We hypothesized that minimally invasive injections of a softening agent at strategic locations in stiff myocardium could de-stiffen the left ventricle (LV) globally. Physics-based finite element models of the LV were created from LV echocardiography images and pressures recorded during experiments in four swine. Results confirmed animal models of LV softening by systemic agents. Regional de-stiffening of myocardium led to global de-stiffening of LV. The mathematical set up was used to design LV global de-stiffening by regional softening of myocardium. At an end diastolic pressure of 23 mmHg, when 8 ml of the free wall was covered by intramyocardial injections, end diastolic volume (EDV) increased by 15.0%, whereas an increase up to 11 ml due to intramyocardial injections in the septum and free wall led to a 26.0% increase in EDV. Although the endocardial intramyocardial injections occupied a lower LV wall volume, they led to an EDV (44 ml) that was equal compared to intramyocardial injections in the mid-wall (44 ml) and larger compared to intramyocardial injections in the epicardium (41 ml). Using an in silico set up, sites of regional myocardium de-stiffening could be planned in order to globally soften overly stiff LV in heart failure with preserved ejection fraction. This novel treatment is built on subject-specific data. Hypothesis-testing of these simulation findings in animal models is warranted.

Force plays critical roles in cell adhesion and mechano-signaling, partially by regulating the dissociation rate, i.e., off-rate, of receptor-ligand bonds. However, the mechanism of such regulation still remains elusive. As a controversial topic of the field, when measuring the "off-rate vs. force" relation of the same molecular system, different dynamic force spectroscopy (DFS) assays (namely, force-clamp and force-ramp assays) often yield contradictive results. Such discrepancies hurdled our further understanding of molecular binding, and casted doubt on the existing theoretical models. In this work, we used a live-cell DFS technique, biomembrane force probe, to measure the single-bond dissociation in three receptor-ligand systems which respectively have important functions in vascular and immune systems: human platelet GPIbα-VWF, mouse T cell receptor-OVA peptide:MHC, and mouse platelet integrin αIIbβ3-fibrinogen. Using force-clamp and force-ramp assays in parallel, we identified that the force loading disrupted the stability of molecular bonds in a rate-dependent manner. This disruptive effect was achieved by the transitioning of bonds between two dissociation states: faster force loading induces more bonds to adopt the fast-dissociating state (and less to adopt the slow-dissociating state). Based on this mechanism, a new biophysical model of bond dissociation was established which took into account the effects of both force magnitude and loading rate. Remarkably, this model reconciled the results from the two assays in all three molecular systems under study. Our discoveries provided a new paradigm for understanding how force regulates receptor-ligand interactions and a guideline for the proper use of DFS technologies. Furthermore, our work highlighted the opportunity of using different DFS assays to answer specific biological questions in the field of cell adhesion and mechano-signaling.

Vascular smooth muscle cells (VSMCs) play an important role in regulating blood flow and pressure by contracting and relaxing in response to a variety of mechanical stimuli. A fully differentiated and functional VSMC should have both the ability to contract and relax in response to environmental stimuli. In addition, it should have the proper mechanical properties to sustain the mechanically active vascular environment. Stem cells can differentiate towards VSMC lineages and so could be used as a potential treatment for vascular repair. However, few studies have assessed the time it takes for stems cells to acquire similar mechanical property to native VSMCs during differentiation. In our study, changes in the mechanical properties of differentiating bone marrow and adipose-derived stem cells were determined by using atomic force microscopy indentation. Overall, bone marrow derived stem cells achieved higher elastic moduli than adipose tissue derived stem cell during differentiation. Immunofluorescence shows that both stem cell types have increasing VSMC-specific markers over differentiation. While adipose-derived stem cells were softer, they expressed slightly higher αSMA than the bone marrow cells as investigated by RT-PCR. Further investigations are required to better determine the appropriate mechanical environment for vascular smooth muscle differentiation.

Patients with repaired tetralogy of Fallot (TOF) account for the majority of cases with late onset right ventricle failure. Comparing TOF patients with healthy people may provide information to address this challenge. Cardiac magnetic resonance (CMR) data were obtained from 16 TOF patients (patient group, PG) and 6 healthy volunteers (healthy group, HG). At begin-of-ejection, better patient group (n=5, BPG) stress was very close to HG stress (54.7±38.4 kPa vs. 51.2±55.7 kPa, p=0.6889) while worse patient group (n=11, WPG) stress was 84% higher than HG stress (p=0.0418). Stress may be used as an indicator to differentiate BPG patients from WPG patients, with further validations.

Delivery of therapeutic agents to the eye requires efficient transport through cellular and extracellular barriers. We evaluated the rate of diffusive transport in excised porcine corneal stroma using fluorescently labeled dextran molecules with hydrodynamic radii ranging from 1.3 to 34 nm. Fluorescence correlation spectroscopy (FCS) was used to measure diffusion coefficients of dextran molecules in the excised porcine corneal stroma. The preferential sensitivity of FCS to diffusion along two dimensions was used to differentially probe diffusion along the directions parallel to and perpendicular to the collagen lamellae of the corneal stroma. In order to develop an understanding of how size affects diffusion in cornea, diffusion coefficients in cornea were compared to diffusion coefficients measured in a simple buffer solution. Dextran molecules diffuse more slowly in cornea as compared to buffer solution. The reduction in diffusion coefficient is modest however (67% smaller), and is uniform over the range of sizes that we measured. This indicates that, for dextrans in the 1.3 to 34 nm range, the diffusion landscape of corneal stroma can be represented as a simple liquid with a viscosity approximately 1.5 times that of water. Diffusion coefficients measured parallel vs. perpendicular to the collagen lamellae were indistinguishable. This indicates that diffusion in the corneal stroma is not highly anisotropic. Our results support the notion that the corneal stroma is highly permeable and isotropic to transport of hydrophilic molecules and particles with hydrodynamic radii up to at least 34 nm.

The osseous tissue repair and regeneration have great importance in orthopedic and maxillofacial surgery. Tissue engineering makes it possible to cure different tissue abnormalities using autologous grafts. It is now obvious that mechanical loading has essential role in directing cells to differentiation. In this study, the influence of cyclic uniaxial loading and its combination with chemical factors on expression of osteogenic markers was investigated. Rat bone marrow-derived stem cells were isolated and cultured. In one group cells were maintained in chemical induction medium. In another group cells were subjected to cyclic uniaxial strain with 3% amplitude and 0.3 Hz frequency for 24 hours and in the last group cells were affected by induction medium and physical stimulation. TaqMan Real time PCR and immunocytochemistry were done to evaluate gene expression variations. Moreover, a small incision was made to access the bone of the cranium and induced cells were seeded on collagen based scaffolds and finally the cell seeded scaffolds were implanted. Results indicated that mechanical loading alone caused a phenomenal increase in Runx2 and osteocalcin expression. Remarkable increment in gene expression was gained when induction medium were added to mechanical stimulation. The order of chemical and mechanical stimulation caused different effects and results were much better when the cells were affected by mechanical strain at first. Histological analysis showed mechanical stimulation could promote bone ingrowth in vivo. These evidences demonstrated that combination of chemical factors with mechanical strain was much more effective for directing osteogenesis since these elements have synergistic effects.

Continuous growth in industrialization and lack of awareness in safety parameters the cases of amputations are growing. The search of safer, simpler and automated prosthetic arms for managing upper limbs is expected. Continuous efforts have been made to design and develop prosthetic arms ranging from simple harness actuated to automated mechanisms with various control options. However due the cost constraints, the automated prosthetic arms are still out of the reach of needy people. Recent data have shown that there is a wide scope to develop a low cost and light weight upper limb prosthesis. This review summarizes the various designs methodologies, mechanisms and control system developed by the researchers and the advances therein. Educating the patient to develop acceptability to prosthesis and using the same for the most basic desired functions of human hand, post amputation care and to improve patient's independent life is equally important. In conclusion it can be interpreted that there is a wide scope in design in an adaptive mechanism for opening and closing of the fingers using other methods of path and position synthesis. Simple mechanisms and less parts may optimize the cost factor. Reduction in the weight of the prosthesis may be achieved using polymers used for engineering applications. Control system will remain never ending challenge for the researchers, but it is essential to maintain the simplicity from the patients perspective.

To quickly construct the orthopedic plates and to conveniently edit it, a novel method for designing the plates is put forward based on feature idea and parameterization. Firstly, attached to the existing or repaired bone model, the region of interest (ROI) is selected as the abutted surface of orthopedic plate, and the ROI is reconstructed to form a CAD surface. Secondly, the CAD surface is to be defined as a surface feature (SF) and then some semantic parameters are configured for it. Lastly, the plate body is constructed through thickening, and some higher parameters are defined for it so as to produce a volumetric feature (VF). In the above process, there exist two main problems: one is parameterization of the abutted surface, and the other is construction of the outer surface. Besides, the mapping relationship has to be built between surface feature parameters and volumetric feature parameters. This method supports the modification of high-level parameters, consequently promoting the quality and efficiency of orthopedic plate design.

Growing evidences suggest that long-term enhanced external counter-pulsation (EECP) treatment can inhibit the initiation of atherosclerotic lesion by improving the hemodynamic environment in aortas. However, whether this kind procedure will intervene the progression of advanced atherosclerotic plaque remains elusive and causes great concern in its clinical application presently. In the current paper, a pilot study combining animal experiment and numerical simulation was conducted to investigate the acute mechanical stress variations during EECP intervention, and then to assess the possible chronic effects. An experimentally induced hypercholesterolemic porcine model was developed and the basic hemodynamic measurement was performed in vivo before and during EECP treatment. Meanwhile, A 3D fluid-structure interaction (FSI) model of blood vessel with symmetric local stenosis was developed for the numerical calculation of some important mechanical factors. The results show that EECP augmented 12.21% of the plaque wall stress (PWS), 57.72% of the time average wall shear stress (AWSS) and 43.67% of the non-dimensional wall shear stress gradient (WSSGnd) at throat site of the stenosis. We suggest that long-term EECP treatment may intervene the advanced plaque progression by inducing the significant variations of some important mechanical factors, but its proper effects will need a further research combined follow-up observation in clinic.

We propose a coupled mathematical model for the detailed quantitative analyses of initial microtumour and micrometastases formation by including cancer cell migration, host vessel cooption and changes in microenvironment. Migrating cells are included as a new phenotype to describe the migration behaviour of malignant tumour cells. Migration probability of a migrating cell is assumed to be influenced by local chemical microenvironment. Pre-existing vessel cooption and remodelling are introduced according to the local haemodynamical microenvironment, such as interstitial pressure and vessel wall permeability. After the tumour cells and tumour vessels distribution are updated, the chemical substances are coupled calculated with the haemodynamical environment. The simulation results clearly reproduce the tumour cells migrate and proliferate along the pre-existing vessels at the very early stage of growth, which are consistent with many published experimental observations. In addition, the model demonstrates the interactions of tumour cells with the pre-existing vessels, which are believed to be essential for initial adhesion, proliferation, invasion, and micrometastases establishment. Quantitative analysis of tumour expansion in longitudinal and transverse directions shows that the cooption and migration along host vessels will be inhibited once angiogenesis phase occurs. The influences of the ability of cell migration and the inclusion of vessel cooption on the formation of micrometastases are discussed.

Modeling ventricle active contraction based on in vivo data is extremely challenging because of complex ventricle geometry, dynamic heart motion and active contraction where the reference geometry (zero-stress geometry) changes constantly. A new modeling approach using different diastole and systole zero-load geometries was introduced to handle the changing zero-load geometries for more accurate stress/strain calculations. Echo image data were acquired from 5 patients with infarction (Infarct Group) and 10 without (Non-Infarcted Group). Echo-based computational two-layer left ventricle models using one zero-load geometry (1G) and two zero-load geometries (2G) were constructed. Material parameter values in Mooney-Rivlin models were adjusted to match echo volume data. Effective Young's moduli (YM) were calculated for easy comparison. For diastole phase, begin-filling (BF) mean YM value in the fiber direction (YMf) was 738% higher than its end-diastole (ED) value (645.39 kPa vs. 76.97 kPa, p=3.38E-06). For systole phase, end-systole (ES) YMf was 903% higher than its begin-ejection (BE) value (1025.10 kPa vs. 102.11 kPa, p=6.10E-05). Comparing systolic and diastolic material properties, ES YMf was 59% higher than its BF value (1025.10 kPa vs. 645.39 kPa. p=0.0002). BE mean stress value was 514% higher than its ED value (299.69 kPa vs. 48.81 kPa, p=3.39E-06), while BE mean strain value was 31.5% higher than its ED value (0.9417 vs. 0.7162, p=0.004). Similarly, ES mean stress value was 562% higher than its BF value (19.74 kPa vs. 2.98 kPa, p=6.22E-05), and ES mean strain value was 264% higher than its BF value (0.1985 vs. 0.0546, p=3.42E-06). 2G models improved over 1G model limitations and may provide better material parameter estimation and stress/strain calculations.

The purpose of the study presented here was to investigate the manufacturability of human anatomical models from Computed Tomography (CT) scan data via a 3D desktop printer which uses fused deposition modelling (FDM) technology. First, Digital Imaging and Communications in Medicine (DICOM) CT scan data were converted to 3D Standard Triangle Language (STL) format by using In Vaselius digital imaging program. Once this STL file is obtained, a 3D physical version of the anatomical model can be fabricated by a desktop 3D FDM printer. As a case study, a patient's skull CT scan data was considered, and a tangible version of the skull was manufactured by a 3D FDM desktop printer. During the 3D printing process, the skull was built using acrylonitrile-butadiene-styrene (ABS) co-polymer plastic. The printed model showed that the 3D FDM printing technology is able to fabricate anatomical models with high accuracy. As a result, the skull model can be used for preoperative surgical planning, medical training activities, implant design and simulation to show the potential of the FDM technology in medical field. It will also improve communication between medical stuff and patients. Current result indicates that a 3D desktop printer which uses FDM technology can be used to obtain accurate anatomical models.

Simulation of the mass distribution in a human proximal femur is important to provide a reasonable therapy scheme for a patient with osteoporosis. An algorithm is developed for prediction of optimal mass distribution in a human proximal femur under a given loading environment. In this algorithm, the bone material is assumed to be bi-modulus, i.e., the tension modulus is not identical to the compression modulus in the same direction. With this bi-modulus bone material, a topology optimization method, i.e., modified SIMP approach, is employed to determine the optimal mass distribution in a proximal femur. The effects of the difference between two moduli on the final material distribution are numerically investigated. Numerical results obtained show that the mass distribution in bi-modular bone materials is different from that in traditional isotropic material. As the tension modulus is less than the compression modulus for bone tissues, the amount of mass required to support tension loads is greater than that required by isotropic material for the same daily activities including one-leg stance, abduction and adduction.

This paper describes the capabilities of fluid structure interaction based multi-physics numerical modelling in solving problems related to vascular biomechanics. In this research work, the onset of a pressure pulse was simulated at the entrance of a three dimensional straight segment of the blood vessel like circular tube and the resulting dynamic response in the form of a propagating pulse wave through the wall was analysed and compared. Good agreement was found between the numerical results and the theoretical description of an idealized artery. Work has also been done on implementing the material constitutive models specific for vascular applications.

In this paper, the hemodynamic characteristics of blood flow and stress distribution in a layered and stenotic aorta are investigated. By introducing symmetrical and unsymmetrical stenosis, the influence of stenosis morphology and stenotic ratio on the coupled dynamic responses of aorta is clarified. In the analysis, the in-vivo pulsatile waveforms and fully fluid-structure interaction (FSI) between the layered elastic aorta and the blood are considered. The results show that the fluid domain is abnormal in the stenotic aorta, and the whirlpool forms at the obstructed and downstream unobstructed regions. The maximum wall shear stresses appear at the throat of the stenosis. Downstream region appears low and oscillated shear stresses. In addition, along with the increase of the stenotic ratio, the amplitude of the maximum shear stress will be intensively increased and localized, and the sensitivity is also increased. In the aorta with unsymmetrical stenosis, the Von Mises stresses reach the peak value at the side with the surface protuberance, but they are reduced at the side with no protuberance. The sign variation of the layer interface shear stresses near the throat indicates the variation of the shear direction which increases the opportunity of shear damage at the transition plane. Moreover, the shear stress levels at the fluid-solid and intima-media interfaces are higher than that at the media-adventitia interface. The unsymmetrical stenosis causes higher stresses at the side with the surface protuberance than symmetrical one, but lower at the side with no protuberance. These results provide an insight in the influence of the stenosis, as well as its morphology, on the pathogenesis and pathological evolution of some diseases, such as arteriosclerosis and aortic dissection.