Age- and Sex-Specific Thorax Finite Element Model Development and Simulation

Objective: The shape, size, bone density, and cortical thickness of the thoracic skeleton vary significantly with age and sex, which can affect the injury tolerance, especially in at-risk populations such as the elderly. Computational modeling has emerged as a powerful and versatile tool to assess injury risk. However, current computational models only represent certain ages and sexes in the population. The purpose of this study was to morph an existing finite element (FE) model of the thorax to depict thorax morphology for males and females of ages 30 and 70 years old (YO) and to investigate the effect on injury risk.

Methods: Age- and sex-specific FE models were developed using thin-plate spline interpolation. In order to execute the thin-plate spline interpolation, homologous landmarks on the reference, target, and FE model are required. An image segmentation and registration algorithm was used to collect homologous rib and sternum landmark data from males and females aged 0–100 years. The Generalized Procrustes Analysis was applied to the homologous landmark data to quantify age- and sex-specific isolated shape changes in the thorax. The Global Human Body Models Consortium (GHBMC) 50th percentile male occupant model was morphed to create age- and sex-specific thoracic shape change models (scaled to a 50th percentile male size). To evaluate the thoracic response, 2 loading cases (frontal hub impact and lateral impact) were simulated to assess the importance of geometric and material property changes with age and sex.

Results: Due to the geometric and material property changes with age and sex, there were observed differences in the response of the thorax in both the frontal and lateral impacts. Material property changes alone had little to no effect on the maximum thoracic force or the maximum percent compression. With age, the thorax becomes stiffer due to superior rotation of the ribs, which can result in increased bone strain that can increase the risk of fracture. For the 70-YO models, the simulations predicted a higher number of rib fractures in comparison to the 30-YO models. The male models experienced more superior rotation of the ribs in comparison to the female models, which resulted in a higher number of rib fractures for the males.

Conclusion: In this study, age- and sex-specific thoracic models were developed and the biomechanical response was studied using frontal and lateral impact simulations. The development of these age- and sex-specific FE models of the thorax will lead to an improved understanding of the complex relationship between thoracic geometry, age, sex, and injury risk.     

Mortality Risk in Pediatric Motor Vehicle Crash Occupants: Accounting for Developmental Stage and Challenging Abbreviated Injury Scale Metrics

Objective: Survival risk ratios (SRRs) and their probabilistic counterpart, mortality risk ratios (MRRs), have been shown to be at odds with Abbreviated Injury Scale (AIS) severity scores for particular injuries in adults. SRRs have been validated for pediatrics but have not been studied within the context of pediatric age stratifications. We hypothesized that children with similar motor vehicle crash (MVC) injuries may have different mortality risks (MR) based upon developmental stage and that these MRs may not correlate with AIS severity.

Methods: The NASS-CDS 2000–2011 was used to define the top 95% most common AIS 2+ injuries among MVC occupants in 4 age groups: 0–4, 5–9, 10–14, and 15–18 years. Next, the National Trauma Databank 2002–2011 was used to calculate the MR (proportion of those dying with an injury to those sustaining the injury) and the co-injury-adjusted MR (MR_MAIS) for each injury within 6 age groups: 0–4, 5–9, 10–14, 15–18, 0–18, and 19+ years. MR differences were evaluated between age groups aggregately, between age groups based upon anatomic injury patterns and between age groups on an individual injury level using nonparametric Wilcoxon tests and chi-square or Fisher's exact tests as appropriate. Correlation between AIS and MR within each age group was also evaluated.

Results: MR and MR_MAIS distributions of the most common AIS 2+ injuries were right skewed. Aggregate MR of these most common injuries varied between the age groups, with 5- to 9-year-old and 10- to 14-year-old children having the lowest MRs and 0- to 4-year-old and 15- to 18-year-old children and adults having the highest MRs (all P <.05). Head and thoracic injuries imparted the greatest mortality risk in all age groups with median MR_MAIS ranging from 0 to 6% and 0 to 4.5%, respectively. Injuries to particular body regions also varied with respect to MR based upon age. For example, thoracic injuries in adults had significantly higher MR_MAIS than such injuries among 5- to 9-year-olds and 10- to 14-year-olds (P =.04; P <.01). Furthermore, though AIS was positively correlated with MR within each age group, less correlation was seen for children than for adults. Large MR variations were seen within each AIS grade, with some lower AIS severity injuries demonstrating greater MRs than higher AIS severity injuries. As an example, MR_MAIS in 0- to 18-year-olds was 0.4% for an AIS 3 radius fracture versus 1.4% for an AIS 2 vault fracture.

Conclusions: Trauma severity metrics are important for outcome prediction models and can be used in pediatric triage algorithms and other injury research. Trauma severity may vary for similar injuries based upon developmental stage, and this difference should be reflected in severity metrics. The MR-based data-driven determination of injury severity in pediatric occupants of different age cohorts provides a supplement or an alternative to AIS severity classification for pediatric occupants in MVCs.     

The transtheoretical model of change in adolescents: implications for injury prevention

INTRODUCTION: Many injury prevention interventions require changes in human behavior to reduce self-risk or risk to others. Promising injury prevention interventions may be discarded if they lack power to create a significant difference in outcomes when judging their ability to "move a person from nonaction or negative action to positive action (safety)." The transtheoretical model of change (TMC) allows greater sensitivity in detecting along the change process where an intervention may be effective. The stages of change consist of precontemplation, contemplation, preparation, action, maintenance, and termination. Change is not viewed as an "all or none phenomenon." METHOD: Use of the TMC was examined using a quasiexperimental, cross-over design involving high school agriculture students enrolled in 21 schools in Kentucky (n=9), Iowa (n=7), and Mississippi (n=5). A series of physical and narrative simulations (safety training exercises) were developed with a focus on preventing amputation, spinal cord injury, hypersensitivity pneumonitis, and noise-induced hearing loss. Contemplation and action, as part of the TMC, were measured using a 10-item, Likert-type, stages of change (SOC) instrument comprised of two subscales (reliability coefficients were.88 and.81, respectively). The final sample consisted of 790 students (373 treatment and 417 control). RESULTS: There was a significant group effect for both contemplation, F(1,732)=197.4; p<.0001, and action, F(1,730)=106.1; p<.0001. A convenience sample of 29 of the participating students was selected for follow-up farm visits 1 year postparticipation. Of these students, 25 (86%) had made safety behavior changes in their farm work. IMPACT ON INDUSTRY: The use of the TMC model can provide researchers with greater precision in examining intervention effectiveness in promoting change.     

Phosphorus leaching in soils amended with piggery effluent or lime residues from effluent treatment

Phosphorus (P) in wastes from piggeries may contribute to the eutrophication of waterways if not disposed of appropriately. Phosphorus leaching, from three soils with different P sorption characteristics (two with low P retention and one with moderate P retention) when treated with piggery effluent (with or without struvite), was investigated using batch and leaching experiments. The leaching of P retained in soil from the application of struvite effluent was determined. In addition, P leaching from lime residues (resulting from the treatment of piggery effluent with lime to remove P) was determined in comparison to superphosphate when applied to the same three soils. Most P was leached from sandy soils with low P retention when effluent with or without struvite was applied. More than 100% of the filterable P applied in struvite effluent was leached in sandy soils with low P retention. Solid, inorganic forms of P (struvite) became soluble and potentially leachable at pH<7 or were sorbed after dissolution if there were sufficient sorption sites. In sandy soils with low P retention, more than 39% of the total filterable P applied in recycled effluent (without struvite) was leached. Soil P increased mainly in surface layers after treatment with effluent. Sandy soils pre-treated with struvite effluent leached 40% of the P retained in the previous application. Phosphorus decreased in surface layers and increased at depth in the soil with moderate P retention after leaching the struvite effluent pre-treated soil with water. The soils capacity to adsorb P and the soil pH were the major soil properties that affected the rate and amount of P leaching, whereas the important characteristics of the effluent were pH, P concentration and the forms of P in the effluent. Phosphorus losses from soils amended with hydrated lime and lime kiln dust residues were much lower than losses from soils amended with superphosphate. Up to 92% of the P applied as superphosphate was leached from sandy soils with low P retention, whereas only up to 60% of the P applied in lime residues was leached. The P source contributing least to P leaching was the lime kiln dust residue. The amount of P leached depended on the water-soluble P content, neutralising value and application rate of the P source, and the pH and P sorption capacity of the soil.     

Phosphorus removal from piggery effluents of varying quality using lime and physico-chemical treatment methods

The choice of management practices for the treatment of piggery effluent prior to its disposal to waterways or land is governed by the desire to simultaneously minimise the cost of treatment whilst minimising pollution of the environment. Laboratory experiments were conducted to compare the removal of total and total filterable phosphorus (P) (<0.45 microm) from ortho-phosphate solutions or piggery effluent by hydrated lime or lime kiln dust alone, or from recycled piggery effluent by lime and physico-chemical treatment methods. In addition, the ability of lime to remove P from recycled piggery effluent at an intensive piggery was assessed. Most P in lime treated effluent was present in the >0.45 microm fraction because of the presence of unsettled flocs of P impregnated lime. The efficiency of total P removal by hydrated lime and lime kiln dust decreased as effluent quality declined. The efficiency of removal of total filterable P by hydrated lime or lime kiln dust was not affected by effluent quality. Hydrated lime was more efficient in removing P from effluent or ortho-phosphate solutions, but lime kiln dust was more cost effective. More than 95% of total P was removed from recycled piggery effluent when physico-chemical treatment followed settling with or without lime. The physico-chemical treatment decreased total P mainly by decreasing the number of suspended particles in the effluent and by precipitating some total filterable P as iron, aluminium or calcium compounds.     

Influence of salinity on bioremediation of oil in soil

Spills from oil production and processing result in soils being contaminated with oil and salt. The effect of NaCl on degradation of oil in a sandy-clay loam and a clay loam soil was determined. Soils were treated with 50 g kg(-1) non-detergent motor oil (30 SAE). Salt treatments included NaCl amendments to adjust the soil solution electrical conductivities to 40, 120, and 200 dS m(-1). Soils were amended with nutrients and incubated at 25 degrees C. Oil degradation was estimated from the quantities of CO(2) evolved and from gravimetric determinations of remaining oil. Salt concentrations of 200 dS m(-1) in oil amended soils resulted in a decrease in oil mineralized by 44% for a clay loam and 20% for a sandy-clay loam soil. A salt concentration of 40 dS m(-1) reduced oil mineralization by about 10% in both soils. Oil mineralized in the oil amended clay-loam soil was 2-3 times greater than for comparable treatments of the sandy-clay loam soil. Amending the sandy-clay loam soil with 5% by weight of the clay-loam soil enhanced oil mineralization by 40%. Removal of salts from oil and salt contaminated soils before undertaking bioremediation may reduce the time required for bioremediation.     

Reproductive success of barn swallows nesting near a selenium-contaminated lake in east Texas, USA

Reproductive success and contaminant levels in 1986 and 1987 were compared between Barn Swallows nesting at selenium-contaminated Martin Lake, Texas, USA, and swallows nesting at a reference site. Nests were initiated about the same time or earlier at Martin Lake than at the reference site and clutch size was similar between the two locations. Nest success was significantly higher at Martin Lake than at the reference site and no embryo or chick deformities were documented. Selenium concentrations in 14 of 20 eggs from Martin Lake were above background (> 3 ppm, dry weight); two of 20 eggs contained > 5 ppm, a concentration associated with a 20% embryo mortality/deformity rate in some bird species. Selenium concentrations in the kidneys of adult swallows were higher at Martin Lake (mean = 14 ppm dry weight) than at the reference site (5.8 ppm). DDE, the only detected organochlorine compound, was in two of 10 eggs from Martin Lake; these concentrations were below those associated with chronic poisoning and reproductive problems. The maximum mercury concentration in livers of adult Barn Swallows (0.83 ppm, dry weight) was within the range for background levels (< 5 ppm).     

Evaluation of developmental metrics for utilization in a pediatric advanced automatic crash notification algorithm

Objective: Appropriate treatment at designated trauma centers (TCs) improves outcomes among injured children after motor vehicle crashes (MVCs). Advanced Automatic Crash Notification (AACN) has shown promise in improving triage to appropriate TCs. Pediatric-specific AACN algorithms have not yet been created. To create such an algorithm, it will be necessary to include some metric of development (age, height, or weight) as a covariate in the injury risk algorithm. This study sought to determine which marker of development should serve as a covariate in such an algorithm and to quantify injury risk at different levels of this metric.

Methods: A retrospective review of occupants age < 19 years within the MVC data set NASS-CDS 2000–2011 was performed. R² values of logistic regression models using age, height, or weight to predict 18 key injury types were compared to determine which metric should be used as a covariate in a pediatric AACN algorithm. Clinical judgment, literature review, and chi-square analysis were used to create groupings of the chosen metric that would discriminate injury patterns. Adjusted odds of particular injury types at the different levels of this metric were calculated from logistic regression while controlling for gender, vehicle velocity change (delta V), belted status (optimal, suboptimal, or unrestrained), and crash mode (rollover, rear, frontal, near-side, or far-side).

Results: NASS-CDS analysis produced 11,541 occupants age < 19 years with nonmissing data. Age, height, and weight were correlated with one another and with injury patterns. Age demonstrated the best predictive power in injury patterns and was categorized into bins of 0–4 years, 5–9 years, 10–14 years, and 15–18 years. Age was a significant predictor of all 18 injury types evaluated even when controlling for all other confounders and when controlling for age- and gender-specific body mass index (BMI) classifications. Adjusted odds of key injury types with respect to these age categorizations revealed that younger children were at increased odds of sustaining Abbreviated Injury Scale (AIS) 2+ and 3+ head injuries and AIS 3+ spinal injuries, whereas older children were at increased odds of sustaining thoracic fractures, AIS 3+ abdominal injuries, and AIS 2+ upper and lower extremity injuries.

Conclusions: The injury patterns observed across developmental metrics in this study mirror those previously described among children with blunt trauma. This study identifies age as the metric best suited for use in a pediatric AACN algorithm and utilizes 12 years of data to provide quantifiable risks of particular injuries at different levels of this metric. This risk quantification will have important predictive purposes in a pediatric-specific AACN algorithm.     

Minimizing Harm in Possum Control Operations and Experiments in New Zealand

Pest control operations andexperimentation on sentient animals such as thebrushtail possum can cause unnecessary andavoidable suffering in the animal subjects.Minimizing animal suffering is an animalwelfare goal and can be used as a guide in thedesign and execution of animal experimentationand pest control operations.The public has little sympathy for the possum,which can cause widespread environmentaldamage, but does believe that control should beas painless as possible. Trapping and poisoningprovide only short-term solutions to the possumproblem and often involve methods that causesuffering. Intrusive experiments connected withthese methods of control and published in thelast 6 years are reviewed. Many of theexperiments do not attain the welfare standardsrequired by members of the public.Possums also act as vectors for bovinetuberculosis. While this is not as important inthe minds of the public as environmentaldegradation, as long as people wish to continueraising cattle, this disease needs to becontrolled.Immunocontraception is a humane means ofcontrolling possums with wide publicacceptance. The use of vaccines for cows and/orpossums would also cause far less sufferingthan present eradication operations. Researchinto these methods does require some intrusiveexperimentation. This can be reduced if liveanimals are not used for secondary antibodyharvesting, if adequate analgesia is provided,and if potential vaccines or contraceptives aretested under conditions that would beexperienced in the field.