{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,12]],"date-time":"2026-03-12T04:29:50Z","timestamp":1773289790671,"version":"3.50.1"},"reference-count":45,"publisher":"Wiley","license":[{"start":{"date-parts":[[2020,5,20]],"date-time":"2020-05-20T00:00:00Z","timestamp":1589932800000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Journal of Healthcare Engineering"],"published-print":{"date-parts":[[2020,5,20]]},"abstract":"<jats:p>Retinal hemorrhaging (RH) is indicative and prevalent in abusive head trauma (AHT)\u2014yet the direct cause of the RH from AHT is unknown. Our hypothesis is that RH in AHT is the combination of shaking forces and hypertension. This combination of effects explains why RH is not normally observed in common childhood accidents but is nearly exclusively observed in AHT. An experimental model using porcine eyes was designed to ascertain the required pressure change for sudden RH and, via a computer model, the subsequent stress increase in blood vessels. The porcine eyes were cannulated via the maxillary artery and pressurized until perfusion and RH were observed. Fluid was injected into the head with a computer-controlled continuous flow syringe pump; video of the fundus was recorded during perfusion; and the pressure of the fluid entering the eye was recorded as well. A computer model was created in COMSOL to simulate loading from hypertension, shaking, and the combination of the forces. This model was validated via experimental data collected from the porcine model. It was found that hypertension or shaking alone did not cause an increase in stress required to cause RH. But when the loading of shaking and hypertension was combined, as would occur in AHT, the stress increases were greater than those extrapolated from the porcine model and would cause RH.<\/jats:p>","DOI":"10.1155\/2020\/4714927","type":"journal-article","created":{"date-parts":[[2020,5,20]],"date-time":"2020-05-20T23:34:48Z","timestamp":1590017688000},"page":"1-10","source":"Crossref","is-referenced-by-count":4,"title":["Modeling Hypertension as a Contributor to Retinal Hemorrhaging from Abusive Head Trauma"],"prefix":"10.1155","volume":"2020","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8461-2810","authenticated-orcid":true,"given":"Christopher","family":"Umstead","sequence":"first","affiliation":[{"name":"Texas Tech University, Department of Mechanical Engineering, Box 41021, Lubbock, TX 79430-9406, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3080-9084","authenticated-orcid":true,"given":"Alan","family":"Barhorst","sequence":"additional","affiliation":[{"name":"Texas Tech University, Department of Mechanical Engineering, Box 41021, Lubbock, TX 79430-9406, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Thivakorn","family":"Kasemsri","sequence":"additional","affiliation":[{"name":"Texas Tech University Health Sciences Center, Department of Pediatrics, Division of Pediatric Critical Care, 3601 4th Street, Lubbock, TX 79430-9406, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kelly","family":"Mitchell","sequence":"additional","affiliation":[{"name":"Texas Tech University Health Sciences Center, Department of Ophthalmology & Visual Sciences, 3601 4th Street, Lubbock, TX 79430-9406, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","reference":[{"key":"1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2004-1896"},{"key":"2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1469-8749.2008.03051_1.x"},{"key":"3","first-page":"4","volume":"97","year":"2009","journal-title":"Illinois Bar Journa"},{"key":"4","doi-asserted-by":"publisher","DOI":"10.1097\/icu.0b013e3282a167f0"},{"key":"5","doi-asserted-by":"publisher","DOI":"10.1016\/j.jemermed.2008.06.022"},{"key":"6","doi-asserted-by":"publisher","DOI":"10.1016\/s0002-9394(02)01628-8"},{"key":"7","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2010-1220"},{"issue":"2","key":"8","doi-asserted-by":"crossref","first-page":"233","DOI":"10.1016\/j.ajo.2006.03.038","volume":"142","year":"2006","journal-title":"American Journal of Ophthalmology"},{"key":"9","doi-asserted-by":"publisher","DOI":"10.1136\/bjo.80.4.282"},{"key":"10","year":"2015"},{"issue":"3","key":"11","first-page":"633","volume":"114","year":"2003","journal-title":"Pediatrics"},{"key":"12","doi-asserted-by":"publisher","DOI":"10.1542\/peds.111.3.602"},{"key":"13","doi-asserted-by":"publisher","DOI":"10.1542\/peds.114.1.165"},{"issue":"9","key":"14","doi-asserted-by":"crossref","first-page":"1718","DOI":"10.1016\/S0161-6420(03)00581-5","volume":"110","year":"2003","journal-title":"Ophthalmology"},{"key":"15","doi-asserted-by":"publisher","DOI":"10.1016\/j.pcl.2009.02.003"},{"key":"16","doi-asserted-by":"publisher","DOI":"10.1007\/s00417-008-0994-1"},{"key":"17","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaapos.2008.11.006"},{"issue":"1","key":"18","doi-asserted-by":"crossref","first-page":"53","DOI":"10.1385\/FSMP:1:1:053","volume":"1","year":"2005","journal-title":"Forensic Science, Medicine, and Pathology"},{"key":"19","doi-asserted-by":"publisher","DOI":"10.3171\/jns.2003.99.1.0143"},{"key":"20","doi-asserted-by":"publisher","DOI":"10.4303\/jfb\/f110601"},{"key":"21","doi-asserted-by":"publisher","DOI":"10.1111\/j.1469-8749.2007.02004.x"},{"key":"22","doi-asserted-by":"publisher","DOI":"10.1016\/j.forsciint.2005.02.033"},{"key":"23","doi-asserted-by":"publisher","DOI":"10.1016\/s0300-9572(02)00154-5"},{"key":"24","doi-asserted-by":"publisher","DOI":"10.1016\/j.resuscitation.2009.12.017"},{"issue":"5","key":"25","first-page":"722","volume":"27","year":"1986","journal-title":"Investigative Ophthalmology & Visual Science"},{"key":"26","volume-title":"Physical and flow properties of blood","year":"2003"},{"issue":"5","key":"27","first-page":"255","volume":"21","year":"1987","journal-title":"Medical instrumentation"},{"issue":"2","key":"28","first-page":"356","volume":"33","year":"1992","journal-title":"Investigative Ophthalmology & Visual Science"},{"key":"29","volume-title":"Developmental anatomy of the retinal and choroidal vasculature","year":"2010"},{"key":"30","doi-asserted-by":"publisher","DOI":"10.3171\/ped.2008.2.11.321"},{"issue":"1","key":"31","first-page":"83","volume":"51","year":"2009","journal-title":"Physiological Research"},{"key":"32","doi-asserted-by":"publisher","DOI":"10.1136\/bjo.78.3.234"},{"key":"33","doi-asserted-by":"publisher","DOI":"10.1136\/bjo.78.3.236"},{"issue":"4-5","key":"34","doi-asserted-by":"crossref","first-page":"380","DOI":"10.1159\/000094164","volume":"28","year":"2006","journal-title":"International Journal of Developmental Neuroscience"},{"key":"35","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaapos.2006.11.074"},{"key":"36","doi-asserted-by":"publisher","DOI":"10.1167\/iovs.10-5211"},{"key":"37","doi-asserted-by":"publisher","DOI":"10.1136\/bjo.55.12.808"},{"key":"38","year":"2004"},{"key":"39","year":"2011"},{"key":"40","year":"2016"},{"key":"41","doi-asserted-by":"publisher","DOI":"10.1097\/opx.0b013e3181baaf4e"},{"key":"42","doi-asserted-by":"publisher","DOI":"10.1142\/s1793048010001184"},{"issue":"11","key":"43","doi-asserted-by":"crossref","first-page":"4189","DOI":"10.1167\/iovs.05-0541","volume":"46","year":"2005","journal-title":"Investigative Ophthalmology & Visual Science"},{"key":"44","doi-asserted-by":"publisher","DOI":"10.1007\/bf02412146"},{"key":"45","doi-asserted-by":"publisher","DOI":"10.1203\/00006450-198905000-00006"}],"container-title":["Journal of Healthcare Engineering"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/downloads.hindawi.com\/journals\/jhe\/2020\/4714927.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/downloads.hindawi.com\/journals\/jhe\/2020\/4714927.xml","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/downloads.hindawi.com\/journals\/jhe\/2020\/4714927.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2020,5,20]],"date-time":"2020-05-20T23:34:57Z","timestamp":1590017697000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.hindawi.com\/journals\/jhe\/2020\/4714927\/"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,5,20]]},"references-count":45,"alternative-id":["4714927","4714927"],"URL":"https:\/\/doi.org\/10.1155\/2020\/4714927","relation":{},"ISSN":["2040-2295","2040-2309"],"issn-type":[{"value":"2040-2295","type":"print"},{"value":"2040-2309","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,5,20]]}}}