Biomechanical Response of the Root System in Tomato Seedlings under Wind Disturbance

Wind disturbance as a green method can effectively prevent the overgrowth of tomato seedlings,and its mechanism may be related to root system mechanics.This study characterized the biophysical mechanical properties of taproot and lateral roots of tomato seedlings at five seedling ages and seedling substrates with three different moisture content.The corresponding root system-substrate finite element(FE)model was then developed and validated.The study showed that seedling age significantly affected the biomechanical properties of the taproot and lateral roots of the seedlings and that moisture content significantly affected the biomechanical properties of the seedling substrate(p<0.05).The established FE model was sensitive to wind speed,substrate moisture content,strong seedling index,and seedling age and was robust.The multiple linear regression equations obtained could predict the maximum stress and strain of the root system of tomato seedlings in the wind field.The strong seedling index had the greatest impact on the biomechanical response of the seedling root system during wind disturbance,followed by wind speed.In contrast,seedling age had no significant effect on the biomechanical response of the root system during wind disturbance.In the simulation,no mechanical damage was observed on the tissue of the seedling root system,but there were some strain behaviors.Based on the plant stress resistance,wind disturbance may affect the growth and development of the root system in the later growth stage.In this study,finite element and statistical analysis methods were combined to provide an effective approach for indepth analysis of the biomechanical mechanisms of wind disturbances that inhibit tomato seedlings’growth from the root system’s perspective.

Rotator cuff repair with an interposition polypropylene mesh:A biomechanical ovine study

BACKGROUND Chronic large to massive rotator cuff tears are difficult to treat and re-tears are common even after surgical repair.We propose using a synthetic polypropylene mesh to increase the tensile strength of rotator cuff repairs.We hypothesize that using a polypropylene mesh to bridge the repair of large rotator cuff tears will increase the ultimate failure load of the repair.AIM To investigate the mechanical properties of rotator cuff tears repaired with a polypropylene interposition graft in an ovine ex-vivo model.METHODS A 20 mm length of infraspinatus tendon was resected from fifteen fresh sheep shoulders to simulate a large tear.We used a polypropylene mesh as an interposition graft between the ends of the tendon for repair.In seven specimens,the mesh was secured to remnant tendon by continuous stitching while mattress stitches were used for eight specimens.Five specimens with an intact tendon were tested.The specimens underwent cyclic loading to determine the ultimate failure load and gap formation.RESULTS The mean gap formation after 3000 cycles was 1.67 mm in the continuous group,and 4.16 mm in the mattress group(P=0.001).The mean ultimate failure load was significantly higher at 549.2 N in the continuous group,426.4 N in the mattress group and 370 N in the intact group(P=0.003).CONCLUSION The use of a polypropylene mesh is biomechanically suitable as an interposition graft for large irreparable rotator cuff tears.

Short and long term corneal biomechanical analysis after overnight orthokeratology

AIM: To investigate the short and long term corneal biomechanical changes after overnight orthokeratology(OK) and compare them with those occurring in subjects not wearing contact lenses.METHODS: Retrospective case control study enrolling 54 subjects that were divided into three groups 18 subjects each: control group(CG), short term(15 nights) OK(STOK) group, and long term(more than 1 y of OK wear) OK(LTOK) group. Corneal biomechanics were characterized using the Cor Vis? ST system(Oculus), recording parameters such as time [first/second applanation time(AT1, AT2)], speed [velocity of corneal apex at the first/second applanation time(AV1, AV2)], and amplitude of deformation(AD1, AD2) in the first and second corneal flattening, corneal stiffness(SPA1), biomechanically corrected intraocular pressure(b IOP) and corneal(CBI) and tomographic biomechanical indices(TBI).RESULTS: Significantly lower AD1 and standard deviate on of Ambrosio’s relational average thickness related to the horizontal profile(ARTh) values were found in the OK groups compared to CG(P<0.05). Likewise, significantly higher values of CBI were found in STOK and LTOK groups compared to CG(P<0.01). No significant differences between groups were found in integrated radius index(P=0.24), strain stress index(P=0.22), tomographic biomechanical index(P=0.91) and corneal stif fness parameter(SPA1, P=0.97). Significant inverse correlations were found between corneal thickness and CBI in STOK(r=-0.90, P<0.01) and LTOK groups(r=-0.71, P<0.01).CONCLUSION: OK does not seem to alter significantly the corneal biomechanical properties, but special care should be taken when analyzing biomechanical parameters influenced by corneal thickness such as amplitude of deformation, ARTh or CBI, because they change significantly after treatment but mainly due to the reduction and pachymetric progression induced by the corneal molding secondary to OK treatment.

A Biomechanical Comparison of Conventional versus an Anatomic Plate and Compression Bolts for Fixation of Intra-articular Calcaneal Fractures

The purpose of this study was to compare the biomechanical stability obtained by using our technique featured an anatomical plate and compression bolts versus that of the conventional anatomic plate and cancellous screws in the fixation of intraarticular calcaneal fractures.Eighteen fresh frozen lower limbs of cadavers were used to create a reproductive Sanders type-Ⅲ calcaneal fracture model by using osteotomy.The calcaneus fractures were randomly selected to be fixed either using our anatomical plate and compression bolts or conventional anatomic plate and cancellous screws.Reduction of fracture was evaluated through X radiographs.Each calcaneus was successively loaded at a frequency of 1 Hz for 1000 cycles through the talus using an increasing axial force 20 N to 200 N and 20 N to 700 N,representing the partial weight bearing and full weight bearing,respectively,and then the specimens were loaded to failure.Data extracted from the mechanical testing machine were recorded and used to test for difference in the results with the Wilcoxon signed rank test.No significant difference was found between our fixation technique and conventional technique in displacement during 20-200 N cyclic loading(P=0.06),while the anatomical plate and compression bolts showed a great lower irreversible deformation during 20-700 N cyclic loading(P=0.008).The load achieved at loss of fixation of the constructs for the two groups had significant difference:anatomic plate and compression bolts at 3839.6±152.4 N and anatomic plate and cancellous screws at 3087.3±58.9 N(P=0.008).There was no significant difference between the ultimate displacements.Our technique featured anatomical plate and compression bolts for calcaneus fracture fixation was demonstrated to provide biomechanical stability as good as or better than the conventional anatomic plate and cancellous screws under the axial loading.The study supports the mechanical viability of using our plate and compression bolts for the fixation of calcaneal fracture.

Effect of Plaque Composition on Biomechanical Performance of a Carotid Stent: Computational Study

Clinical application of bare metal stents is constrained by the occurrence of instent restenosis,mainly due to the complex biomechanical environment in the body.Numerical simulation method was used to evaluate the effect of plaque composition on stent performance in a carotid artery.CT angiography(CTA)data were used as a reference,and zero-load state of the carotid artery was used to establish a 3D stenotic artery model.Different plaque compositions,calcified and hypo-cellular were defined in Model 1 and Model 2,respectively.Interactions between the stents and arterial tissues within the stent crimping-expansion process were analyzed to explore the effects of plaque composition on the mechanical parameters of carotid stents.Goodman diagram and fatigue safety factor(FSF)were analyzed to explore the effects of plaque composition on fatigue performance of a carotid stent in the stent service process.In the stent crimping-expansion process,the von Mises stress in the stent and the dog-boning ratio in Model 1 were higher than that in Model 2.The calcified plaque prevented the stent from expanding the stenotic vessel to a pre-set diameter.Thus,the risk of rupture in the calcified plaque was higher than that in the hypo-cellular plaque.Plaque also affected the stress/strain in the vessel wall,which was observed to be lower in Model 1 than in Model 2.This indicated that calcified plaque could decrease the stress-induced injury of arterial tissues.Within the stent service process,the stents used in these two models were predicted to not fail under fatigue rupture as calculated by the Goodman diagram.Additionally,the points closer to the fatigue limit were generally observed at the inner bend of the stent crowns.The FSF of the stent in Model 1 was lower than that in Model 2.The stent operating in the presence of calcified plaques suffered high risk of fractures.Reliability and fatigue performance of the stent were found to be associated with plaque composition.Hence,this study may provide stent designers an approach toward enhancing the mechanical reliability of a stent.

Precontoured buttress plate vs reconstruction plate for acetabulum posterior wall fractures: A biomechanical study

BACKGROUND The purpose of open reduction and internal fixation of acetabulum posterior wall fractures is to restore anatomical structure and stability of the hip joint, in order to start weight bearing as soon as possible and prevent hip arthrosis; restoration of the anatomy should preserve function of the joint as well. Although "special shaped precontoured plates" have been developed in recent years for surgical treatment of this region, studies comparing the traditional plates with the newly designed precontoured plates are lacking.AIM To evaluate the biomechanical properties of precontoured anatomic buttress and conventional curved reconstruction plates(CCRPs) for posterior wall acetabulum fracture treatment.METHODS Twelve pelvis models were created for testing plate treatment of fracture in the posterior wall of the acetabulum. These 12 pelvis models were used to create 24 hemipelvis models(experimental) by cutting from the sagittal plane and passing over the center of gravity, after which the posterior wall acetabular fractures(of similar type and size) were created. In these experimental models, the right acetabulum was fixed with a 5-hole CCRP, while the left was fixed with a precontoured anatomic buttress plate(PABP). Samples were placed through thetest device and were subjected to static load testing, with a constant testing velocity of 2 mm/min until the load reached 2.3 kN or the acetabular fixation failed. Dynamic tests were also performed with sinusoidal wave load, with a maximal load of 2.3 kN and a load ratio of 0.1.RESULTS The average stiffness values were 460.83 ± 95.47 N/mm for the PABP and 291.99± 118.58 N/mm for the 5-hole CCRP. The precontoured anatomic acetabulum buttress plates had significantly higher rigidity than the CCRPs(P = 0.022). There was a statistically significant difference between the unloaded and 2.3 kN-loaded values of AL(posterosuperior fracture line vertical to the ground surface) and CL(posteroinferior fracture line vertical to the ground surface) parameters for both the PABPs and the 5-hole CCRPs(P = 0.036 and P = 0.045, respectively).According to the static tests, the amount of total displacement was significantly less in the PABPs than in the CCRPs. Comparative analysis of the displacement in the BL(posterior wall fracture line horizontal to the ground) parameter yielded no statistically significant differences between the PABP and the 5-hole CCRPs(P= 0.261).CONCLUSION PABP provides more stable fixation in acetabulum posterior wall fractures than5-hole CCRP, allowing for proximal or distal fracture line screw application without reshaping.

Corneal biomechanical properties changes after coaxial 2,2-mm microincision and standard 3,0-mm phacoemulsification

AIM： To compare the changes in corneal biomechanics measured by ocular response analyzer （ORA） after 2.2-ram microincision cataract surgery and 3.0-mm standard coaxial phacoemulsification. METHODS： The prospective nonrandomized study comprised eyes with cataract that had 2.2-mm coaxial microincision or 3.0 -mm standard incision phacoemulsification. The corneal hysteresis （CH）, corneal resistance factor （CRF）, corneal-compensated intraocular pressure （IOPcc） and Goldmann-correlated intraocular pressure （IOPg） were measured by ORA preoperatively and at ld, 1-, 2-, 3- and 4-week postoperatively. Results were analyzed and compared between groups. RESULTS： In both groups, CH decreased in the immediate postoperative period （P〈0.05）, returned to the preoperative level at one week （P =0.249） in the 2.2-mm group, and at two weeks in the 3.0-mm group （P --0.264）; there was no significant change in CRF values. In 2.2-mm group, mean IOPcc and IOPg increased at ld postoperatively （both ,P〈0.05）, and returned to preoperative level at one week （,0 =0.491 and P =0.923, respectively）. In 3.0-mm group, mean IOPcc and IOPg increased at ld and lwk postoperatively （P =0.005 and ,P =0.029, respectively）, and returned to preoperative level at 2wk （P =0.347 and P =0.887, respectively）. CONCLUSION： Significant differences between preoperative and postoperative corneal biomechanical values were found for CH, IOPcc and IOPg. But the recovery time courses were different between the two groups. The 2.2-mm coaxial microincision cataract surgery group seemed recovery faster compared to the 3.0-mm standard coaxial phacoemulsification group.

Effects of Blast Wave-induced Biomechanical Changes on Lung Injury in Rats

Objective To observe the dynamic impacts of shock waves on the severity of lung injury in rats with different injury distances.Methods Simulate open-field shock waves;detect the biomechanical effects of explosion sources at distances of 40,44,and 48 cm from rats;and examine the changes in the gross anatomy of the lungs,lung wet/dry weight ratio,hemoglobin concentration,blood gas analysis,and pathology.Results Biomechanical parameters such as the overpressure peak and impulse were gradually attenuated with an increase in the injury distance.The lung tissue hemorrhage,edema,oxygenation index,and pathology changed more significantly for the 40 cm group than for the 44 and 48 cm groups.The overpressure peak and impulse were significantly higher for the 40 cm group than for the 44 and 48 cm groups(P<0.05 or P<0.01).The animal mortality was significantly higher for the 40 cm group than for the other two groups(41.2%vs.17.8%and 10.0%,P<0.05).The healing time of injured lung tissues for the 40 cm group was longer than those for the 44 and 48 cm groups.Conclusions The effects of simulated open-field shock waves on the severity of lung injuries in rats were correlated with the injury distances,the peak overpressure,and the overpressure impulse.

Evaluation of corneal topographic,tomographic and biomechanical indices for detecting clinical and subclinical keratoconus:a comprehensive three-device study

AIM:To evaluate the diagnostic ability of topographic and tomographic indices with Pentacam and Sirius as well as biomechanical parameters with Corvis ST for the detection of clinical and subclinical forms of keratoconus(KCN).METHODS:In this prospective diagnostic test study,70 patients with clinical KCN,79 patients with abnormal findings in topography and tomography maps with no evidence on clinical examination(subclinical KCN),and 68 normal control subjects were enrolled.The accuracy of topographic,tomographic,and biomechanical parameters was evaluated using the area under the receiver operating characteristic curve(AUC)and cross-validation analysis.The Delong method was used for comparing AUCs.RESULTS:In distinguishing KCN from normal,all parameters showed statistically significant differences between the two groups(P<0.001).Indices with the perfect diagnostic ability(AUC≥0.999)were Sirius KCN vertex of back(KVb),Pentacam random forest index(PRFI),Pentacam index of height decentration(IHD),and Corvis integrated tomographic/biomechanical index(TBI).In distinguishing subclinical KCN from normal,Sirius symmetry index of back(SIb;AUC=0.908),Pentacam inferior-superior difference(IS)value(AUC=0.862),PRFI(AUC=0.847),and Corvis TBI(AUC=0.820)performed best.There were no significant differences between the highest AUCs within keratoconic groups(De Long,P>0.05).CONCLUSION:In clinical KCN,all topographic,tomographic,and biomechanical indices have acceptable outcomes in terms of sensitivity and specificity.However,in differentiating subclinical forms of KCN from normal corneas,curvature-based parameters(SIb and IS value)followed by integrated indices(PRFI and TBI)are the most powerful tools for early detection of KCN.

Human umbilical cord blood stem cells and brainderived neurotrophic factor for optic nerve injury: a biomechanical evaluation

Treatment for optic nerve injury by brain-derived neurotrophic factor or the transplantation of human umbilical cord blood stem cells has gained progress, but analysis by biomechanical indicators is rare. Rabbit models of optic nerve injury were established by a clamp. At 7 days after injury, the vitreous body received a one-time injection of 50 μg brain-derived neurotrophic factor or 1 × 10^6 human umbilical cord blood stem cells. After 30 days, the maximum load, maximum stress, maximum strain, elastic limit load, elastic limit stress, and elastic limit strain had clearly improved in rabbit models of optical nerve injury after treatment with brain-derived neurotrophic factor or human umbilical cord blood stem cells. The damage to the ultrastructure of the optic nerve had also been reduced. These findings suggest that human umbilical cord blood stem cells and brain-derived neurotrophic factor effectively repair the injured optical nerve, improve biomechanical properties, and contribute to the recovery after injury.

Biomechanical Mapping of the Female Pelvic Floor: Prolapse versus Normal Conditions

Background: Quantitative biomechanical characterization of pelvic supportive structures and functions in vivo is thought to provide insight into pathophysiology of pelvic organ prolapse (POP). An innovative approach—vaginal tactile imaging—allows biomechanical mapping of the female pelvic floor to quantify tissue elasticity, pelvic support, and pelvic muscle functions. The Vaginal Tactile Imager (VTI) records high definition pressure patterns from vaginal walls under an applied tissue deformation and during pelvic floor muscle contractions. Objective: To explore an extended set of 52 biomechanical parameters for differentiation and characterization of POP relative to normal pelvic floor conditions. Methods: 96 subjects with normal and POP conditions were included in the data analysis from multi-site observational, case-controlled studies;42 subjects had normal pelvic floor conditions and 54 subjects had POP. The VTI, model 2S, was used with an analytical software package to calculate automatically 52 biomechanical parameters for 8 VTI test procedures (probe insertion, elevation, rotation, Valsalva maneuver, voluntary muscle contractions in 2 planes, relaxation, and reflex contraction). The groups were equalized for subject age and parity. Results: The ranges, mean values, and standard deviations for all 52 VTI parameters were established. 33 of 52 parameters were identified as statistically sensitive (p 0.05;t-test) to the POP development. Among these 33 parameters, 11 parameters show changes (decrease) in tissue elasticity, 8 parameters show deteriorations in pelvic support and 14 parameters show weakness in muscle functions for POP versus normal conditions. Conclusions: The biomechanical mapping of the female pelvic floor with the VTI provides a unique set of parameters characterizing POP versus normal conditions. These objectively measurable biomechanical transformations of pelvic tissues, support structures, and functions under POP may be used in future research and practical applications.

Biomechanical Manifestations of Diastolic and Systolic Function in Rats with Heart Failure with Preserved Ejection Fraction

Objective Heart failure(HF)is divided into two types:Heart failure with reduced ejection fraction(HFrEF)and heart failure with preserved ejection fraction(HFpEF).The latter always results in diastolic dysfunction,characterized by changes in mechanical properties.The objective of this study is to build a finite element(FE)model of HFpEF and analyze diastolic and systolic function in rats.Methods Ten Dahl salt-sensitive rats were fed either a low-salt(LS)(n=5)or highsalt(HS)(n=5)diet beginning at 7 weeks of age and scanned by ultrasonic machine at 14 weeks of age.A non-linear FE model of the left ventricle(LV)was built from cardiac echo images at end-diastole and passive material properties of the LV were prescribed using Fung’s transversely isotropic constitutive law.Fiber angles of the endocardium and epicardium were prescribed as 53°°and-52°,respectively,with respect to the circumferential direction and varied linearly through the LV wall.The method developed by Krishnamurthywas used to determine the unloaded geometry to estimate the Fung passive material parameters.LV end-diastolic pressure(EDP)was determined from the measured pressure waves and applied to the endocardium at the unloaded geometry to simulate passive filling.Active material properties of the LV were prescribed using Guccione’s time-varying elastance model and maximum isometric tension was scaled to match the measured peak systolic pressure.The finite element model was then coupled to the Windkessel model,whose parameters were adjusted to the measured hemodynamics.Results Measured LVEDPs of LS and HS rats were 4.9±3.4 mmHg and 13.2±5.4 mmHg(P-0.030 8),respectively.End-diastolic Cauchy stress along the fiber direction for LS rats was significantly lower than for HS rats(0.91±0.60 kPa vs 3.00±0.63 kPa,P=0.001 4)and there was a similar trend in end-diastolic Green Strain along the fiber direction(0.058±0.003 vs 0.072±0.010,P=0.012 8,Figure 1b),as well.There was no distinctive difference between end-systolic Cauchy stress along the fiber direction for LS rats and HS rats(17.2±4.3 kPa vs 17.2±5.5 kPa,P=0.991 9)but end-systolic Green Strain along the fiber direction for LS rats was significantly higher than for HS rats(-0. 108±0.017 vs-0.065±0.024,negative sign represents direction).Conclusions For rats with HFpEF,it is the elevated LVEDP that induces the increase in end-diastolic stress and strain,thereby leading to diastolic dysfunction.Because of the preserved ejection fraction,HFpEF has less effect on systolic function.

Biomechanical Design in Osteogenic Engineering

The bone is a naturally occurring composite system comprising collagen matrix and hydroxyapatites capable of generating sufficient strength and toughness to support mechanical loads and resist fracture,respectively.The material strength depends largely on the elastic properties,whereas the toughness depends on not only the elastic,but also the plastic properties.Thus,both elastic and plastic properties must be considered in the analysis of bone biomechanics and the design of osteogenic materials.The bone is capable of optimizing its elastic and plastic properties by integrating stiff hydroxyapatites and ductile collagen fibrils into a hierarchically ordered architecture,an effective mechanism to support the bone strength and toughness.Such a mechanism can be used as a model for designing osteogenic materials.

Intraprosthetic fixation techniques in the treatment of periprosthetic fractures: A biomechanical study

AIM: To develop new fixation techniques for the treatment of periprosthetic fractures using intraprosthetic screw fixation with inserted threaded liners. METHODS: A Vancouver B1 periprosthetic fracture was simulated in femur prosthesis constructs using sawbones and cemented regular straight hip stems. Fixation was then performed with either unicortical locked-screw plating using the less invasive stabilization system-plate or with intraprosthetic screw fixation using inserted liners. Two experimental groups were formed using either prostheses made of titanium alloy or prostheses made of cobalt chrome alloy. Fixation stability was compared in an axial load-to-failure model. Drilling was performed using a specially invented prosthesis drill with constantly applied internal cooling.RESULTS: The intraprosthetic fixation model with titanium prostheses was superior to the unicortical lockedscrew fixation in all tested devices. The intraprosthetic fixation model required 10 456 N ± 1892 N for failure and the unicortical locked-screw plating required 7649 N ± 653 N(P < 0.05). There was no significant difference between the second experimental group and the control group.CONCLUSION: Intraprosthetic screw anchorage with special threaded liners enhances the primary stability in treating periprosthetic fractures by internal fixation.

Biomechanical study of modular hemipelvic endoprosthesis for Type I-IV defect of pelvic tumor

Background： The modular hemipelvic prosthesis has been used in patient of Type I-IV pelvic tumor with good outcomes, but how to keep the stability between the prosthesis and the residual sacrum is a problem. An additional screw-rod system seems to solve it, but its biomechanical characters are still not well understood, which need experimental evaluation. Methods： Six pelvic specimens were prepared in three conditions （normal intact pelvis, ＂normal＂; the pelvis of left Type I-IV defect and implanted with prosthesis without/with additional screw-rod system, ＂rod-＂ and ＂rod＋＂）. Compressing biomechanical experiments （50-500N） were performed in these three conditions, respectively. Results： The loadings during the experiments are in accordance with the linear elastic control mode. Under the increasing loading, the implanted pelvises displaced asymmetrically, unlike normal intact pelvis. The vertical displacement of ＂rod＋＂ changed significantly, whereas ＂rod-＂ did not. For both implanted pelvis, right side displaced less than left side （P values 〈0.05）. Conclusions： The implanted pelvis showed asymmetric displacement under loading, where healthy side displaced more. The implanted pelvis plus screw-rod system showed less displacement at implanted side but more at contralateral side in comparison with those without screw-rod system.

Study of corneal biomechanical properties in patients with childhood glaucoma

AIM:To study of corneal biomechanical properties and intraocular pressure(IOP)measured with Corvis Scheimpflug Technology(ST)in patients with childhood glaucoma(CG).METHODS:Cross-sectional study in which 89 eyes were included 56 of them with CG.Only one eye per patient was included.The following variables were obtained from the clinical history and the ophthalmological examination:age,sex,IOP,number of surgeries,and the cup/disc ratio(CDR).The following parameters were recorded using Corvis ST:corrected by biomechanics IOP(b IOP),not corrected IOP(nct IOP),central corneal thickness(CCT),maximum concavity[radius,peak distance(PD)and deformation amplitude],applanation 1 and 2(length and velocity).The mean age was 23±14.55 and 33±19.5 years old for the control group and CG group,respectively.Totally 36 were males and 53 were females.In the CG group,7 patients were controlled only with medical treatment.Sixteen had at least one previous goniotomy,19 had at least one trabeculectomy,and 11 had an Ahmed implant.RESULTS:A significant and positive intraclass correlation coefficient was found between Goldman IOP and the IOP measured by Corvis in both groups.No differences were found between the IOP measured with Corvis and Goldman using a student t-test.Regarding biomechanical parameters,there were differences in the applanation length 2(A-L2),in the applanation velocity 2(A-V2)and in the PD.By sex,only the applanation length 1(A-L1)was found to be different in control group.A positive and significant Pearson correlation was found between CDR and the A-L1.CONCLUSION:Corneal biomechanical properties have shown differences between CG and healthy subjects and also between men and women.

Biomechanical Comparison of Prototype of a Novel Intramedullary Injectable Bioresorbable Polymer-Bioresorbable Balloon Osteosynthesis and a Volar Locking Plate for Treatment of Distal Radius Fractures

Background: There is a large assortment of modalities for the surgical treatment/management of distal radius fractures (DRFs), where the most widely used is the fixed-angle volar plating (VLP) system, which, sometimes, is referred to as the “surgical modality of choice”. While outcomes with each modality are usually good to excellent, each has its share of shortcomings and complications. Thus, there is scope for improvements to existing modalities and/or introduction of new ones. Study Purpose: We introduce a novel modality, namely, the prototype of an intramedullary injectable bioresorbable polymer-bioresorbable balloon osteosynthesis (IPBO) system, and investigated its plausibility. Experimental Procedures: The biomechanical performance of a construct comprising a synthetic distal radius (fourth-generation Sawbones?) on which a simulated fracture was created (4-mm wide osteotomy positioned 25 mm from the most distal end of the radius) and fixated with a placement of the IPBO system (SIPBO Construct) was compared to that when the fixation was with an approved Ti-6Al-4V alloy VLP system (SVLP Construct), under a clinically-relevant compressive loading protocol. Performance involved determination of quantitative parameters of the construct (initial longitudinal stiffness (ICLS), final longitudinal stiffness (FCLS), and load-to-failure (Pf)) and observation and recording of features of the construct at the fracture point. We also determined the quantitative parameters for the intact synthetic distal radius (control). Results: For each of the quantitative parameters, the range of values for SIPBO Construct was within that for SVLP Construct, suggesting that the IPBO System is a plausible modality. Also, for SIPBO Construct, failure occurred within the polymer zone, whereas, for SVLP Construct, some failure features were fracture of the cortical wall and of the dorsal proximal fragments. Conclusion: The findings suggest that the IPBO system is plausible. As such, it merits further study;for example, determination of the influence of fracture gap fill ratio (defined as the proportion of the fracture gap that is filled by the expanding balloon as the polymer is injected into the balloon) on a large collection of quantitative biomechanical parameters.

Biomechanical comparison of distal locking screws for distal tibia fracture intramedullary nailing

Background: Newer generation intramedullary (IM) tibial nails provide several distal interlocking screw options. The objectives were to determine: 1) if the new oblique interlocking option provides superior stability, 2) which screw orientation/ configuration is the most biomechanically stable, and 3) if three distal interlocking screws provide better stability. Methods: A preliminary experiment was performed in torsion, compression, and bending tests with four different screw configurations: (I) one medial-to-lateral and one oblique, (II) two me-dial-to-lateral, (III) one medial-to-lateral and one anterior-to-posterior, and (IV) one medial-to-lateral, one anterior-to-posterior and one oblique in simu-lated distal metaphyseal fracture tibiae. Twenty- four Synthes EXPERT tibial IM nails were used for six specimens of each screw configuration. Parts I and II, tibial IM nails were locked with 5.0 mm in-terlocking screws into simulated distal tibiae (PVC and composite analogue tibia). Part III, the two most stable configurations were tested using five pairs of simulated cadaveric distal tibiae metaphy-seal fractures. Results: Significant differences were attributable to distal screw orientation for intrame- dullary nailing of distal tibia fractures. Configura-tions II and IV were found to be more stable than the other two configurations. No significant differ-ence was detected in construct stability in all modes of testing between Configurations II and IV. Dis-cussion: Configuration I did not provide superior stability for the distal tibia fracture fixation. Con-figurations II and IV provided equivalent stability. When choosing IM fixation for treatment of distal tibia metaphyseal fractures two medial-to-lateral screws provide the necessary stability for satisfac-tory fixation. Clinical Relevance: This study indi-cated an option for operative treatment of distal metaphyseal tibia fracture fixation where preserva-tion of soft tissue and rigid stabilization are needed.

Conformationally Dynamic Supramolecular Single Chain Nanogels for Mutilscale Biomechanical Regulation of Stem Cells

Objective The binding of cell adhesive peptides(such as RGD)to integrins initiates the recruitment of cytoplasmic adaptor proteins(e.g.,vinculin)and the formation of focal adhesion(FA)complexes required for cell adhesion.The ability to manipulate this ligand-mediated cell adhesion process is crucial for regulating cell migration,cell differentiation,injury healing,and immune response.Some recent studies reported the importance of the tether length/mobility of the cell adhesive ligands in regulating the traction force development of cells.In the native cellular microenvironment,such a dynamic change in the nanoscale tether length of bioactive ligands is often mediated by conformational changes of the structural proteins due to protein folding or degradation.However,no prior studies have demonstrated the modulation of the ligand tether mobility by controlling the intramolecular folding of polymeric linkers.Unfoldable synthetic macromolecules with easy synthetic routes and controllable structures,such as supramolecular host-guest single chain nanogels(SCNGs),are ideal candidates for mimicking the changes in the tether mobility of bioactive ligands via biorthogonal triggers.Methods S,S’-bis(a’a’-dimethyl-a’’-propargyl acetate)trithiocarbonate was first used to mediate the RAFT polymerization of N,N-dimethyl acrylamide,vinyl-adamantane and vinyl-β-cyclodextrin to yield the ADA@CD-SCNGs.The preparation of the unfoldable host-guest SCNGs was evidenced by the by gel permeation chromatography,proton nuclear magnetic resonance spectroscopy,atomic force microscopy and dynamic light scattering.Then the RGD peptide was conjugated to the alkynyl group on one end of the SCNGs before immobilizing the material on the substrate,which was confirmed by scanning electron microscopy(SEM).The regulation of cell behaviours by unfolding of the SCNG-RGD was confirmed by immunofluorescence staining of vinculin and Yes-associated protein(YAP).Results The preparation of ADA@CD-SCNGs was confirmed by GPC which showed a unimodal molecular weight distribution.DLS and AFM data also proved that the SCNGs had an average diameter of 12±3nm.SEM images showed that SCNGs were conjugated as a linker of RGD peptide to thiolated glass substrate at an average density of 162±11 particles/μm2.These particles disappeared after adding free competitive ADA guest molecules,indicating the triggered unfolding of the tether SCNGs.In addition,the unfolding of supramolecular ADA@CD-SCNGs was also evidenced by a decrease in the GPC elution time and a slight increase in the apparent molecular weight.These results show that the immobilized ADA@CD-SCNGs can be unfolded to tune the tether length and mobility of the conjugated RGD ligands.Then we investigated the regulation of the cell behaviors on the substrate by triggering the unfolding of SCNG linkers.A critical level of traction force is required to effectively initiate and maintain integrin-mediated formation of FA complexes and subsequent mechano-transduction signaling.An increased tether length in cell-adhesive ligands can lead to a diminished cell traction force as if cells are adhering to soft substrates.Here,the unfolding of the ADA@CD-SCNG-RGD triggered by the addition of free ADA led to disassembly of the mature focal adhesions in the cells as evidenced by the reduced vinculin and F-actin in staining.Subsequently,nuclear YAP also decreased significantly because of the impaired mechano-sensing and diminished cell cytoskeleton tension.In addition,the extensively spread cells gradually became round after the medium was supplemented with free competitive ADA to unfold the SCNG linker.These finding demonstrates that the substrates with the unfolded ADA@CD-SCNG-RGD only supported weak cell adhesions.In contrast,on the substrate conjugated with the nonunfoldable MBA-SCNG-RGD linker,the addition of free ADA resulted in no change in the spread cell morphology and protein expressions.These results indicate that the unfoldable host-guest ADA@CD-SCNG can be used to manipulate the nanoscale presentation of ligands to regulate cell behaviors.Conclusions We demonstrate the application of SCNGs as the supramolecular linker to tune the nanoscale ligand tether length.These findings demonstrate that the strategy of manipulating the tether mobility of bioactive ligands by using supramolecular SCNGs as linkers provides a highly tunable,biomimetic,and bio-orthogonal approach to study the dynamic events of cell adhesion.

Biomechanical modeling for the response of human thorax to blast waves

A simplified finite element model of a human thorax had been developed for probing into the mechani- cal response in simple and complex blast environments. The human thorax model was first created by CT images with blast loading applied via a coupled arbitrary Lagrangian- Eulerian method, allowing for a variety of loads to be considered. The goal is to analyze the maximum stress distri- butions of lung tissue and peak inward thorax wall velocity and to know the possible regions and levels of lung injury. In parallel, a mathematical model has been modified from the Lobdell model to investigate the detailed percentage of lung injury at each level. The blast loadings around the human tho- rax were obtained from the finite element model, and were then applied in the mathematical model as the boundary con- ditions to predict the normalized work of the human thorax lung. The present results are found in agreement with the modified Bowen curves and the results predicted by Axels- son＇s model.