A Neural Mechanism in the Human Orbitofrontal Cortex for Preferring High-Fat Foods Based on Oral Texture.

Although overconsumption of high-fat foods is a major driver of weight gain, the neural mechanisms that link the oral sensory properties of dietary fat to reward valuation and eating behavior remain unclear. Here we combine novel food-engineering approaches with functional neuroimaging to show that the human orbitofrontal cortex (OFC) translates oral sensations evoked by high-fat foods into subjective economic valuations that guide eating behavior. Male and female volunteers sampled and evaluated nutrient-controlled liquid foods that varied in fat and sugar ("milkshakes"). During oral food processing, OFC activity encoded a specific oral-sensory parameter that mediated the influence of the foods' fat content on reward value: the coefficient of sliding friction. Specifically, OFC responses to foods in the mouth reflected the smooth, oily texture (i.e., mouthfeel) produced by fatty liquids on oral surfaces. Distinct activity patterns in OFC encoded the economic values associated with particular foods, which reflected the subjective integration of sliding friction with other food properties (sugar, fat, viscosity). Critically, neural sensitivity of OFC to oral texture predicted individuals' fat preferences in a naturalistic eating test: individuals whose OFC was more sensitive to fat-related oral texture consumed more fat during ad libitum eating. Our findings suggest that reward systems of the human brain sense dietary fat from oral sliding friction, a mechanical food parameter that likely governs our daily eating experiences by mediating interactions between foods and oral surfaces. These findings identify a specific role for the human OFC in evaluating oral food textures to mediate preference for high-fat foods.SIGNIFICANCE STATEMENT Fat and sugar enhance the reward value of food by imparting a sweet taste and rich mouthfeel but also contribute to overeating and obesity. Here we used a novel food-engineering approach to realistically quantify the physical-mechanical properties of high-fat liquid foods on oral surfaces and used functional neuroimaging while volunteers sampled these foods and placed monetary bids to consume them. We found that a specific area of the brain's reward system, the orbitofrontal cortex, detects the smooth texture of fatty foods in the mouth and links these sensory inputs to economic valuations that guide eating behavior. These findings can inform the design of low-calorie fat-replacement foods that mimic the impact of dietary fat on oral surfaces and neural reward systems.

Preferences for nutrients and sensory food qualities identify biological sources of economic values in monkeys.

Value is a foundational concept in reinforcement learning and economic choice theory. In these frameworks, individuals choose by assigning values to objects and learn by updating values with experience. These theories have been instrumental for revealing influences of probability, risk, and delay on choices. However, they do not explain how values are shaped by intrinsic properties of the choice objects themselves. Here, we investigated how economic value derives from the biologically critical components of foods: their nutrients and sensory qualities. When monkeys chose nutrient-defined liquids, they consistently preferred fat and sugar to low-nutrient alternatives. Rather than maximizing energy indiscriminately, they seemed to assign subjective values to specific nutrients, flexibly trading them against offered reward amounts. Nutrient-value functions accurately modeled these preferences, predicted choices across contexts, and accounted for individual differences. The monkeys' preferences shifted their daily nutrient balance away from dietary reference points, contrary to ecological foraging models but resembling human suboptimal eating in free-choice situations. To identify the sensory basis of nutrient values, we developed engineering tools that measured food textures on biological surfaces, mimicking oral conditions. Subjective valuations of two key texture parameters-viscosity and sliding friction-explained the monkeys' fat preferences, suggesting a texture-sensing mechanism for nutrient values. Extended reinforcement learning and choice models identified candidate neuronal mechanisms for nutrient-sensitive decision-making. These findings indicate that nutrients and food textures constitute critical reward components that shape economic values. Our nutrient-choice paradigm represents a promising tool for studying food-reward mechanisms in primates to better understand human-like eating behavior and obesity.

Association of Collagen, Elastin, Glycosaminoglycans, and Macrophages With Tissue Ultimate Material Strength and Stretch in Human Thoracic Aortic Aneurysms: A Uniaxial Tension Study.

Fiber structures and pathological features, e.g., inflammation and glycosaminoglycan (GAG) deposition, are the primary determinants of aortic mechanical properties which are associated with the development of an aneurysm. This study is designed to quantify the association of tissue ultimate strength and extensibility with the structural percentage of different components, in particular, GAG, and local fiber orientation. Thoracic aortic aneurysm (TAA) tissues from eight patients were collected. Ninety-six tissue strips of thickened intima, media, and adventitia were prepared for uni-extension tests and histopathological examination. Area ratios of collagen, elastin, macrophage and GAG, and collagen fiber dispersion were quantified. Collagen, elastin, and GAG were layer-dependent and the inflammatory burden in all layers was low. The local GAG ratio was negatively associated with the collagen ratio (r2 = 0.173, p < 0.05), but positively with elastin (r2 = 0.037, p < 0.05). Higher GAG deposition resulted in larger local collagen fiber dispersion in the media and adventitia, but not in the intima. The ultimate stretch in both axial and circumferential directions was exclusively associated with elastin ratio (axial: r2 = 0.186, p = 0.04; circumferential: r2 = 0.175, p = 0.04). Multivariate analysis showed that collagen and GAG contents were both associated with ultimate strength in the circumferential direction, but not with the axial direction (collagen: slope = 27.3, GAG: slope = -18.4, r2 = 0.438, p = 0.002). GAG may play important roles in TAA material strength. Their deposition was found to be associated positively with the local collagen fiber dispersion and negatively with ultimate strength in the circumferential direction.

Finite Element Model for Hydrocephalus and Idiopathic Intracranial Hypertension.

Hydrocephalus and idiopathic intracranial hypertension (IIH) are neuropathies associated with disturbed cerebrospinal fluid dynamics. Several finite element (FE) brain models were suggested to simulate the pathological changes in hydrocephalus, but with overly simplified assumptions regarding the properties of the brain parenchyma. This study proposes a two-dimensional FE brain model, capable of simulating both hydrocephalus and IIH by incorporating poro-hyperelasticity of the brain and detailed structural information (i.e., sulci).

Sound and Noise Sources in Sonotubometry: An Investigation of Eustachian Tube Assessment.

This research aims to enhance the understanding of the acoustic processes occurring during sonotubometry, a method used to assess the Eustachian tube (ET) function. Recent advancements in digital signal processing enable a more comprehensive data analysis. In this project, a silicone model of the ET was developed to systematically study the existing noise and sound sources. These measurements were then compared with recordings from human subjects. Three distinct 'noise sources' were identified, which can influence the assessment of the ET opening using transmission measurements of the imposed signal: sound leakage from the speaker, a clicking noise at the initiation of ET opening, and rumbling/swallowing noise. Through spectral analysis, it was also possible to ascertain the spectral and temporal occurrence of these sound and noise types. The silicone model exhibited remarkable similarity to the healthy human ET, making it a robust experimental model for investigating the acoustics of sonotubometry. The findings underscore the significance of delving deeper into the analysed sound, as the noise occurring during sonotubometry can be easily misconstrued as an actual ET opening. Particularly, careful consideration is warranted when evaluating data involving clicking and swallowing noise.

Could spinal cord oscillation contribute to spinal cord injury in degenerative cervical myelopathy?

Introduction: Degenerative Cervical Myelopathy [DCM] is a slow-motion spinal cord injury. Compression and dynamic compression have been considered disease hallmarks. However, this is likely an oversimplification, as compression is more commonly incidental and has only modest correlation to disease severity. MRI studies have recently suggested spinal cord oscillation could play a role. Research question: To determine if spinal cord oscillation could contribute to spinal cord injury in degenerative cervical myelopathy. Material and methods: A computational model of an oscillating spinal cord was developed from imaging of a healthy volunteer. Using finite element analysis, the observed implications of stress and strain, were measured in the context of a simulated disc herniation. The significance was bench marked by comparison to a more recognised dynamic injury mechanism; a flexion extension model of dynamic compression. Results: Spinal cord oscillation altered both compressive and shear strain on the spinal cord. Following initial compression, compressive strain moves from within the spinal cord to the spinal cord surface, whilst shear strain is magnified by 0.1-0.2, depending on the amplitude of oscillation. These orders of magnitude are equivalent to a dynamic compression model. Discussion and conclusion: Spinal cord oscillation could significantly contribute to spinal cord damage across DCM. Its repeated occurrence with every heartbeat, draws parallels to the concept of fatigue damage, which could reconcile differing theories on the origins of DCM. This remains hypothetical at this stage, and further investigations are required.

3D printed biomimetic cochleae and machine learning co-modelling provides clinical informatics for cochlear implant patients.

Cochlear implants restore hearing in patients with severe to profound deafness by delivering electrical stimuli inside the cochlea. Understanding stimulus current spread, and how it correlates to patient-dependent factors, is hampered by the poor accessibility of the inner ear and by the lack of clinically-relevant in vitro, in vivo or in silico models. Here, we present 3D printing-neural network co-modelling for interpreting electric field imaging profiles of cochlear implant patients. With tuneable electro-anatomy, the 3D printed cochleae can replicate clinical scenarios of electric field imaging profiles at the off-stimuli positions. The co-modelling framework demonstrated autonomous and robust predictions of patient profiles or cochlear geometry, unfolded the electro-anatomical factors causing current spread, assisted on-demand printing for implant testing, and inferred patients' in vivo cochlear tissue resistivity (estimated mean = 6.6 kΩcm). We anticipate our framework will facilitate physical modelling and digital twin innovations for neuromodulation implants.

Accuracy and repeatability of fourier velocity encoded M-mode and two-dimensional cine phase contrast for pulse wave velocity measurement in the descending aorta.

PURPOSE: To assess the accuracy and repeatability of Fourier velocity encoded (FVE) M-mode and two-dimensional (2D) phase contrast with through-plane velocity encoding (2D-PC) for pulse wave velocity (PWV) evaluation in the descending aorta using five different analysis techniques. MATERIALS AND METHODS: Accuracy experiments were conducted on a tubular human-tissue-mimicking phantom integrated into a flow simulator. The theoretical PWV value was derived from the Moens-Korteweg equation after measurement of the tube elastic modulus by uniaxial tensile testing (PWV = 6.6 +/- 0.7 m/s). Repeatability was assessed on 20 healthy volunteers undergoing three consecutive MR examinations. RESULTS: FVE M-mode PWV was more repeatable than 2D-PC PWV independently of the analysis technique used. The early systolic fit (ESF) method, followed by the maximum of the first derivative (1st der.) method, was the most accurate (PWV = 6.8 +/- 0.4 m/s and PWV = 7.0 +/- 0.6 m/s, respectively) and repeatable (inter-scan within-subject variation delta = 0.096 and delta = 0.107, respectively) for FVE M-mode. For 2D-PC, the 1st der. method performed best in terms of accuracy (PWV = 6.8 +/- 1.1 m/s), whereas the ESF algorithm was the most repeatable (delta = 0.386). CONCLUSION: FVE M-mode allows rapid, accurate and repeatable central PWV evaluation when the ESF algorithm is used. 2D-PC requires long scan times and can provide accurate although much less repeatable PWV measurements when the 1st der. method is used.

Accuracy of phase contrast, black-blood, and bright-blood pulse sequences for measuring compliance and distensibility coefficients in a human-tissue mimicking phantom.

PURPOSE: To assess the accuracy of MR-derived luminal diameter variations and its implications for compliance (CC) and distensibility coefficients (DC) by comparison with high-resolution digital photography (HRDP) in a tissue-mimicking phantom with pulsatile flow. MATERIALS AND METHODS: Diameters, CC, and DC extracted using cine phase-contrast (CPC), cine bright-blood (CBrB), and a cine black-blood (CBB) sequence were compared. The diameter in the left-right direction was compared against HRDP, as the gold-standard. The experiments were performed using 256(2) and 512(2) matrix sizes. Bland-Altman analysis was performed to compare each sequence with the gold-standard in terms of diameter changes over the simulated cardiac cycle. RESULTS: The bias and 95% limits of agreement (LOA) for CBB and CBrB were comparable. The bias for CPC was larger, however, the LOA were comparable. Increasing spatial resolution improved agreement with HRDP for all sequences. CBrB-derived CC and DC were within 3% of the high resolution CBB values while CPC CC and DC were underestimated but still within 11%. CONCLUSION: CPC images were found to underestimate the luminal area over the cardiac cycle. CBrB-derived diameters were more accurate in diastole while CBB-derived diameters gave the best results in systole. CC and DC varied depending on the pulse sequence.

The hemodynamic effects of in-tandem carotid artery stenosis: implications for carotid endarterectomy.

OBJECTIVES: It remains controversial whether patients with severe disease of the internal carotid artery and a coexisting stenotic lesion downstream would benefit from a carotid endarterectomy (CEA) of the proximal lesion. The aim of this study was to simulate the hemodynamic and wall shear effects of in-tandem internal carotid artery stenosis using a computational fluid dynamic (CFD) idealized model to give insight into the possible consequences of CEA on these lesions. METHODS: A CFD model of steady viscous flow in a rigid tube with two asymmetric stenoses was introduced to simulate blood flow in arteries with multiple constrictions. The effect of varying the distance between the two stenoses, and the severity of the upstream stenosis on the pressure and wall shear stress (WSS) distributions on the second plaque, was investigated. The influence of the relative positions of the two stenoses was also assessed. RESULTS: The distance between the plaques was found to have minimal influence on the overall hemodynamic effect except for the presence of a zone of low WSS (range -20 to 30 dyne/cm2) adjacent to both lesions when the two stenoses were sufficiently close (<4 times the arterial diameter). The upstream stenosis was protective if it was larger than the downstream stenosis. The relative positions of the stenoses were found to influence the WSS but not the pressure distribution. CONCLUSIONS: The geometry and positions of the lesions need to be considered when considering the hemodynamic effects of an in-tandem stenosis. Low WSS is thought to cause endothelial dysfunction and initiate atheroma formation. The fact that there was a flow recirculation zone with low WSS in between the two stenoses may demonstrate how two closely positioned plaques may merge into one larger lesion. Decision making for CEA may need to take into account the hemodynamic situation when an in-tandem stenosis is found. CFD may aid in the risk stratification of patients with this problem.

Evaluation of the repeatability of kinetic and temporospatial gait variables measured with a pressure-sensitive treadmill for dogs.

OBJECTIVE: To evaluate intrasession and intersession repeatability of measurements for temporospatial and kinetic variables obtained with a pressure-sensitive treadmill designed for gait analysis of dogs. ANIMALS: 16 client-owned dogs. PROCEDURES: The influence of treadmill speed on accuracy of ground reaction force (GRF) measurements was assessed by simulated gait analysis at 0 to 7.5 km/h with a custom test device. A similar test was performed with 1 client-owned dog ambulating on the treadmill at 5 speeds (3 to 7 km/h) for GRF calculations. Fifteen client-owned dogs were then walked on the treadmill at 3 km/h for collection of temporospatial and kinetic data. Intrasession repeatability was determined by comparing 2 sets of measurements obtained ≤ 2 hours apart. Intersession repeatability was determined by comparing the first set of these measurements with those for a second session ≥ 4 days later. Intraclass correlation coefficients (ICCs; consistency test) and difference ratios were calculated to assess repeatability. RESULTS: Increases in treadmill speed yielded a mean 9.1% decrease in weight-normalized force data at belt speeds of up to 7.5 km/h for the test device, compared with the value when the treadmill belt was stationary. Results were similar for the dog at increasing treadmill speeds (mean decrease, 12.4%). For temporospatial data, intrasession ICCs were > 0.9 and intersession ICCs ranged from 0.75 to 0.9; for GRFs, intrasession and intersession ICCs ranged from 0.68 to 0.97 and from 0.35 to 0.78, respectively. CONCLUSIONS AND CLINICAL RELEVANCE: Repeatability of temporospatial data for healthy dogs was good to excellent; results for kinetic data varied. Further research is needed to investigate use of this system for gait analysis with larger samples of dogs and dogs with lameness.

Associations between voxel-level accumulated dose and rectal toxicity in prostate radiotherapy.

BACKGROUND AND PURPOSE: Associations between dose and rectal toxicity in prostate radiotherapy are generally poorly understood. Evaluating spatial dose distributions to the rectal wall (RW) may lead to improvements in dose-toxicity modelling by incorporating geometric information, masked by dose-volume histograms. Furthermore, predictive power may be strengthened by incorporating the effects of interfraction motion into delivered dose calculations.Here we interrogate 3D dose distributions for patients with and without toxicity to identify rectal subregions at risk (SRR), and compare the discriminatory ability of planned and delivered dose. MATERIAL AND METHODS: Daily delivered dose to the rectum was calculated using image guidance scans, and accumulated at the voxel level using biomechanical finite element modelling. SRRs were statistically determined for rectal bleeding, proctitis, faecal incontinence and stool frequency from a training set (n = 139), and tested on a validation set (n = 47). RESULTS: SRR patterns differed per endpoint. Analysing dose to SRRs improved discriminative ability with respect to the full RW for three of four endpoints. Training set AUC and OR analysis produced stronger toxicity associations from accumulated dose than planned dose. For rectal bleeding in particular, accumulated dose to the SRR (AUC 0.76) improved upon dose-toxicity associations derived from planned dose to the RW (AUC 0.63). However, validation results could not be considered significant. CONCLUSIONS: Voxel-level analysis of dose to the RW revealed SRRs associated with rectal toxicity, suggesting non-homogeneous intra-organ radiosensitivity. Incorporating spatial features of accumulated delivered dose improved dose-toxicity associations. This may be an important tool for adaptive radiotherapy in the future.

The monitoring of relative changes in compartmental compliances of brain.

The study aimed to develop a computational method for assessing relative changes in compartmental compliances within the brain: the arterial bed and the cerebrospinal space. The method utilizes the relationship between pulsatile components in the arterial blood volume, arterial blood pressure (ABP) and intracranial pressure (ICP). It was verified by using clinical recordings of intracranial pressure plateau waves, when massive vasodilatation accompanying plateau waves produces changes in brain compliances of the arterial bed (C(a)) and compliance of the cerebrospinal space (C(i)). Ten patients admitted after head injury with a median Glasgow Coma Score of 6 were studied retrospectively. ABP was directly monitored from the radial artery. Changes in the cerebral arterial blood volume were assessed using Transcranial Doppler (TCD) ultrasonography by digital integration of inflow blood velocity. During plateau waves, ICP increased (P = 0.001), CPP decreased (P = 0.001), ABP remained constant (P = 0.532), blood flow velocity decreased (P = 0.001). Calculated compliance of the arterial bed C(a) increased significantly (P = 0.001); compliance of the CSF space C(i) decreased (P = 0.001). We concluded that the method allows for continuous monitoring of relative changes in brain compartmental compliances. Plateau waves affect the balance between vascular and CSF compartments, which is reflected by the inverse change of compliance of the cerebral arterial bed and global compliance of the CSF space.

The effect of vancomycin addition to the compression strength of antibiotic-loaded bone cements.

The purpose of this study was to record the effect of the addition of vancomycin on the compression strength of antibiotic-loaded bone cement and to compare the results with the international standards (ISO 5833-2). The formulations tested were: Palamed G and Copal. Vancomycin concentrations of 2.5%, 5% and 10% per powder weight were added. Samples of Palamed G with 5% vancomycin and non-standardised mixing procedures were also tested. The ISO requirements for the testing procedures were followed. None of the combinations tested fall short of the ISO standards for compression strength. Copal with 10% and Palamed G with 5% vancomycin and non-standardised mixing procedures, however, did not significantly exceed them. The addition of up to 5% vancomycin per powder weight to the Palamed G and Copal bone cements can be considered safe. Care should be given to the mixing procedure of the cement, as it significantly affects its compression strength.

Adhesive-based tendon-to-bone repair: failure modelling and materials selection.

Surgical reattachment of tendon to bone is a procedure marked by high failure rates. For example, nearly all rotator cuff repairs performed on elderly patients with massive tears ultimately result in recurrence of tearing. These high failure rates have been attributed to stress concentrations that arise due to the mechanical mismatch between tendon and bone. Although recent studies have identified potential adhesives with mechanical properties tuned to alleviate these stress concentrations, and thereby delay the onset of failure, resistance to the progression of failure has not been studied. Here, we refined the space of adhesive material properties that can improve surgical attachment by considering the fracture process. Using cohesive zone modelling and physiologically relevant values of mode I and mode II adhesive fracture toughnesses, we predicted the maximum displacement and strength at failure of idealized, adhesively bonded tendon-to-bone repairs. Repair failure occurred due to excessive relative displacement of the tendon and bone tissues for strong and compliant adhesives. The failure mechanism shifted to rupture of the entire repair for stiffer adhesives below a critical shear strength. Results identified a narrow range of materials on an Ashby chart that are suitable for adhesive repair of tendon to bone, including a range of elastomers and porous solids.

Bayesian Inference-Based Estimation of Normal Aortic, Aneurysmal and Atherosclerotic Tissue Mechanical Properties: From Material Testing, Modeling and Histology.

OBJECTIVE: Mechanical properties of healthy, aneurysmal, and atherosclerotic arterial tissues are essential for assessing the risk of lesion development and rupture. Strain energy density function (SEDF) has been widely used to describe these properties, where material constants of the SEDF are traditionally determined using the ordinary least square (OLS) method. However, the material constants derived using OLS are usually dependent on initial guesses. METHODS: To avoid such dependencies, Bayesian inference-based estimation was used to fit experimental stress-stretch curves of 312 tissue strips from 8 normal aortas, 19 aortic aneurysms, and 21 carotid atherosclerotic plaques to determine the constants, C1, D1, and D2 of the modified Mooney-Rivlin SEDF. RESULTS: Compared with OLS, material constants varied much less with prior in the Bayesian inference-based estimation. Moreover, fitted material constants differed amongst distinct tissue types. Atherosclerotic tissues associated with the biggest D2, an indicator of the rate of increase in stress during stretching, followed by aneurysmal tissues and those from normal aortas. Histological analyses showed that C1 and D2 were associated with elastin content and details of the collagen configuration, specifically, waviness and dispersion, in the structure. CONCLUSION: Bayesian inference-based estimation robustly determines material constants in the modified Mooney-Rivlin SEDF and these constants can reflect the inherent physiological and pathological features of the tissue structure. SIGNIFICANCE: This study suggested a robust procedure to determine the material constants in SEDF and demonstrated that the obtained constants can be used to characterize tissues from different types of lesions, while associating with their inherent microstructures.

Impact of Fiber Structure on the Material Stability and Rupture Mechanisms of Coronary Atherosclerotic Plaques.

The rupture of an atherosclerotic plaque in the coronary circulation remains the main cause of heart attack. As a fiber-oriented structure, the fiber structure, in particular in the fibrous cap (FC), may affect both loading and material strength in the plaque. However, the role of fiber orientation and dispersion in plaque rupture is unclear. Local orientation and dispersion of fibers were calculated for the shoulder regions, mid FC, and regions with intimal thickening (IT) from histological images of 16 human coronary atherosclerotic lesions. Finite element analysis was performed to assess the effect of these properties on mechanical conditions. Fibers in shoulder regions had markedly reduced alignment (Median [interquartile range] 12.9° [6.6, 18.0], p < 0.05) compared with those in mid FC (6.1° [5.5, 9.0]) and IT regions (6.7° [5.1, 8.6]). Fiber dispersion was highest in shoulders (0.150 [0.121, 0.192]), intermediate in IT (0.119 [0.103, 0.144]), and lowest in mid FC regions (0.093 [0.081, 0.105], p < 0.05). When anisotropic properties were considered, stresses were significantly higher for the mid FC (p = 0.030) and IT regions (p = 0.002) and no difference was found for the shoulder or global regions. Shear (sliding) stress between fibers in each region and their proportion of maximum principal stress were: shoulder (25.8 kPa [17.1, 41.2], 12.4%), mid FC (13.9 kPa [5.8, 29.6], 13.8%), and IT (36.5 kPa [25.9, 47.3], 15.5%). Fiber structure within the FC has a marked effect on principal stresses, resulting in considerable shear stress between fibers. Fiber structure including orientation and dispersion may determine mechanical strength and thus rupture of atherosclerotic plaques.

A Review of Natural Joint Systems and Numerical Investigation of Bio-Inspired GFRP-to-Steel Joints.

There are a great variety of joint types used in nature which can inspire engineering joints. In order to design such biomimetic joints, it is at first important to understand how biological joints work. A comprehensive literature review, considering natural joints from a mechanical point of view, was undertaken. This was used to develop a taxonomy based on the different methods/functions that nature successfully uses to attach dissimilar tissues. One of the key methods that nature uses to join dissimilar materials is a transitional zone of stiffness at the insertion site. This method was used to propose bio-inspired solutions with a transitional zone of stiffness at the joint site for several glass fibre reinforced plastic (GFRP) to steel adhesively bonded joint configurations. The transition zone was used to reduce the material stiffness mismatch of the joint parts. A numerical finite element model was used to identify the optimum variation in material stiffness that minimises potential failure of the joint. The best bio-inspired joints showed a 118% increase of joint strength compared to the standard joints.

Modelling of Brain Deformation After Decompressive Craniectomy.

Hyperelastic finite element models, with either an idealized cylindrical geometry or with realistic craniectomy geometries, were used to explore clinical issues relating to decompressive craniectomy. The potential damage in the brain tissue was estimated by calculating the volume of material exceeding a critical shear strain. Results from the idealized model showed how the potentially damaged volume of brain tissue increased with an increasing volume of brain tissue herniating from the skull cavity and with a reduction in craniectomy area. For a given herniated volume, there was a critical craniectomy diameter where the volume exceeding a critical shear strain fell to zero. The effects of details at the craniectomy edge, specifically a fillet radius and a chamfer on the bone margin, were found to be relatively slight, assuming that the dura is retained to provide effective protection. The location in the brain associated with volume expansion and details of the material modeling were found to have a relatively modest effect on the predicted damage volume. The volume of highly sheared material in the realistic models of the craniectomy varied roughly in line with differences in the craniectomy area.

Recalculation of dose for each fraction of treatment on TomoTherapy.

OBJECTIVE: The VoxTox study, linking delivered dose to toxicity requires recalculation of typically 20-37 fractions per patient, for nearly 2000 patients. This requires a non-interactive interface permitting batch calculation with multiple computers. METHODS: Data are extracted from the TomoTherapy(®) archive and processed using the computational task-management system GANGA. Doses are calculated for each fraction of radiotherapy using the daily megavoltage (MV) CT images. The calculated dose cube is saved as a digital imaging and communications in medicine RTDOSE object, which can then be read by utilities that calculate dose-volume histograms or dose surface maps. The rectum is delineated on daily MV images using an implementation of the Chan-Vese algorithm. RESULTS: On a cluster of up to 117 central processing units, dose cubes for all fractions of 151 patients took 12 days to calculate. Outlining the rectum on all slices and fractions on 151 patients took 7 h. We also present results of the Hounsfield unit (HU) calibration of TomoTherapy MV images, measured over an 8-year period, showing that the HU calibration has become less variable over time, with no large changes observed after 2011. CONCLUSION: We have developed a system for automatic dose recalculation of TomoTherapy dose distributions. This does not tie up the clinically needed planning system but can be run on a cluster of independent machines, enabling recalculation of delivered dose without user intervention. ADVANCES IN KNOWLEDGE: The use of a task management system for automation of dose calculation and outlining enables work to be scaled up to the level required for large studies.