Senior Research Career Scientist

高级研究职业科学家

• 批准号: 10754191
• 负责人: William R. Ledoux
• 金额: --
• 依托单位: VA PUGET SOUND HEALTHCARE SYSTEM
• 依托单位国家: 美国
• 财政年份: 2018
• 资助国家: 美国
• 起止时间: 2018-10-01 至 2030-09-30
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10754191
• 关键词: 3-Dimensional; Activities of Daily Living; Address; Adult; Affect; Age; Agreement; American; Amputation; Anatomy; Ankle; Applications Grants; Area; Arthritis; Arthrodesis; Biomechanics; Cadaver; Classification; Clawtoe; Clinical; Clinical Treatment; Collaborations; Complex; Computer Models; Computer software; Data; Degenerative polyarthritis; Development; Devices; Diabetes Mellitus; Diabetic Foot; Diabetic Foot Ulcer; Diagnosis; Disease; Dissection; Elements; Environment; Etiology; Exhibits; Flatfoot; Fluoroscopy; Foot Deformities; Foot Ulcer; Foot joint structure; Fracture Fixation; Functional disorder; Funding; Gait; General Population; Geometry; Goals; Hallux Rigidus; High Prevalence; Hip Osteoarthritis; Human; Image; Impairment; Implant; Incidence; Intervention; Joints; Knee Osteoarthritis; Laboratories; Limb structure; Link; Location; Lower Extremity; Magnetic Resonance Imaging; Measurement; Mechanics; Metatarsal bone structure; Metatarsophalangeal joint structure; Methods; Modeling; Motion; Musculoskeletal; Neuropathy; Operative Surgical Procedures; Orthopedics; Pain; Paper; Pathology; Patient-Focused Outcomes; Patients; Physiological; Pilot Projects; Population; Population Study; Positioning Attribute; Prevalence; Prevention; Prevention strategy; Preventive care; Procedures; Process; Property; Quality of life; Reaction; Replacement Arthroplasty; Research; Resolution; Risk; Robotics; Scanning; Scientist; Shapes; Site; Skin Temperature; Structure; Study models; Sum; Surface; System; Talipes cavus; Techniques; Technology; Tendon structure; Testing; Tissues; Toes; Ulcer; Ultrasonography; United States National Institutes of Health; Vascularization; Veterans; Woman; Work; achilles tendon; arthropathies; bone; career; design; diabetic; digital; elastography; evidence base; experimental study; foot; foot bone; improved; insight; interest; joint biomechanics; joint function; kinematics; limb amputation; limb loss; mechanical load; men; military veteran; neural network; non-diabetic; novel; pain reduction; pathomechanics; pelvis fracture; pressure; prevent; programs; prospective; residual limb; response; sample fixation; sensor; shear stress; simulation; soft tissue; success; tool; treatment strategy; trend; ultrasound

PROJECT SUMMARY/ABSTRACT Dr. Ledoux’s current research program aims to reduce both functional and anatomical limb loss by: exploring the disease processes that lead to aberrant limb function; quantifying the effects of conservative and surgical treatment options; and developing novel, state-of-the-art technologies for studying the foot. His research focuses on two Veteran populations: those with musculoskeletal impairment at the foot and ankle, where pain and limitations in mobility are the key issues (i.e., functional limb loss); and those at risk of lower limb amputation due to diabetes, where loss of the foot is a major concern (i.e., anatomical limb loss). The overarching goals of his research include: (1) insight into the pathomechanics of: diabetic foot ulceration, ankle and great toe arthritis, and severe foot deformities; (2) quantitative comparison of different treatment options for foot pathologies that can lead to improved limb function or prevention of amputation; and (3) the development of novel research tools. Dr. Ledoux is working on several projects related to hallux rigidus, or arthritis of the first metatarsophalangeal joint (MTPJ1). Various designs for MTPJ1 arthroplasties have been proposed, but none have been particularly successful. Development of new implants aimed at addressing these problems has been limited by insufficient quantitative data on the MTPJ1 mechanical environment. Similarly, due to previous technological limitations, no precise 3D data are available on either the kinematics of this disease. CLiMB is engaged in novel research to identify the kinematic envelope of normal MTPJ1 function required during activities of daily living (RX0032590). We will build on our initial successes generating novel, evidence-based implant concepts that emphasize strong initial component fixation to improve MTPJ1 implant technology through computational modeling and robotic gait simulation of human cadavers (R01AR076475). These better-performing implants will ultimately lead to improved patient outcomes. It is our working hypothesis that a successful MTPJ1 implant will exhibit both strong initial component fixation and physiologically normative joint biomechanics. Additionally, Dr. Ledoux is collaborating with Dr. Sangeorzan on a multisite hallux rigidus study comparing motion sparing procedures (joint replacement or bone shaping) to arthrodesis (fusion). This study will determine factors associated with treatment success. Developing improved treatment options requires a better fundamental understanding of diabetic disease pathomechanics. Despite growing agreement that aberrant pressures and shear stresses are linked to ulceration, the specific causative mechanism of ulceration remains poorly understood. From a structural perspective—in which tissues of different material properties and different geometries interact to create a bulk response—most studies have been 2D and limited in the number of locations considered. Given the complex structure and functional motion of the foot, it should be investigated in 3D across the entire plantar surface. However, many techniques that afford volumetric inquiry have other concerns: dissection is disruptive, finite element models rely on assumptions and simplifications, CT has poor soft tissue resolution, and MRI is computationally and fiscally expensive. Ultrasound has good soft tissue resolution, but most commercial systems create planar images or are limited to small, angularly swept volumes. Ultrasound can also be difficult to read for the naïve user. In order to overcome these barriers, we propose these specific aims: 1) Develop a mechanical system and the necessary software to generate a 3D scan of the entire plantar soft tissue, using B-mode ultrasound for structural information and shear wave elastography for tissue properties. 2) Collect plantar soft tissue scans for 7 diabetic non-neuropathic subjects and 7 non-diabetic subjects. 3) Analyze these scans using segmentation and strain information calculated with digital volume correlation as well as an interpretable classification neural network. The successful completion of this NIH funded pilot study (5U24DK115255-04, subaward 32307-94) will demonstrate the utility of the proposed methods and support a larger grant application.

项目摘要/摘要 Ledoux博士当前的研究计划旨在减少功能和解剖肢体损失：探索 导致肢体功能异常的疾病过程；量化保守和外科手术的影响 治疗选择；并开发用于研究脚的新型，最先进的技术。他的研究重点 在两个资深人群中：脚和脚踝有肌肉骨骼障碍的人群，疼痛和疼痛 移动性的限制是关键问题（即功能肢体损失）；以及有下肢截肢的风险 到糖尿病，脚损失是主要问题（即解剖肢体损失）。他的总体目标 研究包括：（1）洞悉：糖尿病足溃疡，脚踝和大脚趾关节炎， 和严重的脚畸形； （2）对脚步病理的不同治疗选择的定量比较 可以改善肢体功能或预防截肢； （3）开发新型研究工具。 Ledoux博士正在从事与Hallux Rigidus有关的几个项目 关节（MTPJ1）。已经提出了MTPJ1节肢动物的各种设计，但没有特别的设计 成功的。旨在解决这些问题的新兴的开发受到不足的限制 MTPJ1机械环境的定量数据。同样，由于以前的技术限制，否 有关该疾病的运动学的精度3D数据可获得。攀登从事新颖的研究 确定日常生活活动中所需的正常MTPJ1功能的运动膜（RX0032590）。 我们将基于我们最初的成功，从而产生小说，基于证据的植入物概念，这些概念强调强大 通过计算建模和机器人步态改善MTPJ1植入技术的初始组件固定 人尸体的模拟（R01AR076475）。这些绩效表现更好的焦油最终将改善 患者的结果。我们的工作假设是，成功的MTPJ1植入物将存在既有最初的初始植入物 组件固定和物理正常的关节生物力学。此外，Ledoux博士正在合作 与Sangeorzan博士进行的多站点HALLUX RIGIDUS研究，比较了运动保分程序（关节置换） 或骨塑形）至关节固定（融合）。这项研究将确定与治疗成功相关的因素。 开发改进的治疗选择需要对糖尿病疾病有更好的基本了解 病理学。尽管越来越同意，异常压力和剪切应力与 溃疡，溃疡的特定灾难性机制仍然鲜为人知。来自结构 透视图 - 在哪些不同材料特性的组织和不同的几何形状相互作用以创建大量 响应 - 大多数研究在所考虑的位置数量中是2D和有限的。给定复合物 脚的结构和功能运动，应在整个足底表面进行3D研究。 但是，许多提供体积查询的技术还有其他问题：解剖是破坏性的，有限的 元素模型依赖于假设和简化，CT的软组织分辨率差，MRI为 计算和fist昂贵。超声波具有良好的软组织分辨率，但大多数商业系统 创建平面图像或仅限于小的，角度扫荡的体积。超声波也可能很难阅读 适用于幼稚的用户。为了克服这些障碍，我们提出了这些特定目的：1）开发机械 系统和必要的软件，用于使用B模式生成整个足底软组织的3D扫描 超声检查结构信息和剪切波弹性图，用于组织特性。 2）收集足底软 组织扫描7个糖尿病非神经性受试者和7个非糖尿病患者。 3）使用 通过数字体积相关以及可解释的分割和应变信息计算 分类神经网络。这项NIH资助的试点研究成功完成（5U24DK115255-04， Subaward 32307-94）将证明拟议方法的实用性并支持更大的赠款应用程序。

项目成果

Step Activity After Surgical Treatment of Ankle Arthritis.

踝关节炎手术治疗后的步骤活动。

• DOI: 10.2106/jbjs.18.00511
• 发表时间: 2019
• 期刊: The Journal of bone and joint surgery. American volume
• 作者: Shofer,JaneB;Ledoux,WilliamR;Orendurff,MichaelS;Hansen,SigvardT;Davitt,James;Anderson,JohnG;Bohay,Donald;Coetzee,JChris;Houghton,Michael;Norvell,DanielC;Sangeorzan,BruceJ
• 通讯作者: Sangeorzan,BruceJ

The compressive, shear, biochemical, and histological characteristics of diabetic and non-diabetic plantar skin are minimally different.

• DOI: 10.1016/j.jbiomech.2021.110797
• 发表时间: 2021-12-02
• 期刊: Journal of biomechanics
• 影响因子: 2.4
• 作者: Brady L;Pai S;Iaquinto JM;Wang YN;Ledoux WR
• 通讯作者: Ledoux WR

The effect of diabetes and tissue depth on adipose chamber size and plantar soft tissue features.

• DOI: 10.1016/j.foot.2023.101989
• 发表时间: 2023-09-01
• 期刊: Foot (Edinburgh, Scotland)
• 作者: Brady, Lynda M;Rombokas, Eric;Ledoux, William R
• 通讯作者: Ledoux, William R

3D Printed lattice microstructures to mimic soft biological materials.

3D 打印晶格微结构来模拟软生物材料。

• DOI: 10.1088/1748-3190/aae10a
• 发表时间: 2018
• 期刊: Bioinspiration & biomimetics
• 影响因子: 3.4
• 作者: Johnson,LukeK;Richburg,Chris;Lew,Madelyn;Ledoux,WilliamR;Aubin,PatrickM;Rombokas,Eric
• 通讯作者: Rombokas,Eric

Comparison of texture-based classification and deep learning for plantar soft tissue histology segmentation.

• DOI: 10.1016/j.compbiomed.2021.104491
• 发表时间: 2021-07
• 期刊: Computers in biology and medicine
• 影响因子: 7.7
• 作者: Brady L;Wang YN;Rombokas E;Ledoux WR
• 通讯作者: Ledoux WR