A simple accurate chest-compression depth gauge using magnetic coils during cardiopulmonary resuscitation

This paper describes a new method for calculating chest compression depth and a simple chest-compression gauge for validating the accuracy of the method. The chest-compression gauge has two plates incorporating two magnetic coils, a spring, and an accelerometer. The coils are located at both ends of the spring, and the accelerometer is set on the bottom plate. Waveforms obtained using the magnetic coils (hereafter, "magnetic waveforms"), which are proportional to compression-force waveforms and the acceleration waveforms were measured at the same time. The weight factor expressing the relationship between the second derivatives of the magnetic waveforms and the measured acceleration waveforms was calculated. An estimated-compression-displacement (depth) waveform was obtained by multiplying the weight factor and the magnetic waveforms. Displacements of two large springs (with similar spring constants) within a thorax and displacements of a cardiopulmonary resuscitation training manikin were measured using the gauge to validate the accuracy of the calculated waveform. A laser-displacement detection system was used to compare the real displacement waveform and the estimated waveform. Intraclass correlation coefficients (ICCs) between the real displacement using the laser system and the estimated displacement waveforms were calculated. The estimated displacement error of the compression depth was within 2 mm (<1 standard deviation). All ICCs (two springs and a manikin) were above 0.85 (0.99 in the case of one of the springs). The developed simple chest-compression gauge, based on a new calculation method, provides an accurate compression depth (estimation error < 2 mm).

An over-nonlocal implicit gradient-enhanced damage-plastic model for trabecular bone under large compressive strains

PURPOSE

Investigation of trabecular bone strength and compaction is important for fracture risk prediction. At 1-2% compressive strain, trabecular bone undergoes strain softening, which may lead to numerical instabilities and mesh dependency in classical local damage-plastic models. The aim of this work is to improve our continuum damage-plastic model of bone by reducing the influence of finite element mesh size under large compression.

METHODOLOGY

This spurious numerical phenomenon may be circumvented by incorporating the nonlocal effect of cumulated plastic strain into the constitutive law. To this end, an over-nonlocal implicit gradient model of bone is developed and implemented into the finite element software ABAQUS using a user element subroutine. The ability of the model to detect the regions of bone failure is tested against experimental stepwise loading data of 16 human trabecular bone biopsies.

FINDINGS

The numerical outcomes of the nonlocal model revealed reduction of finite element mesh dependency compared with the local damage-plastic model. Furthermore, it helped reduce the computational costs of large-strain compression simulations.

ORIGINALITY

To the best of our knowledge, the proposed model is the first to predict the failure and densification of trabecular bone up to large compression independently of finite element mesh size. The current development enables the analysis of trabecular bone compaction as in osteoporotic fractures and implant migration, where large deformation of bone plays a key role.

On the effects of leaflet microstructure and constitutive model on the closing behavior of the mitral valve

Recent long-term studies showed an unsatisfactory recurrence rate of severe mitral regurgitation 3-5 years after surgical repair, suggesting that excessive tissue stresses and the resulting strain-induced tissue failure are potential etiological factors controlling the success of surgical repair for treating mitral valve (MV) diseases. We hypothesized that restoring normal MV tissue stresses in MV repair techniques would ultimately lead to improved repair durability through the restoration of MV normal homeostatic state. Therefore, we developed a micro- and macro- anatomically accurate MV finite element model by incorporating actual fiber microstructural architecture and a realistic structure-based constitutive model. We investigated MV closing behaviors, with extensive in vitro data used for validating the proposed model. Comparative and parametric studies were conducted to identify essential model fidelity and information for achieving desirable accuracy. More importantly, for the first time, the interrelationship between the local fiber ensemble behavior and the organ-level MV closing behavior was investigated using a computational simulation. These novel results indicated not only the appropriate parameter ranges, but also the importance of the microstructural tuning (i.e., straightening and re-orientation) of the collagen/elastin fiber networks at the macroscopic tissue level for facilitating the proper coaptation and natural functioning of the MV apparatus under physiological loading at the organ level. The proposed computational model would serve as a logical first step toward our long-term modeling goal-facilitating simulation-guided design of optimal surgical repair strategies for treating diseased MVs with significantly enhanced durability.

Microstructure and micromechanics of the heart urchin test from X-ray tomography

The microstructure of many echinoid species has long fascinated scientists because of its high porosity and outstanding mechanical properties. We have used X-ray microtomography to examine the test of Echinocardium cordatum (heart urchin), a burrowing cousin of the more commonly known sea urchins. Three dimensional imaging demonstrates that the bulk of the test is composed of only two distinct, highly porous, fenestrated regions (stereom), in which the thickness of the struts is constant. Different degrees of porosity are achieved by varying the spacing of the struts. Drawing an analogy to vertebrate trabecular bone, where for example, human bone has a connectivity density of ≈1/mm(3), we measure up to 150,000 strut connections per mm(3). Simulations of mechanical loading using finite element calculations indicate that the test performs at very close to the optimum expected for foams, highlighting the functional link between structure and mechanical properties.

Bone Response to Static Compressive Stress at Bone-Implant Interface: A Pilot Study of Critical Static Compressive Stress

PURPOSE

Mechanical imbalance caused by mechanical overload or poor bone quality around a dental implant can result in osseointegration failure. To avoid that, it is important to identify an appropriate safety stress margin (critical stress level). For this study, a novel device was developed to generate a quantitative amount of static compressive stress under an aseptic closed condition. The aim was to clarify the amount of critical stress produced on the cortical bone when static compression is applied to the osseointegrated bone-implant interface.

MATERIALS AND METHODS

Small parts for bone sustaining, load generation, and load transmittance were developed to generate quantitative static compressive stress at the bone-implant interface and implanted inside the tibial cortical bone in adult beagle dogs. Each tibia in two dogs received bone-sustaining parts, then after 2 months, the load-transmitting parts were placed into the bone-sustaining parts. After another 2 months, various magnitudes of static compressive stress (0-180 MPa) were generated by tightening the load-generating part to the osseointegrated bone-implant interface. After 7 days, the animals were euthanized, and dissected blocks were prepared for histomorphometric analyses.

RESULTS

There were no obvious signs of bone resorption or loss of osseointegration in any of the dogs. The change in shape of osteon was not influenced by the amount of static compressive stress. However, periosteal reactions were observed under the cortical bone on the opposite side.

CONCLUSION

These results indicate that osseointegrated bone-implant interfaces show minimal response based on the magnitude of static compressive stress, even when such stress is greater than 120 MPa.

Prediction of local proximal tibial subchondral bone structural stiffness using subject-specific finite element modeling: Effect of selected density-modulus relationship

BACKGROUND

Quantitative computed tomography based subject-specific finite element modeling has potential to clarify the role of subchondral bone alterations in knee osteoarthritis initiation, progression, and pain initiation. Calculation of bone elastic moduli from image data is a basic step when constructing finite element models. However, different relationships between elastic moduli and imaged density (known as density-modulus relationships) have been reported in the literature. The objective of this study was to apply seven different trabecular-specific and two cortical-specific density-modulus relationships from the literature to finite element models of proximal tibia subchondral bone, and identify the relationship(s) that best predicted experimentally measured local subchondral structural stiffness with highest explained variance and least error.

METHODS

Thirteen proximal tibial compartments were imaged via quantitative computed tomography. Imaged bone mineral density was converted to elastic moduli using published density-modulus relationships and mapped to corresponding finite element models. Proximal tibial structural stiffness values were compared to experimentally measured stiffness values from in-situ macro-indentation testing directly on the subchondral bone surface (47 indentation points).

FINDINGS

Regression lines between experimentally measured and finite element calculated stiffness had R(2) values ranging from 0.56 to 0.77. Normalized root mean squared error varied from 16.6% to 337.6%.

INTERPRETATION

Of the 21 evaluated density-modulus relationships in this study, Goulet combined with Snyder and Schneider or Rho appeared most appropriate for finite element modeling of local subchondral bone structural stiffness. Though, further studies are needed to optimize density-modulus relationships and improve finite element estimates of local subchondral bone structural stiffness.

Ultrashort echo time magnetization transfer (UTE-MT) imaging of cortical bone

Magnetization transfer (MT) imaging is one way to indirectly assess pools of protons with fast transverse relaxation. However, conventional MT imaging sequences are not applicable to short T2 tissues such as cortical bone. Ultrashort echo time (UTE) sequences with TE values as low as 8 µs can detect signals from different water components in cortical bone. In this study we aim to evaluate two-dimensional UTE-MT imaging of cortical bone and its application in assessing cortical bone porosity as measured by micro-computed tomography (μCT) and biomechanical properties. In total, 38 human cadaveric distal femur and proximal tibia bones were sectioned to produce 122 rectangular pieces of cortical bone for quantitative UTE-MT MR imaging, μCT, and biomechanical testing. Off-resonance saturation ratios (OSRs) with a series of MT pulse frequency offsets (Δf) were calculated and compared with porosity assessed with μCT, as well as elastic (modulus, yield stress, and strain) and failure (ultimate stress, failure strain, and energy) properties, using Pearson correlation and linear regression. A moderately strong negative correlation was observed between OSR and μCT porosity (R(2)  = 0.46-0.51), while a moderate positive correlation was observed between OSR and yield stress (R(2)  = 0.25-0.30) and failure stress (R(2)  = 0.31-0.35), and a weak positive correlation (R(2)  = 0.09-0.12) between OSR and Young's modulus at all off-resonance saturation frequencies. OSR determined with the UTE-MT sequence provides quantitative information on cortical bone and is sensitive to μCT porosity and biomechanical function.

The role of organic proteins on the crack growth resistance of human enamel

With only 1% protein by weight, tooth enamel is the most highly mineralized tissue in mammals. The focus of this study was to evaluate contributions of the proteins on the fracture resistance of this unique structural material. Sections of enamel were obtained from the cusps of human molars and the crack growth resistance was quantified using a conventional fracture mechanics approach with complementary finite element analysis. In selected specimens the proteins were extracted using a potassium hydroxide treatment. Removal of the proteins resulted in approximately 40% decrease in the fracture toughness with respect to the fully proteinized control. The loss of organic content was most detrimental to the extrinsic toughening mechanisms, causing over 80% reduction in their contribution to the total energy to fracture. This degradation occurred by embrittlement of the unbroken bridging ligaments and consequent reduction in the crack closure stress. Although the organic content of tooth enamel is very small, it is essential to crack growth toughening by facilitating the formation of unbroken ligaments and in fortifying their potency. Replicating functions of the organic content will be critical to the successful development of bio-inspired materials that are designed for fracture resistance.

Effects of sensilla morphology on mechanosensory sensitivity in the crayfish

Crustaceans contain a great variety of sensilla along their antennules that enable them to sense both hydrodynamic and chemical stimuli in aquatic environments, and can be used to inspire the design of engineered sensing systems. For example, along the antennule of the freshwater crayfish, Procambarus clarkii, four predominant mechanosensory sensilla morphologies are found. To study their response to upstream flow perturbations, atomic force microscopy was utilized to determine P. clarkii sensilla bending in response to an applied force and a mean torsional stiffness, k(t) = 1 × 10(-12) N m degree(-1) was found. A numerical model was developed to quantify the deformation of the four sensilla morphologies due to flow perturbations within their surrounding fluid. These flow perturbations were intended to mimic predator and ambient fluid movements. Results show that upstream fluid motion causes alterations in velocity near the sensilla, accompanied by corresponding variations in pressure along the sensilla surface. The feathered and filamentous sensilla, which are hydrodynamic sensilla, were found to be highly sensitive to flow perturbations. The beaked and asymmetric sensilla, which are bimodal chemo-mechanoreceptors, were found to be much less sensitive to hydrodynamic disturbances. Results also show that sensilla are most sensitive to fluid movement in the along-axis plane of the antennule, with a sharp drop in sensitivity perpendicular to this axis. This sensitivity agrees well with neural responses measured directly from the paired sensory neurons associated with each sensillum. Greater along-axis sensitivity is likely beneficial for determining the direction of fluid movements, which may be important for both aquatic organisms and biomimetic sensing systems.

A generalized method for the analysis of planar biaxial mechanical data using tethered testing configurations

Simulation of the mechanical behavior of soft tissues is critical for many physiological and medical device applications. Accurate mechanical test data is crucial for both obtaining the form and robust parameter determination of the constitutive model. For incompressible soft tissues that are either membranes or thin sections, planar biaxial mechanical testing configurations can provide much information about the anisotropic stress-strain behavior. However, the analysis of soft biological tissue planar biaxial mechanical test data can be complicated by in-plane shear, tissue heterogeneities, and inelastic changes in specimen geometry that commonly occur during testing. These inelastic effects, without appropriate corrections, alter the stress-traction mapping and violates equilibrium so that the stress tensor is incorrectly determined. To overcome these problems, we presented an analytical method to determine the Cauchy stress tensor from the experimentally derived tractions for tethered testing configurations. We accounted for the measured testing geometry and compensate for run-time inelastic effects by enforcing equilibrium using small rigid body rotations. To evaluate the effectiveness of our method, we simulated complete planar biaxial test configurations that incorporated actual device mechanisms, specimen geometry, and heterogeneous tissue fibrous structure using a finite element (FE) model. We determined that our method corrected the errors in the equilibrium of momentum and correctly estimated the Cauchy stress tensor. We also noted that since stress is applied primarily over a subregion bounded by the tethers, an adjustment to the effective specimen dimensions is required to correct the magnitude of the stresses. Simulations of various tether placements demonstrated that typical tether placements used in the current experimental setups will produce accurate stress tensor estimates. Overall, our method provides an improved and relatively straightforward method of calculating the resulting stresses for planar biaxial experiments for tethered configurations, which is especially useful for specimens that undergo large shear and exhibit substantial inelastic effects.

Influence of the scaffold geometry on the spatial and temporal evolution of the mechanical properties of tissue-engineered cartilage: insights from a mathematical model

The production of tissue-engineered cartilage in vitro with inhomogeneous mechanical properties is a problem yet to be solved. Different geometries have been studied to overcome this caveat; however, the reported measurements are limited to average values of some properties and qualitative measures of spatial distributions. We will apply a coupled model to extend knowledge about the introduction of a macrochannel in a scaffold by calculating spatiotemporal patterns for several interest variables related to the remodeling of the mechanical properties. Model parameters were estimated based on experimental data on the temporal patterns of glycosaminoglycans, collagen and compressive Young's modulus for channel-free constructs. The model reproduced the experimental data trends in both geometries, with experimental-numerical correlations between 0.84 and 0.97. The channel had a higher impact on the reduction in spatial heterogeneities and delay of saturation of core properties than in the improvement of average properties. Despite the possible improvement of cell densities for longer periods than 56 days, it is estimated that it will not cause further significant improvements of the mechanical properties. The degrees of spatial heterogeneity of the Young's modulus and permeability in the channeled geometry are 23 and 27 % of the channel-free values. While the average Young's modulus values are in the range of native cartilage, the permeabilities are one to three degrees of magnitude higher than the native cartilage, suggesting that limiting factors such as scaffold porosity and initial permeability are more relevant than scaffold geometry to effectively decrease the tissue permeability.

A depth dependent transversely isotropic micromechanic model of articular cartilage

Articular cartilage owing to the variation of collagen fibers orientation through its zones has been indicated to have depth dependent mechanical properties. The aim of this study was to present an innovative micromechanics model to predict the depth dependent mechanical properties of articular cartilage as a function of collagen fibers and proteoglycan matrix mechanical properties, collagen fibers volume fraction as well as angle toward cartilage surface. The variation of collagen fibers angle toward the cartilage surface as a function of cartilage depth was computed using the micromechanics model. This function showed that the collagen fibers parallel to the cartilage surface in the superficial zone have a nonlinear angle variation in the transition zone and become perpendicular to cartilage surface in the deep zone. Depth dependent elastic modulus in perpendicular to cartilage surface plane direction was calculated using presented micromechanics model and variation function of the collagen fibers' angle. The results revealed a suitable agreement with that of the experimental measurements in different samples at different ages and races (R2=0.944). The results also showed that the elastic and aggregate modules perpendicular to the cartilage surface plane in the deep zone were 25.8 and 26.3 times higher than that of the superficial zone, respectively. These findings have implications not only for computing the depth dependent mechanical properties of any type of articular cartilage at different ages and races, but also of potential ability for developing a depth dependent transversely isotropic biphasic model to predict the accurate mechanical behavior of articular cartilage.

Multi-view stereo analysis reveals anisotropy of prestrain, deformation, and growth in living skin

Skin expansion delivers newly grown skin that maintains histological and mechanical features of the original tissue. Although it is the gold standard for cutaneous defect correction today, the underlying mechanisms remain poorly understood. Here we present a novel technique to quantify anisotropic prestrain, deformation, and growth in a porcine skin expansion model. Building on our recently proposed method, we combine two novel technologies, multi-view stereo and isogeometric analysis, to characterize skin kinematics: Upon explantation, a unit square retracts ex vivo to a square of average dimensions of [Formula: see text]. Upon expansion, the unit square deforms in vivo into a rectangle of average dimensions of [Formula: see text]. Deformations are larger parallel than perpendicular to the dorsal midline suggesting that skin responds anisotropically with smaller deformations along the skin tension lines. Upon expansion, the patch grows in vivo by [Formula: see text] with respect to the explanted, unexpanded state. Growth is larger parallel than perpendicular to the midline, suggesting that elevated stretch activates mechanotransduction pathways to stimulate tissue growth. The proposed method provides a powerful tool to characterize the kinematics of living skin. Our results shed light on the mechanobiology of skin and help us to better understand and optimize clinically relevant procedures in plastic and reconstructive surgery.

A finite element model of the L4-L5-S1 human spine segment including the heterogeneity and anisotropy of the discs

With the aim to study disc degeneration and the risk of injury during occupational activities, a new finite element (FE) model of the L4-L5-S1 segment of the human spine was developed based on the anthropometry of a typical Colombian worker. Beginning with medical images, the programs CATIA and SOLIDWORKS were used to generate and assemble the vertebrae and create the soft structures of the segment. The software ABAQUS was used to run the analyses, which included a detailed model calibration using the experimental step-wise reduction data for the L4-L5 component, while the L5-S1 segment was calibrated in the intact condition. The range of motion curves, the intradiscal pressure and the lateral bulging under pure moments were considered for the calibration. As opposed to other FE models that include the L5-S1 disc, the model developed in this study considered the regional variations and anisotropy of the annulus as well as a realistic description of the nucleus geometry, which allowed an improved representation of experimental data during the validation process. Hence, the model can be used to analyze the stress and strain distributions in the L4-L5 and L5-S1 discs of workers performing activities such as lifting and carrying tasks.

A numerical study on indentation properties of cortical bone tissue: influence of anisotropy

PURPOSE

The purpose of this study is to investigate the effect of anisotropy of cortical bone tissue on measurement of properties such as direction-dependent moduli and hardness.

METHODS

An advanced three-dimensional finite element model of microindentation was developed. Different modelling schemes were considered to account for anisotropy of elastic or/and plastic regimes. The elastic anisotropic behaviour was modelled employing an elasticity tensor, and Hill's criteria were used to represent the direction-dependent post-yield behaviour. The Oliver-Pharr method was used in the data analysis.

RESULTS

A decrease in the value of the transverse elasticity modulus resulted in the increased material's indentation modulus measured in the longitudinal direction and a decreased one in the transverse direction, while they were insensitive to the anisotropy in post-elastic regime. On the other hand, an increase in plastic anisotropy led to a decrease in measured hardness for both directions, but by a larger amount in the transverse one. The size effect phenomenon was found to be also sensitive to anisotropy.

CONCLUSIONS

The undertaken analysis suggests that the Oliver-Pharr method is a useful tool for first-order approximations in the analysis of mechanical properties of anisotropic materials similar to cortical bone, but not necessarily for the materials with low hardening reserves in the plastic regime.

Influence of selective digestion of elastin and collagen on mechanical properties of human aortas

PURPOSE

There are two families of fibres taking part in the process of mechanical loads transfer, i.e. elastin and collagen fibres. Their number, spatial arrangement and specific properties determine the capacity of a blood vessels to resist mechanical loads resulting from the impact of blood on vessel walls. The purpose of the present paper is to define the load-bearing capacities of elastin and collagen scaffolds equivalent to natural fibre arrangements of human aorta and produced by selective digestion.

METHODS

Samples of thoracic human aortas were digested by using phosphate buffer of trypsin at pH 8.0 for 22 hours in order to degrade elastin and by autoclaving followed by incubation in 90% formic acid for 22 hours. The efficacy of digestion was assessed immunohistochemically. Mechanical properties of pre-stretched native and digested samples were determined by uniaxial tensile test.

RESULTS

Samples subjected to autoclaving have been successfully deprived of both types of collagen and elastin has been intact. Treatment with trypsin caused a removal of elastin and the presence of type I and IV collagen was demonstrated. Digestion of aortic samples either by formic acid or trypsin has resulted significantly decreasing mechanical properties in comparison with native samples.

CONCLUSIONS

Collagen and elastin scaffold-like stuctures have been effectively produced by selective digestion of thoracic human aorta and their contribution to the load-bearing process was evaluated. Isolated collagen network are more durable and stiffer and less deformable than elastin network, hence are responsible for load-bearing process at higher strain since the range of working of elastin is at lower strain values.

Quasi-static and dynamic properties of the intervertebral disc: experimental study and model parameter determination for the porcine lumbar motion segment

PURPOSE

The study of axial loading is essential to determine the properties of intervertebral disc. The objectives of this work are (1) to quantify the mechanical properties of porcine lumbar intervertebral discs under static and cyclic compressive loading, and (2) to determine the parameters of a five-parameter rheological model for porcine and compare them with those obtained for human lumbar intervertebral discs.

METHODS

Thus, the porcine lumbar motion segments were subjected to quasi-static and dynamic compression tests. The quasi-static tests were used to obtain the static stiffness coefficient at different strain rates, while the data from the cyclic compressive tests were used to both determine the dynamic stiffness coefficient and to be fitted in a 5-parameter model, in order to simulate the creep response of the porcine intervertebral discs.

RESULTS

The results demonstrated that dynamic stiffness coefficient of porcine discs is between four and ten times higher than the static stiffness coefficient, depending on load applied. The parameters of the rheological model suggested a low permeability of nucleus and endplate during the fast response of porcine discs. In addition, the fast response in terms of displacement is four times higher than those documented for human discs.

CONCLUSIONS

This study revealed that care must be taken on the comparison between porcine and human discs, since they present different behaviour under quasi-static and dynamic compressive loading.

Remodelling of material structure in aortic valve leaflet

PURPOSE

The goal of this study is to model changes in fibre content in aortic valve leaflet material due to mechanical stimuli.

METHODS

The fibre remodelling process is associated with the redistribution of the internal forces acting in the shell. The process is characterized by the occurrence of extreme stresses and strains. The load distribution function is asymmetrical. The optimization problem has been assigned the task of transferring the load imposed on the leaflet. The density of the fibres per unit surface of the middle shell was assumed to be proportional to the shell thickness, which means that fibre density along the normal direction is constant over the entire shell.

RESULTS

The model of valve leaflet loading is the distribution of the pressure generated on the leaflet shell surface by the flowing fluid. The algorithm for the redistribution of the leaflet material mass made it possible to distinguish two regions of enhanced thickness in the leaflet shell. One was localized between the commissures along the leaflet attachment, the other one in the middle part of the leaflet at the level of the commissures. A reduction in shell thickness is observed in the middle part of the leaflet, above the point of its attachment to the aorta.

CONCLUSIONS

The distribution of the thickness field obtained corroborates the findings of the study reported elier. Our study on the remodelling of the valve leaflet entailed the application of the stress criterion, which visibly upgraded the functioning of the valve by improving its mechanical and hemodynamic parameters.

Corneal hyper-viscoelastic model: derivations, experiments, and simulations

PURPOSE

The aim of this study is to propose a method to construct corneal biomechanical model which is the foundation for simulation of corneal microsurgery.

METHODS

Corneal material has two significant characteristics: hyperelastic and viscoelastic. Firstly, Mooney-Rivlin hyperelastic model of cornea obtained based on stored-energy function can be simplified as a linear equation with two unknown parameters. Then, modified Maxwell viscoelastic model of the cornea, whose analytical form is consistent with the generalized Prony-series model, is proposed from the perspective of material mechanics.

RESULTS

Parameters of the model are determined by the uniaxial tensile tests and the stress-relaxation tests. Corneal material properties are simulated to verify the hyper-viscoelastic model and measure the effectiveness of the model in the finite element simulation. On this basis, an in vivo model of the corneal is built. And the simulation of extrusion in vivo cornea shows that the force is roughly nonlinearly increasing with displacement, and it is consistent with the results obtained by extrusion experiment of in vivo cornea. Conlusions: This paper derives a corneal hyper-viscoelastic model to describe the material properties more accurately, and explains the mathematical method for determination of the model parameters. The model is an effective biomechanical model, which can be directly used for simulation of trephine and suture in keratoplasty. Although the corneal hyper-viscoelastic model is taken as the object of study, the method has certain adaptability in biomechanical research of ophthalmology.

Evaluation of Different Experience Levels of Orthopaedic Residents Effect on Polymethylmethacrylate (PMMA) Bone Cement Mechanical Properties

BACKGROUND

PMMA bone cement is a brittle material and the creation of defects that increase porosity during mixing or injecting is a significant factor in reducing its mechanical properties. The goal during residency training is to learn how to avoid creating increased porosity during mixing and injecting the material. The aim of this study was to evaluate and compare tensile and compression strength for PMMA cement mixed by intern orthopaedic residents (PGY-1) and senior orthopaedic residents (PGY-5). The hypothesis was that the mechanical properties of PMMA cement mixed by PGY-5 would be significantly better than PMMA cement mixed by PGY-1 residents.

METHODS

Four PGY-1 and four PGY-5 orthopaedic residents each prepared eight tensile specimens. The bone cement used was Simplex™ P bone cement (Stryker Howmedica Osteonics, Mahwah, NJ) under vacuum mixing in a cement-delivery system. Tensile testing of the specimens was performed in an MTS Bionix servohydraulic materials testing system with loading rate of 2.54 mm/min at room temperature. The mean and standard deviation of the ultimate tensile strength (UTS) for each orthopaedic resident group was calculated. The compression specimens were cylinders formed with a central core to mimic a prosthetic implant. Ten samples from each orthopaedic resident were tested using the same MTS system under identical conditions at room temperature. The specimens were loaded from -50 N to complete structural failure at the rate of 20 mm/min. The ultimate compressive strength (UCS) was then determined and the mean and standard deviation calculated for each group.

RESULTS

The average UTS of the bone cement for the PGY-1 and PGY-5 residents was 37.5 ± 4.5 MPa and 39.2 ± 5.0 MPa, respectively, and there was no statistically significant difference between the two groups. For the tensile elastic modulus of the bone cement, the results for the PGY-1 and PGY-5 residents were 2.40 ± 0.09 GPa and 2.44 ± 0.08 GPa, respectively, and again there was no statistically significant difference. For the compression elastic modulus of the bone cement, the results for the PGY-1 and PGY-5 residents were 1.19 ± 0.13 GPa and 1.21 ± 0.18 GPa, respectively, with no statistically significant difference. However, the UCS of the bone cement for the PGY-1 and PGY-5 residents was 87.4 ± 5.8 MPa and 91.1 ± 4.5 MPa, respectively, and there was a statistically significant difference between the groups.

DISCUSSION

The PMMA specimens prepared by both the PGY-1 and PGY-5 resident groups had similar characteristics during tensile and compression testing, and were similar to known standards. Although mixing and applying bone cement is an important skill for joint replacement surgery, our results indicate that no special training appears to be necessary for orthopaedic residents. Rather, a basic training video demonstrating manufacturer standard procedure is all that is necessary.

CLINICAL RELEVANCE

The results of this study indicate the importance of experience in bone cement mixing and injecting on cement mechanical properties, but indicate that no special training appears to be necessary for orthopaedic residents.

Strain-rate stiffening of cortical bone: observations and implications from nanoindentation experiments

While bone mineralization is considered to be responsible for its stiffness, bone durability partially associated with the time-dependent viscoelasticity of matrix proteins is still poorly elucidated. Here we demonstrate a novel mechanism of highly mineralized bone durability almost independent of inherent viscoelastic behaviour along with a protocol for measuring the mechanical properties of mineralized tissues. Strain-rate nanoindentation tests showed substantial stiffening of the highly mineralized calvarial bone, whereas large creep or stress relaxation was observed during constant load or displacement tests, respectively. Based on the lower viscoelasticity of the highly mineralized structure, such large time-dependent response appears to be associated with nanoscale dimensional recovery, rather than viscoelastic behaviour, implying the inverse namely strain-rate dependent dilatant behaviour. This dilatant expansion increased the indenter penetration resistance into the surface, enhancing instantaneous stiffness. The associated stiffening and higher effective elastic modulus were highly strain-rate dependent and more readily observed in more highly mineralized tissues such as the calvarial bone. Such strain-rate stiffening and consequent dimensional recovery may be vital responses of bone tissues against excessive deformation to maintain tissue integrity.

Geometric effects on stress wave propagation

The present study, through finite element simulations, shows the geometric effects of a bioinspired solid on pressure and impulse mitigation for an elastic, plastic, and viscoelastic material. Because of the bioinspired geometries, stress wave mitigation became apparent in a nonintuitive manner such that potential real-world applications in human protective gear designs are realizable. In nature, there are several toroidal designs that are employed for mitigating stress waves; examples include the hyoid bone on the back of a woodpecker's jaw that extends around the skull to its nose and a ram's horn. This study evaluates four different geometries with the same length and same initial cross-sectional diameter at the impact location in three-dimensional finite element analyses. The geometries in increasing complexity were the following: (1) a round cylinder, (2) a round cylinder that was tapered to a point, (3) a round cylinder that was spiraled in a two dimensional plane, and (4) a round cylinder that was tapered and spiraled in a two-dimensional plane. The results show that the tapered spiral geometry mitigated the greatest amount of pressure and impulse (approximately 98% mitigation) when compared to the cylinder regardless of material type (elastic, plastic, and viscoelastic) and regardless of input pressure signature. The specimen taper effectively mitigated the stress wave as a result of uniaxial deformational processes and an induced shear that arose from its geometry. Due to the decreasing cross-sectional area arising from the taper, the local uniaxial and shear stresses increased along the specimen length. The spiral induced even greater shear stresses that help mitigate the stress wave and also induced transverse displacements at the tip such that minimal wave reflections occurred. This phenomenon arose although only longitudinal waves were introduced as the initial boundary condition (BC). In nature, when shearing occurs within or between materials (friction), dissipation usually results helping the mitigation of the stress wave and is illustrated in this study with the taper and spiral geometries. The combined taper and spiral optimized stress wave mitigation in terms of the pressure and impulse; thus providing insight into the ram's horn design and woodpecker hyoid designs found in nature.

Agent-based modeling traction force mediated compaction of cell-populated collagen gels using physically realistic fibril mechanics

Agent-based modeling was used to model collagen fibrils, composed of a string of nodes serially connected by links that act as Hookean springs. Bending mechanics are implemented as torsional springs that act upon each set of three serially connected nodes as a linear function of angular deflection about the central node. These fibrils were evaluated under conditions that simulated axial extension, simple three-point bending and an end-loaded cantilever. The deformation of fibrils under axial loading varied &lt;0.001% from the analytical solution for linearly elastic fibrils. For fibrils between 100 μm and 200 μm in length experiencing small deflections, differences between simulated deflections and their analytical solutions were &lt;1% for fibrils experiencing three-point bending and &lt;7% for fibrils experiencing cantilever bending. When these new rules for fibril mechanics were introduced into a model that allowed for cross-linking of fibrils to form a network and the application of cell traction force, the fibrous network underwent macroscopic compaction and aligned between cells. Further, fibril density increased between cells to a greater extent than that observed macroscopically and appeared similar to matrical tracks that have been observed experimentally in cell-populated collagen gels. This behavior is consistent with observations in previous versions of the model that did not allow for the physically realistic simulation of fibril mechanics. The significance of the torsional spring constant value was then explored to determine its impact on remodeling of the simulated fibrous network. Although a stronger torsional spring constant reduced the degree of quantitative remodeling that occurred, the inclusion of torsional springs in the model was not necessary for the model to reproduce key qualitative aspects of remodeling, indicating that the presence of Hookean springs is essential for this behavior. These results suggest that traction force mediated matrix remodeling may be a robust phenomenon not limited to fibrils with a precise set of material properties.

Finite element prediction of transchondral stress and strain in the human hip

Cartilage fissures, surface fibrillation, and delamination represent early signs of hip osteoarthritis (OA). This damage may be caused by elevated first principal (most tensile) strain and maximum shear stress. The objectives of this study were to use a population of validated finite element (FE) models of normal human hips to evaluate the required mesh for converged predictions of cartilage tensile strain and shear stress, to assess the sensitivity to cartilage constitutive assumptions, and to determine the patterns of transchondral stress and strain that occur during activities of daily living. Five specimen-specific FE models were evaluated using three constitutive models for articular cartilage: quasilinear neo-Hookean, nonlinear Veronda Westmann, and tension-compression nonlinear ellipsoidal fiber distribution (EFD). Transchondral predictions of maximum shear stress and first principal strain were determined. Mesh convergence analysis demonstrated that five trilinear elements were adequate through the depth of the cartilage for precise predictions. The EFD model had the stiffest response with increasing strains, predicting the largest peak stresses and smallest peak strains. Conversely, the neo-Hookean model predicted the smallest peak stresses and largest peak strains. Models with neo-Hookean cartilage predicted smaller transchondral gradients of maximum shear stress than those with Veronda Westmann and EFD models. For FE models with EFD cartilage, the anterolateral region of the acetabulum had larger peak maximum shear stress and first principal strain than all other anatomical regions, consistent with observations of cartilage damage in disease. Results demonstrate that tension-compression nonlinearity of a continuous fiber distribution exhibiting strain induced anisotropy incorporates important features that have large effects on predictions of transchondral stress and strain. This population of normal hips provides baseline data for future comparisons to pathomorphologic hips. This approach can be used to evaluate these and other mechanical variables in the human hip and their potential role in the pathogenesis of osteoarthritis (OA).

The effect of creep on human lumbar intervertebral disk impact mechanics

The intervertebral disk (IVD) is a highly hydrated tissue, with interstitial fluid making up 80% of the wet weight of the nucleus pulposus (NP), and 70% of the annulus fibrosus (AF). It has often been modeled as a biphasic material, consisting of both a solid and fluid phase. The inherent porosity and osmotic potential of the disk causes an efflux of fluid while under constant load, which leads to a continuous displacement phenomenon known as creep. IVD compressive stiffness increases and NP pressure decreases as a result of creep displacement. Though the effects of creep on disk mechanics have been studied extensively, it has been limited to nonimpact loading conditions. The goal of this study is to better understand the influence of creep and fluid loss on IVD impact mechanics. Twenty-four human lumbar disk samples were divided into six groups according to the length of time they underwent creep (tcreep = 0, 3, 6, 9, 12, 15 h) under a constant compressive load of 400 N. At the end of tcreep, each disk was subjected to a sequence of impact loads of varying durations (timp = 80, 160, 320, 400, 600, 800, 1000 ms). Energy dissipation (ΔE), stiffness in the toe (ktoe) and linear (klin) regions, and neutral zone (NZ) were measured. Analyzing correlations with tcreep, there was a positive correlation with ΔE and NZ, along with a negative correlation with ktoe. There was no strong correlation between tcreep and klin. The data suggest that the IVD mechanical response to impact loading conditions is altered by fluid content and may result in a disk that exhibits less clinical stability and transfers more load to the AF. This could have implications for risk of diskogenic pain as a function of time of day or tissue hydration.