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4 results on '"post mortem human subjects"'

1. The ethics, applications, and contributions of cadaver testing in injury prevention research.

Author

Lopez-Valdes, Francisco J., Mascareñas Brito, Alberto, Agnew, Amanda M., Cripton, Peter, Kerrigan, Jason, Masouros, Spyros, Schmitt, Kai-Uwe, and Siegmund, Gunter

Subjects
CRASH test dummies, LITERATURE reviews, HUMAN experimentation, MEDICAL sciences, PREVENTION of injury
Abstract

Objective: This study aims to establish best practices and guidelines to ensure that experimental research utilizing Postmortem Human Subjects (PMHS) for injury prevention adheres to relevant ethical principles, which are also commonly accepted in research involving human tissues and living subjects. Furthermore, it reviews existing literature to underscore the pivotal role of PMHS testing in evaluating the efficacy of safety systems, with a particular focus on airbag performance. Methods: This paper conducts an examination of the primary ethical principles governing human subject research as outlined in the Declaration of Helsinki (1965) and traces their evolution up to the latest framework proposed by the Council for International Organizations of Medical Sciences (CIOMS) in 2002. Input was solicited from international experts and laboratories experienced in PMHS testing to understand how these ethical principles are implemented in practice. This is complemented by a comprehensive review of literature that assesses the contribution of PMHS testing to airbag performance enhancements in frontal impacts. Results: The findings underscore the importance of informed consent from donors or their next-of-kin, as highlighted in CIOMS declarations, to ensure the ethical integrity of the donation process in line with international standards. The study also finds it customary for an independent review board to evaluate the research methodology and the necessity of employing PMHS tissue over alternative methods, such as computational models or crash test dummies. Despite various national regulations on human subject participation and living tissue research, no specific legal framework governing PMHS tissue use was identified. The systematic literature review revealed that PMHS testing has been crucial in identifying potential injury mechanisms not detected by Anthropomorphic Test Devices (ATD), significantly contributing to the enhancement of computer human body models and the biofidelity of crash test dummies. Conclusion: The International Council on the Biomechanics of Injury (IRCOBI) recognizes the need to provide guidance for research involving human cadaveric tissue to be conducted with the highest ethical standards. This study proposes five recommendations to ensure adherence to these ethical principles in PMHS testing, highlighting the paramount importance of obtaining informed consent and securing independent committee approval. Moreover, IRCOBI emphasizes that until a thorough understanding of tissue damage tolerance levels is achieved and human surrogates, such as ATDs or Human Body Models (HBM), reach full biofidelity, the use of human cadavers remains indispensable for developing effective injury prevention strategies and measures. [ABSTRACT FROM AUTHOR]

Published
2024
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2. PMHS Use as a Surrogate for Living Populations in Lower Extremity Research

Author

Marcallini, Angelo Michael, Jr.

Subjects
Biomedical Engineering, Engineering, Biology, Biomechanics, PMHS, surrogates, surrogate, living, living people, foot, feet, lower extremity, lower extremities, injury, injury research, post mortem human subjects, cadavers, cadaver, research, anthropometry, ultrasound, heel pad, heel, heels, heel pads, seated, standing, sex differences, laterality, left versus right, left vs right, x-ray, radiography
Abstract

Objective: The purpose of this thesis was to determine the degree of difference between anthropometric and heel pad tissue characteristics of the lower extremities of PMHS compared to living populations as well as to establish a wholistic procedure for extensive measurements of the foot using methodology previously used in lower limb anthropometry, x-ray imaging, and ultrasound imaging studies.Methods: Thirty-seven PMHS were included in the anthropometry analysis, 21 PMHS were included in the x-ray analysis, and 32 PMHS were included in the ultrasound analysis. For the anthropometry, measurements were taken in seated and standing positions and included bimalleolar breadth, heel breadth, navicular height (medial prominence), navicular height (inferior medial border), talar head height, plantar curvature height, lateral malleolar height, medial malleolar height, acropodion foot length, hallux foot length, horizontal foot breadth, ball of foot length, and dorsum height. Comparisons were then made between left and right feet, seated and standing positions, males and females, and PMHS and living populations. For the x-ray analysis, two of the anthropometry measurements, navicular height (inferior medial border) and talar head height, had values for anthropometry compared against measurements determined through x-ray imaging. For the ultrasound analysis, ultrasound images were taken of the plantar foot at the calcaneus at loadings of 0, 5, 10, 15, 20, and 30 Newtons. Thicknesses, stiffnesses, and compressibility indexes were determined using the images, and these values were then compared against values seen in living populations. Results: Left and right feet were found to have no significant differences in anthropometry. Seated and standing positions were found to be significantly different in 12 of the 13 measurements. Male values were found to be significantly different from female values in both seated and standing positions for all measurements except for plantar curvature height. By determining percent difference values between seated and standing positions for both males and females, no significant difference was found between sexes in their respective measurement changes from seated to standing positions except in plantar curvature height and lateral malleolus height. Eleven of the 13 measurements showed agreement between PMHS and living populations, with talar head height and plantar curvature height showing greater than 10% difference. In the x-ray analysis, navicular height was significantly different between anthropometry and x-ray values, and talar height was not significantly different. In the ultrasound analysis PMHS were found to have thinner and stiffer heel pads with lower compressibility than living populations.Conclusions: A wholistic procedure for foot measurements and analysis was developed which incorporates methodology from previous literature. For foot measurement, x-ray imaging was shown to be necessary for certain landmarks but not for others. Results from this study have provided quantification of posture and sex differences as well as quantification for differences between PMHS and living populations for foot anthropometry. Differences were also quantified for the thickness, stiffness, and compressibility of PMHS compared to living populations. The results show that PMHS anthropometry sufficiently represents that of living people’s anthropometry when sex and postural differences are accounted for, but PMHS is not representative of living populations regarding heel pad thickness, stiffness, or compressibility, and these differences must be considered in lower extremity testing.

Published
2023

3. Development of a Paediatric Head Model for the Computational Analysis of Head Impact Interactions

Author

G. A. Khalid, M. D. Jones, R. Prabhu, A. Mason-Jones, W. Whittington, H. Bakhtiarydavijani, and P. S. Theobald

Subjects
infant head trauma, Finite element analysis, impact simulation, material properties, post mortem human subjects
Abstract

Head injury in childhood is a common cause of death or permanent disability from injury. However, despite its frequency and significance, there is little understanding of how a child’s head responds during injurious loading. Whilst Infant Post Mortem Human Subject (PMHS) experimentation is a logical approach to understand injury biomechanics, it is the authors’ opinion that a lack of subject availability is hindering potential progress. Computer modelling adds great value when considering adult populations; however, its potential remains largely untapped for infant surrogates. The complexities of child growth and development, which result in age dependent changes in anatomy, geometry and physical response characteristics, present new challenges for computational simulation. Further geometric challenges are presented by the intricate infant cranial bones, which are separated by sutures and fontanelles and demonstrate a visible fibre orientation. This study presents an FE model of a newborn infant’s head, developed from high-resolution computer tomography scans, informed by published tissue material properties. To mimic the fibre orientation of immature cranial bone, anisotropic properties were applied to the FE cranial bone model, with elastic moduli representing the bone response both parallel and perpendicular to the fibre orientation. Biofiedility of the computational model was confirmed by global validation against published PMHS data, by replicating experimental impact tests with a series of computational simulations, in terms of head kinematic responses. Numerical results confirm that the FE head model’s mechanical response is in favourable agreement with the PMHS drop test results., {"references":["Langlois J. A, Rutland –Brown W, Thomas K.E. Traumatic Brain Injury in the United States: Emergency department visits, hospitalizations, and deaths. CDCP, NCIPC. Atlanta, GA 2004.","Greenes D. S. and Schutzman S. A. Clinical indicators of intracranial injury in head-injured infants Pediatrics, 1999: 104, 861-7","Roth S, Raul J-S, Ludes B, Willinger R. Finite element analysis of impact and shaking inflicted to a child. International journal of legal medicine. 2007: 121(3):223-228.","Roth S, Raul J, Willinger R. Biofidelic child head FE model to simulate real world trauma. Computer methods and programs in biomedicine. 2008: 90(3):262-274.","Roth S, Vappou J, Raul J, Willinger R. Child head injury criteria investigation through numerical simulation of real world trauma. Computer methods and programs in biomedicine. 2009: 93(1):32-45.","Coats B, Margulies S. Parametric study of head impact in the infant. Stapp Car Crash J. 2007: 51:1-15","Roth S, Raul J, Ruan J, Willinger R. Limitation of scaling methods in child head finite element modelling. International Journal of Vehicle Safety. 2007: 2(4):404-421.","Roth S, Raul JS, Willinger R. Finite element modelling of paediatric head impact: Global validation against experimental data. Computer methods and programs in biomedicine. 2010: 99(1):25-33.","Li Z, Hu J, Reed MP, Rupp JD, Hoff CN, Zhang J, Cheng B. Development, validation, and application of a parametric pediatric head finite element model for impact simulations. Annals of biomedical engineering.2011; 39(12):2984-2997.\n[10]\tKlinich K, Hulbert G, Schneider L. Estimating infant head injury criteria and impact response using crash reconstruction and finite element modelling. Stapp car crash journal. 2002;46:165\n[11]\tA.M. Nahum, R. Smith, C.C. Ward, Intracranial pressure dynamics during head impact, Proceedings of the 21st STAPP Car Crash Conference 1977: 339–366.\n[12]\tW.N. Hardy, C. Foster, M. Mason, K. Yang, A. King, S. Tashman, Investigation of head injury mechanisms using neutral density technology and high-speed biplanar X-ray, Stapp Car Crash J. 45 2001: 337–368.\n[13]\tN. Yoganandan, F.A. Pintar, A. Sances, P.R. Walsh, C.L. Ewing, T. Snyder, R.G. Snyder, Biomechanics of skull fracture, in: Proceedings of the Head Injury Symposium, Washington, DC, 1994:. 227–236.\n[14]\tGhaidaa A Khalid, Michael D Jones et al. Preliminary Numerical Simulations to Investigate the Kinematics of Infant Head Impact. Proceedings of the 24th UK Conference of the Association for Computational Mechanics in Engineering. March 2016: Cardiff University, Cardiff.\n[15]\tCoats, B. & Margulies, S.S. Material properties of human infant skull and suture at high rates. Journal of Neurotrauma, 2006: 23(8), 1222–1232.\n[16]\tLi, Z., Luo, X. & Zhang, J. Development/global validation of a 6-month-old pediatric head finite element model and application in investigation of drop-induced infant head injury. Computer Methods and Programs in Biomedicine, 2013: 112(3), 309–319.\n[17]\tG.K. Mc Pherson, T.J. Kriewall, The elastic modulus of fetal cranial bone: a first step toward an understanding of the biomechanics of fetal head molding, J. Biomech. 13 (1981) 9–16.\n[18]\tCheng, J., Howard, I.C. Rennison, M. Study of an infant brain subjected to periodic motion via a custom experimental apparatus design and finite element modelling. Journal of Biomechanics, 2010: 43(15), 2887–2896.\n[19]\tPrange M, Luck J, Dibb A, Van Ee C, Nightingale R, Myers B. Mechanical properties and anthropometry of the human infant head. Stapp car crash journal. 2004: 48:279.\n[20]\tTarantino CA, Dowd MD, Murdock TC. Short vertical falls in infants. Pediatr Emerg Care. 1999:15(1):5-8."]}

Published
2017
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4. Human Shoulder Response to High Velocity Lateral Impact

Author

Denis Lafont, Philippe Vezin, Frédéric Rongieras, Matthieu Lebarbé, Centre Européen d'Etudes de Sécurité et d'Analyse des Risques (CEESAR), Laboratoire de Biomécanique et Mécanique des Chocs (LBMC UMR T9406), Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Institut Français des Sciences et Technologies des Transports, de l'Aménagement et des Réseaux (IFSTTAR), and DGA TT

Subjects
Male, Humeral Fractures, NATO, Time Factors, Shoulders, 020209 energy, High velocity, 02 engineering and technology, HIGH VELOCITY, Fractures, Bone, 0203 mechanical engineering, Cadaver, Deflection (engineering), 0202 electrical engineering, electronic engineering, information engineering, medicine, Humans, Humerus, Joint dislocation, Acromion, Aged, Orthodontics, Aged, 80 and over, LATERAL IMPACT, COLLISION LATERALE, PMHS, Accidents, Traffic, [SPI.MECA.BIOM]Engineering Sciences [physics]/Mechanics [physics.med-ph]/Biomechanics [physics.med-ph], medicine.disease, Clavicle, Biomechanical Phenomena, 020303 mechanical engineering & transports, medicine.anatomical_structure, POST MORTEM HUMAN SUBJECTS, Humeral Head, Female, Stress, Mechanical, SHOULDER, EPAULE, ARMORED VEHICLE, Geology
Abstract

The armies of the North Atlantic Treaty Organization need a shoulder injury criterion for the EuroSID-2re dummy that must be reliable over a large range of loading conditions, from high velocity, short duration impacts (28 m/s - 3 ms) to low velocity long, duration impacts (4 m/s - 50 ms). In the literature, the human shoulder response to lateral impact was investigated at bounds of the loading condition spectrum as previously mentioned. For the low velocities, the injuries were mainly clavicle fractures and the maximum compression between the acromion and the sternum (Cmax) was proposed as an injury criterion. For the high velocities, the typical injury was humerus fractures, including a crushed humeral head. The present study investigates the human shoulder response at an intermediate loading condition (14 m/s - 9 ms). Six lateral shoulder impact tests have been performed with three Post Mortem Human Subjects using a rigid impactor. The duration of the impact was controlled by means of an aluminum honeycomb that decelerated the impactor during the impact. The shoulder external deflection (impactor-to-sternum) ranged between 40 to 64 mm and the applied forces ranged from 4.3 kN to 8 kN. Four shoulders out of six sustained AIS2 injuries. Two acromio-clavicular joint dislocations, one clavicle fracture, and one scapula fracture were observed. Though the shoulder force responses were closer to those induced by the high velocity, short duration impacts, the injury patterns resembled those observed for low velocity, long duration loading conditions. Furthermore, the estimated acromion-to-sternum deflection values were not inconsistent with the prediction of the shoulder injury risk curve of the literature. Despite the relatively high-velocity impact (14.3 m/s), the shoulder injury mechanism appeared to be similar to those observed in the automotive field.

Published
2017

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