The raw data related to the second study of this thesis (Chapter 3) is available online in the section of supporting information at https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0232677. These files present the following data: S1 File. The pattern of foot orthosis depression/reformation for healthy subjects during walking with sport versus regular foot orthosis. S2 File. Raw data for the training session of sport foot orthosis. This Excel file consists three sheets in which the position of triad markers, the orientation of triad markers and the position of markers on plantar surface of foot orthosis are provided respectively. S3 File. Raw data for walking with sport foot orthosis. This Excel file consists two sheets in which the position of triad markers and the orientation of triad markers are provided respectively for subject 1. S4 File. The results of each participant during walking with sport foot orthosis. This .mat file includes “DispEachPoint” and “DispEachPointMean” which shows the displacement of each predicted marker on foot orthosis plantar surface during stance phase of walking relative to its corresponding position in static non weight-bearing for each trial and the average of trials respectively. In addition, “loc_stance” and “loc_meanstance” show the location of each predicted marker during stance phase of walking. “peaks” and “peaksMean” represent the minimum (depression) and maximum (reformation) value of displacement during walking S5 File. The results of each participant during walking with regular foot orthosis. This .mat file includes “DispEachPoint” and “DispEachPointMean” which shows the displacement of each predicted marker on foot orthosis plantar surface during stance phase of walking relative to its corresponding position in static non weight-bearing for each trial and the average of trials respectively. In addition, “loc_stance” and “loc_meanstance” show the location of each predicted marker during stance phase of walking. “peaks” and “peaksMean” represent the minimum (depression) and maximum (reformation) value of displacement during walking / Les orthèses plantaires (OP) sont des dispositifs médicaux fréquemment utilisés pour réduire les douleurs et blessures de surutilisation, notamment chez les personnes ayant les pieds plats. Le port d'OP permettrait de corriger les altérations biomécaniques attribuées à la déformation du pied plat, que sont la perte de l’arche longitudinale médiale et la pronation excessive du pied. Cependant, le manque de compréhension de la fonction des OP entraine une grande variabilité des OP prescrites en milieu clinique. L'objectif de cette thèse est d'approfondir les connaissances sur l’effet des OP sur la biomécanique, de quantifier les déformations des OP à la marche et de mettre en relation ces déformations avec la biomécanique du pied. La première étude a évalué la manière dont les différentes conceptions d'OP imposent des modifications dans le mouvement et le chargement appliqué sur le pied. Cet objectif a été atteint grâce à une revue systématique traitant des effets des OP sur la cinématique et la cinétique du membre inférieur pendant la marche chez des personnes ayant des pieds normaux. Les critères d'inclusion ont réduit les études à celles qui ont fait état des résultats pour les géométries les plus fréquentes des OP, à savoir les biseaux, les supports d’arche et les stabilisateurs de talon. La revue a mis en évidence que les orthèses avec un biseau médial peuvent réduire le moment d'éversion de la cheville. Aucune évidence significative n'a été trouvée dans notre méta-analyse sur l'efficacité des orthèses incluant des supports d’arche ou des stabilisateurs de talon. Les différents procédés et matériaux utilisés dans la conception des OP ainsi que les caractéristiques des pieds des participants pourraient expliquer la variabilité retrouvée au regard des effets des OP sur la biomécanique. La deuxième étude a apporté des informations précieuses et inédites sur le comportement dynamique des OP à la marche. La cinématique du contour des OP a été utilisée pour prédire la déformation de leur surface plantaire pendant la marche chez 13 individus ayant des pieds normaux en utilisant un réseau de neurones artificiels. Une erreur moyenne inférieure à 0,6 mm a été obtenue pour nos prédictions. En plus de la précision des prédictions, le modèle a été capable de différencier le patron de déformations pour deux OP de rigidités différentes et entre les participants inclus dans l’étude. Enfin, dans une troisième étude, nous avons identifié la relation entre la déformation des OP personnalisées et la biomécanique du pied à la marche chez 17 personnes avec des pieds plats. L'utilisation de modèles linéaires mixtes a permis d’exprimer les variations de la déformation des OP dans différentes régions en fonction des variables cinématiques du pied et de pressions plantaires. Cette étude a montré que l'interaction pied-OP varie selon les différentes régions de l’OP et les différentes phases du cycle de marche. Ainsi, des lignes directrices préliminaires ont été fournies afin de standardiser et optimiser la conception des OP. Dans l'ensemble, les résultats de cette thèse justifient l'importance d’'intégrer des caractéristiques dynamiques du pied de chaque individu dans la conception d'OP personnalisées. Des études futures pourraient étendre les modèles de prédiction de l'interaction pied-OP en incluant d'autres paramètres biomécaniques tels que les moments articulaires, les activations musculaires et la morphologie du pied. De tels modèles pourraient être utilisés pour développer des fonctions coût pour l'optimisation de la conception des OP par une approche itérative utilisant la simulation par les éléments finis. / Foot orthoses (FOs) are frequently used medical devices to manage overuse injuries and pain in flatfoot individuals. Wearing FOs can result in improving the biomechanical alterations attributed to flatfoot deformity such as the loss of medial longitudinal arch and excessive foot pronation. However, a lack of a clear understanding of the function of FOs contributes to the highly variable FOs prescribed in clinical practice. The objective of this thesis was to deepen the knowledge about the biomechanical outcomes of FOs and to formulate the dynamic behaviour of FOs as a function of foot biomechanics during gait. The primary study investigated how different designs of FOs impose alterations in foot motion and loading. This objective was achieved through a systematic review of all literature reporting the kinematics and kinetics of the lower body during walking with FOs in healthy individuals. The inclusion criteria narrowed the studies to the ones which reported the outcomes for common designs of FOs, namely posting, arch support, and heel support. The review identified some evidence that FOs with medial posting can decrease ankle eversion moment. No significant evidence was found in our meta-analysis for the efficiency of arch supported and heel supported FOs. The findings of this study revealed that differences in FO design and material as well as foot characteristics of participants could explain the variations in biomechanical outcomes of FOs. The second study provided valuable information on the dynamic behaviour of customized FOs. The kinematics of FO contour was used to predict the deformation of FO plantar surface in 13 healthy individuals during walking using an artificial intelligence approach. An average error below 0.6 mm was achieved for our predictions. In addition to the prediction accuracy, the model was capable to differentiate between different rigidities of FOs and between included participants in terms of range and pattern of deformation. Finally, the third study identified the relationship between the deformation of customized FOs and foot biomechanics in 17 flatfoot individuals during walking. The use of linear mixed models made it possible to identify the variables of foot kinematics and region-dependent plantar pressure that could explain the variations in FO deformation. This study showed that the foot-FO interaction changes over different regions of FO and different phases of gait cycle. In addition, some preliminary guidelines were provided to standardize and optimize the design of FOs. Overall, the results of this thesis justify the importance of incorporating the dynamic characteristics of each individual’s foot into the design of customized FOs. Future studies can extend the predictive models for foot-FO interactions by including other determinants of foot biomechanics such as joint moments, muscle activation, and foot morphology. Based on such extended models, the cost functions could be devised for optimizing the designs of customized 3D printed FOs through an iterative approach using finite element modeling.

BACKGROUND: Missed foot fractures are a known problem in the care of the traumatized patient. They do not usually have an influence on the survival, but on the long-term result and the quality of the patient''s life. The aim of this study is to find out how many of these fractures are overlooked in a Level I trauma center and what the consequences for the patients are hypothesing that patients with a delayed diagnosis will have worse clinical results. METHODS: Forty-seven patients (7.3%) with foot fractures could be identified in 642 polytrauma patients, retrospectively. All patients were divided into two groups: early diagnosed fractures and delayed diagnosed fractures, the latter defined as diagnosed after Secondary Survey. Patients were evaluated according to the Hannover Outcome Score, the Short Form-36 Health Survey, the AOFAS Score and the Hannover Scoring System. The average follow-up was 5 years and 8 months. Reasons for overlooking a foot fracture were analyzed. RESULTS: The foot fracture was early diagnosed in 26 (55.3%) patients, but delayed in 21 (44.7%). There were no significant differences in the mean stay in the hospital or in the ICU. The fractures that were most often missed were those of the cuboid or the metarsalia. The highest risk factor for a delayed diagnosis was a fracture already diagnosed on the same foot. In 52.4% of the delayed diagosed fractures, an operative therapy was necessary. There were no significant differences between the two groups in the clinical results. CONCLUSIONS: In summary, the results of this study show that foot injuries can be a safety problem for the patient and the examination of the feet in the trauma room has to be a compulsory part of the algorithm. Although the majority of delayed diagnosed foot fractures demonstrated comparable results to the immediately diagnosed fractures, approximately 10% might have benefited from an earlier diagnosis. Even if there were no significant differences in the clinical results, we have to be aware that missing a fracture in the foot can lead to worse results in the complete polytrauma care.

Background: Various ankle ligaments have different structural composition. The aim of this study was to analyze the morphological structure of ankle ligaments to further understand their function in ankle stability. Methods: One hundred forty ligaments from 10 fresh-frozen cadaver ankle joints were dissected: the calcaneofibular, anterior, and posterior talofibular ligaments; the inferior extensor retinaculum, the talocalcaneal oblique ligament, the canalis tarsi ligament; the deltoid ligament; and the anterior tibiofibular ligament. Hematoxylin-eosin and Elastica van Gieson stains were used for determination of tissue morphology. Results: Three different morphological compositions were identified: dense, mixed, and interlaced compositions. Densely packed ligaments, characterized by parallel bundles of collagen, were primarily seen in the lateral region, the canalis tarsi, and the anterior tibiofibular ligaments. Ligaments with mixed tight and loose parallel bundles of collagenous connective tissue were mainly found in the inferior extensor retinaculum and talocalcaneal oblique ligament. Densely packed and fiberrich interlacing collagen was primarily seen in the areas of ligament insertion into bone of the deltoid ligament. Conclusions: Ligaments of the lateral region, the canalis tarsi, and the anterior tibiofibular ligaments have tightly packed, parallel collagen bundles and thus can resist high tensile forces. The mixed tight and loose, parallel oriented collagenous connective tissue of the inferior extensor retinaculum and the talocalcaneal oblique ligament support the dynamic positioning of the foot on the ground. The interlacing collagen bundles seen at the insertion of the deltoid ligament suggest that these insertion areas are susceptible to tension in a multitude of directions. Clinical Relevance: The morphology and mechanical properties of ankle ligaments may provide an understanding of their response to the loads to which they are subjected.

Tumbling take-offs on floor exercise apparatuses of varying stiffness properties may contribute to apparatus behaviors that lead to increased injury exposure. The purpose of this pilot study was to compare the kinematics, kinetics, and timing performance characteristics of a springfloor and a spring-floor with an added Air Floor™. Five male international gymnasts performed a forward handspring to forward somersault and a round off, flic flac, backward somersault on a standard spring-floor and a spring-floor with an Air Floor™. Performances were measured via high-speed video kinematics (lower extremity joint angles and positions), electromyography of eight lower extremity muscles, mean peak forces on the feet, and timing. Comparisons of spring-floor types, lower extremity joint angles, lower extremity muscle activations, foot forces, and selected durations were determined. The spring floor with Air Floor™ resulted in longer take-off contact durations than spring-floor alone. Dynamic knee angles may indicate an unexpected and potentially injurious motion of the triceps surae musculotendinous structures. This pilot and hypothesis generating study has suggested future research examining dynamic knee position and angle changes, the role of spring-floor vibration and stiffness in take-offs, and take-off muscle activation alignment with the stiffness of the spring-floor. Pragmatically, there appears to be a convergence of evidence indicating that a slower frequency response of the spring floor may assist tumbling performance and reduce stress and strain in the lower extremity.

Tumbling take-offs on floor exercise apparatuses of varying stiffness properties may contribute to apparatus behaviors that lead to increased injury exposure. The purpose of this pilot study was to compare the kinematics, kinetics, and timing performance characteristics of a springfloor and a spring-floor with an added Air Floor™. Five male international gymnasts performed a forward handspring to forward somersault and a round off, flic flac, backward somersault on a standard spring-floor and a spring-floor with an Air Floor™. Performances were measured via high-speed video kinematics (lower extremity joint angles and positions), electromyography of eight lower extremity muscles, mean peak forces on the feet, and timing. Comparisons of spring-floor types, lower extremity joint angles, lower extremity muscle activations, foot forces, and selected durations were determined. The spring floor with Air Floor™ resulted in longer take-off contact durations than spring-floor alone. Dynamic knee angles may indicate an unexpected and potentially injurious motion of the triceps surae musculotendinous structures. This pilot and hypothesis generating study has suggested future research examining dynamic knee position and angle changes, the role of spring-floor vibration and stiffness in take-offs, and take-off muscle activation alignment with the stiffness of the spring-floor. Pragmatically, there appears to be a convergence of evidence indicating that a slower frequency response of the spring floor may assist tumbling performance and reduce stress and strain in the lower extremity.

The majority of the world’s most widespread and problematic pathogens evade host immune responses by inducing strain-specific immunity. The host immune system seems to induce a vigorous immune response towards hypervariable epitopes, seemingly attracting less attention to more highly conserved vital regions. The South African Territory (SAT)-2 foot-and-mouth disease virus (FMDV) is the most prevalent and antigenic diverse of the SAT serotypes with the occurrence of multiple antigenic and genetic subtypes. Identification of the fine antigenic structure of the capsid of these viruses remains essential in the design and engineering of a vaccine seed strain that confers cross-protection against intra-typic viruses. Towards refocusing the antigenicity of SAT2/ZIM/07/83 virus, two strategies were utilised, (1) replacement of predicted antigenic determinants to corresponding sites of the antigenic distant SAT2/EGY/09/12 virus and (2) charge-dampening of previously identified epitope regions with alanine residues. The antigenic distance of refocused mutants was evaluated by (1) virus neutralisation assays using parental and heterologous convalescent bovine sera and (2) through antigenic profiling with non-neutralising SAT2-specific murine monoclonal antibodies (mAbs). One antigenic site on VP1 (Site 3) was identified using bovine polyclonal antibodies, whereas an additional three epitope regions were elucidated using the murine mAbs. Furthermore, the cell culture-adapted vSAT2 was shown to utilise a third FMDV alternate receptor to infect integrin- and heparin sulphate-deficient cell lines. Comprehensive knowledge on the antigenic structure of these viruses will assist in the fundamental design of engineered vaccines by incorporating critical antigenic sites that confer increased antigenicity and cross-protective immune response against myriad SAT2 field strains. Furthermore, this information will not only improve design of vaccine seed viruses, but will also contribute towards novel vaccine constructs or even empty nanoparticles as a vaccine strategy in the future. / Thesis (PhD)--University of Pretoria, 2020. / Agricultural Research Council / National Research Foundation / Red Meat Industry Trust / Poliomyelitis Research Foundation / Microbiology and Plant Pathology / PhD / Unrestricted

In recent decades, a number of foot-and-mouth disease (FMD) outbreaks have occurred in countries that had been FMD-free for many years. The last FMD outbreak in the United States occurred in 1929 and the country contains a naïve livestock population, meaning it is susceptible to an outbreak. In the event of an FMD outbreak in the United States, the speed at which the source and contacts between livestock can be identified impacts both the implementation and effectiveness of mitigation strategies. The purpose of this thesis was to analyze the impact of higher levels of animal traceability on the immediate welfare losses resulting from an FMD outbreak originating in Utah. An epidemiological model was used to simulate the spread of the disease throughout the livestock population of Utah and estimate a mean number of animals depopulated over 1000 iterations for low, medium and high levels of trace intensity. This number of animals depopulated was then used to create supply shocks in an equilibrium displacement model. This model revealed the welfare losses across four marketing levels for beef, three for pork and two for pork. The research contained in this thesis determined that the adoption of a high intensity trace system can prevent immediate welfare losses of between $131 and $190 million for the United States beef industry, including $49 million to the Utah fed cattle, feeder cattle and market hog marketing levels

Tools that highlight the human impact on ecosystems and the accelerating depletion of natural resources are essential in the strife towards a more sustainable way of living. Emergy analysis is a scientific and robust method to assess the degree of sustainability of human as well as natural systems. Despite the advantages of the method, its public breakthrough has been slow. One reason could be that the results of an emergy analysis are difficult to grasp. In contrast, ecological footprint is a concept that has a widespread impact, much due to its pedagogical disposition. Ecological footprint made use of the vision to develop a method to well communicate the magnitude of human effect on nature. Another more recently created method suitable in this context is ecosystem services. Ecosystem services as a concept is not yet so well developed methodologically, but its use of mainstream concepts point toward a promising application. The main purpose of this study is to make the emergy analysis and ecosystem services methods more accessible and also to facilitate effective communication of the results from these methods. The second part of the study aims to assess the degree of sustainability ofan agricultural system in central Sweden by means of emergy analysis and ecosystems services. By demonstrating the results of the emergy analysis as a foot- and fingerprint, a better understanding of the outcome may be achieved. The footprint, here called emergy-based footprint, visualizes all resources used in the production system. An emergy-based fingerprint identifies the resources of the most important items in the system. Furthermore, ecosystem services are evaluated from a data matrix and presented by means of a radar diagram. Alternative scenarios for the agricultural system were created in the study, each presented as an emergy-based foot- and fingerprint, as well as by means of a radar diagram to visualize the values of the ecosystem services. Together, these methods demonstrate the sustainability characteristics of the different production systems. Results from this study suggest the agricultural system analysed, as well as the developed scenarios, not to be sustainable. The use of emergy analysis combined with ecosystem services and the visualization methods developed in this study, serve to provide accessible and effective communication methods when aiming to transform agricultural systems towards sustainability. The communication methods developed in this study are alsoapplicable in systems other than agriculture.

京都大学 / 0048 / 新制・課程博士 / 博士(人間・環境学) / 甲第20474号 / 人博第824号 / 新制||人||197(附属図書館) / 28||人博||824(吉田南総合図書館) / 京都大学大学院人間・環境学研究科共生文明学専攻 / (主査)教授 桂山 康司, 教授 水野 眞理, 准教授 池田 寛子, 教授 長畑 明利 / 学位規則第4条第1項該当 / Doctor of Human and Environmental Studies / Kyoto University / DGAM

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