Postmortem Human Subjects Research Articles

Spatial distribution of human arachnoid trabeculae.

Traumatic brain injury (TBI) is a common injury modality affecting a diverse patient population. Axonal injury occurs when the brain experiences excessive deformation as a result of head impact. Previous studies have shown that the arachnoid trabeculae (AT) in the subarachnoid space significantly influence the magnitude and distribution of brain deformation during impact. However, the quantity and spatial distribution of cranial AT in humans is unknown. Quantification of these microstructural features will improve understanding of force transfer during TBI, and may be a valuable dataset for microneurosurgical procedures. In this study, we quantify the spatial distribution of cranial AT in seven post-mortem human subjects. Optical coherence tomography (OCT) was used to conduct in situ imaging of AT microstructure across the surface of the human brain. OCT images were segmented to quantify the relative amounts of trabecular structures through a volume fraction (VF) measurement. The average VF for each brain ranged from 22.0% to 29.2%. Across all brains, there was a positive spatial correlation, with VF significantly greater by 12% near the superior aspect of the brain (p<.005), and significantly greater by 5%-10% in the frontal lobes (p<.005). These findings suggest that the distribution of AT between the brain and skull is heterogeneous, region-dependent, and likely contributes to brain deformation patterns. This study is the first to image and quantify human AT across the cerebrum and identify region-dependencies. Incorporation of this spatial heterogeneity may improve the accuracy of computational models of human TBI and enhance understanding of brain dynamics.

Identification of Pedicle Screw Pullout Load Paths for Osteoporotic Vertebrae

Study DesignA biomechanical study.PurposeTo determine the actual load path and compare pullout strengths as a function of screw size used in revision surgeries using postmortem human subject specimens.Overview of LiteraturePedicle screw fixation has become the standard of care in the surgical management of spinal instability. However, pullout failures are widely observed in osteoporotic spines and treated by revision surgeries using a higher diameter screw, performing cement augmentation, or increasing the levels of fixation. While the peak forces to final pullout are reported, the actual load path to achieve the final force level is not available. MethodsSix osteoporotic lumbar spines (L2–L5) were instrumented with 5.5×40 mm polyaxial screws and loaded along the axis of the screw using a material testing machine according to American Society for Testing of Materials 543-07 test protocol. Tests were again conducted by replacing them with 6.5×40 mm (group A) or 7.5×40 mm (group B) screws. Force-displacement data were grouped and load paths (mean±1 standard deviation) were compared.ResultsPullout strength decreased by 36% when the size of the revision screw was increased by 1 mm, while it increased by 35% when the size of the revision screw was increased by 2 mm compared to the index screw value. While the morphologies of the load paths were similar in all cases, they differ between the two groups: the larger screw responded with generally elevated stiffer path than the smaller screw, suggesting that revision surgery using a larger screw has more purchase along the inserted body-pedicle axis.ConclusionsA larger screw enhances strength and increases biomechanical stability in revision surgeries, although the final surgical decision is made by the clinician, which includes the patient’s anatomy and associated characteristics.

Validating diverse human body models against side impact tests with post-mortem human subjects

This study aimed at evaluating the ability of morphed finite element (FE) human body models (HBMs) to reproduce the impact responses of post-mortem human subjects (PMHS) with various stature and shape. Ten side impact tests previously performed using seven PMHS under 3 m/s and 8 m/s impact velocities were selected for model evaluation. With weight, stature, sex, and age of PMHS, seven FE HBMs were developed by morphing the midsize male THUMS model into the target geometries predicted by the statistical skeleton and external body shape models. The model-predicted force histories, accelerations along the spine, and deflections in the chest and abdomen were compared to the test data. For comparison, simulations in all testing conditions were also conducted with the original midsize male THUMS, and the results from the THUMS simulations were scaled to the weight and stature from each PMHS. The CORrelation and Analysis (CORA) was used to evaluate the model accuracy, with CORA scores close to one indicating excellent agreement. Ten simulations using the morphed models exhibited 0.80 ± 0.01, 0.80 ± 0.01, 0.78 ± 0.02, and 0.78 ± 0.02 CORA scores for the impact forces to the thorax, abdomen, iliac-wings, and greater-trochanter, respectively; the corresponding CORA scores with the original THUMS were markedly lower at 0.60 ± 0.06, 0.69 ± 0.05, 0.71 ± 0.05, and 0.69 ± 0.04; while those for the scaled THUMS were 0.65 ± 0.05, 0.71 ± 0.05, 0.73 ± 0.05, and 0.72 ± 0.02, also lower than the morphed models. Across all simulations, the morphed HBMs demonstrated significantly higher accuracy than the THUMS with or without scaling. These results suggested the necessity of accounting for size and shape effects on predicting human responses in side impacts.

ATD Biodynamics During Lateral Impact for USAF Neck Injury Criteria

Research was conducted involving a series of lateral impact tests on a horizontal sled facility by scientists at the Air Force Research Laboratory (AFRL). The purpose of the research was to conduct an assessment of the biodynamic response of an anthropomorphic test device (ATD) to support the development of AFRL neck injury criteria. Impacts were completed using a 50th male Hybrid III aerospace ATD due to this ATD being used by the USAF to qualify and evaluate ejection systems. A test matrix was developed to assess ATD response as a function of various seat configurations which were an approximation of the seat configurations used by the Medical College of Wisconsin (MCW) for previously conducted lateral impact tests of PMHS subjects (post-mortem human subjects). The specially fabricated seat configurations were a rigid seat fixture with a 5-point harness and a padded rigid seat with a 3-point harness. The input acceleration pulses were trapezoidal in shape and varied in peak magnitude from 8.5 to 17 G. The rigid and padded seat configurations both generated fairly linear ATD responses across the input acceleration range. The ATD’s response with the padded seat and the 3-point restraint was greater than the ATD’s response with the rigid seat and the 5-point restraint with the upper neck. The My torque showed the greatest increase from the rigid seat configuration to the padded seat configuration. This highlights the importance of a proper restraint and the importance of controlling the motion of the torso since it could reduce the loads and torques of the unrestrained head and neck, resulting in a lower probability of injury. The lateral impact program with the ATD provided critical impact data to fill data gaps that support the development of the ATD-to-human transfer functions for AFRL’s Multi-Axial Neck Injury Criteria (MANIC) for lateral impact or MANICy calculation. The program also highlighted gaps in human and PMHS head response data in identical lateral impact configurations that would not only improve the current MANICy transfer function but would allow the investigation of the efficacy of using the 6F-MANICy to replace the current MANICy.

Validation of a simplified human body model in relaxed and braced conditions in low-speed frontal sled tests

Objective: The goal of this study was to implement active musculature into the Global Human Body Models Consortium (GHBMC) average male simplified occupant model (M50-OS v2) and validate its performance in low-speed frontal crash scenarios.Methods: Volunteer and postmortem human subjects (PMHS) data from low-speed frontal sled tests by Beeman et al., including 2.5 and 5.0 g acceleration pulses, were used to simulate events in LS-DYNA. All muscles were modeled as 1D beam elements and assigned a Hill-type muscle material. From the output of proportional–integral–derivative (PID) controllers, the activation level for each muscle was calculated using a sigmoid function, representing the firing rate of motor neurons. The PID controller attempts to preserve the initial posture of the model. Percentage muscle contribution for all skeletal muscles was precalculated using the M50-OS with active muscles (M50-OS + Active). The M50-OS + Active employs varying levels of neural delays to represent volunteer relaxed and braced conditions, taken from literature. Braced condition experiments were simulated using elevated joint angle set values for the PID controller. The M50-OS + Active model was used to simulate 2 muscle conditions (relaxed and braced) at 2 pulse severities (2.5 and 5.0 g). A control set of simulations was conducted to compare the effect of adding active muscle. Ten whole-body simulations were conducted.Results: The results from volunteer simulations showed a strong dependence of reaction loads and kinematics on muscle activation. Compared to baseline, M50-OS, at 5.0 g acceleration, 33.3% and 7.6% decreases were observed in the overall head kinematics of the M50-OS + Active for the braced and relaxed conditions, respectively. Regarding the anterior direction, similar reductions in overall kinematics were observed for both volunteer test conditions. In comparison to control simulations in which no active muscle was implemented, objective evaluation scores increased markedly at both speeds for the braced condition. Little to no gain was found in the relaxed condition.Conclusions: The results justify the need for use of an active human body model for predicting low-speed frontal kinematics, particularly in the braced condition. Head kinematics were reduced when using active modeling for all simulations (braced and relaxed).

Evaluating thoracolumbar spine response during simulated underbody blast impact using a total human body finite element model

In a study of spine injuries in Operation Iraqi Freedom (OIF) and Operation Enduring Freedom (OEF) from 2001-09, spinal fractures sustained by mounted soldiers accounted for 26% of all injuries, and of that, 43% were caused by explosions [1]. The thoracolumbar region is the most vulnerable area of the spine [2], and injuries are often incapacitating, making egress from vehicles difficult. Injury prediction from such events continues to remain a challenge due to the limited availability of studies specifically focused on underbody blasts (UBB) and criteria on related injuries. This study focuses on developing and validating the spine response of an updated 50th percentile male Global Human Body Models Consortium (GHBMC) Finite Element (FE) model using instrumented post-mortem human subject (PMHS) laboratory tests under two unique conditions. The model was validated against response corridors created using scaled thoracic (T12, T8, T5, T1) and sacrum (S1) spine Z-axis accelerations obtained from WSU whole-body PMHS tests. The scores for the updated spine model ranged from 0.557 – 0.756 for condition 1 (Seat- 4 m/s in 10 ms; Floor- 6 m/s in 5 ms) and 0.639–0.849 for condition 2 (Seat- 4 m/s in 55 ms; Floor- 8 m/s in 2 ms). The PMHS tests sustained spinal injuries in the thoracolumbar region. The validated model indicates high stress and strain concentrations at the same locations, providing an explanation for the fractures sustained in the PMHS tests.

Anatomically-based skeletal coordinate systems for use with impact biomechanics data intended for anthropomorphic test device development

Post-mortem human subjects (PMHS) are frequently used to characterize biomechanical response and injury tolerance of humans to various types of loading by means of instrumentation installed directly on the skeleton. Data extracted from such tests are often used to develop and validate anthropomorphic test devices (ATDs), which function as human surrogates in tests for injury assessment. Given that the location and orientation of installed instrumentation differs between subjects, nominally similar measurements made on different PMHS must be transformed to standardized, skeletal-based local coordinate systems (LCS) before appropriate data comparisons can be made. Standardized PMHS LCS that correspond to ATD instrumentation locations and orientations have not previously been published. This paper introduces anatomically-defined PMHS LCS for body regions in which kinematic measurements are made using ATDs. These LCS include the head, sternum, single vertebrae, pelvis, femurs (distal and proximal), and tibiae (distal and proximal) based upon skeletal landmarks extracted from whole body CT scans. The proposed LCS provide a means to standardize the reporting of PMHS data, and facilitate both the comparison of PMHS impact data across institutions and the application of PMHS data to the development and validation of ATDs.

Personificación de Modelos de Elementos Finitos de Cuerpo Humano

The goal of this study was to quantify the effect of improving the geometry of a human body model on the accuracy of the predicted kinematics for 4 post-mortem human subject sled tests. Three modifications to the computational human body model THUMS were carried out to evaluate if subject personification can increase the agreement between predicted and measured kinematics of post-mortem human subjects in full frontal and nearside oblique impacts. The modifications consisted of: adjusting the human body model mass to the actual subject mass, morphing it to the actual anthropometry of each subject and finally adjustment of the model initial position to the measured position in selected post-mortem human subject tests.&#x0D; A quantitative assessment of the agreement between predicted and measured response was carried out by means of CORA analysis by comparing the displacement of selected anatomical landmarks (head CoG, T1 and T8 vertebre and H-Point).&#x0D; For all three scenarios, the more similar the human body model was to the anthropometry and posture of the sled tested post-mortem human subject, the more similar the predictions were to the measured responses of the post-mortem human subject, resulting in higher CORA score.

A minimum area discrepancy method (MADM) for force displacement response correlation

With the increasing use of Computer Aided Engineering, it has become vital to be able to evaluate the accuracy of numerical models. Specific methods such as CORA were developed to objectively evaluate the correlation between a physical test and a numerical simulation results in terms of parameter vs time. However, no metric has so far been developed for Force Vs Deflection (FvD) signals often used in crashworthiness and biomechanics. A unique method called the Minimum Area Discrepancy Method, or MADM, is proposed to address this deficiency. This new method initially calculates a parameter ‘R’ which represents the area between numerical model and the average physical test response and then divides it by the average area generated by the upper and lower test corridors, based on the same standard deviation. The parameter ‘R’ is then normalized between 0 (no correlation) and 1 (perfect correlation) to become the MADM correlation rating. The MADM method was then validated by comparing a one dimensional Finite Element (FE) model of a chest model, under 2 impact velocities, against reference Post Mortem Human Subject (PMHS) data. The MADM method was further used to improve the correlation of this thorax model, by varying model parameters and generating 81 model variations. Based on the MADM ratings, a set parameter values leading to the best fit was identified. The best fit exhibits a response significantly better than the original chest model. MADM is novel, unique, easy to use and fulfills an important gap in objectively evaluating FVD correlation responses.AbbreviationsMADMCorrelation rating value (Minimum Area Discrepancy Method)MADMn,mMADM correlation rating using a specific scaling value of ‘n’ and power rating ‘m’FvDForce versus DisplacementFvTForce versus TimeDvTDisplacement versus TimeNMNumerical modelPEPhysical ExperimentAmodelArea under the average signal and the Numerical ModelAupperArea under the average signal +1 standard deviationAlowerArea under the average signal -1 standard deviationRRatio between Amodel and the average of Aupper and Alower

Material and Structural Modeling Aspects of Brain Tissue Deformation under Dynamic Loads.

The aim of this work was to assess the numerous approaches to structural and material modeling of brain tissue under dynamic loading conditions. The current technological improvements in material modeling have led to various approaches described in the literature. However, the methods used for the determination of the brain’s characteristics have not always been stated or clearly defined and material data are even more scattered. Thus, the research described in this paper explicitly underlines directions for the development of numerical brain models. An important element of this research is the development of a numerical model of the brain based on medical imaging methods. This approach allowed the authors to assess the changes in the mechanical and geometrical parameters of brain tissue caused by the impact of mechanical loads. The developed model was verified through comparison with experimental studies on post-mortem human subjects described in the literature, as well as through numerical tests. Based on the current research, the authors identified important aspects of the modeling of brain tissue that influence the assessment of the actual biomechanical response of the brain for dynamic analyses.

Development and Validation of an Occupant Biomechanical Model for the Aortic Injury Analysis under Side Impacts

Traumatic rupture of the aorta (TRA) is one of the leading causes of death in side impacts. However, the injury mechanism of TRA is still not clear now. In this study, an occupant biomechanical model for the aortic injury study was presented. The anatomical structures and mechanical characteristics of the thoracic organs, especially the cardiac aortic system, were replicated as precise as possible. Through model validations against the Post Mortem Human Subjects (PMHS) tests, good agreements were achieved between them in terms of the aortic strain, stress and deflection responses and injury distributions. Moreover, it was found that the injury mechanisms of the aorta under pure left side impact and oblique left side impact were different. In pure left side impact, the peri-isthmic region and descending aorta presented higher risks of TRA. In oblique left side impact, the TRA risk in aortic boot was higher than in other regions. The biomechanical model presented in this study could be of use to both the injury mechanism study of TRA as well as the design of occupants’ safety countermeasures involving aortic injuries in side impacts.

Influence of ATD versus PMHS reference sensor inputs on computational brain response in frontal impacts to advanced combat helmet (ACH)

ABSTRACTObjective: This study analyzed the influence of reference sensor inputs from anthropomorphic test devices (ATDs) versus postmortem human subjects (PMHSs) on simulations of frontal blunt impacts to the advanced combat helmet (ACH).Methods: A rigid-arm pendulum was used to generate frontal impacts to ACHs mounted on ATDs and PMHS. An appropriately sized ACH was selected according to standard fitting guidelines. The National Operating Committee on Standards for Athletic Equipment (NOCSAE) head was selected for ATD tests due to shape features that enabled a realistic helmet fit. A custom procedure was used to mount a reference sensor internally near the center of gravity (CG) of the PMHS. Reference sensor data from the head CG were used as inputs for the Simulated Injury Monitor (SIMon). Brain responses were assessed with the cumulative strain damage measure set at 10%, or CSDM(10).Results: Compared to ATD tests, PMHS tests produced 18.7% higher peak linear accelerations and 5.2% higher peak angular velocities. Average times to peak for linear accelerations were relatively similar between ATDs (5.5 ms) and PMHSs (5.8 ms). However, times to peak for angular velocities were higher by a factor of up to 3.4 for PMHSs compared to ATDs. Values for were also higher by a factor of up to 13.1 when PMHS inputs were used for SIMon.Conclusions: The preliminary findings of this work indicate that small differences in ATD versus PMHS head kinematics could lead to large differences in strain-derived brain injury metrics such as CSDM.

Development of an injury risk curve for pelvic fracture in vertical loading environments

Objective: Pelvis injury mechanisms are dependent upon loading direction (frontal, lateral, and vertical). Studies exist on the frontal and lateral modes; however, similar studies in the vertical mode are relatively sparse. Injury risk curves and response corridors are needed to delineate the biomechanical responses. The objective of the study was to derive risk curves for pelvis injuries using postmortem human subjects (PMHSs).Methods: Published data from whole-body PMHSs loaded axially through the pelvis were analyzed. Accelerometers were placed on the pelvis/sacrum and seat. Specimens were loaded along the inferior to superior direction using a horizontal sled or a vertical accelerator device. Specimens were positioned supine in the horizontal sled and seated upright on the vertical accelerator. Pre- and posttest images were obtained and autopsies were completed to document the pathology. Variables used in the development of risk curves included velocity, acceleration, time to peak acceleration, pulse duration of acceleration, and jerk for the seat and sacrum. Survival analysis was used for risk curves. To determine the best predictor of pelvis injury, the Brier Score metric (BSM) was used. The best parametric distribution was determined using the corrected Akaike information criterion (AICc). Injury data points were treated as either uncensored or left/interval censored. Noninjury data points were treated as right censored.Results: Twenty-four PMHS specimens were identified from 3 published data sets. Fifteen PMHS specimens sustained injuries and 9 remained intact. The BSM ranged from 1.24 to 24.75 and, in general, the BSMs for the seat metric-related scores were greater than the sacrum data. The sacrum acceleration was the optimal metric for predicting pelvis tolerance (lowest BSM). The Weibull distribution had the lowest AICc, with right and left/interval-censored data. This was also true when injury data were treated as exact (uncensored) observations. The 50% probability of injury was associated with 229 G for the uncensored analysis and 139 G for the censored analysis, and the quality indices in both cases were in the “good” range.Conclusions: Statistical determination of the best injury metric will help improve the accuracy of injury prediction, prioritize instrumentation choice in dummy development, and improve design criteria for crash mitigation. The present study showed that injury risk curves using response data are better biomechanical descriptors of human responses than exposure data. These data are important in automotive safety because complex loading of the pelvis, including submarining, occurs in frontal car crashes.

Chest injuries of elderly postmortem human surrogates (PMHSs) under seat belt and airbag loading in frontal sled impacts: Comparison to matching THOR tests

Objective: The goal of the study was to develop experimental chest loading conditions that would cause up to Abbreviated Injury Scale (AIS) 2 chest injuries in elderly occupants in moderate-speed frontal crashes. The new set of experimental data was also intended to be used in the benchmark of existing thoracic injury criteria in lower-speed collision conditions.Methods: Six male elderly (age >63) postmortem human subjects (PMHS) were exposed to a 35 km/h (nominal) frontal sled impact. The test fixture consisted of a rigid seat, rigid footrest, and cable seat back. Two restraint conditions (A and B) were compared. Occupants were restrained by a force-limited (2.5 kN [A] and 2 kN [B]) seat belt and a preinflated (16 kPa [A] and 11 kPa [B]; airbag). Condition B also incorporated increased seat friction. Matching sled tests were carried out with the THOR-M dummy. Infra-red telescoping rod for the assessment of chest compression (IRTRACC) readings were used to compute chest injury risk. PMHSs were exposed to a posttest injury assessment. Tests were carried out in 2 stages, using the outcome of the first one combined with a parametric study using the THUMS model to adjust the test conditions in the second. All procedures were approved by the relevant ethics board.Results: Restraint condition A resulted in an unexpected high number of rib fractures (fx; 10, 14, 15 fx). Under condition B, the adjustment of the relative airbag/occupant position combined with a lower airbag pressure and lower seat belt load limit resulted in a reduced pelvic excursion (85 vs. 110 mm), increased torso pitch and a substantially lower number of rib fractures (1, 0, 4 fx) as intended.Conclusions: The predicted risk of rib fractures provided by the THOR dummy using the Cmax and PC Score injury criteria were lower than the actual injuries observed in the PMHS tests (especially in restraint condition A). However, the THOR dummy was capable of discriminating between the 2 restraint scenarios. Similar results were obtained in the parametric study with the THUMS model.

Three-dimensional kinematic corridors of the head, spine, and pelvis for small female driver seat occupants in near- and far-side oblique frontal impacts

Objectives: Analyses of recent automotive accident data indicate an increased risk of injury for small female occupants compared to males in similar accidents. Females have been shown to be more susceptible to spinal injuries than males. To protect this more vulnerable population, advanced anthropomorphic test devices (ATDs) and computer human body models are being developed and require biofidelity curves for validation. The aim of this study is to generate female-specific 3D kinematic corridors in near- and far-side oblique frontal impacts for the head, spine, and pelvis.Methods: Eight specimens were procured and prescreened for mass, stature, and quantitative computed tomography bone mineral density and preexisting injuries to minimize biologic variability. Sets of 4 noncolinear retroreflective targets were placed on the back of the head; dorsal spine at T1, T8, and L2; and posterior sacrum. Instrumented computed tomography scans were obtained to measure the orientation and position of the markers relative to anatomic fiducials. The specimens were placed on a buck representative of a generic automotive driver’s seat environment designed to minimize lower-extremity and pelvic motion. The buck was oriented such that the buck centerline was seated 30° from the impact vector in either a near- or far-side oblique frontal configuration. Preposition of the occupant was specified to the 50th percentile male H-point location, thigh and tibial angles, and torso angle. Impact was delivered via a servo-acceleration sled to the base of the buck with a 30 km/h 9 g trapezoidal pulse. Occupants were restrained by a standard 3-point belt that had a custom load-limiter device set to 2 kN at the D-ring side of the shoulder belt. Target motion was recorded at 1 kHz using a 3D optical motion capture system. Anatomic motion of the head, spine, and pelvis was calculated relative to the seat, and the average response was determined from 4 near-side and 4 far-side tests. The borders of the corridor were determined by calculating a standard deviational ellipse in the x, y, and z planes at each time step.Results: Plots of the biofidelity corridors for near- and far-side tests are shown in planes parallel to the seat from the lateral, rear, and overhead directions. Averaged peak excursions in the fore/aft and lateral directions are compared for the near- and far-side corridors. Near-side female and male tests are similarly compared.Conclusions: In general, average peak excursions were greater in the far-side configuration than in the near-side configuration. Peak excursion results compared well with similar tests conducted on male postmortem human subjects (PMHS). The kinematic corridors developed in the current study serve as a set of biofidelity corridors for the development of current and future physical and computational surrogates.

Nurr1 (NR4A2) regulates Alzheimer's disease-related pathogenesis and cognitive function in the 5XFAD mouse model.

The orphan nuclear receptor Nurr1 (also known as NR4A2) is critical for the development and maintenance of midbrain dopaminergic neurons, and is associated with Parkinson's disease. However, an association between Nurr1 and Alzheimer's disease (AD)‐related pathology has not previously been reported. Here, we provide evidence that Nurr1 is expressed in a neuron‐specific manner in AD‐related brain regions; specifically, it is selectively expressed in glutamatergic neurons in the subiculum and the cortex of both normal and AD brains. Based on Nurr1’s expression patterns, we investigated potential functional roles of Nurr1 in AD pathology. Nurr1 expression was examined in the hippocampus and cortex of AD mouse model and postmortem human AD subjects. In addition, we performed both gain‐of‐function and loss‐of‐function studies of Nurr1 and its pharmacological activation in 5XFAD mice. We found that knockdown of Nurr1 significantly aggravated AD pathology while its overexpression alleviated it, including effects on Aβ accumulation, neuroinflammation, and neurodegeneration. Importantly, 5XFAD mice treated with amodiaquine, a highly selective synthetic Nurr1 agonist, showed robust reduction in typical AD features including deposition of Aβ plaques, neuronal loss, microgliosis, and impairment of adult hippocampal neurogenesis, leading to significant improvement of cognitive impairment. These in vivo and in vitro findings suggest that Nurr1 critically regulates AD‐related pathophysiology and identify Nurr1 as a novel AD therapeutic target.

In Vivo Testing of a Miniature 2.4/4.8 GHz Implantable Antenna in Postmortem Human Subject

We present a novel miniaturized dual-band implantable antenna for microwave backscattering at 2.4/4.8 GHz. These bands are recently emerging as highly promising for batteryless implants, viz., implants that receive power from an exterior interrogator at 2.4 GHz and backscatter their sensed signals at 4.8 GHz. Compared to the smallest reported 2.4/4.8 GHz implantable antenna, the proposed design is miniaturized by 39%, and exhibits higher gain by 10.3 dB (at 2.4 GHz) and 2.6 dB (at 4.8 GHz). To validate the antenna performance under anatomically correct conditions, postmortem human subject (PMHS) testing is performed. To the best of our knowledge, this is the first time that implantable antennas are tested in PMHS and further compared versus simulations in tissue-emulating models. Notably, good agreement exists between the two, with the proposed antenna exhibiting a reflection coefficient of <−4.5 dB at both 2.4 and 4.8 GHz for all six subcutaneous locations measured: left/right sides of thigh, hip, and abdomen.

Human Shoulder Response to Lateral Impact in Intermediate Loading Conditions Between High-Velocity, Short-Duration and Low-Velocity, Long-Duration.

The EuroSID-2re (ES-2re) Anthropomorphic Test Device (ATD) commonly known as the crash test dummy is also used in the military domain to assess the risk of injury of armored vehicles occupants from lateral impact. The loading conditions range from low velocity - long duration impacts (4 m/s - 50 ms) similar to the automotive domain, to high velocity - short duration impacts (28 m/s - 3 ms) corresponding to cases where the panel deforms under an explosion. The human shoulder response to lateral impact was investigated at bounds of the loading condition spectrum previously mentioned, and also at intermediate conditions (14 m/s - 9 ms) in previous studies. The aim of the current study is to provide additional insight at the intermediate loading conditions which are not found in the literature. Eight pure lateral shoulder impact tests were performed on Post Mortem Human Subjects (PMHS) using an 8.1 kg rigid impactor at velocities ranging from 3.3 m/s to 8.8 m/s with the duration ranging from 25 ms to 35 ms. The PMHS were instrumented with accelerometers attached to the sternum, and the upper thoracic spine (T1 vertebra). Strain gages were glued onto the right and left clavicles and ribs 2 to 6. The shoulder force was measured at the interface with the impactor and the impact was filmed by high speed cameras (5000 fps) to track the YZ displacements of the impactor, T1 vertebra, and sternum in the laboratory frame. Three shoulders out of the eight sustained AIS 2 injuries which included a clavicle fracture. The impactor forces ranged from 1200 to 4600 N. The PMHS accelerations ranged from 44 to 163 g at the sternum, and from 17 to 60 g at the T1 vertebra. The analysis of the strain gage signals revealed that the clavicle fractures occurred at the beginning of the impact and coincided with a peak force. An estimate of the acromion-to-shoulder compression (Cmax) was computed. It ranged from 0% to 15% for the non-injured shoulders, and from 19% to 28% for the injured shoulders. This new PMHS test series will be used in a future work to develop a shoulder injury criterion for the ES-2re ATD that is relevant for the whole loading conditions spectrum of the military domain.

Reference PMHS Sled Tests to Assess Submarining of the Small Female.

In the last decade, extensive efforts have been made to understand the physics of submarining and its consequences in terms of abdominal injuries. For that purpose, 27 Post Mortem Human Subject (PMHS) tests were performed in well controlled conditions on a sled and response corridors were provided to assess the biofidelity of dummies or human body models. All these efforts were based on the 50th percentile male. In parallel, efforts were initiated to transfer the understanding of submarining and the prediction criteria to the THOR dummies. Both the biofidelity targets and the criteria were scaled down from the 50th percentile male to the 5th percentile THOR female. The objective of this project was to run a set of reference PMHS tests in order to check the biofidelity of the THOR F05 in terms of submarining. Three series of tests were performed on nine PMHS, the first one was designed to avoid submarining, the second and third ones were designed to result in submarining. In the first configuration, no submarining was observed in 3 cases out of 4 and only one iliac wing fracture occurred in one subject. In the second and third configurations, all subjects but one sustained submarining. In addition, two subjects out of three in the third configuration sustained substantial iliac wing fractures. Nevertheless, all configurations can be represented by at least one or several cases without any pelvis fracture. Corridors were constructed for the external forces and the PMHS kinematics. They are provided in this paper as new experimental references to assess the biofidelity of small female human surrogates in different configurations where submarining did or did not occur.

Lower Limb Posture Affects the Mechanism of Injury in Under-Body Blast

Over 80% of wounded Service Members sustain at least one extremity injury. The ‘deck-slap’ foot, a product of the vehicle’s floor rising rapidly when attacked by a mine to injure the limb, has been a signature injury in recent conflicts. Given the frequency and severity of these combat-related extremity injuries, they require the greatest utilisation of resources for treatment, and have caused the greatest number of disabled soldiers during recent conflicts. Most research efforts focus on occupants seated with both tibia-to-femur and tibia-to-foot angles set at 90°; it is unknown whether results obtained from these tests are applicable when alternative seated postures are adopted. To investigate this, lower limbs from anthropometric testing devices (ATDs) and post mortem human subjects (PMHSs) were loaded in three different seated postures using an under-body blast injury simulator. Using metrics that are commonly used for assessing injury, such as the axial force and the revised tibia index, the lower limb of ATDs were found to be insensitive to posture variations while the injuries sustained by the PMHS lower limbs differed in type and severity between postures. This suggests that the mechanism of injury depends on the posture and that this cannot be captured by the current injury criteria. Therefore, great care should be taken when interpreting and extrapolating results, especially in vehicle qualification tests, when postures other than the 90°–90° are of interest.