Biomechanics research investigating the knee kinematics of youth participants is very limited. The most accurate method of measuring knee kinematics utilizes invasive procedures such as bone pins. However, various experimental techniques have improved the accuracy of gait kinematic analyses using minimally invasive methods. In this study, gait trials were conducted with two participants between the ages of 11 and 13 to obtain the knee flexion-extension (FE), adduction-abduction (AA) and internal-external (IE) rotation angles of the right knee. The objectives of this study were to (1) conduct pilot experiments with youth participants to test whether any adjustments were necessary in the experimental methods used for adult gait experiments, (2) apply a Triangular Cosserat Point Element (TCPE) analysis for Soft-Tissue Artifact (STA) correction of knee kinematics with youth participants, and (3) develop a code to conduct a Principal Component Analysis (PCA) to find the PCA-defined flexion axis and calculate knee angles with both STA and PCA-correction for youth participants. The kinematic results were analyzed for six gait trials on a participant-specific basis. The TCPE knee angle results were compared between uncorrected angles and another method of STA correction, Procrustes Solution, with a repeated measures ANOVA of the root mean square errors between each group and a post-hoc Tukey test. The PCA-corrected results were analyzed with a repeated measures ANOVA of the FE-AA correlations from a linear regression analysis between TCPE, PS, PCA-TCPE and PCA-PS angles. The results indicated that (1) youth experiments can be conducted with minor changes to experimental methods used for adult gait experiments, (2) TCPE and PS analyses did not yield statistically different knee kinematic results, and (3) PCA-correction did not reduce FE-AA correlations as predicted.

Human motion capture technology is a powerful tool for advancing the understanding of human motion biomechanics (Andriacchi and Alexander, 2000). This is most readily accomplished by applying retroreflective markers to a participant’s skin and tracking the position of the markers during motion. Skin and adipose tissue move independently of the underlying bone during motion creating error known as soft tissue artifact (STA), the primary source of error in human motion capture (Leardini et al., 2005). (Solav et al., 2014) proposed and (Solav et al., 2015) expanded the triangular Cosserat point element (TCPE) method to reduce the effect of STA on derived kinematics through application of a marker cluster analyzed as a set of triangular Cosserat point elements. This method also provides metrics for three different modes of STA. Here the updated TCPE method (Solav et al., 2015) was compared to the established point cluster (PC) method of (Andriacchi et al., 1998) and the marker position error minimizing Procrustes solution (PS) method of (Söderkvist and Wedin, 1993) in two implant-based simulations, providing quantitative measures of error, and standard gait analysis, providing qualitative comparisons of each method’s determined kinematics. Both of these experiments allowed the TCPE method to generate observed STA parameters, informing the efficacy of the simulation. The TCPE method’s performance was similar to the PS method’s in the implant simulations and in standard gait. The PC method’s results seemed to be affected by numerical instability: simulation trial errors were larger and standard gait results were only similar to the other methods’ in general terms. While the PS and TCPE results were comparable, the TCPE method’s physiological basis provided the added benefit of non-rigid behavior quantization through its STA parameters. In this study, these parameters were on the same order of v magnitude between the standard gait experiments and the simulations, suggesting that implant simulations could be valuable substitutes when invasive methods are not available.

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Soft tissue sarcomas (STS), a group of rare malignant tumours with high tissue heterogeneity, still lack effective clinical stratification and prognostic models. Therefore, we conducted this study to establish a reliable prognostic gene signature. Using 189 STS patients’ data from The Cancer Genome Atlas database, a four-gene signature including DHRS3, JRK, TARDBP and TTC3 was established. A risk score based on this gene signature was able to divide STS patients into a low-risk and a high-risk group. The latter had significantly worse overall survival (OS) and relapse free survival (RFS), and Cox regression analyses showed that the risk score is an independent prognostic factor. Nomograms containing the four-gene signature have also been established and have been verified through calibration curves. In addition, the predictive ability of this four-gene signature for STS metastasis free survival was verified in an independent cohort (309 STS patients from the Gene Expression Omnibus database). Finally, Gene Set Enrichment Analysis indicated that the four-gene signature may be related to some pathways associated with tumorigenesis, growth, and metastasis. In conclusion, our study establishes a novel four-gene signature and clinically feasible nomograms to predict the OS and RFS. This can help personalized treatment decisions, long-term patient management, and possible future development of targeted therapy.

The Procollagen-Lysine, 2-Oxoglutarate 5-Dioxygenase (PLOD) family contains three members: PLOD1, PLOD2 and PLOD3. The PLOD family catalyze the lysyl hydroxylase (LH) which plays a crucial role in the synthesis of collagen. As one of the most important components in ECM, collagen plays a crucial role in normal tissues. Soft tissue sarcomas (STS) are malignant tumors with more than 100 subtypes which origin from mesenchymal tissue. Although the STS is a rare malignancy accounting for less than 1% of all adult tumors, it has been reported to be responsible for 20% of all cancer-related deaths in childhood and adolescence. In this study, the relation between PLOD family and STS was analyzed. The overexpression of PLOD family is associated with poor prognosis and the PLOD family seems to be a regulator in TME. The PLOD family could serve as strong novel biomarkers and may be used as a therapy target for personalized treatment in STS.

Changwu Wu's doctoral dissertation with the date of the award decision on the title page. Changwu Wu defended his dissertation on March 21, 2023 and was awarded the Dr.rer.med by the University of Leipzig School of Medicine on March 28, 2023. The dissertation is entitled 'RNA-sequencing-based risk stratification and individualized immunotherapy strategies for soft tissue sarcoma'.

Methicillin-resistant Staphylococcus aureus (MRSA) is a serious public health problem nationwide, threatening to develop into an epidemic. Many of these patients are presenting to their primary care clinics with skin and soft tissue infections (SSTIs). The CDC has reported that in 2005, MRSA was responsible for an estimated 94,000 life-threatening infections and 16,650 deaths. The purpose of this study is to estimate the incidence of CA-MRSA within a specific family practice in Florida and to identify epidemiologic factors, classify antibiotic susceptibility patterns, and evaluate patient education in regard to disease management and prevention. This study was a descriptive, epidemiologic, three-year retrospective medical record review of all wound cultured skin and soft tissue infections that presented to a family practice between January 2007 and December 2009. Sixty-two medical records met the inclusion and exclusion criteria for the study. Of these 62 SSTIs, 44 cultures grew one or more bacterial organisms. The incidence of CA-MRSA was 66% (n=29). The mean age of those with CA-MRSA was 40 years old, with a range from 7 to 90 years old. Sixty-two percent (n=18) were male and 38% (n=11) were female; additionally 69% (n=20) lived within a 10 mile radius from the family practice, while 31% (n=9) lived in a surrounding suburb. The most frequent race was Caucasian 83% (n=24), with African American at 10% (n=3) and Hispanics 7% (n=2). Risk factors associated with CA-MRSA was obesity 41% (n=10), diabetes mellitus 24% (n=7), and a previous history of MRSA infection 24% (n=7). Skin and soft tissue infections were diagnosed as either an abscess 62% (n=18), boil 24% (n=7), pustule 10% (n=3), or cellulitis 4% (n=1). CA-MRSA isolates were susceptible to trimethoprim-sulfamethoxazole 100% (n=29), doxycycline 93% (n=27), and rifampin 100% (n=14). Clindamycin susceptibility was 65% (n=15) with resistance at 30% (n=7) and 5% (n=1) intermediate. Both cephalexin and erythromycin were 100% resistant. Documentation in the medical record on wound care was found in 45% (n=13) of the records. The incidence of CA-MRSA SSTI was 66%, which identifies this suburban community at high risk for this bacterial infection. Risk factors associated with CA-MRSA included obesity (BMI > 30), history of previous MRSA infection, and diabetes mellitus. There were no clinical characteristics that helped distinguish MRSA infection from other bacterial SSTIs. Most SSTI were treated with incision and drainage and a susceptible antibiotic. Judicious use of antibiotics not only provides appropriate treatment, but is also critical in prevention of antibiotic resistance. Lastly, patient education in adequate hygiene is essential in preventing the spread of CA-MRSA

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