Abstract:Mechanical data on upper extremity surrogate bones, supporting use as biomechanical tools, is limited. The objective of this study was to characterize the structural behavior of the fourth generation composite humerus under simulated physiologic bending, specifically, stiffness, rigidity, and middiaphysial surface strains. Three humeri were tested in four-point bending, in anatomically defined anteroposterior(AP) and mediolateral(ML) planes. Stiffness and rigidity were derived using load-displacement data. Principal strains were determined at the anterior, posterior, medial and lateral surfaces in the humeral mid-diaphysial transverse plane of one specimen using stacked rosettes. Linear structural behavior was observed within test range. Average stiffness and rigidity were greater in the ML (918+18 N/mm; 98.4+1.9 Nm 2 ) than the AP plane (833+16 N/mm; 89.3+1.6 Nm 2 ), with little interspecimen variability. The ML/AP rigidity ratio was 1.1. Surface principal strains were similar at the anterior (5.41 /N) and posterior (5.43 /N) gauges for AP bending, and comparatively less for ML bending, i.e., 5.1 and 4.5 /N, at the medial and lateral gauges, respectively. The study provides novel strain and stiffness data for the fourth generation composite humerus, and adds to published construct rigidity data. Results support use of this composite bone as a tool for modeling and experimentation.

A growing body of literature is focused on the use of eye tracking (ET) technology to understand the association between objective visual parameters and higher order brain processes such as cognition. One of the settings where this principle has found practical utility is in the area of driving safety. Methods: We reviewed the literature to identify the changes in ET parameters with older adults and neurodegenerative disease. Results: This narrative review provides a brief overview of oculomotor system anatomy and physiology, defines common eye movements and tracking variables that are typically studied, explains the most common methods of eye tracking measurements during driving in simulation and in naturalistic settings, and examines the association of impairment in ET parameters with advanced age and neurodegenerative disease. Conclusion: ET technology is becoming less expensive, more portable, easier to use, and readily applicable in a variety of clinical settings. Older adults and especially those with neurodegenerative disease may have impairments in visual search parameters, placing them at risk for motor vehicle crashes. Advanced driver assessment systems are becoming more ubiquitous in newer cars and may significantly reduce crashes related to impaired visual search, distraction, and/or fatigue.

Physical medicine and rehabilitation residency programs do not demonstrate a uniform level of training and mentorship for resident scholarly activities related in part to variable utilization of standardized curricula. The aim of this study was to design, develop, implement, and evaluate a structured Quality Improvement and Research Curriculum for a physical medicine and rehabilitation residency program in academic year 2015 using standardized methodology. A combination of five-phase project-lifecycle and six-step medical-curriculum development methodologies was used to integrate existing resources into five institutional domains: (1) Patient Safety and Quality Improvement Program; (2) Research Mentorship Program; (3) Rehab in Review; (4) Publication and Presentation Resources, and (5) Research and QI Lecture Series. Dedicated resident-faculty teams were created for individual domains and for the overall curriculum. Written materials developed included scope documents, reporting forms, and tracking tables. A dedicated webpage on the department website served as an accessible resource. A bimonthly Updates newsletter highlighted ongoing resident achievements. Program and resident outcome metrics were evaluated at the mid and end of academic year 2015. Excellent resident and good faculty participation in the curriculum was observed. Resident publication and presentation productivity improved. Time was the biggest barrier to success. Key factors for success included phased implementation, dedicated teams, scope clarity, accessible resources, personnel support, resident champions, and faculty mentorship.