antagonist, in collagen-induced arthritis (CIA) in mice. CIA was induced in DBA/1J mice. Arthritic mice were treated with bosentan (100 mg/kg) once a day, starting from the day when arthritis was clinically detectable. CIA progression was assessed by measurements of visual clinical score, paw swelling and hypernociception. Histological changes, neutrophil infiltration and pro-inflammatory cytokines were evaluated in the joints. Gene expression in the lymph nodes of arthritic mice was evaluated by microarray technology. PreproET-1 mRNA expression in the lymph nodes of mice and in peripheral blood mononuclear cells (PBMCs) was evaluated by real-time PCR. The differences were evaluated by one-way ANOVA or Student's t test. Oral treatment with bosentan markedly ameliorated the clinical aspects of CIA (visual clinical score, paw swelling and hyperalgesia). Bosentan treatment also reduced joint damage, leukocyte infiltration and pro-inflammatory cytokine levels (IL-1β, TNFα and IL-17) in the joint tissues. Changes in gene expression in the lymph nodes of arthritic mice returned to the levels of the control mice after bosentan treatment. PreproET mRNA expression increased in PBMCs from rheumatoid arthritis (RA) patients but returned to basal level in PBMCs from patients under anti-TNF therapy. In-vitro treatment of PBMCs with TNFα upregulated ET system genes. These findings indicate that ET receptor antagonists, such as bosentan, might be useful in controlling RA. Moreover, it seems that ET mediation of arthritis is triggered by TNFα.
Mimicry of lyme arthritis by synovial hemangioma.
Hospach, Toni; Langendörfer, M; Kalle, T V; Tewald, F; Wirth, T; Dannecker, G E
2011-12-01
To report on the differential diagnosis of lyme arthritis and synovial hemangioma due to similar clinical and radiological signs and symptoms. A 15-year-old boy presented at the age of 9 with recurrent rather painless swelling of the right knee. Altogether four episodes lasting for 1-2 weeks each occurred over a period of 18 months before medical advice was sought. Physical examination revealed only a slightly limited range of motion. Living in an endemic area of borreliosis, he reported a tick bite 6 months prior to onset of his symptoms with erythema migrans and was treated for 10 days with amoxicillin. Serology revealed two positive unspecific bands in IgG immunoblot (p41 and 66) with slight positivity for ELISA. Ultrasound revealed synovial thickening and increased fluid. Despite the weak positive serology a diagnosis of lyme arthritis could not be excluded and intravenous antibiotic treatment with ceftriaxone was started. After two further relapses antiinflammatory therapy including intraarticular steroids were introduced with no long lasting effect. A chronical disease developed with alternate periods of swelling and almost complete remission. Ultrasound as well as MRI demonstrated ongoing signs of synovitis, therefore after further progression, a diagnostic arthroscopy was performed showing an inconspicuous knee joint. A second MRI showed focal suprapatellar enhancement and was followed by open arthrotomy revealing a histopathological proven synovial cavernous juxtaarticular hemangioma. To our knowledge, the differential diagnosis of lyme arthritis and synovial hemangioma has not yet been reported despite obvious clinical similarities. In conclusion, in children and adolescents synovial hemangioma has to be considered in differential diagnosis of recurrent knee swelling. Early diagnosis is important to prevent prolonged suffering from chronic joint swelling with probable joint damages, unnecessary treatment procedures and as well school and sports absenteeism.
Slart, Riemer H J A
2018-07-01
Large vessel vasculitis (LVV) is defined as a disease mainly affecting the large arteries, with two major variants, Takayasu arteritis (TA) and giant cell arteritis (GCA). GCA often coexists with polymyalgia rheumatica (PMR) in the same patient, since both belong to the same disease spectrum. FDG-PET/CT is a functional imaging technique which is an established tool in oncology, and has also demonstrated a role in the field of inflammatory diseases. Functional FDG-PET combined with anatomical CT angiography, FDG-PET/CT(A), may be of synergistic value for optimal diagnosis, monitoring of disease activity, and evaluating damage progression in LVV. There are currently no guidelines regarding PET imaging acquisition for LVV and PMR, even though standardization is of the utmost importance in order to facilitate clinical studies and for daily clinical practice. This work constitutes a joint procedural recommendation on FDG-PET/CT(A) imaging in large vessel vasculitis (LVV) and PMR from the Cardiovascular and Inflammation & Infection Committees of the European Association of Nuclear Medicine (EANM), the Cardiovascular Council of the Society of Nuclear Medicine and Molecular Imaging (SNMMI), and the PET Interest Group (PIG), and endorsed by the American Society of Nuclear Cardiology (ASNC). The aim of this joint paper is to provide recommendations and statements, based on the available evidence in the literature and consensus of experts in the field, for patient preparation, and FDG-PET/CT(A) acquisition and interpretation for the diagnosis and follow-up of patients with suspected or diagnosed LVV and/or PMR. This position paper aims to set an internationally accepted standard for FDG-PET/CT(A) imaging and reporting of LVV and PMR.
A Case Report of an Acromioclavicular Joint Ganglion Associated with a Rotator Cuff Tear.
Tanaka, Suguru; Gotoh, Masafumi; Mitsui, Yasuhiro; Shirachi, Isao; Okawa, Takahiro; Higuchi, Fujio; Shiba, Naoto
2017-04-13
We report a case of subcutaneous ganglion adjacent to the acromioclavicular joint with massive rotator cuff tear [1-7]. An 81-year-old woman presented with a ganglion adjacent to the acromioclavicular joint that had first been identified 9 months earlier. The ganglion had recurred after having been aspirated by her local physician, so she was referred to our hospital. The puncture fluid was yellowish, clear and viscous. Magnetic resonance imaging identified a massive rotator cuff tear with multi- lobular cystic lesions continuous to the acromioclavicular joint, presenting the "geyser sign". During arthroscopy, distal clavicular resection and excision of the ganglion were performed together with joint debridement. At present, the ganglion has not recurred and the patient has returned to normal daily activity. In this case, the ganglion may have developed subsequent to the concomitant massive cuff tear, due to subcutaneous fluid flow through the damaged acromioclavicular joint.
TRAIP promotes DNA damage response during genome replication and is mutated in primordial dwarfism
Leitch, Andrea; Higgs, Martin R.; Bicknell, Louise S.; Yigit, Gökhan; Blackford, Andrew N.; Zlatanou, Anastasia; Mackenzie, Karen J.; Reddy, Kaalak; Halachev, Mihail; McGlasson, Sarah; Reijns, Martin A. M.; Fluteau, Adeline; Martin, Carol-Anne; Sabbioneda, Simone; Elcioglu, Nursel H.; Altmüller, Janine; Thiele, Holger; Greenhalgh, Lynn; Chessa, Luciana; Maghnie, Mohamad; Salim, Mahmoud; Bober, Michael B.; Nürnberg, Peter; Jackson, Stephen P.; Hurles, Matthew E.; Wollnik, Bernd; Stewart, Grant S.; Jackson, Andrew P.
2015-01-01
DNA lesions encountered by replicative polymerases threaten genome stability and cell cycle progression. Here we report the identification of mutations in TRAIP, encoding an E3 RING ubiquitin ligase, in patients with microcephalic primordial dwarfism/Seckel syndrome. We establish that TRAIP relocalizes to sites of DNA damage where it is required for optimal phosphorylation of H2AX and RPA2 during S-phase in response to UV irradiation, as well as fork progression through UV-induced DNA lesions. TRAIP is necessary for efficient cell cycle progression and mutations in TRAIP therefore limit cellular proliferation, providing a potential mechanism for microcephaly and dwarfism phenotypes. Human genetics thus identifies TRAIP as a novel component of the DNA damage response to replication-blocking DNA lesions. PMID:26595769
Prink, Adam; Hayashi, Kei; Kim, Sun-Young; Kim, James; Kapatkin, Amy
2010-01-01
To evaluate whether synovial fluid concentrations of an osteoarthritis biomarker in dysplastic canine elbows with medial coronoid disease (MCD) are elevated compared with unaffected elbows and to determine if these concentrations correlate to the degree of articular cartilage damage. Cross sectional clinical study. Dogs (n=19; 35 elbows) with MCD and dogs (8; 16 elbows) with unaffected elbows. Concentrations of a collagenase-generated cleavage neoepitope of type II collagen (Col2-3/4C(long mono), or C2C) in joint fluid from elbows were analyzed and compared between dogs with MCD and unaffected dogs. Correlation of C2C concentration with subjective grading of articular cartilage surface damage was also evaluated. Mean (+/-SD) C2C concentration from MCD dogs was significantly higher (112.3+/-24.8 ng/mL) than in unaffected dogs (76.1+/-16.9 ng/mL; P<.05). There was a moderate correlation between cartilage damage grade and increasing C2C concentrations (P<.05, r=0.62) C2C concentrations are elevated in the synovial fluid of dogs with MCD compared with unaffected elbows, and a moderate, significant correlation was identified between these concentrations and subjective grading of articular cartilage damage. This preliminary data suggest that C2C concentrations in synovial fluid may have potential as a biomarker for diagnosis of articular cartilage damage associated with MCD and as a means of objectively determining the degree of articular cartilage damage.
A Progressive Damage Methodology for Residual Strength Predictions of Notched Composite Panels
NASA Technical Reports Server (NTRS)
Coats, Timothy W.; Harris, Charles E.
1998-01-01
The translaminate fracture behavior of carbon/epoxy structural laminates with through-penetration notches was investigated to develop a residual strength prediction methodology for composite structures. An experimental characterization of several composite materials systems revealed a fracture resistance behavior that was very similar to the R-curve behavior exhibited by ductile metals. Fractographic examinations led to the postulate that the damage growth resistance was primarily due to fractured fibers in the principal load-carrying plies being bridged by intact fibers of the adjacent plies. The load transfer associated with this bridging mechanism suggests that a progressive damage analysis methodology will be appropriate for predicting the residual strength of laminates with through-penetration notches. A progressive damage methodology developed by the authors was used to predict the initiation and growth of matrix cracks and fiber fracture. Most of the residual strength predictions for different panel widths, notch lengths, and material systems were within about 10% of the experimental failure loads.
Progressive Fracture of Composite Structures
NASA Technical Reports Server (NTRS)
Minnetyan, Levon
2001-01-01
This report includes the results of a research in which the COmposite Durability STRuctural ANalysis (CODSTRAN) computational simulation capabilities were augmented and applied to various structures for demonstration of the new features and verification. The first chapter of this report provides an introduction to the computational simulation or virtual laboratory approach for the assessment of damage and fracture progression characteristics in composite structures. The second chapter outlines the details of the overall methodology used, including the failure criteria and the incremental/iterative loading procedure with the definitions of damage, fracture, and equilibrium states. The subsequent chapters each contain an augmented feature of the code and/or demonstration examples. All but one of the presented examples contains laminated composite structures with various fiber/matrix constituents. For each structure simulated, damage initiation and progression mechanisms are identified and the structural damage tolerance is quantified at various degradation stages. Many chapters contain the simulation of defective and defect free structures to evaluate the effects of existing defects on structural durability.
Health monitoring of prestressing tendons in post-tensioned concrete structures
NASA Astrophysics Data System (ADS)
Salamone, Salvatore; Bartoli, Ivan; Nucera, Claudio; Phillips, Robert; Lanza di Scalea, Francesco
2011-04-01
Currently 90% of bridges built in California are post-tensioned box-girder. In such structures the steel tendons are the main load-carrying components. The loss of prestress, as well as the presence of defects or the tendon breakage, can be catastrophic for the entire structure. Unfortunately, today there is no well-established method for the monitoring of prestressing (PS) tendons that can provide simultaneous information related to the presence of defects and the level of prestress in a continuous, real time manner. If such a monitoring system were available, considerable savings would be achieved in bridge maintenance since repairs would be implemented in a timely manner without traffic disruptions. This paper presents a health monitoring system for PS tendons in post-tensioned structures of interest to Caltrans. Such a system uses ultrasonic guided waves and embedded sensors to provide simultaneously and in real time, (a) measurements of the level of applied prestress, and (b) defect detection at early grow stages. The proposed PS measurement technique exploits the sensitivity of ultrasonic waves to the inter-wire contact developing in a multi-wire strand as a function of prestress level. In particular the nonlinear ultrasonic behavior of the tendon under changing levels of prestress is monitored by tracking higher-order harmonics at (nω) arising under a fundamental guided-wave excitation at (ω). Moreover this paper also present real-time damage detection and location in post-tensioned bridge joints using Acoustic Emission techniques. Experimental tests on large-scale single-tendon PT joint specimens, subjected to multiple load cycles, will be presented to validate the monitoring of PS loads (through nonlinear ultrasonic probing) and the monitoring of damage progression and location (through acoustic emission techniques). Issues and potential for the use of such techniques to monitor post-tensioned bridges in the field will be discussed.
Nezu, Masahiro; Souma, Tomokazu; Yu, Lei; Suzuki, Takafumi; Saigusa, Daisuke; Ito, Sadayoshi; Suzuki, Norio; Yamamoto, Masayuki
2017-02-01
Acute kidney injury is a devastating disease with high morbidity in hospitalized patients and contributes to the pathogenesis of chronic kidney disease. An underlying mechanism of acute kidney injury involves ischemia-reperfusion injury which, in turn, induces oxidative stress and provokes organ damage. Nrf2 is a master transcription factor that regulates the cellular response to oxidative stress. Here, we examined the role of Nrf2 in the progression of ischemia-reperfusion injury-induced kidney damage in mice using genetic and pharmacological approaches. Both global and tubular-specific Nrf2 activation enhanced gene expression of antioxidant and NADPH synthesis enzymes, including glucose-6-phosphate dehydrogenase, and ameliorated both the initiation of injury in the outer medulla and the progression of tubular damage in the cortex. Myeloid-specific Nrf2 activation was ineffective. Short-term administration of the Nrf2 inducer CDDO during the initial phase of injury ameliorated the late phase of tubular damage. This inducer effectively protected the human proximal tubular cell line HK-2 from oxidative stress-mediated cell death while glucose-6-phosphate dehydrogenase knockdown increased intracellular reactive oxygen species. These findings demonstrate that tubular hyperactivation of Nrf2 in the initial phase of injury prevents the progression of reactive oxygen species-mediated tubular damage by inducing antioxidant enzymes and NADPH synthesis. Thus, Nrf2 may be a promising therapeutic target for preventing acute kidney injury to chronic kidney disease transition. Copyright © 2016 International Society of Nephrology. Published by Elsevier Inc. All rights reserved.
Emura, Takeshi; Nakatochi, Masahiro; Matsui, Shigeyuki; Michimae, Hirofumi; Rondeau, Virginie
2017-01-01
Developing a personalized risk prediction model of death is fundamental for improving patient care and touches on the realm of personalized medicine. The increasing availability of genomic information and large-scale meta-analytic data sets for clinicians has motivated the extension of traditional survival prediction based on the Cox proportional hazards model. The aim of our paper is to develop a personalized risk prediction formula for death according to genetic factors and dynamic tumour progression status based on meta-analytic data. To this end, we extend the existing joint frailty-copula model to a model allowing for high-dimensional genetic factors. In addition, we propose a dynamic prediction formula to predict death given tumour progression events possibly occurring after treatment or surgery. For clinical use, we implement the computation software of the prediction formula in the joint.Cox R package. We also develop a tool to validate the performance of the prediction formula by assessing the prediction error. We illustrate the method with the meta-analysis of individual patient data on ovarian cancer patients.
Magnussen, Robert A; Borchers, James R; Pedroza, Angela D; Huston, Laura J; Haas, Amanda K; Spindler, Kurt P; Wright, Rick W; Kaeding, Christopher C; Allen, Christina R; Anderson, Allen F; Cooper, Daniel E; DeBerardino, Thomas M; Dunn, Warren R; Lantz, Brett A; Mann, Barton; Stuart, Michael J; Albright, John P; Amendola, Annunziato; Andrish, Jack T; Annunziata, Christopher C; Arciero, Robert A; Bach, Bernard R; Baker, Champ L; Bartolozzi, Arthur R; Baumgarten, Keith M; Bechler, Jeffery R; Berg, Jeffrey H; Bernas, Geoffrey A; Brockmeier, Stephen F; Brophy, Robert H; Bush-Joseph, Charles A; Butler, J Brad; Campbell, John D; Carey, James L; Carpenter, James E; Cole, Brian J; Cooper, Jonathan M; Cox, Charles L; Creighton, R Alexander; Dahm, Diane L; David, Tal S; Flanigan, David C; Frederick, Robert W; Ganley, Theodore J; Garofoli, Elizabeth A; Gatt, Charles J; Gecha, Steven R; Giffin, James Robert; Hame, Sharon L; Hannafin, Jo A; Harner, Christopher D; Harris, Norman Lindsay; Hechtman, Keith S; Hershman, Elliott B; Hoellrich, Rudolf G; Hosea, Timothy M; Johnson, David C; Johnson, Timothy S; Jones, Morgan H; Kamath, Ganesh V; Klootwyk, Thomas E; Levy, Bruce A; Ma, C Benjamin; Maiers, G Peter; Marx, Robert G; Matava, Matthew J; Mathien, Gregory M; McAllister, David R; McCarty, Eric C; McCormack, Robert G; Miller, Bruce S; Nissen, Carl W; O'Neill, Daniel F; Owens, Brett D; Parker, Richard D; Purnell, Mark L; Ramappa, Arun J; Rauh, Michael A; Rettig, Arthur C; Sekiya, Jon K; Shea, Kevin G; Sherman, Orrin H; Slauterbeck, James R; Smith, Matthew V; Spang, Jeffrey T; Svoboda, Steven J; Taft, Timothy N; Tenuta, Joachim J; Tingstad, Edwin M; Vidal, Armando F; Viskontas, Darius G; White, Richard A; Williams, James S; Wolcott, Michelle L; Wolf, Brian R; York, James J
2018-03-01
Articular cartilage health is an important issue following anterior cruciate ligament (ACL) injury and primary ACL reconstruction. Factors present at the time of primary ACL reconstruction may influence the subsequent progression of articular cartilage damage. Larger meniscus resection at primary ACL reconstruction, increased patient age, and increased body mass index (BMI) are associated with increased odds of worsened articular cartilage damage at the time of revision ACL reconstruction. Case-control study; Level of evidence, 3. Subjects who had primary and revision data in the databases of the Multicenter Orthopaedics Outcomes Network (MOON) and Multicenter ACL Revision Study (MARS) were included. Reviewed data included chondral surface status at the time of primary and revision surgery, meniscus status at the time of primary reconstruction, primary reconstruction graft type, time from primary to revision ACL surgery, as well as demographics and Marx activity score at the time of revision. Significant progression of articular cartilage damage was defined in each compartment according to progression on the modified Outerbridge scale (increase ≥1 grade) or >25% enlargement in any area of damage. Logistic regression identified predictors of significant chondral surface change in each compartment from primary to revision surgery. A total of 134 patients were included, with a median age of 19.5 years at revision surgery. Progression of articular cartilage damage was noted in 34 patients (25.4%) in the lateral compartment, 32 (23.9%) in the medial compartment, and 31 (23.1%) in the patellofemoral compartment. For the lateral compartment, patients who had >33% of the lateral meniscus excised at primary reconstruction had 16.9-times greater odds of progression of articular cartilage injury than those with an intact lateral meniscus ( P < .001). For the medial compartment, patients who had <33% of the medial meniscus excised at the time of the primary reconstruction had 4.8-times greater odds of progression of articular cartilage injury than those with an intact medial meniscus ( P = .02). Odds of significant chondral surface change increased by 5% in the lateral compartment and 6% in the medial compartment for each increased year of age ( P ≤ .02). For the patellofemoral compartment, the use of allograft in primary reconstruction was associated with a 15-fold increased odds of progression of articular cartilage damage relative to a patellar tendon autograft ( P < .001). Each 1-unit increase in BMI at the time of revision surgery was associated with a 10% increase in the odds of progression of articular cartilage damage ( P = .046) in the patellofemoral compartment. Excision of the medial and lateral meniscus at primary ACL reconstruction increases the odds of articular cartilage damage in the corresponding compartment at the time of revision ACL reconstruction. Increased age is a risk factor for deterioration of articular cartilage in both tibiofemoral compartments, while increased BMI and the use of allograft for primary ACL reconstruction are associated with an increased risk of progression in the patellofemoral compartment.
NASA Technical Reports Server (NTRS)
Wang, John T.; Pineda, Evan J.; Ranatunga, Vipul; Smeltzer, Stanley S.
2015-01-01
A simple continuum damage mechanics (CDM) based 3D progressive damage analysis (PDA) tool for laminated composites was developed and implemented as a user defined material subroutine to link with a commercially available explicit finite element code. This PDA tool uses linear lamina properties from standard tests, predicts damage initiation with an easy-to-implement Hashin-Rotem failure criteria, and in the damage evolution phase, evaluates the degradation of material properties based on the crack band theory and traction-separation cohesive laws. It follows Matzenmiller et al.'s formulation to incorporate the degrading material properties into the damaged stiffness matrix. Since nonlinear shear and matrix stress-strain relations are not implemented, correction factors are used for slowing the reduction of the damaged shear stiffness terms to reflect the effect of these nonlinearities on the laminate strength predictions. This CDM based PDA tool is implemented as a user defined material (VUMAT) to link with the Abaqus/Explicit code. Strength predictions obtained, using this VUMAT, are correlated with test data for a set of notched specimens under tension and compression loads.
Roman-Blas, Jorge A; Mediero, Aránzazu; Tardío, Lidia; Portal-Nuñez, Sergio; Gratal, Paula; Herrero-Beaumont, Gabriel; Largo, Raquel
2017-01-05
Osteoarthritis is the most common chronic joint disorder especially during aging. Although with controversies, glucosamine, both in its forms of sulfate and hydrochloride, and chondroitin sulfate are commonly employed to treat osteoarthritis. Due to the modest improve in the symptoms observed in patients treated with these drugs alone, a formulation combining both agents has been considered. The discrepant results achieved for pain control or structural improvement in osteoarthritis patients has been attributed to the quality of chemical formulations or different bias in clinical studies. The current study has been designed to test the effects of two different combined formulations with adequate pharmaceutical grade of these drugs in osteoarthritic joints, and to explore the underlying mechanisms modulated by both formulations in different osteoarthritis target tissues. Knee osteoarthritis was surgically induced in experimental rabbits. Some animals received the combined therapy (CT)1, (chondroitin sulfate 1200mg/day + glucosamine sulfate 1500mg/day), or the CT2 ((chondroitin sulfate 1200mg/day + glucosamine hydrochloride 1500mg/day). Neither CT1 nor CT2 significantly modified the cartilage damage or the synovial inflammation observed in osteoarthritic animals. Treatments were also unable to modify the presence of pro-inflammatory mediators, and the synthesis of metalloproteinases in the cartilage or in the synovium of osteoarthritic animals. Combined therapies did not modify the decrease in the subchondral bone mineral density observed in osteoarthritic rabbits. Therapies of chondroitin sulfate plus glucosamine sulfate or chondroitin sulfate plus glucosamine hydrochloride failed to improve structural damage or to ameliorate the inflammatory profile of joint tissues during experimental osteoarthritis. Published by Elsevier B.V.
Preliminary clinical report of flexible videoarthroscopy in diagnostic knee and hip arthroscopy.
Bouaicha, Samy; Dora, Claudio; Puskas, Gabor J; Koch, Peter P; Wirth, Stephan H; Meyer, Dominik C
2012-01-01
Compared to rigid arthroscopic optics, a flexible camera system offers theoretically significant advantages: It has the potential to adapt to the naturally curved surface of joints, to move within the joint without stress to the cartilage or capsule and thereby to reduce the number of portals needed. Former studies evaluated flexible fiberoptic systems which were insufficient regarding image resolution. This is the first report on a new flexible videoendoscope with the so called "chip-on-the-tip" technology used in human joints. With a plasma sterilized 3.9 diameter flexible video endoscopy system (Visera ENF V, OLYMPUS) commonly used in diagnostic rhino-laryngoscopy, we performed preliminary testing in cadaveric knee joints. After successful feasibility testing we utilized the tool in two qualitative diagnostic knee and five hip arthroscopies in combination with conventional rigid 30° and 70° arthroscopes (STORZ). Qualitative evaluation showed superior visualisation of the posterior aspects of the knee joint as insertion of the posterior medial and lateral meniscal horn, tibial insertion of the posterior cruciate ligament and the posterolateral capsulo-ligamentous corner with acceptable image resolution and clarity compared to the rigid arthroscope. In the hip, it was possible to pass around the femoral neck, avoiding additional portals. There seemed to be virtually no risk for cartilage damage at all. Difficulties of the system were scope handling, navigation and orientation within the joint as well as potential damage to the tool itself. This is to our knowledge the first report on flexible videoarthroscopy. Some of the expectations were met, such as to reach virtually every corner the joint with minimal risk for the cartilage or other joint structures and with acceptable image quality. However, there are many significant disadvantages which question the routine use of such a videoendoscopic system with its present technical features. © 2012 – IOS Press and the authors. All rights reserved
Modification of osteoarthritis in the guinea pig with pulsed low-intensity ultrasound treatment.
Gurkan, I; Ranganathan, A; Yang, X; Horton, W E; Todman, M; Huckle, J; Pleshko, N; Spencer, R G
2010-05-01
The Hartley guinea pig develops articular cartilage degeneration similar to that seen in idiopathic human osteoarthritis (OA). We investigated whether the application of pulsed low-intensity ultrasound (PLIUS) to the Hartley guinea pig joint would prevent or attenuate the progression of this degenerative process. Treatment of male Hartley guinea pigs was initiated at the onset of degeneration (8 weeks of age) to assess the ability of PLIUS to prevent OA, or at a later age (12 months) to assess the degree to which PLIUS acted to attenuate the progression of established disease. PLIUS (30 mW/cm(2)) was applied to stifle joints for 20 min/day over periods ranging from 3 to 10 months, with contralateral limbs serving as controls. Joint cartilage histology was graded according to a modified Mankin scale to evaluate treatment effect. Immunohistochemical staining for interleukin-1 receptor antagonist (IL-1ra), matrix metalloproteinase (MMP)-3, MMP-13, and transforming growth factor (TGF)-beta1 was performed on the cartilage to evaluate patterns of expression of these proteins. PLIUS did not fully prevent cartilage degeneration in the prevention groups, but diminished the severity of the disease, with the treated joints showing markedly decreased surface irregularities and a much smaller degree of loss of matrix staining as compared to controls. PLIUS also attenuated disease progression in the groups with established disease, although to a somewhat lesser extent as compared to the prevention groups. Immunohistochemical staining demonstrated a markedly decreased degree of TGF-beta1 production in the PLIUS-treated joints. This indicates less active endogenous repair, consistent with the marked reduction in cartilage degradation. PLIUS exhibits the ability to attenuate the progression of cartilage degeneration in an animal model of idiopathic human OA. The effect was greater in the treatment of early, rather than established, degeneration. Published by Elsevier Ltd.
Hand Surgery In World War II. Medical Department, United States Army,
1955-09-01
Few of these patients presented deep cicatrices , latent infection was minimal, and as a rule the position of function was maintained. DEBARKATION...HOSPITAL 217 Many patients were received with large dorsal cicatrices which, although healed, were unstable. Joints and tendons not directly injured by...burns were frequently damaged by constriction and immobility because of superimposed cicatrices . Joint stiffness was likely to be even more pronounced
Concept for a fast analysis method of the energy dissipation at mechanical joints
NASA Astrophysics Data System (ADS)
Wolf, Alexander; Brosius, Alexander
2017-10-01
When designing hybrid parts and structures one major challenge is the design, production and quality assessment of the joining points. While the polymeric composites themselves have excellent material properties, the necessary joints are often the weak link in assembled structures. This paper presents a method of measuring and analysing the energy dissipation at mechanical joining points of hybrid parts. A simplified model is applied based on the characteristic response to different excitation frequencies and amplitudes. The dissipation from damage is the result of relative moments between joining partners und damaged fibres within the composite, whereas the visco-elastic material behaviour causes the intrinsic dissipation. The ambition is to transfer these research findings to the characterisation of mechanical joints in order to quickly assess the general quality of the joint with this non-destructive testing method. The inherent challenge for realising this method is the correct interpretation of the measured energy dissipation and its attribution to either a bad joining point or intrinsic material properties. In this paper the authors present the concept for energy dissipation measurements at different joining points. By inverse analysis a simplified fast semi-analytical model will be developed that allows for a quick basic quality assessment of a given joining point.
DOE Office of Scientific and Technical Information (OSTI.GOV)
Paulus, Wilfred; Malaysian Nuclear Agency, Bangi, 43000 Kajang, Selangor; Rahman, Irman Abdul
Lead-free solders are important material in nano and microelectronic surface mounting technology for various applications in bio medicine, environmental monitoring, spacecraft and satellite instrumentation. Nevertheless solder joint in radiation environment needs higher reliability and resistance to any damage caused by ionizing radiations. In this study a lead-free 99.0Sn0.3Ag0.7Cu wt.% (SAC) solder joint was developed and subjected to various doses of gamma radiation to investigate the effects of the ionizing radiation to micromechanical hardness of the solder. Averaged hardness of the SAC joint was obtained from nanoindentation test. The results show a relationship between hardness values of indentations and the incrementmore » of radiation dose. Highest mean hardness, 0.2290 ± 0.0270 GPa was calculated on solder joint which was exposed to 5 Gray dose of gamma radiation. This value indicates possible radiation hardening effect on irradiated solder. The hardness gradually decreased to 0.1933 ± 0.0210 GPa and 0.1631 ± 0.0173 GPa when exposed to doses 50 and 500 gray respectively. These values are also lower than the hardness of non irradiated sample which was calculated as 0.2084 ± 0.0.3633 GPa indicating possible radiation damage and needs further related atomic dislocation study.« less