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Biomedical subjects

E F Wachtel

Publications and source records attributed to E F Wachtel.

9 recordsLinked to original sources

The language of becoming: helping children change how they think about themselves.

In this article, I describe the language of becoming, which is a way of speaking to children that enables them to see themselves as continually evolving and changing. By noticing and reflecting back the specific ways the child is becoming, the parent gives a meta-message that one's personality is not set in stone but, rather, evolves and changes over time. In order for parents to use the language of becoming, the child must actually act differently. I will describe a three-pronged approach to helping children try new behaviors. The language of becoming helps parents and children see the child's personality, not just his or her behavior, as fluid rather then static. This helps parents and children break the vicious circles and self-fulfilling prophesies of rigid definitions of self. An understanding of stages of cognitive development in the construction of beliefs about the self and the implications of these stages for using the language of becoming is also discussed.

Child↗

Mechanical behavior of human trabecular bone after overloading.

With the etiology of osteoporotic fractures as motivation, the goal of this study was to characterize the mechanical behavior of human trabecular bone after overloading. Specifically, we quantified the reductions in modulus and strength and the development of residual deformations and determined the dependence of these parameters on the applied strain and apparent density. Forty cylindrical specimens of human L1 vertebral trabecular bone were destructively loaded in compression at 0.5% strain per second to strains of up to 3.0% and then immediately unloaded to zero stress and reloaded. (An ancillary experiment on more readily available bovine bone had been performed previously to develop this testing protocol.) In general, the reloading stress-strain curve had a short initial nonlinear region with a tangent modulus similar to Young's modulus. This was followed by an approximately linear region spanning to 0.7% strain, with a reduced residual modulus. The reloading curve always approached the extrapolated envelope of the original loading curve. Percent modulus reduction (between Young's and residual), a quantitative measure of mechanical damage, ranged from 5.2 to 91.0% across the specimens. It increased with increasing plastic strain (r2 = 0.97) but was not related to modulus or apparent density. Percent strength reduction, in the range of 3.6-63.8%, increased with increasing plastic strain (r2 = 0.61) and decreasing apparent density (r2 = 0.23). The residual strains of up to 1.05% depended strongly on applied strain (r2 = 0.96). Statistical comparisons with previous data for bovine tibial bone lend substantial generality to these trends and provide an envelope of expected behavior for other sites. In addition to providing a basis for biomechanical analysis of the effects of damage in trabecular bone at the organ level, these findings support the concept that occasional overloads may increase the risk of fracture by substantially degrading the mechanical properties of the underlying trabecular bone.

Adult↗

Application of the Tsai-Wu quadratic multiaxial failure criterion to bovine trabecular bone.

As a first step toward development of a multiaxial failure criterion for human trabecular bone, the Tsai-Wu quadratic failure criterion was modified as a function of apparent density and applied to bovine tibial trabecular bone. Previous data from uniaxial compressive, tensile, and torsion tests (n = 139 total) were combined with those from new triaxial tests (n = 17) to calibrate and then verify the criterion. Combinations of axial compression and radial pressure were used to produce the triaxial compressive stress states. All tests were performed with minimal end artifacts in the principal material coordinate system of the trabecular network. Results indicated that the stress interaction term F12 exhibited a strong nonlinear dependence on apparent density (r2 > 0.99), ranging from -0.126 MPa-2 at low densities (0.29 g/cm3) to 0.005 MPa-2 at high densities (0.63 g/cm3). After calibration and when used to predict behavior of new-specimens without any curve-fitting, the Tsai-Wu criterion had a mean (+/- SD) error of -32.6 +/- 10.6 percent. Except for the highest density triaxial specimens, most (15/17 specimens) failed at axial stresses close to their predicted uniaxial values, and some reinforcement for transverse loading was observed. We conclude that the Tsai-Wu quadratic criterion, as formulated here, is at best only a reasonable predictor of the multiaxial failure behavior of trabecular bone, and further work is required before it can be confidently applied to human bone.

Animals↗

Dependence of trabecular damage on mechanical strain.

Trabecular damage may play a role in hip fracture, bone remodeling, and prosthesis loosening. We hypothesized that when trabecular bone is loaded beyond its elastic range, both the type and the amount of damage depend on the applied strains. Thirty specimens of trabecular bone from the bovine tibia underwent compression tests to one of three levels of strain (0.4. 1.0. and 2.5%) (n = 10 per group). The 0.4% level was a mechanically nondestructive control group that accounted for any systematic errors. Optical microscopy at magnifications as high as x200 was then used to quantify the trabecular damage for each group. The amount of damage in the yield group (1.0% strain) did not differ from that in the control group (p = 0.66), whereas damage in the post-ultimate strain group (2.5% strain) increased more than 3-fold (p < 0.0008). Four types of damage were observed: transverse cracks, shear bands, parallel cracks, and complete fractures, of which the first two were dominant. These findings therefore indicate that damage occurs within trabeculae at yield. By comparison with our previous work, it can also be concluded that substantial modulus reductions in trabecular bone (as much as 60%) are caused by damage primarily within trabeculae. The ability to detect such damage clinically may improve in vivo estimates of whole-bone strength by identifying regions of densitometrically normal but mechanically compromised trabecular bone.

Animals↗

Age-related reductions in the strength of the femur tested in a fall-loading configuration.

UNLABELLED: To assess age-related changes in femoral strength as a component in the risk of fracture of the hip, we compared the loads at fracture of the proximal aspects of femora from the cadavera of older and younger individuals, as tested in a fall-loading configuration. To provide a basis for non-invasive in vivo estimates of femoral strength, we also determined the correlations between variables measured with dual-energy x-ray absorptiometry and these loads. Femora from the cadavera of eight older individuals (mean age, seventy-four years) and nine younger individuals (mean age, thirty-three years) were scanned with a Hologic QDR-2000 densitometer to obtain densitometric and geometric information. The femora were then tested mechanically in a loading configuration that simulated a fall on the greater trochanter. The femora from the older group were half as strong as those from the younger group (p < 0.001), and they absorbed one-third as much energy (p < 0.001). The area bone-mineral density of the femoral neck correlated strongly with the load at fracture (r2 = 0.92). CLINICAL RELEVANCE: The prevalence of fracture of the hip increases exponentially with age. 90 percent of those fractures are the result of a simple fall from a standing height.(ABSTRACT TRUNCATED AT 250 WORDS)

Absorptiometry, Photon↗

Effects of loading rate on strength of the proximal femur.

Results from previous quasi-static mechanical tests indicate that femurs from elderly subjects fail in vitro at forces 50% below those available in a fall from standing height. However, bone is a rate-dependent material, and it is not known whether this imbalance is present at rates of loading which occur in a fall. Based on recent data on time to peak force and body positions at impact during simulated falls, we designed a high rate test of the femur in a loading configuration meant to represent a fall on the hip. We used elderly (mean age 73.5 +/- 7.4 (SD) years) and younger adult (32.7 +/- 12.8 years) cadaveric femurs to investigate whether (1) the strength, stiffness, and energy absorption capacity of the femur increases under high rate loading conditions; (2) elderly femurs have reduced strength, stiffness, and energy absorption capacity compared with younger adult femurs at this loading rate; and (3) densitometric and geometric measures taken at the hip correlate with the measured fracture loads. Femurs were scanned using dual-energy X-ray absorptiometry (DXA) and then tested to failure in a fall loading configuration at a displacement rate of 100 mm/second. The fracture load in elderly and younger adult femurs increased by about 20% with a 50-fold increase in displacement rate. However, energy absorption did not increase with displacement rate because of a twofold increase in stiffness at the higher loading rate.(ABSTRACT TRUNCATED AT 250 WORDS)

Absorptiometry, Photon↗

Mechanical behavior of damaged trabecular bone.

The mechanical behavior of damaged trabecular bone may play a role in the etiology of age-related spine fractures since damaged bone exists in and may weaken the elderly vertebral body. To describe some characteristics of damaged trabecular bone, we measured the changes in modulus and strength that occur when bovine trabecular bone is loaded in compression to various strains beyond its elastic range. Twenty-three reduced-section specimens, taken from 17 different bones, were loaded from 0-X-0-9% strain, where X was one of four strains: 1.0% (n = 7), 2.5% (n = 6), 4.0% (n = 5), or 5.5% (n = 5). We found that modulus was reduced for all applied strains, whereas strength was reduced only for strain levels > or = 2.5%; the percentage changes in modulus and strength were independent of Young's modulus but were highly dependent on the magnitude of the applied strains; modulus was always reduced more than strength; and simple statistical models, using knowledge of only the applied strains, predicted well the percentage reductions in modulus (r2 = 0.97) and strength (r2 = 0.74). The modulus reductions reported here are in qualitative agreement with those for cortical bone in tensile loading, supporting the concept that the damage behaviors of cortical and trabecular bone are similar for low strains (< or = 4.0%). In addition, because modulus was always reduced more than strength, damaged trabecular bone may be stress protected in vivo by redistribution of stresses to undamaged bone.

Algorithms↗

Trabecular bone exhibits fully linear elastic behavior and yields at low strains.

Using a protocol designed to reduce experimental artifacts associated with the conventional compression test for trabecular bone, we performed in vitro mechanical testing on bovine tibial trabecular bone to obtain accurate descriptions of the elastic and yield behaviors. Reduced-section cylindrical specimens were preconditioned for eight tension-compression (+/- 0.5% strain) cycles and then loaded to failure either in tension (n = 15) or compression (n = 14). We found that the pre-yield behavior for every specimen was fully linear, indicating that the initial nonlinear 'toe' is an experimental artifact. Analysis of variance on the moduli indicated that there was no significant difference between the tensile and compressive moduli before preconditioning. However, preconditioning decreased the tensile and compressive moduli on average by 8.8% (p < 0.01) and 5.3% (p < 0.01), respectively, with the decrease in tensile modulus being larger (p < 0.01). These small but significant decreases in modulus suggest that initial yielding involves microstructural damage (as opposed to plastic slip) of individual trabeculae and also indicate that the tensile and/or the compressive yield strain of (bovine tibial) trabecular bone is less than 0.5%. The mean tensile strength was approximately 70% of the mean compressive strength, although this difference in strengths may have been affected by the preconditioning-induced damage. Taken together, these results suggest that there are more similarities between the elastic and yield behaviors of trabecular and cortical bone than had been assumed previously.

Analysis of Variance↗

Differences between the tensile and compressive strengths of bovine tibial trabecular bone depend on modulus.

The conflicting conclusions regarding the relationship between the tensile and compressive strengths of trabecular bone remain unexplained. To help resolve this issue, we compared measurements of the tensile (n = 22) and compressive (n = 22) yield strengths, and yield strains, of trabecular bone specimens taken from 38 bovine proximal tibiae. We also studied how these failure properties depended on modulus and apparent density. To enhance accuracy, trabecular orientation was controlled, and each specimen had a reduced section where strains were measured with a miniature extensometer. We found that the mean yield strength was 30% lower for tensile loading. However, the difference between individual values of the tensile and compressive strengths increased linearly with increasing modulus and density, being negligible for low moduli, but substantial for high moduli. By contrast, both the tensile and compressive yield strains were independent of modulus and density, with the yield strain being 30% lower for tensile loading. Thus, the difference between the tensile and compressive strengths of bovine tibial trabecular bone depends on the modulus, but the difference between yield strains does not. This phenomenon may explain in part that conflicting conclusions reached previously on the tensile and compressive strengths of trabecular bone since the mean modulus has varied among different studies. Realizing that our data pertain only directly to bovine tibial trabecular bone for longitudinal loading, our results nevertheless suggest that failure parameters based on strains may provide more powerful and general comparisons of the failure properties for trabecular bone than measures based on stress.

Animals↗