nils-herrmann/clean_scirepeval huggingface dataset:
Modifying hernia mesh design to improve device mechanical performance and promote tension-free repair.
Venue: Journal of biomechanics

Approximately 348,000 ventral hernia repairs are performed annually in the United States and the incisional hernia recurrence rate is approximately 20% as a result of suture and mesh device failure. Device failure is related to changes at the suture/tissue interface that leads to acute or chronic suture pull-through and surgical failure. To better manage mechanical tension, we propose a modified mesh design with extensions and demonstrate its mechanical superiority.



Comparative uniaxial static tensile testing was conducted on polypropylene suture and a modified mesh. Subsequently, a standard of care (SOC) mesh and modified mesh were evaluated using a tensometer in an acute hernia bench-top model.



Modified mesh breaking strength, extension knot breaking strength, extension disruption, and extension anchoring were superior to suture (p < .05). Modified mesh ultimate tensile strength of anchoring was superior to SOC mesh (p < .05). Various stitch patterns and modifications in device design significantly improved device tension-free performance far beyond clinically relevant benchmarks (p < .05).



Testing demonstrates that the modified mesh outperforms SOC mesh and suture in all tested failure modes. SOC hernia mesh tears through tissue at stress levels below maximum physiologic stress, whereas, the modified hernia mesh is up to 200% stronger than SOC mesh at resisting suture tearing through tissue and maintains anchoring at stresses far beyond clinically relevant benchmarks. Modifying hernia mesh design significantly improves device mechanical performance and enhances tension-free repair.
Statistical shape modeling characterizes three-dimensional shape and alignment variability in the lumbar spine.
Venue: Journal of biomechanics

The mechanics of the lumbar spine are heavily dependent on the underlying anatomy. Anatomical measures are used to assess the progression of pathologies related to low back pain and to screen patients for surgical treatment options. To describe anatomical norms and pathological differences for the population, statistical shape modeling, which uses full three-dimensional representations of bone morphology and relative alignment, can capture intersubject variability and enable comparative evaluations of subject to population. Accordingly, the objective of this study was to develop a comprehensive set of three-dimensional statistical models to characterize anatomical variability in the lumbar spine, by specifically describing the shape of individual vertebrae, and shape and alignment of the entire lumbar spine (L1-S1), with a focus on the L4-L5 and L5-S1 functional spinal units (FSU). Using CT scans for a cohort of 52 patients, lumbar spine geometries were registered to a template to establish correspondence and a principal component analysis identified the primary modes of variation. Scaling was the most prevalent mode of variation for all models. Subsequent modes of the statistical shape models of the individual bones characterized shape variation within the processes. Subsequent modes of variation for the FSU and entire spine models described alignment changes associated with disc height and lordosis. Quantification of anatomical variation in the spine with statistical models can inform implant design and sizing, assist clinicians in diagnosing pathologies, screen patients for treatment options, and support pre-operative planning.
The effect of prolonged level and uphill walking on the postural control of older adults.
Venue: Journal of biomechanics

Prolonged walking could alter postural control leading to an increased risk of falls in older adults. The aim of this study was to determine the effect of level and uphill prolonged walking on the postural control of older adults. Sixteen participants (64 ± 5 years) attended 3 visits. Postural control was assessed during quiet standing and the limits of stability immediately pre, post and post 15 min rest a period of 30 min walking on level and uphill (5.25%) gradients on separate visits. Each 30 min walk was divided into 3 10 min blocks, the limits of stability were measured between each block. Postural sway elliptical area (PRE: 1.38 ± 0.22 cm2, POST: 2.35 ± 0.50 cm2, p = .01), medio-lateral (PRE: 1.33 ± 0.03, POST: 1.40 ± 0.03, p = .01) and anterio-posterior detrended fluctuation analysis alpha exponent (PRE: 1.43 ± 0.02, POST: 1.46 ± 0.02, p = .04) increased following walking. Medio-lateral alpha exponent decreased between post and post 15 min' rest (POST: 1.40 ± 0.03, POST15: 1.36 ± 0.03, p = .03). Forward limits of stability decreased between the second walking interval and post 15 min' rest (Interval 2: 28.1 ± 1.6%, POST15: 25.6 ± 1.6%, p = .01) and left limits of stability increased from pre-post 15 min' rest (PRE: 27.7 ± 1.2%, POST15: 29.4 ± 1.1%, p = .01). The neuromuscular alterations caused by prolonged walking decreased the anti-persistence of postural sway and altered the limits of stability in older adults. However, 15 min' rest was insufficient to return postural control to pre-exercise levels.
A computer vision based method for 3D posture estimation of symmetrical lifting.
Venue: Journal of biomechanics

Work-related musculoskeletal disorders (WMSD) are commonly observed among the workers involved in material handling tasks such as lifting. To improve work place safety, it is necessary to assess musculoskeletal and biomechanical risk exposures associated with these tasks. Such an assessment has been mainly conducted using surface marker-based methods, which is time consuming and tedious. During the past decade, computer vision based pose estimation techniques have gained an increasing interest and may be a viable alternative for surface marker-based human movement analysis. The aim of this study is to develop and validate a computer vision based marker-less motion capture method to assess 3D joint kinematics of lifting tasks. Twelve subjects performing three types of symmetrical lifting tasks were filmed from two views using optical cameras. The joints kinematics were calculated by the proposed computer vision based motion capture method as well as a surface marker-based motion capture method. The joint kinematics estimated from the computer vision based method were practically comparable to the joint kinematics obtained by the surface marker-based method. The mean and standard deviation of the difference between the joint angles estimated by the computer vision based method and these obtained by the surface marker-based method was 2.31 ± 4.00°. One potential application of the proposed computer vision based marker-less method is to noninvasively assess 3D joint kinematics of industrial tasks such as lifting.
An instrumental approach for monitoring physical exercises in a visual markerless scenario: A proof of concept.
Venue: Journal of biomechanics

This work proposes a real-time monitoring tool aimed to support clinicians for remote assessing exercise performances during home-based rehabilitation. The study relies on clinician indications to define kinematic features, that describe five motor tasks (i.e., the lateral tilt of the trunk, lifting of the arms, trunk rotation, pelvis rotation, squatting) usually adopted in the rehabilitation program for axial disorders. These features are extracted by the Kinect v2 skeleton tracking system and elaborated to return disaggregated scores, representing a measure of subjects performance. A bell-shaped function is used to rank the patient performances and to provide the scores. The proposed rehabilitation tool has been tested on 28 healthy subjects and on 29 patients suffering from different neurological and orthopedic diseases. The reliability of the study has been performed through a cross-sectional controlled design methodology, comparing algorithm scores with respect to blinded judgment provided by clinicians through filling a specific questionnaire. The use of task-specific features and the comparison between the clinical evaluation and the score provided by the instrumental approach constitute the novelty of the study. The proposed methodology is reliable for measuring subject's performance and able to discriminate between the pathological and healthy condition.
Collective spreading of red blood cells flowing in a microchannel.
Venue: Journal of biomechanics

Due to recent advances in micro total analysis system technologies, microfluidics provides increased opportunities to manipulate, stimulate, and diagnose blood cells. Controlling the concentration of cells at a given position across the width of a channel is an important aspect in the design of microfluidic devices. Despite its biomedical importance, the collective spreading of red blood cells (RBCs) in a microchannel has not yet been fully clarified. In this study, we experimentally investigated the collective spreading of RBCs in a straight microchannel, and found that RBCs initially distributed in one side of the microchannel spread to the spanwise direction during downstream flow. Spreading increased considerably as the hematocrit increased, though the flow rate had a small effect. We proposed a scaling argument to show that this spreading phenomenon was diffusive and mainly induced by cell-cell interactions. The dispersion coefficient was approximately proportional to the flow rate and the hematocrit. These results are useful in understanding collective behaviors of RBCs in a microchannel and in microcirculation.
Comparison of lower limb kinetics, kinematics and muscle activation during drop jumping under shod and barefoot conditions.
Venue: Journal of biomechanics

This study was to investigate the acute effects of wearing shoes on lower limb kinetics, kinematics and muscle activation during a drop jump. Eighteen healthy men performed a drop jump under barefoot and shod conditions. Vertical ground reaction force (GRF) was measured on a force plate during the contact phase of a drop jump, and GRF valuables were calculated for each condition. The angles of the knee and ankle joints, and the foot strike angle (the angle between the plantar surface of the foot and the ground during ground contact) as well as the electromyography of 7 muscles were measured. The shod condition showed a significant larger first peak GRF, longer time to first peak GRF from the initial ground contact and lower initial loading rate than the barefoot condition. The shod condition showed a significant larger ankle joint angle at initial ground contact, smaller knee joint angle between the second peak GRF and take-off as well as smaller foot strike angle at both initial ground contact and take-off than the barefoot condition. There were significant correlations between relative differences in ankle joint at the initial ground contact and relative differences in the initial loading rate. The muscle activity of all muscles during foot ground contact did not differ between two conditions; however, in the shod condition, muscle activation of 150 ms before foot ground contact was significantly higher in the rectus femoris, whereas it was lower in the biceps femoris and tibialis anterior muscles than the barefoot condition. These results indicate that wearing shoes alternates the GRF variables at initial ground contact, joint kinematics at the ground contact and muscle activation before foot ground contact during a drop jump, suggesting that the effects of wearing shoes on drop jump training differ from being barefoot.
Application of the advanced system for implant stability testing (ASIST) to natural teeth for noninvasive evaluation of the tooth root interface.
Venue: Journal of biomechanics

In this paper we present the development of the Advanced System for Implant Stability Testing (ASIST) for application to natural teeth. The ASIST uses an impact measurement combined with an analytical model of the system and surrounding support to provide a measure of the interface stiffness. In this study, an analytical model is developed for a single-rooted natural tooth allowing the ASIST to estimate the stiffness characteristics of the periodontal ligament (PDL). The geometry and inertia parameters of the tooth model are presented in two ways: (1) using full CT scans of the individual tooth and (2) using an approximate geometry model with estimates of only the tooth length and diameter. The developed system is evaluated with clinical data for patients undergoing orthodontic treatment. This study shows that ASIST technique can be applied to natural teeth to estimate the stiffness characteristics of the PDL. The developed system can provide a valuable clinical tool for assessment of tooth stability properties and PDL stiffness in a variety of clinical situations such as dental trauma, orthodontics, and periodontology.
A finite nonlinear hyper-viscoelastic model for soft biological tissues.
Venue: Journal of biomechanics

Soft tissues exhibit highly nonlinear rate and time-dependent stress-strain behaviour. Strain and strain rate dependencies are often modelled using a hyperelastic model and a discrete (standard linear solid) or continuous spectrum (quasi-linear) viscoelastic model, respectively. However, these models are unable to properly capture the materials characteristics because hyperelastic models are unsuited for time-dependent events, whereas the common viscoelastic models are insufficient for the nonlinear and finite strain viscoelastic tissue responses. The convolution integral based models can demonstrate a finite viscoelastic response; however, their derivations are not consistent with the laws of thermodynamics. The aim of this work was to develop a three-dimensional finite hyper-viscoelastic model for soft tissues using a thermodynamically consistent approach. In addition, a nonlinear function, dependent on strain and strain rate, was adopted to capture the nonlinear variation of viscosity during a loading process. To demonstrate the efficacy and versatility of this approach, the model was used to recreate the experimental results performed on different types of soft tissues. In all the cases, the simulation results were well matched (R2⩾0.99) with the experimental data.
Biomechanical response of intact, degenerated and repaired intervertebral discs under impact loading - Ex-vivo and In-Silico investigation.
Venue: Journal of biomechanics

Understanding the effect of impact loading on the mechanical response of the intervertebral disc (IVD) is valuable for investigating injury mechanisms and devising effective therapeutic modalities. This study used 24 porcine thoracic motion segments to characterize the mechanical response of intact (N = 8), degenerated (Trypsin-denatured, N = 8), and repaired (Genepin-treated, N = 8) IVDs subject to impact loading. A meta-model analysis of poroelastic finite element simulations was used in combination with ex-vivo creep and impact tests to extract the material properties. Forward analyses using updated specimen-specific FE models were performed to evaluate the effect of impact duration. The maximum axial stress in the IVDs, Von-Mises stress in the endplates, and intradiscal pore pressure (IDP) were calculated, under a 400 N preload, subject to a sequence of impact loads for 10 impact durations (10-100 ms). The results were in good agreement with both creep and impact experiments (error < 10%). A significant difference was found in the maximum axial stress between the intact and degenerated disc groups. The IDP was also significantly lower in the degenerated disc group. The Von Mises stress in the adjacent endplates significantly increased with degeneration. It is concluded that the disc time-dependent response significantly changes with disc degeneration. Cross-linker Genipin has the potential to recover the hydraulic permeability and can potentially change the time dependent response, particularly in the IDP. This is the first study, to our best knowledge, which explores the effect of impact loading on the healthy, degenerated and repaired IVD using both creep and impact validation tests.
Validation of an ambient system for the measurement of gait parameters.
Venue: Journal of biomechanics

Fall risk in elderly people is usually assessed using clinical tests. These tests consist in a subjective evaluation of gait performed by healthcare professionals, most of the time shortly after the first fall occurrence. We propose to complement this one-time, subjective evaluation, by a more quantitative analysis of the gait pattern using a Microsoft Kinect. To evaluate the potential of the Kinect sensor for such a quantitative gait analysis, we benchmarked its performance against that of a gold-standard motion capture system, namely the OptiTrack. The "Kinect" analysis relied on a home-made algorithm specifically developed for this sensor, whereas the OptiTrack analysis relied on the "built-in" OptiTrack algorithm. We measured different gait parameters as step length, step duration, cadence, and gait speed in twenty-five subjects, and compared the results respectively provided by the Kinect and OptiTrack systems. These comparisons were performed using Bland-Altman plot (95% bias and limits of agreement), percentage error, Spearman's correlation coefficient, concordance correlation coefficient and intra-class correlation. The agreement between the measurements made with the two motion capture systems was very high, demonstrating that associated with the right algorithm, the Kinect is a very reliable and valuable tool to analyze gait. Importantly, the measured spatio-temporal parameters varied significantly between age groups, step length and gait speed proving the most effective discriminating parameters. Kinect-monitoring and quantitative gait pattern analysis could therefore be routinely used to complete subjective clinical evaluation in order to improve fall risk assessment during rehabilitation.
Adaptation of a clinical fixation device for biomechanical testing of the lumbar spine.
Venue: Journal of biomechanics

In-vitro biomechanical testing is widely performed for characterizing the load-displacement characteristics of intact, injured, degenerated, and surgically repaired osteoligamentous spine specimens. Traditional specimen fixture devices offer an unspecified rigidity of fixation, while varying in the associated amounts and reversibility of damage to and "coverage" of a specimen - factors that can limit surgical access to structures of interest during testing as well as preclude the possibility of testing certain segments of a specimen. Therefore, the objective of this study was to develop a specimen fixture system for spine biomechanical testing that uses components of clinically available spinal fixation hardware and determine whether the new system provides sufficient rigidity for spine biomechanical testing. Custom testing blocks were mounted into a robotic testing system and the angular deflection of the upper fixture was measured indirectly using linear variable differential transformers. The fixture system had an overall stiffness 37.0, 16.7 and 13.3 times greater than a typical human functional spine unit for the flexion/extension, axial rotation and lateral bending directions respectively - sufficient rigidity for biomechanical testing. Fixture motion when mounted to a lumbar spine specimen revealed average motion of 0.6, 0.6, and 1.5° in each direction. This specimen fixture method causes only minimal damage to a specimen, permits testing of all levels of a specimen, and provides for surgical access during testing.
Knee medial and lateral contact forces in a musculoskeletal model with subject-specific contact point trajectories.
Venue: Journal of biomechanics

Contact point (CP) trajectory is a crucial parameter in estimating medial/lateral tibio-femoral contact forces from the musculoskeletal (MSK) models. The objective of the present study was to develop a method to incorporate the subject-specific CP trajectories into the MSK model. Ten healthy subjects performed 45 s treadmill gait trials. The subject-specific CP trajectories were constructed on the tibia and femur as a function of extension-flexion using low-dose bi-plane X-ray images during a quasi-static squat. At each extension-flexion position, the tibia and femur CPs were superimposed in the three directions on the medial side, and in the anterior-posterior and proximal-distal directions on the lateral side to form the five kinematic constraints of the knee joint. The Lagrange multipliers associated to these constraints directly yielded the medial/lateral contact forces. The results from the personalized CP trajectory model were compared against the linear CP trajectory and sphere-on-plane CP trajectory models which were adapted from the commonly used MSK models. Changing the CP trajectory had a remarkable impact on the knee kinematics and changed the medial and lateral contact forces by 1.03 BW and 0.65 BW respectively, in certain subjects. The direction and magnitude of the medial/lateral contact force were highly variable among the subjects and the medial-lateral shift of the CPs alone could not determine the increase/decrease pattern of the contact forces. The suggested kinematic constraints are adaptable to the CP trajectories derived from a variety of joint models and those experimentally measured from the 3D imaging techniques.
Original article submission: Platelet stress accumulation analysis to predict thrombogenicity of an artificial kidney.
Venue: Journal of biomechanics

An implantable artificial kidney using a hemofilter constructed from an array of silicon membranes to provide ultrafiltration requires a suitable blood flow path to ensure stable operation in vivo. Two types of flow paths distributing blood to the array of membranes were evaluated: parallel and serpentine. Computational fluid dynamics (CFD) simulations were used to guide the development of the blood flow paths. Pressure data from animal tests were used to obtain pulsatile flow conditions imposed in the transient simulations. A key consideration for stable operation in vivo is limiting platelet stress accumulation to avoid platelet activation and thrombus formation. Platelet stress exposure was evaluated by CFD particle tracking methods through the devices to provide distributions of platelet stress accumulation. The distributions of stress accumulation over the duration of a platelet lifetime for each device revealed that stress accumulation for the serpentine flow path exceeded levels expected to cause platelet activation while the accumulated stress for the parallel flow path was below expected activation levels.