Search Results (19)

Background/Objectives: Calcific aortic valve disease (CAVD) is a progressive condition marked by thickening and calcification of the valve leaflets, leading to impaired cardiac function and increased cardiovascular risk. As disease progression is strongly influenced by hemodynamics and lipid accumulation, computational modeling provides a powerful tool for understanding the biomechanical drivers of calcification. Methods: This study investigates the effects of coronary artery flow and varying left ventricular outflow tract (LVOT) velocity profiles on low density lipoprotein (LDL) accumulation and associated aortic valve calcification using a partitioned fluid–structure interaction framework coupled with scalar transport modeling, with a focus on understanding the differential behaviors of the three valve leaflets: the non-coronary cusp (NCC), right coronary cusp (RCC), and left coronary cusp (LCC). Four distinct LVOT flow velocity profiles (anterior, lateral, posterior, and medial) and coronary flow are simulated to determine their effects on the distribution of LDL accumulation and associated calcification across the valve leaflets. Results/Conclusions: Our results indicate that the RCC experiences greatest excursion and lowest calcification. The LCC shows lowest excursion and slightly higher susceptibility for calcification. Finally, the NCC experiences intermediate excursion, but is most prone to calcification. Full article

Background/Objectives: The process of designing and fabricating bone tissue engineering scaffolds is a multi-faceted and intricate process. The scaffold is designed to attach cells to the required volume of regeneration to subsequently migrate, grow, differentiate, proliferate, and consequently develop tissue within the scaffold which, in time, will degrade, leaving just the regenerated tissue. The fabrication of tissue scaffolds requires adapting the properties of the scaffolds to mimic, to a large extent, the specific characteristics of each type of bone tissue. However, there are some significant limitations due to the constrained scaffolds’ architecture and structural features that inhibit the optimization of bone scaffolds. Methods: To overcome these shortcomings, new computational approaches for scaffold design have been adopted through currently adopted computational methods such as finite element analysis (FEA), computational fluid dynamics (CFD), and fluid–structure interaction (FSI). Results: This paper presents a narrative review of the state of the art in the field of parametric numerical modeling and computational fluid dynamics geometry-based models used in bone tissue engineering. Computational methods for scaffold design improve the process of constructing scaffolds and contribute to tissue engineering. Conclusions: This paper highlights the benefits of computational methods on employing scaffolds with different architectures and inherent characteristics that can potentially contribute to a favorable environment for hosting cells and predict their behavior and response. By recognizing these benefits, researchers can enhance and optimize scaffold properties for future advancements in tissue engineering research that will lead to more accurate and robust outcomes. Full article

Objectives: The aim of this study was to evaluate the impact of four working heights on lumbar biomechanics during wall construction tasks, focusing on work-related musculoskeletal disorders (WMSDs). Methods: Fifteen young male participants performed simulated mortar-spreading and bricklaying tasks while actual body movements were recorded using Inertial Measurement Unit (IMU) sensors. Muscle activities of the lumbar erector spinae (ES), quadratus lumborum (QL), multifidus (MF), gluteus maximus (GM), and iliopsoas (IL) were estimated using a 3D musculoskeletal (MSK) model and measured via surface electromyography (sEMG). The analysis of variance (ANOVA) test was conducted to identify the significant differences in muscle activities across four working heights (i.e., foot, knee, waist, and shoulder). Results: Findings showed that working at foot-level height resulted in the highest muscle activity (7.6% to 40.6% increase), particularly in the ES and QL muscles, indicating an increased risk of WMSDs. The activities of the ES, MF, and GM muscles were statistically significant across both tasks and all working heights (p < 0.01). Conclusions: Both MSK and sEMG analyses indicated significantly lower muscle activities at knee and waist heights, suggesting these as the best working positions (47 cm to 107 cm) for minimizing the risk of WMSDs. Conversely, working at foot and shoulder heights was identified as a significant risk factor for WMSDs. Additionally, the similar trends observed between MSK simulations and sEMG data suggest that MSK modeling can effectively substitute for sEMG in future studies. These findings provide valuable insights into ergonomic work positioning to reduce WMSD risks among wall construction workers. Full article

A brain aneurysm is a structural deterioration of the arterial wall in the brain, resulting in the formation of a bulge in or ballooning of a blood vessel. Around 3–5% of the global population is affected by brain aneurysms, wherein only a small fraction results in rupture. Although an unruptured aneurysm is typically asymptomatic and not immediately life threatening, it poses a potential risk of rupture, which can lead to severe health complications or mortality. Therefore, it is crucial to detect and treat aneurysms during the unruptured phase. Moreover, a comprehensive understanding of the flow dynamics within the aneurysm and its parent artery is essential for accurate diagnosis and the prevention of aneurysm recurrence. While prior reviews have focused on computational fluid dynamics (CFD) studies on brain aneurysms, particularly patient-specific models from studies conducted over a decade ago, a more recent review is necessary. Additionally, reviewing various studies on the fluid dynamic behavior of treated aneurysms is crucial. Thus, the advancements in both experimental and computational studies on brain aneurysms must be explored to better understand their underlying fluid flow mechanisms and to develop robust treatment strategies. This review aims to summarize the different types of brain aneurysms, the screening and treatment processes, the key hemodynamic factors, and the fluid dynamic characteristics observed in aneurysms before and after treatment. Full article

Transcatheter aortic valve replacement (TAVR) has become the preferred treatment for patients with aortic stenosis (AS) at high surgical risk. However, TAVR is challenging in patients with a pre-existing mitral valve prosthesis, such as a transcatheter mitral valve replacement (TMVR), due to the likelihood of device interference. This study explores the feasibility and safety of performing TAVR in a patient with a pre-existing TMVR procedure using 3D printing, augmented reality (AR) and computational simulations to optimize preprocedural planning. Computational modeling allowed predictions of the spatial relationship between the TAVR and TMVR devices. The simulation output was therefore used as input for augmented visualization of the device interference. The 3D printing of an anatomical replica was used to physically simulate the procedure, ensuring that no significant interference would occur during heart function. The results demonstrated a safe distance of 6.4 mm between the TAVR and TMVR devices, and no functional interference was observed during simulated cardiac cycles. The use of AR in the operating room enhanced the understanding of device positioning, offering a new dimension of precision of the complex cardiovascular intervention. This study concludes that integrating AR, 3D printing, and computational simulations into preprocedural planning for high-risk structural intervention can significantly improve procedural outcomes by enhancing accuracy, safety, and operator confidence. Full article

Companies are becoming increasingly aware of the health of their employees and are now integrating exoskeleton solutions for both prevention and job maintenance. However, the effect of using exoskeletons is still an open question. Therefore, this study aimed to evaluate the impact of an active lumbar exoskeleton and its passive belt on trunk kinematics and muscle activity using instrumented motion analysis. Twenty-three healthy subjects volunteered to perform three handlings of a 5 kg load (free lifting, squat lifting, and load transfer) under three different experimental conditions. The “Control” condition was when the subject did not wear any device, the “Belt” condition was when the subject wore only the passive part of the exoskeleton, and the “Exo” condition was when the subject wore the active exoskeleton. Based on the Rapid Upper Limb Assessment scale, the exoskeleton reduced the time spent in angles that were considered dangerous for the back, according to ergonomic evaluations. Furthermore, for the handling sessions, it was observed that the exoskeleton did not modify muscle activity in the abdominal–lumbar region. Full article

We investigated the influence of Achilles tendon (AT) geometry on local-strain magnitude and distribution during loading, using finite element analysis. We calculated the following eight AT parameters for 18 healthy men: thickness and width of the most distal part, minimum cross-sectional area (mCSA), and most proximal part; length; and position of the mCSA. To investigate the effect of AT geometry on the magnitude and distribution of local strain, we created three-dimensional numerical models by changing the AT parameter values for every one standard deviation (SD) in the range of ±2 SD. A 4000 N lengthening force was applied to the proximal surface of all the models. The mean first principal strain (FPS) was determined every 3% of the length. The highest FPS in each model was mainly observed in the proximal regions; the 86–89% site (the most proximal site was set at 100%) had the highest number of models with the highest FPS (nine models). The highest FPS was observed in the model with a distal thickness of −2 SD, which was 27.1% higher than that of the standard model observed in the 2–5% site. Therefore, the AT geometry influences local-strain magnitude and distribution during loading. Full article

Specific finite detail modeling of the human body gives a capable primary enhancement to the prediction of damage risk through automobile impact. Currently, car crash protection countermeasure improvement is based on an aggregate of testing with installed anthropomorphic test devices (i.e., ATD or dummy) and a mixture of multibody (dummy) and finite element detail (vehicle) modeling. If an incredibly easy finite element detail version can be advanced to capture extra statistics beyond the abilities of the multi-body structures, it might allow advanced countermeasure improvement through a more targeted prediction of overall performance. Numerous research has been done on finite element analysis of broken femurs. However, there are two missing pieces of information: 1- choosing the right material properties, and 2- designing a precise model including the inner structure of the bone. In this research, most of the chosen material properties for femur bone will be discussed and evaluated. Full article

In biomedical studies as well as in clinical trials, it is often useful to have a reliable measure of the force exerted by the body (e.g., clenching force at the teeth or pinch force at fingertips) or on the body by external stimuli (e.g., taps to elicit reflexes or local pressure for nociceptive stimulation). Thin-film sensors such as FlexiForce^® provide a very handy and versatile solution for these applications, but can be easily damaged and offer poor accuracy and repeatability, being heavily affected by the surface material they come into contact with. The aim of the study is the realization of a 3D-printed housing that completely embeds the sensor, thus providing mechanical protection and increasing the reliability of the measurement. The increasing availability of 3D printers and of printing materials for medical use allows the user to shape the housing according to specific needs, with short developing time and low cost. Full article

A cerebral aneurysm is a medical condition described as the bulging out of the cerebral artery under adverse pressure conditions. Patients with such medical conditions have a mortality of 20% and additional morbidity of 30–40% due to aneurysm rupture. The currently used imaging tools such as MRI and CT scans only provide geometrical information of the aneurysm and not the rupture risk associated with the progression of the aneurysm. A novel computational modeling framework was developed to model aneurysm progression and evaluate the stress distribution under varying pressure loading conditions to bridge this gap. Image segmentation was used to segment two middle cerebral arteries (MCA) and reconstructed to design aneurysm models at vulnerable sites for aneurysm progression simulation. Five aneurysm sizes and two different wall thicknesses were modeled to simulate different stages of aneurysm progression. Three pressures (i.e., diastolic, systolic, and hypertensive) were adopted to mimic the realistic pressure loading scenario for the middle cerebral arteries, and the stress distributions across all the models were estimated to understand the rupture risk. It was observed that the induced stresses in the aneurysm walls increased with an increase in the aneurysm diameter and blood pressure. Additionally, an aneurysm with a large diameter and thin walls exhibited a high risk of rupture, especially at high blood pressures. The reported results are anticipated to help medical practitioners predict rupture risks with known imaging-based aneurysm sizes and make timely decisions for such aneurysm conditions. Full article

Recently, a new bi-layer dressing was proposed by Urgo RID to reduce the healing time of pressure ulcers (PU). This dressing was numerically evaluated in previously published work. In the current work, the influence on the maximal shear strains of modelling parameters such as the dressing local geometry, the pressure applied by the gauze inside the wound, the wound deepness, and the mattress stiffness, was assessed. A sensitivity analysis was performed on these four parameters. Among all experiments, the mean maximal Green–Lagrange shear strain was 0.29. The gauze pressure explained 60% of the model response in terms of the volume of tissues under strains of 0.3, while the wound deepness explained 28%. The mattress had a significant, but low impact, whereas the dressing local geometry had no significant impact. As expected, the wound deepness was one of the most influential parameters. The gauze turned out to be more significant than expected. This may be explained by the large range of values chosen for this study. The results should be extended to more subjects, but still suggest that the gauze is a parameter that might not be neglected. Care should also be taken in clinical practice when using gauze that could have either a positive or negative impact on the soft tissues’ strains. This may also depend on the wound deepness. Full article

A thorough biomechanical understanding of human organs is of increasing importance for designing and improving a wide range of medical technologies from simulators to medical devices. Despite the crucial need for data, little procedure-specific biomechanical testing on human tissue has been published. Specifically, pancreatic duct anastomosis, which has high rates of complications related to pancreatic duct leakage and patency, could benefit from improved assistive technologies. This study aims to help characterize the biomechanics of this critical step of the procedure by measuring the suture pullout force (SPOF) of the pancreatic duct and capsule. 216 tests were performed on 33 fresh, unfixed donated human pancreases. A previously reported uniaxial testing frame, was used to measure the SPOF of the pancreases. The mean pancreatic duct SPOF was 2.62 ± 1.11 N and the mean pancreatic capsule SPOF was 1.99 ± 1.33 N. To our knowledge, this is the first reported human pancreatic duct and capsule suture pullout measurement. These data can be used to inform a wide variety of biomedical technologies with primary interest in high-fidelity training simulators. Full article

Ascending Thoracic Aortic Aneurysm (ATAA) is a permanent dilatation of the aorta which is usually related to tissue degeneration, hemodynamic conditions, lifestyle, environmental and genetic factors. As the mechanical conditions can become critical in a dilated aorta, a patient-specific computational model can be very useful to assist clinical decisions in the management of ATAAs. In this article, we model the biomechanical conditions of ATAA by performing Fluid–Structure Interaction (FSI) simulations in the SimVascular open-source software package. The patient-specific geometric model is reconstructed from Computed Tomography scan (CT). The numerical implementation takes into account patient-specific outlet conditions and a temporal flow variation at the model inlet. We performed a mesh convergence analysis on a new mesh reconstruction method in SimVascular and showed that it can significantly reduce the computational cost without impacting the accuracy. Full article

Patients with end stage renal disease require some form of vascular access for treatment, with Arterio-Venous Fistulas (avf) being the preferred form available due to better patency rates. However, they continue to present complications after creation, leading to early or late failure. While many studies are examining the flow in patient-specific fistulas, they often neglect the influence of vessel compliance on its hemodynamics. The objective of this study is to investigate the effect of wall compliance on the complex hemodynamics of a patient-specific brachio-cephalic avf and how it differs from a rigid fistula. Particle Image Velocimetry (piv) was used to capture the flow pattern within the fistula for both steady (Re = 1817) and pulsatile (${\mathrm{Re}}_{\mathrm{av}}=1817$, ${\mathrm{Re}}_{\max }=2232$) flow conditions. The results were compared to rigid model measurements performed under the same Reynolds number. The streamline plots and coefficient of variation results did not differ significantly between the models; however, the non-dimensional velocity and directional variability results did vary between the two fistulas. A difference of approximately 8% was seen between the two models for both steady and pulsatile flow. The findings of this study suggest that to determine the bulk flow, a rigid model is adequate, but to capture the finer details of the flow, a compliant model is necessary. Full article

Interface pressure applied by compression bandages is the therapeutic action of the treatment of some venous or lymphatic pathologies. The so-called Static Stiffness Index, which quantifies the pressure increase from supine to standing position, is usually used to differentiate compression bandages. It was hypothesized that this pressure increase was the consequence of a change in leg geometry (blood and muscle falling down) and a change in calf soft tissue mechanical properties (muscles contraction). Calf soft tissue global stiffness of both legs of 25 patients was characterized in a sitting and standing position. This characterization was combined with interface pressure measurements applied by six different bandages. Though soft tissue mechanical properties significantly increased from sitting to standing position, no correlation was observed with the corresponding pressure increase. Thus, pressure increase is mainly attributed to a change in leg geometry. Full article