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

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W. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Misdiagnosis+of+overweight+and+underweight+children+younger+than+2+years+of+age+due+to+length+measurement+bias.">Misdiagnosis of overweight and underweight children younger than 2 years of age due to length measurement bias.</a> MedGenMed. 7 (4), 56 (2005).</li><li>Horan, M., Gibney, E., Molloy, E., McAuliffe, F. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Methodologies+to+assess+paediatric+adiposity.">Methodologies to assess paediatric adiposity.</a> Ir J Med Sci. 814 (1), 1-16 (2014).</li><li>Wells, J. C., Fewtrell, M. S. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Measuring+body+composition.">Measuring body composition.</a> Arch Dis Child. 91 (7), 612-617 (2006).</li><li>Wells, J. C., Fuller, N. J., Dewit, O., Fewtrell, M. S., Elia, M., Cole, T. J. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Four-component+model+of+body+composition+in+children:+Density+and+hydration+of+fat-free+mass+and+comparison+with+simpler+models.">Four-component model of body composition in children: Density and hydration of fat-free mass and comparison with simpler models.</a> Am J Clin Nutr. 69 (5), 904-912 (1999).</li><li>Damilakis, J., Adams, J. E., Guglielmi, G., Link, T. 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W. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Cohort+profile:+Project+Viva.">Cohort profile: Project Viva.</a> Int J Epidemiol. 44 (1), 37-48 (2015).</li><li>Ulijaszek, S. J., Lourie, J. A. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Intra-+and+inter-observer+error+in+anthropometric+measurement.">Intra- and inter-observer error in anthropometric measurement.</a> Anthropometry: the Individual and the Population. , 30-55 (1994).</li><li>H&#228;ggstr&#246;m, M. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Medical+gallery+of+Mikael+H&#228;ggstr&#246;m+2014.">Medical gallery of Mikael H&#228;ggstr&#246;m 2014.</a> Wikiversity Journal of. Medicine. 1 (2), (2014).</li><li>. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Acromion+of+Scapula05.">Acromion of Scapula05.</a> DBCLS. , (2013).</li></ol>

The authors have nothing to disclose.

<html> צעדי רכב גוף מדויקים הם קריטיים להערכת צמיחת ילדות כראוי במחקרים. חוקרים נרחבים לקבל DXA כשיטה תקן זהב, ורבי ביקורת אמצעי אנתרופומטריות ידניים כמו להיות מדויק ולא מדויק. עם זאת, ניתוח זה של טכניקות אנתרופומטריות להעריך שומן בגוף עולה כי מאומן היטב עוזרי מחקר שעוקבי...

עודף משקל והשמנה להישאר ברמות מגיפה, עם שליש מהילדים בארה&quot;ב ושני שלישים של מבוגרים שיש עודף משקל או השמנת יתר, על פי עד 2011 כ - 2012 מעריכה 2. עודף משקל, השמנה, שומן גוף עודף להעניק בסיכון גבוה יותר של תוצאות הקרדיו לוואי, כוללים סוכרת מסוג 2 ומחלות לב וכלי דם, כמו גם תוצאות בריאותיות פיסיות ופסיכולוגיות לוואים אחרות, כוללים אסתמה ודיכאון 3, 4, 5, 6. רוב המחקרים הבוחנים את הקשר בין השמנת יתר התוצאות הבריאותיות בשלב מאוחר יותר בחיים להניח מדידות מדויקות של משקל ואורך / גובה. קטגוריות של מעמד משקל אצל מבוגרים וילדים כוללים (אינדקס מסת הגוף (BMI) &lt;18.0 ק&quot;ג / מ 2 למבוגרים &lt;5 th אחוזון גיל ספציפי ממין לילדים) בתת משקל, לא<html> משקל rmal (BMI 18.0 ל &lt;25.0 ק&quot;ג / מ 2 למבוגרים ו -5 עד ה &lt;85 לאחוזון ה לילדים), עודף משקל (BMI 25.0 ל &lt;30.0 ק&quot;ג / מ 2 למבוגרים ו -85 עד ה &lt;95 לאחוזון ה לילדים) , והשמנה (30 ק&quot;ג BMI ≥ / m 2 למבוגרים ≥ אחוזון 95 th לילדים). גם טעויות מדידת קטין יכולות להשפיע categorizations אלה, בעיקר אצל ילדים שעבורם שגיאות המופיעות קטן בקנה מידה מוחלט יכולות לייצג ביחס שגיאה גדולה לגודל של הילד 7. לדוגמא, במחקר קודם של ילדים מתחת לגיל 2 שנים, השוואות של אורך שנמדדו בשיטת נייר והעיפרון הקלינית הקונבנציונלית עם שיטת אורך הפנסיון שכיבה עולה כי שיטת נייר ועיפרון בהערכת אורך שיטתית בשיעור ממוצע של 1.3 (1.5) ס&quot;מ - שגיאה שתוצאתו misclassification משמעותית 7. תחת = &quot;jove_content&quot;&gt; שימוש BMI להעריך השמנה מציע יתרונות רבים למחקר, כוללים עלות הנמוכה והציוד והניטל מינימאלי של גובה ומדידת משקל, כמו גם את ההזדמנות למנף דיווח עצמי ואמצעים קליניים. עם זאת, אפילו עם מדידה מדויקת של גובה ומשקל, וריאציה BMI אינו משקף בהכרח וריאציה השמנה, מאז BMI משלבת הן רזה מסת שומן 1. לפיכך, שיטות למדוד ישירות שמן גם חשובות להבנת יחסים עם תוצאות בריאותיות. שיטות סטנדרטיות זהב של השמנה ומדידת רכב גוף להסתמך על אמצעים טכנולוגיים, כולל plethysmography עקירת האוויר (ADP), ההידרוסטטי במשקל, הדמיית תהודה מגנטית (MRI), טומוגרפיה ממוחשבת (CT), כמו גם absorptiometry רנטגן הכפול (DXA 8), 9, 10. בעוד אלהשיטות לספק חלק מהצעדים המדויקים ביותר של רכב גוף, רבים מהם אינם מעשיים במחקרי ילדים, במיוחד אלה מבוססים בשטח. לדוגמה, ההידרוסטטי במשקל דורש כי אנשים להיות שקוע כולו במים. יש ציוד ADP, עד לא מזמן, היה זמין רק למדוד תינוקות עד 8 ק&quot;ג או ילדים ומבוגרים מעל גיל 6 שנים, אבל לא פעוטות או ילדים בגיל הגן. סריקות CT פולטות כמות גדולה של קרינה לעומת הטכניקות האחרות, ובפעם הרכישה הארוכה עבור MRI עושה את זה מעשי עבור מחקרים רבים 8. DXA פולט כ 1/500 מינון הקרינה של בדיקת CT, כ המקביל של יום אחד של קרינת רקע טבעית 11, מה שהופך אותו לאופציה אטרקטיבית עבור מחקרים מעורבי ילדים. כל השיטות האלה, עם זאת, הם יקרים לרכוש ואף אחד הוא ניידים, מה שהופך אותם מעשיות ללימודים מבוססים בשטח עם קרן מוגבלתing. ניתוח העכבה bioelectrical (BIA), המודד את העכבה של אות חשמלי דקות נשלח דרך הגוף להעריך את רכב גוף, יכול להיות פחות יקר ויותר נייד, אך הנחות שבבסיס חישוב השומן בגוף אינן ישימות ילדים קטנים 10. בניגוד לצעדים מבוסס טכנולוגיית אלה, אמצעי אנתרופומטריות ידניים יכולים להתבצע על ידי משקיף מאומן ברוב הגדרות שדות ובעלות ציוד נמוכה משמעותי. Anthropometry ידני כולל מדידות של גובה, משקל, circumferences, ועוביים skinfold 8. יתרונות נוספים של anthropometry הידנית הן כי זה כרוך אין חשיפה לקרינה מיותרת, וצוות מיומן יכול להשיג אותם ביעילות. עם זאת, דאגה משותפת על מדידות אנתרופומטריות ידניות היא שהם עשויים להיות גם לא מדויקים ולא מדויקים 12. קבלה מדויקת ויחסי ציבורמדידות ecise אפשריות עם נהלים אחידים, הכשרה מתאימה, ותשומת לב מספיק כדי נהלי בקרת איכות (QC). צוות הפרויקט ויוה פתח פרוטוקול אימון anthropometry מדריך שיכול להניב באיכות גבוהה, אמצעים לשחזור בעל שיעור קומה, circumferences, ועובי skinfold. במשך יותר מעשור, יישמנו את אימון ואת פרוטוקול QC לאמהות וילדי הפרויקט ויוה, מחקר עוקבה אורכת, טרום לידתי 13. הפרויקט ויוה צוות אסף אמצעי אנתרופומטריות הילד במהלך ביקורים בלידה (0 - 3 ימים), ועם שני האם וילד בנקודות הזמן הבא: ינקות (4.9 - 10.6 חודשים), גיל רך (2.8 - 6.3 שנים), באמצע -childhood (6.6 - 10.9 שנים), ו העשרה מוקדמת (11.5 - 16.5 שנים) 13. מאמר זה מתאר את הפרוטוקול שפתחנו ומעודן למדידת גובה, משקל, עובי skinfold (זרוע אחורית ו subscapular skinfolds), ו circumferences הגוף (המותניים, הירך, ו circumferences הזרוע העליונה באמצע [MUAC]) בפרויקט ויוה. כמו כן, אנו מתארים כיצד יש לנו להעריך את הדיוק של מדידת אנתרופומטריות ידנית באמצעות טעות הטכנית של חישובים מדידים (TEM) ודיוק בהשוואת מדידות DXA תקן זהב.

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

assessment of child anthropometry in a large epidemiologic study

שיעור גבוה של ילדים יש עודף משקל והשמנה בארצות הברית ובמדינות אחרות. הערכה מדויקת של anthropometry חיונית להבין השפעות בריאותיות של צמיחת ילד שמן. שיטות סטנדרטיות זהב של השמנה מדידה, כגון absorptiometry רנטגן הכפול (DXA), עלולות להיות לא ריאליות במחקרי שדה גדולים. מחקר צוות יכול, לעומת זאת, מדידות אנתרופומטריות מלאות, כגון circumferences גוף ומדידות skinfold, באמצעות ציוד נייד זול. בפירוט אנו בפרוטוקול זה איך להשיג מדידות אנתרופומטריות ידנית מילדים, לרבות עומדים ויושבים גובה, משקל, היקף מותניים, היקף הירך, היקף זרוע-העליון באמצע, עובי skinfold התלת ראשי, ועובי skinfold subscapular, ונהלים כדי להעריך את איכות מדידות אלה. כדי להדגים דיוק של מדידות אלה, בין 1,110 ילדים בגיל בית הספר ב ויוה פרויקט מחזור טרום לידתי חשבנו ספירמן קורמקדמי תעלות השוואת מדידות אנתרופומטריות ידניות עם מידת זהב רמת שומן גוף, מסת שומן 1 DXA. כדי לתת מענה אמין, אנו מעריכים טעות טכנית תוך rater מדידה בישיבת בקרת איכות שנערכה על התנדב נקבה בוגרים.

ניתוח זה מטפל הדיוק של מדידות אנתרופומטריות ידנית באמצעות נתונים המופקים בקרת איכות (QC) נהלים, ומעריכה טעות המדידה התוך rater ידי טעות טכנית של מדידה (TEM) 12. טווחי TEM של קבילות מבוססים על חישובים של אמצעי אנתרופומטריות תוך rater חזרו, שב...

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Assessment of Child Anthropometry in a Large Epidemiologic Study

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

הערכת הילד anthropometry במחקר אפידמיולוגיים גדול

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

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26.9K Views.  Harvard Medical School and Harvard Pilgrim Health Care Institute. In epidemiologic studies of children, well-trained research staff can accurately and precisely assess weight, height, sitting height, skinfold thicknesses, and body circumferences. 

Video: Assessment of Child Anthropometry in a Large Epidemiologic Study

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

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

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

סמנים ביולוגיים במודל חיה לחשיפה קושרת עצבית, המטולוגית, והתנהגות של PTSD

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

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

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

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

בזמן אמת fMRI ביופידבק מיקוד Cortex orbitofrontal עבור חרדה זיהום

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

A Novel Application of Musculoskeletal Ultrasound Imaging

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

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

יישום רומן של השלד והשרירים אולטראסאונד הדמיה

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

Myocardial Infarction and Functional Outcome Assessment in Pigs

Introduction of newly discovered cardiovascular therapeutics into first-in-man trials depends on a strictly regulated ethical and legal roadmap. One important prerequisite is a good understanding of all safety and efficacy aspects obtained in a large animal model that validly reflect the human scenario of myocardial infarction (MI). Pigs are widely used in this regard since their cardiac size, hemodynamics, and coronary anatomy are close to that of humans. Here, we present an effective protocol for using the porcine MI model using a closed-chest coronary balloon occlusion of the left anterior descending artery (LAD), followed by reperfusion. This approach is based on 90 min of myocardial ischemia, inducing large left ventricle infarction of the anterior, septal and inferoseptal walls. Furthermore, we present protocols for various measures of outcome that provide a wide range of information on the heart, such as cardiac systolic and diastolic function, hemodynamics, coronary flow velocity, microvascular resistance, and infarct size. This protocol can be easily tailored to meet study specific requirements for the validation of novel cardioregenerative biologics at different stages (i.e. directly after the acute ischemic insult, in the subacute setting or even in the chronic MI once scar formation has been completed). This model therefore provides a useful translational tool to study MI, subsequent adverse remodeling, and the potential of novel cardioregenerative agents.

This protocol describes the porcine myocardial infarction (MI) model using a 90 min closed-chest coronary balloon occlusion of the left anterior descending artery (LAD), followed by reperfusion. Furthermore, the protocol for several outcome parameters, such as cardiac function, hemodynamics, microvascular resistance, and infarct size, are also presented.

אוטם שריר לב והערכת תוצאה תפקודית בחזירים

Introduction of newly discovered cardiovascular therapeutics into first-in-man trials depends on a strictly regulated ethical and legal roadmap. One ...

An Isolated Working Heart System for Large Animal Models

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

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

מערכת העבודה לב מבודדת למודלים בבעלי חיים גדולים

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

Clinical Assessment of Spatiotemporal Gait Parameters in Patients and Older Adults

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

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

הערכה קלינית של פרמטרי ההליכה Spatiotemporal בחולים ומבוגרים

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

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

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

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

אנגיוגנזה כירורגי אלוגרפט הטיביאלי חזירי: עצם חדשים בעלי חיים גדולים Vascularized דגם אלוגרפט ללא הפרדות צבע

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

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

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

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

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

הערכה של קרישה בפלסמה על רקמת הכבד במודל חיה גדולה In Vivo

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

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

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

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

הערכה אובייקטיבית Nociceptive בחולים נמרץ מאוורר: בדיקת התכנות באמצעות Pupillometry ואת רפלקס כיפוף Nociceptive

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

In Vitro Model of Coronary Angiogenesis

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

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

מודל מבחנה של אנגיוגנזה כלילית

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