RESUMEN

OBJECTIVE: Characterising the morphological differences between healthy and early osteoarthritic (EOA) trapeziometacarpal (TMC) joints is important for understanding osteoarthritis onset, and early detection is important for treatment and disease management. This study has two aims: first, to characterise morphological differences between healthy and EOA TMC bones. The second aim was to determine the efficacy of using a statistical shape model (SSM) to detect early signs of osteoarthritis (OA). METHODS: CT image data of TMC bones from 22 asymptomatic volunteers and 47 patients with EOA were obtained from an ongoing study and used to generate a SSM. A linear discriminant analysis (LDA) classifier was trained on the principal component (PC) weights to characterise features of each group. Multivariable statistical analysis was performed on the PC to investigate morphologic differences. Leave-one-out classification was performed to evaluate the classifiers performance. RESULTS: We found that TMC bones of EOA subjects exhibited a lower aspect ratio (P = 0.042) compared with healthy subjects. The LDA classifier predicted that protrusions (up to 1.5 mm) at the volar beak of the first metacarpal were characteristic of EOA subjects. This was accompanied with widening of the articular surface, deepening of the articular surface, and protruding bone growths along the concave margin. These characteristics resulted in a leave-one-out classification accuracy of 73.9% (95% CI [61.9%, 83.8%]), sensitivity of 89.4%, specificity of 40.9%, and precision of 75.9%. CONCLUSION: Our findings indicate that morphological degeneration is well underway in the EOA TMC joint, and shows promise for a clinical tool that can detect these features automatically.

Asunto(s)

RESUMEN

Abusive head trauma (AHT) is a potentially fatal result of child abuse, but the mechanisms by which injury occur are often unclear. To investigate the contention that shaking alone can elicit the injuries observed, effective computational models are necessary. The aim of this study was to develop a probabilistic model describing infant head kinematics in AHT. A deterministic model incorporating an infant's mechanical properties, subjected to different shaking motions, was developed in OpenSim. A Monte Carlo analysis was used to simulate the range of infant kinematics produced as a result of varying both the mechanical properties and the type of shaking motions. By excluding physically unrealistic shaking motions, worst-case shaking scenarios were simulated and compared to existing injury criteria for a newborn, a 4.5 month-old, and a 12 month-old infant. In none of the three cases were head kinematics observed to exceed previously-estimated subdural haemorrhage injury thresholds. The results of this study provide no biomechanical evidence to demonstrate how shaking by a human alone can cause the injuries observed in AHT, suggesting either that additional factors, such as impact, are required, or that the current estimates of injury thresholds are incorrect.

Asunto(s)

RESUMEN

A triaxial force-sensitive microrobot was developed to dynamically perturb skin in multiple deformation modes, in vivo. Wiener static nonlinear identification was used to extract the linear dynamics and static nonlinearity of the force-displacement behavior of skin. Stochastic input forces were applied to the volar forearm and thenar eminence of the hand, producing probe tip perturbations in indentation and tangential extension. Wiener static nonlinear approaches reproduced the resulting displacements with variances accounted for (VAF) ranging 94-97%, indicating a good fit to the data. These approaches provided VAF improvements of 0.1-3.4% over linear models. Thenar eminence stiffness measures were approximately twice those measured on the forearm. Damping was shown to be significantly higher on the palm, whereas the perturbed mass typically was lower. Coefficients of variation (CVs) for nonlinear parameters were assessed within and across individuals. Individual CVs ranged from 2% to 11% for indentation and from 2% to 19% for extension. Stochastic perturbations with incrementally increasing mean amplitudes were applied to the same test areas. Differences between full-scale and incremental reduced-scale perturbations were investigated. Different incremental preloading schemes were investigated. However, no significant difference in parameters was found between different incremental preloading schemes. Incremental schemes provided depth-dependent estimates of stiffness and damping, ranging from 300 N/m and 2 Ns/m, respectively, at the surface to 5 kN/m and 50 Ns/m at greater depths. The device and techniques used in this research have potential applications in areas, such as evaluating skincare products, assessing skin hydration, or analyzing wound healing.

Asunto(s)

RESUMEN

Personalized biophysical modeling of the heart is a useful approach for noninvasively analyzing and predicting in vivo cardiac mechanics. Three main developments support this style of analysis: state-of-the-art cardiac imaging technologies, modern computational infrastructure, and advanced mathematical modeling techniques. In vivo measurements of cardiac structure and function can be integrated using sophisticated computational methods to investigate mechanisms of myocardial function and dysfunction, and can aid in clinical diagnosis and developing personalized treatment. In this article, we review the state-of-the-art in cardiac imaging modalities, model-based interpretation of 3D images of cardiac structure and function, and recent advances in modeling that allow personalized predictions of heart mechanics. We discuss how using such image-based modeling frameworks can increase the understanding of the fundamental biophysics behind cardiac mechanics, and assist with diagnosis, surgical guidance, and treatment planning. Addressing the challenges in this field will require a coordinated effort from both the clinical-imaging and modeling communities. We also discuss future directions that can be taken to bridge the gap between basic science and clinical translation.

Asunto(s)

RESUMEN

Abusive head trauma (AHT) is a potentially fatal result of child abuse but the mechanisms of injury are controversial. To address the hypothesis that shaking alone is sufficient to elicit the injuries observed, effective computational and experimental models are necessary. This paper investigates the use of a coupled rigid-body computational modelling framework to reproduce in vivo shaking kinematics in AHT. A sagittal plane OpenSim computational model of a lamb was developed and used to interpret biomechanical data from in vivo shaking experiments. The acceleration of the head during shaking was used to provide in vivo validation of the associated computational model. Results of this study demonstrated that peak accelerations occurred when the head impacted the torso and produced acceleration magnitudes exceeding 200ms(-)(2). The computational model demonstrated good agreement with the experimental measurements and was shown to be able to reproduce the high accelerations that occur during impact. The biomechanical results obtained with the computational model demonstrate the utility of using a coupled rigid-body modelling framework to describe infant head kinematics in AHT.

Asunto(s)

RESUMEN

Two very different sorts of experiments have characterized the field of cardiac energetics over the past three decades. In one of these, Gibbs and colleagues measured the heat production of isolated papillary muscles undergoing isometric contractions and afterloaded isotonic contractions. The former generated roughly linear heat vs. force relationships. The latter generated enthalpy-load relationships, the peak values of which occurred at or near peak isometric force, i.e., at a relative load of unity. Contractile efficiency showed a pronounced dependence on afterload. By contrast, Suga and coworkers measured the oxygen consumption (Vo(2)) while recording the pressure-volume-time work loops of blood-perfused isolated dog hearts. From the associated (linear) end-systolic pressure-volume relations they derived a quantity labeled pressure-volume area (PVA), consisting of the sum of pressure-volume work and unspent elastic energy and showed that this was linearly correlated with Vo(2) over a wide range of conditions. This linear dependence imposed isoefficiency: constant contractile efficiency independent of afterload. Neither these data nor those of Gibbs and colleagues are in dispute. Nevertheless, despite numerous attempts over the years, no demonstration of either compatibility or incompatibility of these disparate characterizations of cardiac energetics has been forthcoming. We demonstrate that compatibility between the two formulations is thwarted by the concept of isoefficiency, the thermodynamic basis of which we show to be untenable.

Asunto(s)

RESUMEN

The concept of pressure-volume area (PVA) in whole heart studies is central to the phenomenological description of cardiac energetics proposed by Suga and colleagues (Physiol Rev 70: 247-277, 1990). PVA consists of two components: an approximately rectangular work loop (W) and an approximately triangular region of potential energy (U). In the case of isovolumic contractions, PVA consists entirely of U. The utility of Suga's description of cardiac energetics is the observation that the oxygen consumption of the heart (Vo(2)) is linearly dependent on PVA. By using isolated ventricular trabeculae, we found a basis on which to correlate the components of stress-length area (SLA; i.e., the 1-D equivalent of PVA) with specific regions of the stress-time integral (STI; i.e., the area under the force-time profile of a single twitch). In each case, proportionality obtains and is robust, independent of the type of twitch contraction (isometric or isotonic), and insensitive to changes of preload or afterload. We apply our results by examining retrospectively the interpretations reached in three independent studies published in the literature.

Asunto(s)

RESUMEN

We tested the proposition that linear length dependence of twitch duration underlies the well-characterised linear dependence of oxygen consumption (V(O(2)) ) on pressure­volume area (PVA) in the heart. By way of experimental simplification, we reduced the problem from three dimensions to one by substituting cardiac trabeculae for the classically investigated whole-heart. This allowed adoption of stress­length area (SLA) as a surrogate for PVA, and heat as a proxy for V(O(2)) . Heat and stress (force per cross-sectional area), at a range of muscle lengths and at both 1 mM and 2 mM [Ca(2+)](o), were recorded from continuously superfused rat right-ventricular trabeculae undergoing fixed-end contractions. The heat­SLA relations of trabeculae (reported here, for the first time) are linear. Twitch duration increases monotonically (but not strictly linearly) with muscle length. We probed the cellular mechanisms of this phenomenon by determining: (i) the length dependence of the duration of the Ca(2+) transient, (ii) the length dependence of the rate of force redevelopment following a length impulse (an index of Ca(2+) binding to troponin-C), (iii) the effect on the simulated time course of the twitch of progressive deletion of length and Ca(2+)-dependent mechanisms of crossbridge cooperativity, using a detailed mathematical model of the crossbridge cycle, and (iv) the conditions required to achieve these multiple length dependencies, using a greatly simplified model of twitch mechano-energetics. From the results of these four independent investigations, we infer that the linearity of the heat­SLA relation (and, by analogy, the V(O(2))­PVA relation) is remarkably robust in the face of departures from linearity of length-dependent twitch duration.

Asunto(s)

RESUMEN

An accurate mathematical representation of the mechanical behaviour of human skin is essential when simulating deformations occurring in the skin during body movements or clinical procedures. In this study constitutive stress-strain relationships based on experimental data from human skin in vivo were obtained. A series of multiaxial loading experiments were performed on the forearms of four age- and gender matched subjects. The tissue geometry, together with recorded displacements and boundary forces, were combined in an analysis using finite element modelling. A non-linear optimization technique was developed to estimate values for the material parameters of a previously published constitutive law, describing the stress-strain relationship as a non-linear anisotropic membrane. Ten sets of material parameters where estimated from the experiments, showing considerable differences in mechanical behaviour both between individual subjects as well as mirrored body locations on a single subject. The accuracy of applications that simulate large deformations of human skin could be improved by using the parameters found from the in vivo experiments as described in this study.

Asunto(s)

RESUMEN

A number of biomechanical models have been proposed to improve nonrigid registration techniques for multimodal breast image alignment. A deformable breast model may also be useful for overcoming difficulties in interpreting 2D X-ray projections (mammograms) of 3D volumes (breast tissues). If a deformable model could accurately predict the shape changes that breasts undergo during mammography, then the model could serve to localize suspicious masses (visible in mammograms) in the unloaded state, or in any other deformed state required for further investigations (such as biopsy or other medical imaging modalities). In this paper, we present a validation study that was conducted in order to develop a biomechanical model based on the well-established theory of continuum mechanics (finite elasticity theory with contact mechanics) and demonstrate its use for this application. Experimental studies using gel phantoms were conducted to test the accuracy in predicting mammographic-like deformations. The material properties of the gel phantom were estimated using a nonlinear optimization process, which minimized the errors between the experimental and the model-predicted surface data by adjusting the parameter associated with the neo-Hookean constitutive relation. Two compressions (the equivalent of cranio-caudal and medio-lateral mammograms) were performed on the phantom, and the corresponding deformations were recorded using a MRI scanner. Finite element simulations were performed to mimic the experiments using the estimated material properties with appropriate boundary conditions. The simulation results matched the experimental recordings of the deformed phantom, with a sub-millimeter root-mean-square error for each compression state. Having now validated our finite element model of breast compression, the next stage is to apply the model to clinical images.

Asunto(s)

RESUMEN

Patient-specific models of the biomechanics of the breast based on finite deformation theory is potentially a valuable tool to assist clinicians in assimilating and assessing information obtained from different views of the breast, under different loading conditions and using different imaging modalities. It is anticipated that a computational model of the large deformation mechanics of the breast will also improve the accuracy of non-rigid registration techniques by restricting the deformations imposed by the algorithm to be those which are physically plausible. Accurate registration will assist clinicians in tracking suspicious regions of tissue across multiple views of the breast, which are typically taken by applying different loads on the breast during imaging. For instance, a model that can predict deformations during mammography would help to track a region of tissue between a cranio-caudal (CC) view and a medio-lateral oblique (MLO) view. Due to the nonlinear deformations imposed on the breast during different imaging techniques, the finite element reference geometry from which deformations are predicted is important. Gravity loads act on the breast during all imaging modalities. In this paper, we describe a novel modification to solving the finite element implementation of finite deformation theory, which can predict the reference state of the breast from a deformed configuration that has been derived from images of a patient placed in a single known orientation with respect to the direction of gravity.

Asunto(s)

RESUMEN

Non-rigid-body registration techniques, that constrain the set of possible soft tissue deformations to be consistent with the basic laws of physics, offer a means of providing realistic and accurate estimates of breast movement under mammographic compression. Such constraints can be imposed by the use of anatomically accurate finite element models that predict soft tissue deformations. The overarching aim is to develop tools for tracking regions of interest across multiple images (different views taken at different times) for image-guided surgeries and reliable diagnostic and therapy monitoring. Due to the nonlinear deformations imposed on the breast under the various imaging modalities, the finite element reference geometry from which deformations are predicted is important. Gravity loads act on the breast in all imaging modalities. In this paper, we propose a method of identifying a stress-free reference state of the breast given a series of loaded deformed configurations that have been derived from images of a patient placed in different orientations with respect to the direction of gravity.

RESUMEN

Studies of the passive mechanical properties of cardiac tissue have traditionally been conducted at subphysiological temperatures and various concentrations of extracellular Ca(2+) ([Ca(2+)](o)). More recently, the negative inotropic agent 2,3-butanedione monoxime (BDM) has been used. However, there remains a lack of data regarding the influence of temperature, Ca(2+), and BDM on the passive mechanical properties of cardiac tissue. We have used the dynamic stiffness technique, a sensitive measurement of cross-bridge activity, in which minute (approximately 0.2% of muscle length) sinusoidal perturbations are applied at various frequencies (0.2-100 Hz) to quiescent, viable right ventricular rat trabeculae at two temperatures (20 degrees C and 26 degrees C) and at two [Ca(2+)](o) (0.5 and 1.25 mM) in the presence and absence of BDM (20 mM). The stiffness spectra (amplitude and phase) were sensitive to temperature and [Ca(2+)](o) in the absence of BDM but insensitive in the presence of BDM. From the index of cross-bridge cycling (the ratio of high- to low-frequency stiffness amplitude), we infer that BDM inhibits a small degree of spontaneous sarcomere activity, thereby allowing the true passive properties of trabeculae to be determined. In the absence of BDM, the extent of spontaneous sarcomere activity decreases with increasing temperature. We caution that the measured mechanical properties of passive cardiac tissue are critically dependent on the experimental conditions under which they are measured. Experiments must be performed at sufficiently high temperatures (>25 degrees C) to ensure a low resting concentration of intracellular Ca(2+) or in the presence of an inhibitor of cross-bridge cycling.

Asunto(s)

RESUMEN

Strain softening is commonly reported during mechanical testing of passive whole hearts. It is typically manifested as a stiffer force-extension relationship in the first deformation cycle relative to subsequent cycles and is distinguished from viscoelasticity by a lack of recovery of stiffness, even after several hours of rest. The cause of this behaviour is presently unknown. In order to investigate its origins, we have subjected trabeculae to physiologically realistic extensions (5-15% of muscle length at 26 degrees C and 0.5 mm Ca(2+)), while measuring passive force and dynamic stiffness. While we did not observe strain softening in viable trabeculae, we found that it was readily apparent in nonviable (electrically inexcitable) trabeculae undergoing the same extensions. This result was obtained in both the presence and absence of 2,3-butanedione monoxime (BDM). Furthermore, BDM had no effect on the passive compliance of viable specimens, while its presence partly inhibited, but could not prevent, stiffening of nonviable specimens. Loss of viability was accompanied by a uniform increase of dynamic stiffness over all frequencies examined (0.2-100 Hz). The presence of strain softening during length extensions of nonviable tissue resulted in a comparable uniform decrease of dynamic stiffness. It is therefore concluded that strain softening is neither intrinsic to viable rat right ventricular trabeculae nor influenced by BDM but, rather, reflects irreversible damage of tissue in partial, or full, rigor.

Asunto(s)

RESUMEN

Recent studies of passive myocardial mechanics have shown that strain softening behavior is present during both inflation of isolated whole rat hearts and shearing of tissue blocks taken from the left ventricular free wall in pigs. Strain softening is typically manifested by a stiffer force-extension relation in the first deformation cycle relative to subsequent cycles and is distinguished from viscoelasticity by a lack of recovery of stiffness, even after several hours of rest. The causes of this behaviour are unknown. We investigated whether strain softening is observed in uniaxial extensions of intact, viable, rat right ventricular (RV) cardiac trabeculae. Stretch and release cycles of 5%, 10%, and 15% muscle length were applied at a constant velocity at 26 degrees C. Muscles were tested in random order in the presence and absence of 50 mM 2,3-butanedione monoxime (BDM). Whereas strain softening was displayed by nonviable trabeculae, it was not observed in viable preparations undergoing physiologically relevant extensions whether in the presence or absence of BDM. BDM also had no effect on passive compliance. There was a reversible increase of muscle compliance between the first and subsequent cycles, with recovery after 30 s of rest, independent of the presence of BDM. We conclude that strain softening is neither intrinsic to viable rat RV trabeculae nor influenced by BDM and that passive trabeculae compliance is not altered by the addition of BDM.

Asunto(s)

RESUMEN

A typical breast cancer examination involves the comparison of image patterns in mammograms of craniocaudal (CC) and mediolateral oblique (MLO) views. Obtaining these mammograms requires the compression of the breast in two different directions. During compression, breast tissues undergo large deformations and hence the CC and MLO views do not show exactly the same region of the breast. Nonrigid body registration algorithms typically do not account for the mechanics of the deformation and are thus prone to alignment errors. Finite element model predictions of breast tissue deformation ensure that only physically plausible deformations are used in registration algorithms. A modeling framework has been developed to create anatomically accurate finite element models of the breast. A semi-automatic procedure has been formulated to generate patient specific finite element geometries of breast anatomy. Validation of model predictions has also been conducted on silicon gel samples subjected to gravity loading.

RESUMEN

A multiaxial testing rig has been designed to investigate mechanical properties of soft tissue membranes. This approach has the advantage over biaxial loading in that it can be used to investigate soft tissue membranes with complex structural architecture. A finite element model of tissue mechanics has been used to analyze the experimental data in order to evaluate the stress-strain relationship, and a forward solve algorithm developed to estimate material parameters values for a given constitutive law. The multiaxial testing rig and the finite element analysis have been used to evaluate the constitutive properties of in-vivo human skin.

RESUMEN

This paper considers the problem of measuring the strain field in biaxially loaded elastic membranes, such as soft biological tissue. Cross-correlation of intrinsic or applied speckle patterns were used to calculate the 2D displacements of small regions on the surface of a deforming membrane. This method was able to resolve 2D displacements to within a twentieth of a pixel. A finite-element model with bicubic-Hermite interpolation was used to represent the geometry of the membrane in the undeformed state. This model was fitted to the measured displacements to obtain the geometry of the membrane in the deformed state, and the strain field was calculated from the change in geometry. The strain fields were measured in both an inhomogeneous isotropic rubber membrane and a section of sheep diaphragm.

Asunto(s)

RESUMEN

This study presents a method for estimating the spatial variations in material properties of elastic membranes, such as biological tissue, which contain both inhomogeneous strain fields and inhomogeneous material properties. In order to validate the method, an inhomogeneous, isotropic rubber membrane was biaxially loaded to obtain a set of states. A neo-Hookean finite element model, together with the measured strains, was used to estimate the material parameters by minimizing the residuals between the measured and modelled residual on surface tractions.

Asunto(s)

RESUMEN

Modern medicine is currently benefiting from the development of new genomic and proteomic techniques, and also from the development of ever more sophisticated clinical imaging devices. This will mean that the clinical assessment of a patient's medical condition could, in the near future, include information from both diagnostic imaging and DNA profile or protein expression data. The Physiome Project of the International Union of Physiological Sciences (IUPS) is attempting to provide a comprehensive framework for modelling the human body using computational methods which can incorporate the biochemistry, biophysics and anatomy of cells, tissues and organs. A major goal of the project is to use computational modelling to analyse integrative biological function in terms of underlying structure and molecular mechanisms. To support that goal the project is establishing web-accessible physiological databases dealing with model-related data, including bibliographic information, at the cell, tissue, organ and organ system levels. This paper discusses the development of comprehensive integrative mathematical models of human physiology based on patient-specific quantitative descriptions of anatomical structures and models of biophysical processes which reach down to the genetic level.

Asunto(s)