Journal of Mechanics in Medicine and Biology

High internal stress in the deep tissues adjacent to bony prominences can cause deep tissue injuries. Therefore, internal stress in the soft tissue should be considered when the performance of anti-decubitus cushions is evaluated during cushion design. This paper reports on a custom-contoured cushion (CCC) system incorporated with a three-dimensional (3D) slice subject-specific finite element (FE) model to investigate the internal stress distribution in the soft tissues. This stress distribution was used to transform the interface pressure into the carving depth of the fabricated cushions based on the biomechanical characteristics of the cushion materials. The internal stress in the soft tissues was investigated using an FE model of buttocks and cushion made from three cushion materials. The cushion design was optimized according to the properties of the material. The simulated interface stress between the buttocks and the cushion (18 kPa) was consistent with the measured interface pressure of the CCC (17.1 kPa). The 3D FE model predicted the internal stress and displacement of the soft tissues and cushion. Additionally, it efficiently optimized the selection of cushion material. Fifty subjects (25 subjects with spinal cord injuries (SCI) and 25 healthy subjects) were recruited to investigate the interface pressure and perform subjective comfort evaluation. The CCC decreased the interface pressure under the buttocks and simultaneously increased the subjective comfort and stability. The effectiveness of the cushion materials was predicted by the CCC system, which also validated the clinical performance of decreasing interface pressure.

Transporting content in most biological systems is done through peristaltic transport phenomenon, examples of which include urine transport from kidney to bladder, swallowing of food through esophagus, the movement of chyme in small intestine, lymph transport in the lymphatic vessels, and in the vasomotion of small blood vessels such as arterioles. The present investigation simulated a transient peristaltic transport by developing a model based on fluid–solid interaction (FSI) method. The conduit in which peristaltic flow occurred was assumed to be axisymmetric. The propagating wave was simulated by prescribing a set of displacements, along the radial direction, on the wall. Both fluid and solid domains underwent large deformations as load applied. Due to large deformations, the adaptive discretization was considered. The ADINA 8.5 software, as finite element analytical software, was applied to study peristaltic transport. The results indicated that the present numerical method can properly introduce the features of the flow. The obtained results reveal that as amplitude ratio increases, axial velocity will increase, resulting in an increase in volume flux. Volume flux fluctuates through the passage of time in a cycle and along a wavelength. An increase in index of non-Newtonian fluid results in a decrease in velocity and increase in wall shear stress. It is observed that by increasing the amplitude of propagating wave, reflux will be increased; meanwhile, peristalsis works as a more efficient pumping process against the pressure applied as a boundary condition. The discussion on reflux according to its physiological importance seems to be helpful, thus the net displacement of the fluid particles after the transit of a single wave was calculated.

Many biomechanical models of whole body vibrations have been developed, as part of the design, optimization, and vibrations control of vehicle seat systems, with the aim of achieving greater comfort. Most of these models are complex and result in large errors. In this paper, we introduce two new models, with and without backrest support, within a specific frequency domain. One is an optimized seven-degrees-of-freedom (7-DoF) lumped-parameter model with a unique structure to display vertical vibrations in one direction. The other is a new type of model called the coupled model, where the stiffness and damping matrices are employed instead of the spring and damper scalar parameters to present vertical vibrations in two directions — vertical and horizontal. The use of matrices not only simplifies and reduces DoF, but also gives more accurate results in comparison with the conventional multi-body models. With the help of a genetic algorithm (GA) through the global criterion method, we obtained numerical parameters of both models including mass, stiffness, and damping, which minimized the errors. The mean error for the 7-DoF model was 2.2%, while the best lumped-parameter models previously developed produced 12.6%. For the coupled model, we measured a mean error of 7%, a significant improvement over a well-known multi-body model with a mean error of 22.4%. Finally, we compared the transmissibility of vibrations in the human body applying the two models in the frequency range below 6 Hz, in both cases of with and without a backrest. These confirmed the importance of the backrest.

Low hemolysis is an important factor for axial blood pumps that has been used in patients with heart failure. The structure of impellers plays a key role in the hemolytic properties of axial blood pumps. Axial blood pumps with various structure impellers exhibit different hemolytic characteristic. In the present study, we aimed to investigate the type of impellers structures in axial blood pumps that contain the best low hemolytic properties. Also, it is expensive and time-consuming to validate the axial blood pump's hemolytic property by in vivo experiments. Therefore, in the present study, the numerical method was applied to analyze the hemolytic property in a blood pump. Specifically, the hemolysis of the pump was calculated by using a forward Euler approach based on the changes in shear stress and related exposure times along the particle trace lines. The different vane structures and rotational speed that affect hemolysis were analyzed and compared. The results showed that long–short alternant vanes exhibited the best hemolytic property which could be utilized in the optimization design of axial blood pumps.

With a varus deformity, repairs of proximal humeral fractures frequently fail after screws pull out due to lack of medial support. Indirect intramedullary grafts have been used to prevent such complications. A biomechanical study was performed to investigate the role of an intramedullary bone peg (strut) in fractures fixed with conventional and locking plates.

Twenty artificial proximal humerus specimens were divided into four groups. Group 1 specimens were fixed with convention plates and group 2 specimens were fixed with the addition of a bone peg. Groups 3 and 4 specimens were fixed using locking plate and additional bone peg, respectively. All specimens were tested with a static loading test, and the axial stiffness and maximal load were recorded.

Locking plates with inlay graft were the most rigid of the four groups. When an intramedullary graft was introduced, the maximal load increased by more than 200%, whether conventional or locking plates were used. The maximal load of a conventional plate with inlay graft was more than twice of that of the locking plate only.

Indirect medial support acts as an anti-bending device, reducing the tension on the plate. It also decreases varus deformity and loosening of screws. Locking plate stabilize the plate-bone interface. Locking plate with indirect medial support is thus recommended for patients withsevere osteoporotic or medial comminuted proximal humeral fractures.

Thermal fluctuations of microtubules (MTs) and other cytoskeletal filaments govern to a great extent the complex rheological properties of the cytoskeleton in eukaryotic cells. In recent years, much effort has been put into capturing the dynamics of these fluctuations by means of analytical and numerical models. These attempts have been very successful for, but also remain limited to, isotropic polymers. To correctly interpret experimental work on (strongly) anisotropic semiflexible polymers, there is a need for a numerical modeling tool that accurately captures the dynamics of polymers with anisotropic material properties. In the current study, we present a finite element (FE) framework for simulating the thermal dynamics of a single anisotropic semiflexible polymer. First, we demonstrated the accuracy of our framework by comparison of the simulated mean square displacement (MSD) of the end-to-end distance with analytical predictions based on the worm-like chain model. Then, we implemented a transversely isotropic material model, characteristic for biopolymers such as MTs, and studied the persistence length for various ratios between the longitudinal shear modulus, G₁₂, and corresponding Young's modulus, E₁. Finally, we put our findings in context by addressing a recent experimental work on grafted transversely isotropic MTs. In that research, a simplified static mechanical model was used to deduce a very high level of MT anisotropy to explain the observation that the persistence length of grafted MTs increases as contour length increases. We showed, by means of our FE framework, that the anisotropic properties cannot account for the reported length-dependent persistence length.

Atomic force microscopy (AFM) has been widely applied to study cellular functions;however, the relationship between cellular elasticity and ultrastructure density of a live cell remains to be discovered. The objective of this study was thus to extend our previous method of integrating AFM and immunofluorescence imaging to measure the ultrastructure distribution-related local mechanical properties of live cells. First, the morphology of a live cell was obtained by AFM. Second, the indentation sites were selected and flexible force volume indentation was performed. Third, the immunofluorescence image of the cell was obtained. The last was the mapping of the indentation site to the immunofluorescence image and obtaining the relationship between the local elastic properties and cytoskeleton density. The results on differentiated rat Schwann cells (RSCs) showed that the elastic modulus of stress fibers is higher than those of the nucleus and cytosol. The local elastic modulus of the live RSCs is correlated to the actin density, and the stress fiber that behaves like a pretension beam can give RSCs enough strength to envelop axons during myelination. In particular, the elastic properties of the live RSCs were twofold lower than those of the fixed. The results demonstrated the integrated method's applicability for a live cell.

Stents have been used successfully for treating stenosis in the vertebral artery ostium. The size of stent is found to be an important link in stent design, implantation strategy, and clinical outcome. However, there is no direct evidence of a relationship between stent expansion ratio and the stented artery. This study investigated the influence of stent expansion ratio on local hemodynamics (such as pressure distribution and pressure gradient) of vertebral artery ostial stenosis to determine a possible biomechanical mechanism. Computer-aided design of models with stents with different expansion ratios (i.e., 1.00, 1.125, and 1.25) and internal flow fields were created. All the models were meshed and simulated using computational fluid dynamics (CFD) tools. The comparisons of pressure distribution and pressure gradient are specifically presented. The results showed that the pressures increase and the pressure gradient decreases after stent implantation. The mean pressure at the stented region rises significantly with the increase of stent oversize. The heterogeneity of the pressure gradient was reduced at the stented region in the case with the expansion ratio of 1.125, whereas this effect was not obvious in other expansion ratio cases. Additionally, the combination of higher pressure and a lower pressure gradient in the case with the expansion ratio of 1.125 was significantly observed. This study demonstrated that the proper size of stent, especially with regards to the expansion ratio, is an important factor influencing the treatment of vertebral artery ostial stenosis. It is the recognition of the necessity to consider the relationship between expansion ratio and stenosis in vertebral artery ostium. These findings could help to address the optimization of hemodynamic performance for stent implantation.

A method that provides the ability to accurately classify trochlea dysplasia would be a valuable tool in treating patients with unstable patellas and anterior knee pain. In this study, a reference frame and a standardised femoral parameter measurement method for three-dimensional models were established to measure key femoral parameters. An artificial neural network was then trained with these parameters and the matching output from qualitative classifications by three orthopaedic surgeons for each knee. The neural network was then evaluated to test its ability for quantitative classification of normal and dysplastic knees. The maximum agreement between the qualitative and quantitative classification methods was found to be 80.6%, whereas agreement between the surgeons was 69.44%.This was achieved for a neural network with 8 input parameters and 19 hidden-layer neurons. The study shows that there is merit in making use of a trained artificial neural network as an additional tool for classification of trochlear dysplasia.

Aortic subendocardial viability ratio (SEVR), an index of myocardial oxygen demand relative to supply, has been used for the early detection of hemodynamic changes. We aimed to validate a new method for determining SEVR directly from radial pressures. Hemodynamic parameters were measured in 231 outpatients (108 males and 123 females) for physical examination, aged from 20–77 years (45.9 ± 17.3 years), including 210 healthy and 21 hypertensive subjects. Aortic SEVR was obtained using a validated device (SphygmoCor; AtCor Medical, Sydney, Australia), and radial SEVR was obtained using a portable vascular testing device (IIM-2010A; Institute and Intelligent of Machines, Hefei, China). Radial SEVR was strongly related to aortic SEVR (r = 0.824, p < 0.01), with approximately 15.7% lower value. Aortic and radial SEVR had similar independent predictors, including diastolic time fraction (DTF), systolic blood pressure, diastolic blood pressure, age, and height. DTF exerted the most influence on both of them. In healthy subjects, there were significant changes in aortic and radial SEVR between age groups in both males and females (p < 0.05 for both). Changes in aortic and radial SEVR with aging were parallel though the differences between them increased. These results suggested that the simple and easily obtainable radial SEVR could provide equivalent information to aortic SEVR, and has potential for the primary prevention of cardiovascular disease in health screening.

Heart rate variability (HRV) is the temporal variation between sequences of consecutive heartbeats. Chaos and fractal-based measurements have been widely used for quantifying the HRV for cardiac risk stratification purposes. In this paper, five different sets of HRVs, viz., normal sinus rhythm (NSR), congestive heart failure (CHF), cardiac arrhythmia suppression trial (CAST), supra ventricular tachyarrhythmia (SVTA) and atrial fibrillation (AF), have been analysed using nonlinear parameters to fix the ranges of each parameter. Data were downloaded from the PhysioNet database with 15 sets in each case. The parameters used for analysis were Poincare plot measures: SD1, SD2 and SD12, largest Lyapunov exponent (LLE), correlation dimension (CD); recurrence plot measures: recurrence rate (REC), determinism (DET), mean diagonal length (L_mean), maximal diagonal length (L_max) and entropy (ENTR); detrended fluctuation analysis measures: scaling exponent (α) and fractal dimension (FD); sample entropy (SampEn); and approximate entropy (ApEn). Analysis of variance (ANOVA) was done for confirming the differences in parameter values between various cases. All parameters except LLE showed a significant statistical difference for different cases.

Cell spreading plays an important role in the modulation of physiological functions such as inflammation and cancer metastasis. The Brownian ratchet model and Bell's model have been used to simulate actin dynamics and bond kinetics for focal adhesion dynamics, respectively. In the present study, these models were modified and two additional subcellular mechanisms, integrin and myosin kinetics, were incoporated. An integrin recruitment function was introduced to determine the size of a focal adhesion associated with the substrate stiffness. The relationship between myosin concentration and the actin protrusion velocity was described by a first-order differential equation. Subcellular processes, including cell protrusion, focal adhesion formation, and stress fiber formation, were integrated into an axial-symmetric biophysical model, while inputs to the model were kinematic data from time-lapse experiments. Numerical simulations of the model using the Gillespie algorithm showed that dynamics of cell spreading can be well described by the model.

In general, the transport of thermal energy in living tissue is a complex process. The analysis of the heat conduction of skin tissue is helpful for understanding of the bio-thermo-mechanical behavior of skin tissue. So far, three kinds of conduction law — (1) the Fourier model, (2) the C-V model and (3) dual-phase-lag (DPL) model — are often investigated in bio-thermal transfer process. In this study, the mathematical model of heat conduction of the skin tissue subjected to a general transient heating at the skin surface was established. The analytical solutions of these three conduction models are presented. In addition, the measure of thermal injury of the skin tissue subjected to a harmonic heating was investigated. It was found that the phenomenon of Fourier model is greatly different to those of the C-V and DPL models. Moreover, the effects of the phase lags, the heating frequency, and the heat quantity on the temperature variation and the index of thermal injury were significant. In sum, the analytical method can be used to solve the conduction problem of any one-layer tissue.

Quantitative evaluation of shear stress in the vessel wall due to the presence of asymptomatic gas emboli is lacking. The goal of this work was to assess the impact of chronic asymptomatic gas emboli on the risk of atherosclerosis through a custom-built cardiovascular flow simulator. Gas bubbles were created by forced air from a syringe pump. The influences of embolism injection rate, pulse rate, and time-averaged flow rate on the wall mean shear stress were investigated at resting and elevated heart rate conditions. The recorded pressure and volumetric flow rate from 24 experimental settings with four repetitions each were used to calculate the mean wall shear stress (MWSS). A directly inverse relationship between gas embolus rate and MWSS in the vessel, particularly at low vascular flow and diminished pulse rates was subsequently found. This study established a positive correlation between gas bubbles in the bloodstream and diminished MWSS, which implied a potential onset of atherosclerosis.

Blast-induced traumatic brain injury (bTBI) has become a signature injury in recent military conflicts and terrorist attacks. However, the mechanisms and thresholds for such injury are still unknown. In this paper, effort has been made toward establishing the threshold due to primary blast based on the published injury data in the rat. Peak incident overpressure and pulse duration of the incident wave were used as predictors and the injury risk curves for the rat were derived via a linear logistic regression analysis. A scaling law based on body mass was then used to scale the tolerance curves from the rat to the pig and the human. The injury risk curve for bTBI was compared with that for the lung. The results reveal different injury mechanisms between these two organs. The developed injury curves can be used in the design of personal protective equipment against primary bTBI.

A two-phase thermo-hydrodynamic model is presented for transport in the vertical chamber of a porous media blood filtration device. A non-Darcy drag force formulation was employed. The Marble–Drew fluid–particle suspension model was used to simulate the plasma phase and the suspension (erythrocyte) particle phase. The non-dimensional transport equations were solved using a semi-computational procedure known as the homotopy analysis method (HAM). With the judicious use of the auxiliary parameter ℏ, HAM affords a powerful mechanism to adjust and control the convergence region of solution series. This method provides an efficient approximate analytical solution with high accuracy, minimal calculation and avoidance of physically unrealistic assumptions. Detailed computations are presented for the effects of Grashof number (Gr), momentum inverse Stokes number (Sk_m), Darcy number (Da), Forchheimer number (Fs), particle loading parameter (P_L), buoyancy parameter (B) and temperature inverse Stokes number (Sk_T) on the dimensionless fluid phase velocity (U), dimensionless particle phase velocity (U_p), dimensionless fluid phase temperature (Φ) and the dimensionless temperature of particle phase (Φ_p). A Prandtl number of 25 was used to simulate blood at room temperature. Excellent correlation was obtained between the HAM and numerical shooting quadrature solutions. The results indicated that there is a strong decrease in fluid phase velocities with increasing Darcian (first order) drag and second-order Forchheimer drag, and a weaker reduction in particle phase velocity field. Applications of the study include porous media bio-filtration devices and dialysis simulations.

A mathematical model has been developed for steady-state boundary layer flow of a nanofluid past an impermeable vertical flat wall in a porous medium saturated with a water-based dilute nanofluid containing oxytactic microorganisms. The nanoparticles were distributed sufficiently to permit bioconvection. The product of chemotaxis constant and maximum cell swimming speed was assumed invariant. Using appropriate transformations, the partial differential conservation equations were non-dimensionalised to yield a quartet of coupled, non-linear ordinary differential equations for momentum, energy, nanoparticle concentration and dimensionless motile microorganism density, with appropriate boundary conditions. The dominant parameters emerging in the normalised model included the bioconvection Lewis number, bioconvection Peclet number, Lewis number, buoyancy ratio parameter, Brownian motion parameter, thermophoresis parameter, local Darcy-Rayleigh number and the local Peclet number. An implicit numerical solution to the well-posed two-point non-linear boundary value problem is developed using the well-tested and highly efficient Keller box method. Computations are validated with the Nakamura tridiagonal implicit finite difference method, demonstrating excellent agreement. Nanoparticle concentration and temperature were found to be generally enhanced through the boundary layer with increasing bioconvection Lewis number, whereas dimensionless motile microorganism density was only increased closer to the wall. Temperature, nanoparticle concentration and dimensionless motile microorganism density were all greatly increased with a rise in Peclet number. Temperature and dimensionless motile microorganism density were reduced with increasing buoyancy parameter, whereas nanoparticle concentration was increased. The present study found applications in the fluid mechanical design of microbial fuel cell and bioconvection nanotechnological devices.

It is recognised that knowledge of air flow characteristics in the tracheo-bronchial tree is essential to the understanding of airway resistance, intrapulmonary gas mixing and deposition of airborne particles. Numerical and mathematical methods have previously been used extensively to obtain particle deposition patterns inside a single airway and various regions of the human lung for a range of physiological conditions. However, detailed analysis of particle deposition, in asymmetrical human upper airways, under transient conditions, has not been uncovered in published literature at the time this research commenced. In this research study, a commercial CFD package, called "CFX Workbench 11" was deployed to analyse flow fields, transient flow and particle deposition. This research work was an extension to earlier research published in 2008 by the present authors. The airway geometry applied in this current research was created by closely following the values published by another researcher (Horsfield), where the transient flows for three different breathing cycles were used as the input boundary conditions. The findings of the modelling presented herein indicated that the release position did not vary significantly at different time steps or with changes in particle size, but varied significantly with breathing patterns. Moreover, the rate of particle deposition at the wall was found to increase with the rising of the branching angles.

Tumor growth is strongly coupled with both residual stress generated during the growth process and also biochemical factors. Several models have already been proposed to capture tumor growth considering either diffusion of nutrients concentration or residual stresses inside a tumor. In this work, a new method was proposed to model the generated residual stress in a growing solid using the continuum framework. This method was coupled with energy metabolism to predict the behavior of a soft tissue tumor. Moreover, it was shown that the main reason of vascular collapse in the middle of a tumor or vascular reopening in the tumor core can be the residual stress, generated during the growth.

The changes of hemodynamics and drug distribution caused by the implantation of drug-eluting stents (DES) have a significant influence on the in-stent restenosis. The present study numerically carried out a comparative study of hemodynamics and drug distribution using four different links of DES: Cordis BX velocity (Model A), Jostent flex (Model B), Sorin Carbostent (Model C), and DT-2 (Model D). The results showed that (1) low wall shear stress (WSS) distribution region spread widely in Model C (16.16%), with the least in Model B (10.35%); (2) Model C has relatively uniform drug concentration and causes of fewer low drug concentration region; and (3) Model A has the largest drug concentration, but also the most uneven distribution of drug. It was concluded that DES with circumferential links helps to improve in-stent restenosis as compared with that with longitudinal designs, and flexible links led to more uniformly and smoothly distributed blood flow than rigid links. However, the links with longitudinal designs had a better performance as drug release carrier than that with circumferential design. And if the links are too close together, the drug cannot be released effectively in the blood vessels. The current study helps to enhance our understanding of the performance of DES and provides assistance for optimal design and selection of DES.