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Research Papers

J Biomech Eng. 2017;139(5):051001-051001-10. doi:10.1115/1.4036145.

Spiral arteries (SAs) lie at the interface between the uterus and placenta, and supply nutrients to the placental surface. Maternal blood circulation is separated from the fetal circulation by structures called villous trees. SAs are transformed in early pregnancy from tightly coiled vessels to large high-capacity channels, which is believed to facilitate an increased maternal blood flow throughout pregnancy with minimal increase in velocity, preventing damage to delicate villous trees. Significant maternal blood flow velocities have been theorized in the space surrounding the villi (the intervillous space, IVS), particularly when SA conversion is inadequate, but have only recently been visualized reliably using pulsed wave Doppler ultrasonography. Here, we present a computational model of blood flow from SA openings, allowing prediction of IVS properties based on jet length. We show that jets of flow observed by ultrasound are likely correlated with increased IVS porosity near the SA mouth and propose that observed mega-jets (flow penetrating more than half the placental thickness) are only possible when SAs open to regions of the placenta with very sparse villous structures. We postulate that IVS tissue density must decrease at the SA mouth through gestation, supporting the hypothesis that blood flow from SAs influences villous tree development.

Commentary by Dr. Valentin Fuster
J Biomech Eng. 2017;139(5):051002-051002-12. doi:10.1115/1.4036146.

In traumatic brain injury (TBI), membranes such as the dura mater, arachnoid mater, and pia mater play a vital role in transmitting motion from the skull to brain tissue. Magnetic resonance elastography (MRE) is an imaging technique developed for noninvasive estimation of soft tissue material parameters. In MRE, dynamic deformation of brain tissue is induced by skull vibrations during magnetic resonance imaging (MRI); however, skull motion and its mode of transmission to the brain remain largely uncharacterized. In this study, displacements of points in the skull, reconstructed using data from an array of MRI-safe accelerometers, were compared to displacements of neighboring material points in brain tissue, estimated from MRE measurements. Comparison of the relative amplitudes, directions, and temporal phases of harmonic motion in the skulls and brains of six human subjects shows that the skull–brain interface significantly attenuates and delays transmission of motion from skull to brain. In contrast, in a cylindrical gelatin “phantom,” displacements of the rigid case (reconstructed from accelerometer data) were transmitted to the gelatin inside (estimated from MRE data) with little attenuation or phase lag. This quantitative characterization of the skull–brain interface will be valuable in the parameterization and validation of computer models of TBI.

Commentary by Dr. Valentin Fuster
J Biomech Eng. 2017;139(5):051003-051003-8. doi:10.1115/1.4036260.

A wireless medical capsule for measuring the contact pressure between a mobile capsule and the small intestine lumen was developed. Two pressure sensors were used to measure and differentiate the contact pressure and the small intestine intraluminal pressure. After in vitro tests of the capsule, it was surgically placed and tested in the proximal small intestine of a pig model. The capsule successfully gathered and transmitted the pressure data to a receiver outside the body. The measured pressure signals in the animal test were analyzed in the time and frequency domains, and a mathematic model was presented to describe the different factors influencing the contact pressure. A novel signal processing method was applied to isolate the contraction information from the contact pressure. The result shows that the measured contact pressure was 1.08 ± 0.08 kPa, and the small intestine contraction pressure's amplitude and rate were 0.29 ± 0.046 kPa and 12 min−1. Moreover, the amplitudes and rates of pressure from respiration and heartbeat were also estimated. The successful preliminary evaluation of this capsule implies that it could be used in further systematic investigation of small intestine contact pressure on a mobile capsule-shaped bolus.

Topics: Pressure , Design
Commentary by Dr. Valentin Fuster
J Biomech Eng. 2017;139(5):051004-051004-11. doi:10.1115/1.4036259.

Preterm birth is the leading cause of childhood mortality and can lead to health risks in survivors. The mechanical functions of the uterus, fetal membranes, and cervix have dynamic roles to protect the fetus during gestation. To understand their mechanical function and relation to preterm birth, we built a three-dimensional parameterized finite element model of pregnancy. This model is generated by an automated procedure that is informed by maternal ultrasound measurements. A baseline model at 25 weeks of gestation was characterized, and to visualize the impact of cervical structural parameters on tissue stretch, we evaluated the model sensitivity to (1) anterior uterocervical angle, (2) cervical length, (3) posterior cervical offset, and (4) cervical stiffness. We found that cervical tissue stretching is minimal when the cervical canal is aligned with the longitudinal uterine axis, and a softer cervix is more sensitive to changes in the geometric variables tested.

Commentary by Dr. Valentin Fuster
J Biomech Eng. 2017;139(5):051005-051005-8. doi:10.1115/1.4036312.

There is a need to better understand the effects of intervertebral spacer material and design on the stress distribution in vertebral bodies and endplates to help reduce complications such as subsidence and improve outcomes following lumbar interbody fusion. The main objective of this study was to investigate the effects of spacer material on the stress and strain in the lumbar spine after interbody fusion with posterior instrumentation. A standard spacer was also compared with a custom-fit spacer, which conformed to the vertebral endplates, to determine if a custom fit would reduce stress on the endplates. A finite element (FE) model of the L4–L5 motion segment was developed from computed tomography (CT) images of a cadaveric lumbar spine. An interbody spacer, pedicle screws, and posterior rods were incorporated into the image-based model. The model was loaded in axial compression, and strain and stress were determined in the vertebra, spacer, and rods. Polyetheretherketone (PEEK), titanium, poly(para-phenylene) (PPP), and porous PPP (70% by volume) were used as the spacer material to quantify the effects on stress and strain in the system. Experimental testing of a cadaveric specimen was used to validate the model's results. There were no large differences in stress levels (<3%) at the bone–spacer interfaces and the rods when PEEK was used instead of titanium. Use of the porous PPP spacer produced an 8–15% decrease of stress at the bone–spacer interfaces and posterior rods. The custom-shaped spacer significantly decreased (>37%) the stress at the bone–spacer interfaces for all materials tested. A 28% decrease in stress was found in the posterior rods with the custom spacer. Of all the spacer materials tested with the custom spacer design, 70% porous PPP resulted in the lowest stress at the bone–spacer interfaces. The results show the potential for more compliant materials to reduce stress on the vertebral endplates postsurgery. The custom spacer provided a greater contact area between the spacer and bone, which distributed the stress more evenly, highlighting a possible strategy to decrease the risk of subsidence.

Commentary by Dr. Valentin Fuster
J Biomech Eng. 2017;139(5):051006-051006-10. doi:10.1115/1.4036314.

Two distinct geometrical models of bone at the nanoscale (collagen fibril and mineral platelets) are analyzed computationally. In the first model (model I), minerals are periodically distributed in a staggered manner in a collagen matrix while in the second model (model II), minerals form continuous layers outside the collagen fibril. Elastic modulus and strength of bone at the nanoscale, represented by these two models under longitudinal tensile loading, are studied using a finite element (FE) software abaqus. The analysis employs a traction-separation law (cohesive surface modeling) at various interfaces in the models to account for interfacial delaminations. Plane stress, plane strain, and axisymmetric versions of the two models are considered. Model II is found to have a higher stiffness than model I for all cases. For strength, the two models alternate the superiority of performance depending on the inputs and assumptions used. For model II, the axisymmetric case gives higher results than the plane stress and plane strain cases while an opposite trend is observed for model I. For axisymmetric case, model II shows greater strength and stiffness compared to model I. The collagen–mineral arrangement of bone at nanoscale forms a basic building block of bone. Thus, knowledge of its mechanical properties is of high scientific and clinical interests.

Commentary by Dr. Valentin Fuster
J Biomech Eng. 2017;139(5):051007-051007-7. doi:10.1115/1.4036215.

Tissue cooling has been proven as a viable therapy for multiple conditions and injuries and has been applied to the brain to treat epilepsy and concussions, leading to improved long-term outcomes. To facilitate the study of temperature reduction as a function of various cooling methods, a thermal brain phantom was developed and analyzed. The phantom is composed of a potassium-neutralized, superabsorbent copolymer hydrogel. The phantom was tested in a series of cooling trials using a cooling block and 37 deg water representing nondirectional blood flow ranging up to 6 gph, a physiologically representative range based on the prototype volume. Results were compared against a validated finite difference (FD) model. Two sets of parameters were used in the FD model: one set to represent the phantom itself and a second set to represent brain parenchyma. The model was then used to calculate steady-state cooling at a depth of 5 mm for all flow rates, for both the phantom and a model of the brain. This effort was undertaken to (1) validate the FD model against the phantom results and (2) evaluate how similar the thermal response of the phantom is to that of a perfused brain. The FD phantom model showed good agreement with the empirical phantom results. Furthermore, the empirical phantom agreed with the predicted brain response within 3.5% at physiological flow, suggesting a biofidelic thermal response. The phantom will be used as a platform for future studies of thermally mediated therapies applied to the cerebral cortex.

Commentary by Dr. Valentin Fuster
J Biomech Eng. 2017;139(5):051008-051008-9. doi:10.1115/1.4036262.

A computational framework consisting of a one-way coupled hemodynamic–acoustic method and a wave-decomposition based postprocessing approach is developed to investigate the biomechanics of arterial bruits. This framework is then applied for studying the effect of the shear wave on the generation and propagation of bruits from a modeled stenosed artery. The blood flow in the artery is solved by an immersed boundary method (IBM) based incompressible flow solver. The sound generation and propagation in the blood volume are modeled by the linearized perturbed compressible equations, while the sound propagation through the surrounding tissue is modeled by the linear elastic wave equation. A decomposition method is employed to separate the acoustic signal into a compression/longitudinal component (curl free) and a shear/transverse component (divergence free), and the sound signals from cases with and without the shear modulus are monitored on the epidermal surface and are analyzed to reveal the influence of the shear wave. The results show that the compression wave dominates the detected sound signal in the immediate vicinity of the stenosis, whereas the shear wave has more influence on surface signals further downstream of the stenosis. The implications of these results on cardiac auscultation are discussed.

Commentary by Dr. Valentin Fuster

Technical Brief

J Biomech Eng. 2017;139(5):054501-054501-5. doi:10.1115/1.4036148.

Acute mechanical damage and the resulting joint contact abnormalities are central to the initiation and progression of post-traumatic osteoarthritis (PTOA). Study of PTOA is typically performed in vivo with replicate animals using artificially induced injury features. The goal of this work was to measure changes in a joint contact stress in the knee of a large quadruped after creation of a clinically realistic overload injury and a focal cartilage defect. Whole-joint overload was achieved by excising a 5-mm wedge of the anterior medial meniscus. Focal cartilage defects were created using a custom pneumatic impact gun specifically developed and mechanically characterized for this work. To evaluate the effect of these injuries on joint contact mechanics, Tekscan (Tekscan, Inc., South Boston, MA) measurements were obtained pre-operatively, postmeniscectomy, and postimpact (1.2-J) in a nonrandomized group of axially loaded cadaveric sheep knees. Postmeniscectomy, peak contact stress in the medial compartment is increased by 71% (p = 0.03) and contact area is decreased by 35% (p = 0.001); the center of pressure (CoP) shifted toward the cruciate ligaments in both the medial (p = 0.004) and lateral (p = 0.03) compartments. The creation of a cartilage defect did not significantly change any aspect of contact mechanics measured in the meniscectomized knee. This work characterizes the mechanical environment present in a quadrupedal animal knee joint after two methods to reproducibly induce joint injury features that lead to PTOA.

Commentary by Dr. Valentin Fuster
J Biomech Eng. 2017;139(5):054502-054502-5. doi:10.1115/1.4036313.

There is an increased need to develop female-specific injury criteria and anthropomorphic test devices (dummies) for military and automotive environments, especially as women take occupational roles traditionally reserved for men. Although some exhaustive reviews on the biomechanics and injuries of the human spine have appeared in clinical and bioengineering literatures, focus has been largely ignored on the difference between male and female cervical spine responses and characteristics. Current neck injury criteria for automotive dummies for assessing crashworthiness and occupant safety are obtained from animal and human cadaver experiments, computational modeling, and human volunteer studies. They are also used in the military. Since the average human female spines are smaller than average male spines, metrics specific to the female population may be derived using simple geometric scaling, based on the assumption that male and female spines are geometrically scalable. However, as described in this technical brief, studies have shown that the biomechanical responses between males and females do not obey strict geometric similitude. Anatomical differences in terms of the structural component geometry are also different between the two cervical spines. Postural, physiological, and motion responses under automotive scenarios are also different. This technical brief, focused on such nonuniform differences, underscores the need to conduct female spine-specific evaluations/experiments to derive injury criteria for this important group of the population.

Commentary by Dr. Valentin Fuster

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