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17 records
All sourcesNASA NTRSDOE OSTI
DOE OSTI2022

A Novel Method for Preoperative Positioning of Total Ankle Replacement Using 3D Digital Model

Abstract Objective To establish a digital model of the ankle joint through 3D imaging technology and explore the preoperative placement of ankle replacement prostheses. Methods Computed tomography images of intact ankle joints from 54 cases in the outpatient and inpatient departments of our hospital were collected; according to the INBONE® total ankle system surgery process, the surgery model and surgical osteotomy were finished using MIMICS based on computer simulation method. The shortest distance was measured between the center point and the anterior, posterior, medial, and lateral, respectively, to ensure the precise position of the ankle replacement prosthesis by digital simulation surgery. The relationship between the two variables was analyzed by bivariate correlation analysis. Results The dataset of this study included 48 cases of the sub‐data set (26 males and 22 females) and included 27 cases of left ankle and 21 cases of right ankle. The average medial malleolar angle was 18.67°± 2.87°, the average amount of bone resection was 12.13 ± 1.86 cm 3 , the mid‐anterior distance was 1.72 ± 0.19 cm, the mid‐posterior distance was 2.00 ± 0.19 cm, the ratio of mid‐anterior to mid‐posterior was 0.87, the mid‐medial distance was 1.26 ± 0.17 cm, the mid‐lateral distance was 1.19 ± 0.16 cm, and the ratio of mid‐medial to mid‐lateral was 1.06. After osteotomy, the anteroposterior diameter was 3.73 ± 0.32 cm, the transverse diameter was 2.46 ± 0.27 cm, and the ratio of anteroposterior diameter to transverse diameter was 1.53. In the bottom view, the shape after osteotomy is rectangular. The mid‐anterior distance was strongly negatively correlated with age, the mid‐anterior distance and the amount of bone resection, the mid‐medial distance and the amount of bone resection, the mid‐lateral distance and the amount of bone resection, the mid‐lateral distance and the anteroposterior diameter, the anteroposterior diameter and the transverse diameter were all strongly positively correlated. Conclusion The projection point of the lower tibia centerline on the tibial horizontal osteotomy surface is located at a position slightly anterior to the midpoint of the transverse diameter after ankle arthroplasty. The rational positioning of the total ankle replacement is located at both a position slightly anterior to the midpoint of the transverse diameter and midpoint of the anteroposterior diameter, which can be used as a reference method before total ankle arthroplasty surgery.

Wu, Shi‐xun↗
DOE OSTI2023

Clinical effects of 3D printing-assisted posterolateral incision in the treatment of ankle fractures involving the posterior malleolus

Objective To explore the clinical outcomes of a 3D printing-assisted posterolateral approach for the treatment of ankle fractures involving the posterior malleolus. Methods A total of 51 patients with ankle fractures involving the posterior malleolus admitted to our hospital from January 2018 to December 2019 were selected. The patients were divided into 3D printing group (28 cases) and control group (23 cases). 3D printing was performed for ankle fractures, followed by printing of a solid model and simulation of the operation on the 3D model. The operation was then performed according to the preoperative plan, including open reduction and internal fixation via the posterolateral approach with the patient in the prone position. Routine x-ray and CT examinations of the ankle joint were performed, and ankle function was evaluated using the American Foot and Ankle Surgery Association (AOFAS) ankle-hindfoot score. Results All patients underwent x-ray and CT examinations. All fractures healed clinically, without loss of reduction or failure of internal fixation. Good clinical effects were achieved in both groups of patients. The operation time, intraoperative blood loss and intraoperative fluoroscopy frequency in the 3D printing group were significantly less than those in the control group ( p < 0.05). There was no significant difference between the two groups in the anatomical reduction rate of fractures or the incidence of surgical complications ( p > 0.05). Conclusion The 3D printing-assisted posterolateral approach is effective in the treatment of ankle fractures involving the posterior malleolus. The approach can be well planned before the operation, is simple to perform, yields good fracture reduction and fixation, and has good prospects for clinical application.

Zheng, Hongming↗
DOE OSTI2021

Sensitivity of a Subject-specific Ankle Sprain Simulation to Extrinsic Versus Intrinsic Biomechanical Factors

Ankle sprains are the most common musculoskeletal injury in sport and military activity, despite existing prophylactic strategies. The purpose of this report was to develop a probabilistic simulation of lateral ankle sprains during single-limb drop landing, towards accelerating innovation in ankle sprain prevention. A deterministic, subject-specific musculoskeletal model was extended with automation and probabilistic distributions on sprain-related biomechanical factors. Probabilistic simulations were generated using traditional Monte Carlo techniques and the advanced mean value method, a more computationally-efficient approach. Predicted distributions of peak ankle joint rotations, velocities, and moments borne by supporting passive structures agreed favorably with the deterministic model and with reports of real sprain biomechanics. Parameter sensitivities identified that predictions were most strongly influenced by drop height, subtalar joint posture at contact, invertor/evertor co-activation, and passive ankle stiffness. The advanced mean value method predicted confidence bounds comparable to a 1000-trial Monte Carlo simulation, and required only 14 model evaluations and 4-min processing time. The extended probabilistic simulation may be useful to virtually test new prophylactic strategies for ankle sprains, and is made available for open-source use (https://simtk.org/projects/sprain-sim).

60 APPLIED LIFE SCIENCES↗
DOE OSTI2020

Wearable Sensors Measure Ankle Joint Changes of Patients with Parkinson’s Disease before and after Acute Levodopa Challenge

Background . Previous studies found levodopa could improve the activity of the ankle joints of patients with Parkinson’s disease (PD). But ankle joint movement is composed of four motion ranges. The specific changes of four motion ranges in PD remain unknown. Objective . The purpose of this study was to decompose the complex ankle joint movement, measure ankle joint changes before and after the acute levodopa challenge test (ALCT), and investigate the effects of these parameters on gait performance. Methods . 29 PD patients and 30 healthy control subjects (HC) completed the Instrumented Stand and Walk (ISAW) test and gait parameters were collected by the JiBuEn gait analysis system. The percentage of improvement of gait data and the UPDRS III in the on-drug condition (ON) were determined with respect to the off-drug condition (OFF). Results . We observed a reduction in the heel strike angle (HS), 3-plantarflexion (3-PF) angle, and 4-dorsiflexion (4-DF) angle of ankle joints. We did not find significant difference in the toe-off angle (TO), 1-plantarflexion (1-PF) angle, and 2-dorsiflexion (2-DF) angle among three groups. Stride length improvement rate was significantly correlated with HS ( r s = 0.616, P < 0.001 ) and 3-PF ( r s = 0.639, P < 0.001 ) improvement rates. The improvement in the sum of rigidity items (UPDRS motor subsection item 22) was also correlated with HS ( r s = 0.389, P = 0.037 ) and 3-PF ( r s = 0.373, P = 0.046 ) improvement rates. Conclusions . Exogenous levodopa supplementation can significantly reduce the rigidity of patients with PD, improve their 3-PF and 4-DF of ankle joint kinematic parameters, and ultimately enhance their gait.

Wu, Zhuang↗
DOE OSTI2023

Constraining the sources of ultra-high-energy cosmic rays across and above the ankle with the spectrum and composition data measured at the Pierre Auger Observatory

In this work we present the interpretation of the energy spectrum and mass composition data as measured by the Pierre Auger Collaboration above 6 × 10$^{17}$ eV. We use an astrophysical model with two extragalactic source populations to model the hardening of the cosmic-ray flux at around 5 × 10$^{18}$ eV (the so-called “ankle” feature) as a transition between these two components. We find our data to be well reproduced if sources above the ankle emit a mixed composition with a hard spectrum and a low rigidity cutoff. The component below the ankle is required to have a very soft spectrum and a mix of protons and intermediate-mass nuclei. The origin of this intermediate-mass component is not well constrained and it could originate from either Galactic or extragalactic sources.To the aim of evaluating our capability to constrain astrophysical models, we discuss the impact on the fit results of the main experimental systematic uncertainties and of the assumptions about quantities affecting the air shower development as well as the propagation and redshift distribution of injected ultra-high-energy cosmic rays (UHECRs).

79 ASTRONOMY AND ASTROPHYSICS↗
DOE OSTI2021

Multiplanar Stiffness of Commercial Carbon Composite Ankle-Foot Orthoses

The mechanical properties of an ankle-foot orthosis (AFO) can impact how a user's movement is either restricted or augmented by the device. However, standardized methods for assessing stiffness properties of AFOs are lacking, posing a challenge for comparing between devices and across vendors. Therefore, the purpose of this study was to quantify the rotational stiffness of thirteen commercial, nonarticulated, carbon composite ankle-foot orthoses. A custom, instrumented test fixture, for evaluating mechanical properties in rotating exoskeletons (EMPIRE), deflected an AFO through 20 deg of plantar/dorsiflexion motion about a specified, but adjustable, ankle axis. Sagittal, frontal, and transverse plane rotational stiffness were calculated, and reliability was assessed between cycles, sessions, and testers. The EMPIRE demonstrated good-to-excellent reliability between testers, sessions, and cycles (intraclass correlation coefficients all ≥0.95 for sagittal plane stiffness measures). Sagittal plane AFO stiffness ranged from 0.58 N·m/deg to 3.66 N·m/deg. AFOs with a lateral strut demonstrated frontal plane stiffnesses up to 0.71 N·m/deg of eversion while those with a medial strut demonstrated frontal plane stiffnesses up to 0.53 N·m/deg of inversion. Transverse plane stiffnesses were less than 0.30 N·m/deg of internal or external rotation. These results directly compare AFOs of different models and from different manufacturers using consistent methodology and are intended as a resource for clinicians in identifying a device with stiffness properties for individual patients.

Biophysics↗
DOE OSTI2022

A Novel Anatomic Reconstruction for Posterior Tibialis Tendon in Treatment of Flexible Adult‐Acquired Flatfoot Deformity

Objective To present a novel approach for the anatomic reconstruction of the posterior tibialis tendon (PTT) in restoring plantar insertions and evaluate its efficiency in treating flexible adult‐acquired flatfoot deformity (AAFD) caused by PTT dysfunction. Methods For AAFD treatment, a novel PTT reconstruction method was presented. The current study involved 16 patients, including three men, and 13 women, from August 2017 to July 2019. The mean age was 43.2 ± 15.1 years (21–64 years). The innovative PTT repair method was used on all patients. The treatment involved performing a traditional Flexor Digitorum Longus (FDL) transfer in the navicular tuberosity and suturing the plantar insertions to FDL as tension was applied to tighten the plantar structures of the foot. The results were retrospectively analyzed. The clinical outcome was assessed using the pain visual analogue scale (VAS), the satisfaction VAS, and the American Orthopedic Foot and Ankle Society ankle–hindfoot scale (AOFAS‐AH). Isokinetic testing was performed using a dynamometer at 60°/s and 120°/s for inversion/eversion and plantarflexion/dorsiflexion, respectively, to determine the mean peak torque. Radiographic measurements were employed to assess the outcomes. Results Bone surgeries combined with the modified anatomic PTT reconstruction were performed on patients with medializing calcaneal osteotomy in 12 (75%) patients and subtalar joint fusion in four (25%) patients. The branch linking to the plantar insertions was detected in every case, with an average width of 3.5 ± 0.8 mm (3.1–4.3 mm). All patients were followed up for the mean of 16.8 ± 1.8 months (range, 15–20 months). The average postoperative functional scores, including pain VAS, satisfaction VAS, total AOFAS‐AH, and all AOFAS‐AH sub‐scales, steadily improved during the follow‐up. In the last follow‐up, isokinetic testing revealed no loss of plantarflexion strength ( p = 0.350 and 0.098) and significant improvement in the inversion strength ( p = 0.007 and 0.008) in the operated ankles at 60°/s and 120°/s. Radiographic outcomes, particularly the talar head uncovering, improved significantly after more than a year ( p < 0.001 for all). Conclusions The novel technique for PTT reconstruction in restoring the plantar insertions serves as an effective procedure in treating AAFD caused by PTT dysfunction in terms of delivering a consistent improvement in ankle inversion strength, medial longitudinal arch restoring, and satisfactory clinical outcomes.

Hu, Yong↗
DOE OSTI2025

The Second Skin: A Wearable Sensor Suite that Enables Real-Time Human Biomechanics Tracking Through Deep Learning

Objective: Real-time determination of human kinematics and kinetics could advance biomechanics research and enable valuable applications of biofeedback and generalizable exoskeleton control. Here, this work aims to investigate a taskindependent, user-independent method for obtaining precise realtime joint state estimation across lower-body joints during a wide variety of tasks. Methods: We developed a generalizable sensing approach using a suit comprised of inertial measurement units (IMUs) and pressure insoles. With the suit, we collected a dataset of 33 tasks commonly performed during construction and hazardous waste cleanup (N = 10). We then trained deep learning user-independent, task-agnostic models to estimate joint lowerbody kinematics and dynamics using only worn sensor data. We likewise computed joint kinematics and dynamics analytically from sensor data to serve as a comparison tool for model results. Results: Our models achieved overall angle estimation root-meansquared-errors (RMSE) of 6.56±.92°, 8.60±1.01°, 7.58±.89°, and 6.00±.73° compared to 13.9±.1.3°, 15.31±1.0°, 10.76±.70°, and 7.56±.48° via analytical methods at the lower back, hip, knee, and ankle, respectively. Likewise, our models achieved overall normalized moment estimation RMSEs of .207±.069 Nm/kg, .242±.044 Nm/kg, .202±.038 Nm/kg, and .193±.034 Nm/kg compared to .306±.036 Nm/kg, .407±.021 Nm/kg, 1.18 ±.022 Nm/kg, and 1.73±.071 Nm/kg via analytical methods at the lower back, hip, knee, and ankle, respectively. Conclusion: These results are comparable to other state-of-the-art wearable sensing systems, establishing deep learning as a viable sensing approach that generalizes to new users and tasks. Significance: This work shows promise for enabling accurate real-world biomechanical data collection and enhancement of biofeedback systems and wearable robot control.

Casey, Ryan T. F. [Georgia Institute of Technology↗
DOE OSTI2022

Mechanical loading prediction through accelerometry data during walking and running

ABSTRACT Currently, there is no way to assess mechanical loading variables such as peak ground reaction forces (pGRF) and peak loading rate (pLR) in clinical settings. The purpose of this study was to develop accelerometry‐based equations to predict both pGRF and pLR during walking and running. One hundred and thirty one subjects (79 females; 76.9 ± 19.6 kg) walked and ran at different speeds (2–14 km·h −1 ) on a force plate–instrumented treadmill while wearing accelerometers at their ankle, lower back and hip. Regression equations were developed to predict pGRF and pLR from accelerometry data. Leave‐one‐out cross‐validation was used to calculate prediction accuracy and Bland–Altman plots. Our pGRF prediction equation was compared with a reference equation previously published. Body mass and peak acceleration were included for pGRF prediction and body mass and peak acceleration rate for pLR prediction. All pGRF equation coefficients of determination were above 0.96, and a good agreement between actual and predicted pGRF was observed, with a mean absolute percent error (MAPE) below 7.3%. Accuracy indices from our equations were better than previously developed equations. All pLR prediction equations presented a lower accuracy compared to those developed to predict pGRF. Walking and running pGRF can be predicted with high accuracy by accelerometry‐based equations, representing an easy way to determine mechanical loading in free‐living conditions. The pLR prediction equations yielded a somewhat lower prediction accuracy compared with the pGRF equations.

Veras, Lucas↗
DOE OSTI2024

Impact of the magnetic horizon on the interpretation of the Pierre Auger Observatory spectrum and composition data

The flux of ultra-high energy cosmic rays reaching Earth above the ankle energy (5 EeV) can be described as a mixture of nuclei injected by extragalactic sources with very hard spectra and a low rigidity cutoff.Extragalactic magnetic fields existing between the Earth and the closest sources can affect the observed CR spectrum by reducing the flux of low-rigidity particles reaching Earth. We perform a combined fit of the spectrum and distributions of depth of shower maximum measured with the Pierre Auger Observatory including the effect of this magnetic horizon in the propagation of UHECRs in the intergalactic space.We find that, within a specific range of the various experimental and phenomenological systematics, the magnetic horizon effect can be relevant for turbulent magnetic field strengths in the local neighbourhood in which the closest sources lieof order B$_{rms}$ ≃ (50–100) nG (20 Mpc/d$_{s}$)( 100 kpc/L$_{coh}$)$^{1/2}$, with d$_{s}$ the typical intersource separation and L$_{coh}$ the magnetic field coherence length. When this is the case,the inferred slope of the source spectrum becomes softer and can be closer to the expectations of diffusive shock acceleration, i.e., ∝ E$^{-2}$.An additional cosmic-ray population with higher source density and softer spectra, presumably also extragalactic and dominating the cosmic-ray flux at EeV energies, is also required to reproduce the overall spectrum and composition results for all energies down to 0.6 EeV.

79 ASTRONOMY AND ASTROPHYSICS↗
DOE OSTI2025

Measurement of the depth of maximum of air-shower profiles with energies between 10 18.5 and 10 20 eV using the surface detector of the Pierre Auger Observatory and deep learning

We report an investigation of the mass composition of cosmic rays with energies from 3 to 100 EeV ( 1 EeV = 10 18 eV ) using the distributions of the depth of shower maximum X max . The analysis relies on ∼ 50 , 000 events recorded by the surface detector of the Pierre Auger Observatory and a deep-learning-based reconstruction algorithm. Above energies of 5 EeV, the dataset offers a 10-fold increase in statistics with respect to fluorescence measurements at the Observatory. After cross-calibration using the fluorescence detector, this enables the first measurement of the evolution of the mean and the standard deviation of the X max distributions up to 100 EeV. Our findings are threefold: (i) The evolution of the mean logarithmic mass toward a heavier composition with increasing energy can be confirmed and is extended to 100 EeV. (ii) The evolution of the fluctuations of X max toward a heavier and purer composition with increasing energy can be confirmed with high statistics. We report a rather heavy composition and small fluctuations in X max at the highest energies. (iii) We find indications for a characteristic structure beyond a constant change in the mean logarithmic mass, featuring three breaks that are observed in proximity to the ankle, instep, and suppression features in the energy spectrum. Published by the American Physical Society 2025

46 INSTRUMENTATION RELATED TO NUCLEAR SCIENCE AND ↗
DOE OSTI2025

Inference of the Mass Composition of Cosmic Rays with Energies from 10 18.5 to 10 20 eV Using the Pierre Auger Observatory and Deep Learning

We present measurements of the atmospheric depth of the shower maximum X max , inferred for the first time on an event-by-event level using the surface detector of the Pierre Auger Observatory. Using deep learning, we were able to extend measurements of the X max distributions up to energies of 100 EeV ( 10 20 eV ), not yet revealed by current measurements, providing new insights into the mass composition of cosmic rays at extreme energies. Gaining a 10-fold increase in statistics compared to the fluorescence detector data, we find evidence that the rate of change of the average X max with the logarithm of energy features three breaks at 6.5 ± 0.6 ( stat ) ± 1 ( syst ) EeV , 11 ± 2 ( stat ) ± 1 ( syst ) EeV , and 31 ± 5 ( stat ) ± 3 ( syst ) EeV , in the vicinity to the three prominent features (ankle, instep, suppression) of the cosmic-ray flux. The energy evolution of the mean and standard deviation of the measured X max distributions indicates that the mass composition becomes increasingly heavier and purer, thus being incompatible with a large fraction of light nuclei between 50 and 100 EeV. Published by the American Physical Society 2025

46 INSTRUMENTATION RELATED TO NUCLEAR SCIENCE AND ↗
DOE OSTI2024

Compliant Intramedullary Stems for Joint Reconstruction

The longevity of current joint replacements is limited by aseptic loosening, which is the primary cause of non-infectious failure for hip, knee, and ankle arthroplasty. Aseptic loosening is typically caused either by osteolysis from particulate wear, or by high shear stresses at the bone-implant interface from over-constraint. Our objective was to demonstrate feasibility of a compliant intramedullary stem that eliminates over-constraint without generating particulate wear. The compliant stem is built around a compliant mechanism that permits rotation about a single axis. We first established several models to understand the relationship between mechanism geometry and implant performance under a given angular displacement and compressive load. We then used a neural network to identify a design space of geometries that would support an expected 100-year fatigue life inside the body. We additively manufactured one representative mechanism for each of three anatomic locations, and evaluated these prototypes on a KR-210 robot. The neural network predicts maximum stress and torsional stiffness with 2.69% and 4.08% error respectively, relative to finite element analysis data. We identified feasible design spaces for all three of the anatomic locations. Simulated peak stresses for the three stem prototypes were below the fatigue limit. Benchtop performance of all three prototypes was within design specifications. Our results demonstrate the feasibility of designing patient- and joint-specific compliant stems that address the root causes of aseptic loosening. Guided by these results, we expect the use of compliant intramedullary stems in joint reconstruction technology to increase implant lifetime.

60 APPLIED LIFE SCIENCES↗
DOE OSTI2024

Insights into posttranslational regulation of skeletal muscle contractile function by the acetyltransferases, p300 and CBP

Here, mice with skeletal muscle-specific and inducible double knockout of the lysine acetyltransferases, p300 (E1A binding protein p300) and CBP (cAMP-response element-binding protein binding protein), referred to as i-mPCKO, demonstrate a dramatic loss of contractile function in skeletal muscle and ultimately die within 7 days. Given that many proteins involved in ATP generation and cross-bridge cycling are acetylated, we investigated whether these processes are dysregulated in skeletal muscle from i-mPCKO mice and, thus, whether they could underlie the rapid loss of muscle contractile function. Just 4–5 days after inducing knockout of p300 and CBP in skeletal muscle from adult i-mPCKO mice, there was ~90% reduction in ex vivo contractile function in the extensor digitorum longus (EDL) and a ~65% reduction in in vivo ankle dorsiflexion torque, as compared with wild type (WT; i.e., Cre negative) littermates. Despite this profound loss of contractile force in i-mPCKO mice, there were no genotype-driven differences in fatigability during repeated contractions, nor were there genotype differences in mitochondrial-specific pathway enrichment of the proteome, intermyofibrillar mitochondrial volume, or mitochondrial respiratory function. As it relates to cross-bridge cycling, remarkably, the overt loss of contractile function in i-mPCKO muscle was reversed in permeabilized fibers supplied with exogenous Ca 2+ and ATP, with active tension being similar between i-mPCKO and WT mice, regardless of Ca 2+ concentration. Actin-myosin motility was also similar in skeletal muscle from i-mPCKO and WT mice. In conclusion, neither mitochondrial abundance/function, nor actomyosin cross-bridge cycling, are the underlying driver of contractile dysfunction in i-mPCKO mice.

59 BASIC BIOLOGICAL SCIENCES↗
DOE OSTI2025

Spectral Properties of Globally Distributed ENA Fluxes across Diverse Regions of the Heliosphere

This study analyzes energetic neutral atom (ENA) spectral properties across distinct regions of globally distributed flux (GDF) sky maps, using Interstellar Boundary Explorer data from a full solar cycle, corrected for time dispersion. By time-shifting the data to the heliosheath using GDF source distances from D. B. Reisenfeld et al., we achieve a more accurate representation of heliosheath GDF energy spectra. We quantify ENA spectral characteristics, heliosheath line-of-sight-integrated proton pressure, and heliosheath proton temperature, comparing these to solar wind properties at 1 au and interplanetary scintillation-derived solar wind data. Our findings show that the spectral index is generally anticorrelated with heliosheath proton temperature and pressure, except in the central tail, where a partial positive correlation is observed. The lowest spectral index values occur when high-latitude heliosheath regions are dominated by fast solar wind from polar coronal holes. The south pole exhibits the flattest energy spectra due to plasma heating from both fast solar wind and a late-2014 pressure pulse. The central tail shows shorter variability (5–6 yr) for spectral index and heliosheath proton temperature, while proton pressure follows the 11 yr solar cycle. Most spectral shapes exhibit a “knee” distribution, peaking during solar maximum, with an “ankle” shape observed only at the south pole during solar cycle transitions. Asymmetry in proton pressure in the lobes is driven by the draping effect of the local interstellar magnetic field. This study provides insights into the energetic properties of GDF across the heliosphere, enhancing our understanding of the heliospheric environment.

79 ASTRONOMY AND ASTROPHYSICS↗
DOE OSTI2021

Radiation effects on atherosclerosis in atomic bomb survivors: a cross-sectional study using structural equation modeling

Past reports indicated that total-body irradiation at low to moderate doses could be responsible for cardiovascular disease risks, but the mechanism remains unclear. The purpose of this study was to investigate the association between radiation exposure and atherosclerosis, an underlying pathology of cardiovascular diseases, in the Japanese atomic bomb survivors. We performed a cross-sectional study measuring 14 clinical-physiological atherosclerosis indicators during clinical exams from 2010 to 2014 in 3274 participants of the Adult Health Study cohort. Multivariable analyses were performed by using a structural equation model with latent factors representing underlying atherosclerotic pathologies: (1) arterial stiffness, (2) calcification, and (3) plaque as measured with indicators chosen a priori on the basis of clinical-physiological knowledge. Radiation was linearly associated with calcification (standardized coefficient per Gy 0.15, 95 % confidence interval: CI [0.070, 0.23]) and plaque (0.11, 95 % CI [0.029, 0.20]), small associations that were comparable to about 2 years of aging per Gy of radiation exposure, but not with arterial stiffness (0.036, 95 % CI [-0.025, 0.095]). The model fitted better and had narrower confidence intervals than separate ordinary regression models explaining individual indicators independently. The associations were less evident when the dose range was restricted to a maximum of 2 or 1 Gy. By combining individual clinical-physiological indicators that are correlated because of common, underlying atherosclerotic pathologies, we found a small, but significant association of radiation with atherosclerosis.

59 BASIC BIOLOGICAL SCIENCES↗