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  1. Article ; Online: Mechanical evaluation of human cadaveric lumbar soft tissues suggests possible physiological stress shielding within musculoskeletal soft tissues by the thoracolumbar fascia.

    Newell, Emily / Driscoll, Mark

    IEEE transactions on bio-medical engineering

    2024  Volume PP

    Abstract: Objective: This study investigates the potential for stress shielding within musculoskeletal soft tissues through analysis of stress distributions between lumbar fascial and muscle tissues via mechanical testing.: Methods: Using a custom apparatus, ... ...

    Abstract Objective: This study investigates the potential for stress shielding within musculoskeletal soft tissues through analysis of stress distributions between lumbar fascial and muscle tissues via mechanical testing.
    Methods: Using a custom apparatus, 51 posterior thoracolumbar fascia (TLF) samples and 18 erector spinae (ES) cadaveric samples underwent tensile testing involving three loading-unloading cycles, followed by loading to 6% strain, to mechanically characterize samples. Parallel tensile testing using 20 pairs of two TLF samples, and seven pairs of TLF and ES samples was then conducted for stress distribution analysis between tissues. P<0.05 was deemed significant.
    Results: The TLF and ES exhibited an average elastic modulus of 150.9MPa and 0.6MPa, respectively. At 6% strain, parallel testing of the TLF pairs yielded an average tensile stress of 8.4MPa and 1.7MPa (p<0.001) exhibited by the stiffer and less stiff TLF samples, respectively. Similarly, TLF-ES parallel testing resulted in average tensile stresses of 7.1MPa and 0.07MPa of the TLF and ES (p<0.002).
    Conclusion: Results suggest elevated loading towards stiffer TLF samples relative to less stiff TLF and ES samples. In soft tissues affected by LBP, skewed stress distributions may result in the TLF withstanding the majority of stress, yielding cyclical stress shielding that may contribute to and/or promote LBP.
    Significance: This novel study demonstrates a potential load allocation bias towards the TLF, laying the foundation for stress shielding within lumbar musculoskeletal soft tissues affected by degenerative musculoskeletal conditions.
    Language English
    Publishing date 2024-04-10
    Publishing country United States
    Document type Journal Article
    ZDB-ID 160429-6
    ISSN 1558-2531 ; 0018-9294
    ISSN (online) 1558-2531
    ISSN 0018-9294
    DOI 10.1109/TBME.2024.3387343
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: A student nurse in the MICU: Leveraging unexpected leadership on the frontlines of COVID-19.

    Newell, Emily G

    Nursing outlook

    2020  Volume 68, Issue 4, Page(s) 388–390

    MeSH term(s) COVID-19 ; Coronavirus Infections/epidemiology ; Coronavirus Infections/nursing ; Education, Nursing, Baccalaureate ; Humans ; Intensive Care Units/organization & administration ; Leadership ; Pandemics ; Pneumonia, Viral/epidemiology ; Pneumonia, Viral/nursing ; Students, Nursing/psychology ; United States/epidemiology
    Keywords covid19
    Language English
    Publishing date 2020-06-08
    Publishing country United States
    Document type Journal Article
    ZDB-ID 300568-9
    ISSN 1528-3968 ; 0029-6554
    ISSN (online) 1528-3968
    ISSN 0029-6554
    DOI 10.1016/j.outlook.2020.04.014
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  3. Article ; Online: The examination of stress shielding in a finite element lumbar spine inclusive of the thoracolumbar fascia.

    Newell, Emily / Driscoll, Mark

    Medical & biological engineering & computing

    2021  Volume 59, Issue 7-8, Page(s) 1621–1628

    Abstract: Despite the prevalence of low back pain (LBP) in society, the pathomechanism of LBP continues to elude researchers. LBP patients have demonstrated morphological and material property changes to their lumbar soft tissues, potentially leading to irregular ... ...

    Abstract Despite the prevalence of low back pain (LBP) in society, the pathomechanism of LBP continues to elude researchers. LBP patients have demonstrated morphological and material property changes to their lumbar soft tissues, potentially leading to irregular load sharing within the lumbar spine. This study aims to analyze potential stress shielding consequential of augmented soft tissue properties via the comparison of a healthy and LBP finite element models. The models developed in this study include the vertebrae, intervertebral discs and soft tissues from L1-S1. Soft tissue morphology and material properties for the LBP model were augmented to reflect documented clinical findings. Model validation preceded testing and was confirmed through comparison to the available literature. Relative to the healthy model, the LBP model demonstrated an increase in stress by 15.6%, with 99.8% of this stress increase being distributed towards the thoracolumbar fascia. The majority of stress skewed towards the fascia may indicate a potential stress allocation bias whereby the lumbar muscles are unable to receive regular loading, leading to stress shielding. This load allocation bias and subsequent stress shielding may potentially contribute to the progression and pathomechanism of LBP but prospective studies would be required to make that link.
    MeSH term(s) Biomechanical Phenomena ; Fascia ; Finite Element Analysis ; Humans ; Low Back Pain ; Lumbar Vertebrae ; Prospective Studies
    Language English
    Publishing date 2021-07-17
    Publishing country United States
    Document type Journal Article
    ZDB-ID 282327-5
    ISSN 1741-0444 ; 0025-696X ; 0140-0118
    ISSN (online) 1741-0444
    ISSN 0025-696X ; 0140-0118
    DOI 10.1007/s11517-021-02408-9
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  4. Article ; Online: Investigation of physiological stress shielding within lumbar spinal tissue as a contributor to unilateral low back pain: A finite element study.

    Newell, Emily / Driscoll, Mark

    Computers in biology and medicine

    2021  Volume 133, Page(s) 104351

    Abstract: Introduction: The pathomechanism of low back pain (LBP) remains unknown. Unilateral LBP patients have demonstrated ipsilateral morphological and material property changes within the lumbar soft tissues, potentially leading to asymmetric tissue loading. ... ...

    Abstract Introduction: The pathomechanism of low back pain (LBP) remains unknown. Unilateral LBP patients have demonstrated ipsilateral morphological and material property changes within the lumbar soft tissues, potentially leading to asymmetric tissue loading. Through the comparison of healthy and unilateral LBP validated finite element models (FEMs), this study investigates potential stress shielding consequential of spinal tissue property augmentation.
    Methods: Two FEMs of the musculoskeletal system - one demonstrating healthy and unilateral LBP conditions - were developed undergoing 30-degree flexion. FEMs included the vertebrae, intervertebral discs, and soft tissues from L1-S1. Material properties selected for the soft tissues were retrieved from published literature. To reflect unilateral LBP, the paraspinal morphology was atrophied, while the tissue moduli were increased. The symptomatic thoracolumbar fascia (TLF) was uniformly increased. Validation of the models preceded testing.
    Results: Model validation in spinal flexion was accomplished through comparison to literature. Compared to the healthy model, the unilateral LBP multifidus (MF), longissimus thoracis (LT), and TLF exhibited average tension changes of +7.9, -5.1, and +9.3%, respectively. Likewise, the symptomatic MF, LT, and TLF exhibited tension changes of +19.0, -10.4, and +16.1% respectively, whereas the asymptomatic MF, LT, and TLF exhibited -4.0, -2.0, and +0.4% changes in tension, respectively.
    Conclusion: Relative to the healthy tissues, the symptomatic LBP soft tissues demonstrated a 19.5 kPa increase in stress, with 99.8% of this increase distributed towards the TLF, suggesting a load allocation bias within the symptomatic unilateral LBP tissues. Consequentially, symptomatic paraspinal muscles may be unable to withstand loading, leading to stress shielding.
    MeSH term(s) Finite Element Analysis ; Humans ; Low Back Pain ; Lumbar Vertebrae ; Lumbosacral Region ; Stress, Physiological
    Language English
    Publishing date 2021-03-22
    Publishing country United States
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 127557-4
    ISSN 1879-0534 ; 0010-4825
    ISSN (online) 1879-0534
    ISSN 0010-4825
    DOI 10.1016/j.compbiomed.2021.104351
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  6. Article ; Online: A student nurse in the MICU

    Newell, Emily G.

    Nursing Outlook

    Leveraging unexpected leadership on the frontlines of COVID-19

    2020  Volume 68, Issue 4, Page(s) 388–390

    Keywords General Nursing ; covid19
    Language English
    Publisher Elsevier BV
    Publishing country us
    Document type Article ; Online
    ZDB-ID 300568-9
    ISSN 1528-3968 ; 0029-6554
    ISSN (online) 1528-3968
    ISSN 0029-6554
    DOI 10.1016/j.outlook.2020.04.014
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  7. Article ; Online: Augmentation of musculoskeletal soft tissue morphology within low back pain patients may suggest the presence of physiological stress shielding: An in vivo study.

    Newell, Emily / Chorney, Harriet / Tiegs-Heiden, Christin A / Benson, John C / Ouellet, Jean / Driscoll, Mark

    Journal of biomechanics

    2023  Volume 162, Page(s) 111894

    Abstract: Introduction: The pathomechanism of low back pain (LBP) remains unknown. However, changes to mechanical properties of soft tissues affected by LBP may indicate the presence of stress shielding, which may manifest via tissue remodeling. This study ... ...

    Abstract Introduction: The pathomechanism of low back pain (LBP) remains unknown. However, changes to mechanical properties of soft tissues affected by LBP may indicate the presence of stress shielding, which may manifest via tissue remodeling. This study investigates the potential for physiological stress shielding within the lumbar spine by examining differences within lumbar soft tissue morphology between control and LBP subjects.
    Methods: Through MRI, the total and functional cross-sectional area (tCSA, fCSA) and fatty infiltration (FI) of the lumbar multifidus (MF), erector spinae (ES), quadratus lumborum (QL), psoas major (PM), and thoracolumbar fascia (TLF) were measured from the L1/L2 to L5/S1 intervertebral disc levels of 69 subjects (36 LBP and 33 control subjects). Statistical analysis was conducted using Mann-Whitney U. P < 0.05 denoted significance.
    Results: Comparison of male LBP patients and male healthy controls yielded an increase in tCSA and fCSA within the L4/L5 PM (p < 0.01), and the L4/L5 ES (p = 0.02) and PM (p < 0.01), respectively, of LBP patients. Female LBP patients' FI compared to female controls increased within the L1/L2 MF (p = 0.03), L3/L4 MF (p = 0.04) and ES (p = 0.02), and L4/L5 QL (p = 0.01). The L3/L4 TLF also demonstrated an 8% increase in LBP subjects.
    Conclusion: Male patients' results suggest elevated tissue loading during motion yielding hypertrophy in the L4/L5 ES and PM fCSA, and PM tCSA. Female LBP patients' MF, ES, and PM at L3/L4 demonstrating elevated FI coupled with TLF tCSA hypertrophy may suggest irregular stress distributions and lay the foundation for stress shielding within musculoskeletal soft tissues.
    MeSH term(s) Humans ; Male ; Female ; Low Back Pain ; Lumbar Vertebrae/diagnostic imaging ; Lumbosacral Region ; Magnetic Resonance Imaging/methods ; Hypertrophy ; Salicylanilides
    Chemical Substances 3,3',4',5-tetrachlorosalicylanilide (HNE676755I) ; Salicylanilides
    Language English
    Publishing date 2023-12-04
    Publishing country United States
    Document type Journal Article
    ZDB-ID 218076-5
    ISSN 1873-2380 ; 0021-9290
    ISSN (online) 1873-2380
    ISSN 0021-9290
    DOI 10.1016/j.jbiomech.2023.111894
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  8. Article ; Online: Co-exposures to trace elements and polycyclic aromatic compounds (PACs) impacts North American river otter (Lontra canadensis) baculum.

    Thomas, Philippe J / Newell, Emily E / Eccles, Kristin / Holloway, Alison C / Idowu, Ifeoluwa / Xia, Zhe / Hassan, Elizabeth / Tomy, Gregg / Quenneville, Cheryl

    Chemosphere

    2020  Volume 265, Page(s) 128920

    Abstract: Environmental loadings of polycyclic aromatic compounds (PACs) and trace elements are increasing in areas with marked oil and gas extraction, such as in the Athabasca oil sands region, Alberta, Canada. Some of these chemicals are recognized as potent ... ...

    Abstract Environmental loadings of polycyclic aromatic compounds (PACs) and trace elements are increasing in areas with marked oil and gas extraction, such as in the Athabasca oil sands region, Alberta, Canada. Some of these chemicals are recognized as potent endocrine disrupting compounds (EDCs). The impacts of co-exposure to PACs and metals on free-ranging wildlife is of considerable concern. River otters (Lontra canadensis) are sentinel species of aquatic ecosystem health. The baculum (penile bone) is an important part of the reproductive system in otters that ensures successful copulation. Although baculum health is critical to male reproductive success and is sensitive to exposure to EDCs, there is no information available regarding the impact of PAC and metal exposures on measures of baculum health. River otter baculum and livers were dissected from carcasses obtained from the fur trade. Trace element and PAC analyses were carried out in liver with matching baculums subjected to dimensional analysis, bone mineral density (BMD) and mechanical loading testing. Trace elements and select PACs exhibited both protective and deleterious effects on baculum bone health metrics. Alkylated four ring PACs were negatively associated with baculum bone material properties (ex: C4-Chrysene and C4-pyrene). The same compounds have been shown to exhibit strong anti-androgenic activities. Few comparable studies exist related to contamination and adverse effects of PACs in wild terrestrial mammals. Baculum health metrics may be an important tool to include in biomonitoring studies as to date, there are limited means to assess male reproductive performance in wildlife biomonitoring programs.
    MeSH term(s) Alberta ; Animals ; Ecosystem ; Environmental Monitoring ; Male ; Oil and Gas Fields ; Otters ; Polycyclic Compounds ; Trace Elements
    Chemical Substances Polycyclic Compounds ; Trace Elements
    Language English
    Publishing date 2020-11-10
    Publishing country England
    Document type Journal Article
    ZDB-ID 120089-6
    ISSN 1879-1298 ; 0045-6535 ; 0366-7111
    ISSN (online) 1879-1298
    ISSN 0045-6535 ; 0366-7111
    DOI 10.1016/j.chemosphere.2020.128920
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