Lumbar intervertebral disc segmentation for computer modeling and simulation.

BACKGROUND AND OBJECTIVE: The present work had as its main objective the development of a method for localizing and automatically segmenting lumbar intervertebral discs (IVD) in 3D from magnetic resonance imaging (MRI), with the goal of supporting the generation of finite element (FE) models from actual lumbar spine anatomy, by providing accurate and personalized information on the shape of the patient's IVD. The extension of the method to allow performing separate segmentations of the IVD's two main structures - annulus fibrosus (AF) and nucleus pulposus (NP) - as well as automatically detecting degenerated IVD where this distinction is no longer possible was also an objective of the work. METHODS: The method presented here evolves from 2D segmentations in the sagittal profile using Gabor filters towards 3D segmentations. It works by detecting the spine curves and intensity regions corresponding to IVD. As so, the 2D method from Zhu et al. (2013) was partially implemented, modified and adapted to 3D use, and then tested with eight spines from two separated online datasets. The 3D adaptation was achieved by using vertebral body segmentation masks to approximate the shape of the vertebrae and to adjust the spine curves accordingly. RESULTS: The method showed average values of 85%, 83% and 96% for the Dice coefficient, sensitivity and specificity, respectively. The method correctly identified 65 of 68 (96%) IVD as either healthy or degenerated. The method's Dice coefficient is within the range of existing 3D IVD segmentation methods in the literature (81-92%). The method took on average 6-7 s to perform a full 3D segmentation, which is well within the range of the existing methods (2 s - 19 min). CONCLUSIONS: The developed method can be used to generate accurate 3D models of the IVD based on MRI, with AF/NP distinction and detection of marked degeneration by comparing each IVD with the remaining spine levels. Further work shall improve the method towards distinguishing between specific levels of degeneration for clinically oriented FE modeling.

Computational modeling of lumbar disc degeneration before and after spinal fusion.

BACKGROUND: Advancing age and degeneration frequently lead to low back pain, which is the most prevalent musculoskeletal disorder worldwide. Degenerative changes in intervertebral discs and musculo-ligamentous incapacity to compensate sagittal imbalance are typically amongst the sources of instability, with spinal fusion techniques being the main treatment options to relieve pain. The aims of this work were to: (i) assess the link between ligament degeneration and spinal instability by determining the role of each ligament per movement, (ii) evaluate the impact of disc height reduction in degenerative changes, and (iii) unveil the most advantageous type of posterior fixation in Oblique Lumbar Interbody Fusion to prevent adjacent disc degeneration. METHODS: Two L3-L5 finite element models were developed, being the first in healthy condition and the second having reduced L4-L5 height. Different degrees of degeneration were tested, combined with different fixation configurations for Oblique Lumbar Interbody Fusion. FINDINGS: Facet capsular ligament and anterior longitudinal ligament were the most influential ligaments for spinal stability, particularly with increasing degeneration and disc height reduction. Pre-existent degeneration had lower influence than the fusion procedure for the risk of adjacent disc degeneration, being the highest stability and minimal degeneration achieved with bilateral fixation. Right unilateral fixation was more suited to reduce disc stress than left unilateral fixation. INTERPRETATION: Bilateral fixation is the best option to stabilize the spinal segment, but unilateral right fixation may suffice. This has direct implications for clinical practice, and the extension to a population-based study will allow for more efficient fusion surgeries.

Gravity stress tibiotalar laxity evaluation with a biomedical gyroscopes device - cadaver study with progressive sectioning of lateral ankle ligaments.

PURPOSE: Despite the evidence on the role of gravity stress test to access the instability of other ankle injuries, there is limited literature regarding gravity stress on the lateral ankle ligament's insufficiency. The objective of our study was to objectively measure the tibiotalar angular movement under gravity stress after progressive sectioning of the lateral ankle ligaments. METHODS: We performed sequential sectioning of the anterior talofibular (ATFL), calcaneofibular (CFL), and posterior talofibular ligaments (PTFL) in twelve ankle specimens. Under gravity stress, we measured the angular movement of the talus in relation to the tibia. The measuring device is based on a three-axis gyroscope and accelerometer. RESULTS: Comparing to the intact condition, the plantar flexion increased on average 1.78° (95% confidence interval [CI] 1.15;2.42), 5.13° (95%CI 3.10;7.16) and 8.63° (95%CI 6.05;11.22), the rotation increased by 1.00° (95 CI -0.51;2.51), 3.68° (95%CI 1.97;5.40) and 15.62° (95%CI 10.09;21.14), and the varus increased 2.89° (95% CI 1.39, 4.39), 8.12° (95% CI 5.16, 11.07) and 11.68° (95% CI 7.91, 15.46), after sectioning the ATFL, CFL, and PTFL, respectively. The overall changes were statistically significant. CONCLUSIONS: There was a significant tibiotalar laxity after sectioning of lateral ankle ligaments when the foot position is influenced only by gravity. The tibiotalar angular displacement was significant when the CFL and PTFL were cut which suggests that the gravity test could be used to assess combined lateral ankle ligament injury. This evidence might be a step forward in the development of lateral ankle ligaments gravity stress tests. LEVEL OF EVIDENCE: 5 (cadaver study).

Reply to Comment "Assessing Porous Media Permeability in Non-Darcy Flow: A Re-Evaluation Based on the Forchheimer Equation".

In the name of the authors of the paper "Permeability versus Design in TPMS Scaffolds", published in Materials in 2019 and already counting six citations in Google Scholar to date, I would like to formally respond to the comment manuscript now entitled "Assessing Porous Media Permeability in Non-Darcy Flow: A Re-Evaluation Based on the Forchheimer Equation" [...].

Permeability versus Design in TPMS Scaffolds.

Scaffolds for bone tissue engineering are porous structures that serve as support for cellular growth and, therefore, new tissue formation. The present work assessed the influence of the porous architecture of triply periodic minimal surface (TPMS) scaffolds on their macroscopic permeability behavior, combining numerical and experimental methods. The TPMS scaffolds considered were Schwartz D, Schwartz P, and Gyroid, which have been previously studied for bone tissue engineering, with 70% porosity. On the experimental side, these scaffolds were produced by MultiJet 3D printing and tested for fluid passage to calculate their permeability through Darcy's Law. On the numerical side, finite element (FE) models of the scaffolds were simulated on ABAQUS® for fluid passage under compression to assess potential fluid concentration spots. The outcomes revealed that the design of the unit cell had a noticeable effect on both calculated permeability and FE computed fluid flow velocity, regardless of the identical porosity, with the Gyroid scaffold having higher permeability and the Schwartz P a lower probability of fluid trapping. Schwartz D had the worst outcomes in both testing modalities, so these scaffolds would most likely be the last choice for promoting cell differentiation onto bone cells. Gyroid and Schwartz P would be up for selection depending on the application and targeted bone tissue.

Numerical and experimental evaluation of TPMS Gyroid scaffolds for bone tissue engineering.

The combination of computational methods with 3D printing allows for the control of scaffolds microstructure. Lately, triply periodic minimal surfaces (TPMS) have been used to design porosity-controlled scaffolds for bone tissue engineering (TE). The goal of this work was to assess the mechanical properties of TPMS Gyroid structures with two porosity levels (50 and 70%). The scaffold stiffness function of porosity was determined by the asymptotic homogenisation method and confirmed by mechanical testing. Additionally, microCT analysis confirmed the quality of the printed parts. Thus, the potential of both design and manufacturing processes for bone TE applications is here demonstrated.

Stress-induced birefringence in the isotropic phases of lyotropic mixtures.

In this work, the frequency dependence of the known mechano-optical effect which occurs in the micellar isotropic phases (I) of mixtures of potassium laurate (KL), decanol (DeOH), and water is investigated in the range from 200mHz to 200Hz. In order to fit the experimental data, a model of superimposed damped harmonic oscillators is proposed. In this phenomenological approach, the micelles (microscopic oscillators) interact very weakly with their neighbors. Due to shape anisotropy of the basic structures, each oscillator i (i=1,2,3,...,N) remains in its natural oscillatory rotational movement around its axes of symmetry with a frequency ω_{0i}. The system will be in the resonance state when the frequency of the driving force ω reaches a value near ω_{0i}. This phenomenological approach shows excellent agreement with the experimental data. One can find f∼2.5, 9.0, and 4.0Hz as fundamental frequencies of the micellar isotropic phases I, I_{1}, and I_{2}, respectively. The different micellar isotropic phases I, I_{1}, and I_{2} that we find in the phase diagram of the KL-DeOH-water mixture are a consequence of possible differences in the intermicellar correlation lengths. This work reinforces the possibilities of technological applications of these phases in devices such as mechanical vibration sensors.

Computational model of mesenchymal migration in 3D under chemotaxis.

Cell chemotaxis is an important characteristic of cellular migration, which takes part in crucial aspects of life and development. In this work, we propose a novel in silico model of mesenchymal 3D migration with competing protrusions under a chemotactic gradient. Based on recent experimental observations, we identify three main stages that can regulate mesenchymal chemotaxis: chemosensing, dendritic protrusion dynamics and cell-matrix interactions. Therefore, each of these features is considered as a different module of the main regulatory computational algorithm. The numerical model was particularized for the case of fibroblast chemotaxis under a PDGF-bb gradient. Fibroblasts migration was simulated embedded in two different 3D matrices - collagen and fibrin - and under several PDGF-bb concentrations. Validation of the model results was provided through qualitative and quantitative comparison with in vitro studies. Our numerical predictions of cell trajectories and speeds were within the measured in vitro ranges in both collagen and fibrin matrices. Although in fibrin, the migration speed of fibroblasts is very low, because fibrin is a stiffer and more entangling matrix. Testing PDGF-bb concentrations, we noticed that an increment of this factor produces a speed increment. At 1 ng mL-1 a speed peak is reached after which the migration speed diminishes again. Moreover, we observed that fibrin exerts a dampening behavior on migration, significantly affecting the migration efficiency.

Valor nutritivo de pastagens de Coastcross-1 em consórcio com diferentes leguminosas de ciclo hibernal / Nutritive value of coastcross-1 pastures mixed to different cool season legumes

Objetivou-se com esta pesquisa avaliar três sistemas forrageiros constituídos por Coastcross-1 (CC) + 100kg de N/ha/ano + ervilhaca comum; CC + 100kg de N/ha/ano + trevo vesiculoso; e CC + 200kg de N/ha/ano. Durante o período experimental (345 dias), foram realizados treze pastejos. O delineamento experimental utilizado foi o inteiramente ao acaso, com três tratamentos (sistemas forrageiros), três repetições (piquetes) em parcelas subdividas no tempo (valores médios dos pastejos em cada estação do ano). Para avaliação, foram utilizadas vacas em lactação da raça Holandesa. Amostras de simulação de pastejo foram coletadas para análise de proteína bruta (PB), fibra em detergente neutro (FDN) e ácido (FDA), digestibilidade in situ da matéria seca (DISMS) e da matéria orgânica (DISMO) e os nutrientes digestíveis totais (NDT). Os valores médios para PB, FDN, FDA, DISMS, DISMO e NDT foram de 18,1; 16,7 e 17,6%; 57,8; 58,9 e 58,7%; 26,5; 26,5 e 26,7%; 79,6; 78,9 e 80,6%; 79,8; 79,1 e 80,6%; 72,1; 71,4 e 72,7%, respectivamente. Melhores resultados de valor nutritivo foram obtidos no inverno, em especial para o consórcio de Coastcross-1 com ervilhaca.

The aim of this research was to evaluate three grazing systems with Coastcross-1 (CC) + 100kg N/ha/year + common vetch; CC + 100kg N/ha/year + arrowleaf clover; and CC + 200kg N/ha/year. Thirteen grazing cycles were performed during the experimental period (345 days). The experimental design was completely randomized with three treatments (grazing systems), three replicates (paddocks) in completely split-plot time (average values of grazing season). Lactating Holstein cows were used in the evaluation. Forage mass and botanical composition were evaluated. Samples from the hand-plucking method were collected to analyze crude protein (CP), neutral detergent fiber (NDF) and acid (ADF), in situ digestibility of dry matter (ISDMD) and organic matter (ISOMD) and total digestible nutrients (TDN). The averages of CP, NDF, ADF, ISDMD, ISOMD and TDN were 18.1, 16.7 and 17.6 %; 57.8, 58.9 and 58.7 %; 26.5, 26.5 and 26.7 %; 79.6, 78.9 and 80.6 %; 79.8, 79.1 and 80.6 %; 72.1, 71.4 and 72.7 %, respectively. Better results for nutritive value were found during winter, especially on Coastcross-1 mixed with common vetch.

Computational analysis of polyethylene wear in anatomical and reverse shoulder prostheses.

The wear of ultra-high molecular weight polyethylene, UHMWPE, components has been associated with the failure of joint prostheses in the hip, knee, and shoulder. Considering that in vitro experiments are generally too expensive and time-consuming, computational models are an attractive alternative to study the wear behavior of UHMWPE components. The objective of the present study was to develop a computational wear model to evaluate the wear resistance of anatomical and reverse shoulder prostheses. The effects of the wear law and the updating of the UHMWPE surface on the prediction of wear were also considered. Apart from Archard's law, a new wear law, so-called second generation law, which includes the concept of cross-shear and a pressure-independent wear factor, was considered. The wear analyses were performed considering three shoulder joint motions. The muscle and joint reaction forces applied were estimated by an inverse biomechanical model of the upper limb. The results show that abrasive wear is as important for the reverse components as it is for the anatomical. Nevertheless, the volumetric wears estimated over 1 year are within the range considered clinically desirable to reduce the risk of osteolysis. For the anatomical components, the predictions from Archard's law compare better, than those of the second generation law, to the experimental and clinical data available in the literature. Yet, the opposite result is obtained for the reverse components. From the numerical point of view, an updating procedure for the UHMWPE surface is mandatory to improve the numerical predictions.

Human proximal femur bone adaptation to variations in hip geometry.

The study of bone mass distribution at proximal femur may contribute to understand the role of hip geometry on hip fracture risk. We examined how bone mineral density (BMD) of proximal femur adapts to inter individual variations in the femoral neck length (FNL), femoral neck width (FNW) and neck shaft angle (NSA). A parameterized and dimensionally scalable 3-D finite element model of a reference proximal femur geometry was incrementally adjusted to adopt physiological ranges at FNL (3.90-6.90cm), FNW (2.90-3.46cm), and NSA (109-141º), yielding a set of femora with different geometries. The bone mass distribution for each femur was obtained with a suitable bone remodelling model. The BMDs at the integral femoral neck (FN) and at the intertrochanteric (ITR) region, as well as the BMD ratio of inferomedial to superolateral (IM:SL) regions of FN and BMD ratio of FN:ITR were used to represent bone mass distribution. Results revealed that longer FNLs present greater BMD (g/cm(3)) at the FN, mainly at the SL region, and at the ITR region. Wider FNs were associated with reduced BMD at the FN, particularly at the SL region, and at the ITR region. Larger NSAs up to 129° were associated with BMD diminutions at the FN and ITR regions and with increases of the IM:SL BMD ratio while NSAs larger than 129° resulted in decrease of the IM:SL BMD ratio. These findings suggest hip geometry as moderator of the mechanical loading influence on bone mass distribution at proximal femur with higher FNL favoring the BMD of FN and ITR regions and greater FNW and NSA having the opposite effect. Augmented values of FNL and FNW seem also to favor more the BMD at the superolateral than at the inferomedial FN region.

Bone remodelling of the scapula after a total shoulder arthroplasty.

According to Wolff's law, the changes in stress after a prosthesis implantation may modify the shape and internal structure of bone, thus compromising the long-term prosthesis fixation and, consequently, be a significant factor for glenoid loosening. The aim of the present study is to evaluate the changes in the bone adaptation process of the scapula after an anatomical and reverse total shoulder arthroplasty. Five finite element models of the implanted scapula are developed considering the implantation of three anatomical, cemented, all-polyethylene components; an anatomical, cementless, metal-backed component; and a reverse, all-metal component. The methodology followed to simulate the bone adaptation of the scapula was previously validated for the intact model, prior to the prosthesis implantation. Additionally, the influence of the bone quality on the adaptation process is also investigated by considering an osteoporotic condition. The results show that the stress shielding phenomenon is more concerning in cementless, metal-based components than in cemented, all-polyethylene components, regardless of the bone quality. Consequently, as far as the bone adaptation process of the bone is concerned, cemented, all-polyethylene components are better suited for the treatment of the shoulder joint.

Annihilation dynamics of stringlike topological defects in a nematic lyotropic liquid crystal.

Topological defects can appear whenever there is some type of ordering. Its ubiquity in nature has been the subject of several studies, from early Universe to condensed matter. In this work, we investigated the annihilation dynamics of defects and antidefects in a lyotropic nematic liquid crystal (ternary mixture of potassium laurate, decanol and deionized-destillated water) using the polarized optical light microscopy technique. We analyzed Schlieren textures with topological defects produced due to a symmetry breaking in the transition of the isotropic to nematic calamitic phase after a temperature quench. As result, we obtained for the distance D between two annihilating defects (defect-antidefect pair), as a function of time t remaining for the annihilation, the scaling law D âˆ t(α), with α = 0.390 and standard deviation σ = 0.085. Our findings go in the direction to extend experimental results related to dynamics of defects in liquid crystals since only thermotropic and polymerics ones had been investigated. In addition, our results are in good quantitative agreement with previous investigations on the subject.

Femoral neck bone adaptation to weight-bearing physical activity by computational analysis.

Individual differences in bone mass distribution at the proximal femur may be determined by daily weight-bearing physical activity (PA) since bone self-adapts according to the mechanical loads that is submitted. The aim of this study was to analyse computationally the effect of different weight-bearing PA types in the adaptation of the femoral neck (FN) by analysing regional differences in bone mineral density (BMD) at the integral FN and its superior, inferior, anterior and posterior subregions. To achieve this, it was adopted a 3-D femoral finite element (FE) model coupled with a suitable bone remodeling model. Different PA types were determined based both on ordinary lifestyle and mechanically more demanding PA as low magnitude impacts (L-I), moderate-magnitude impacts from odd directions (O-I) and high-magnitude vertical impacts (H-I). It was observed that as time spent in weight-bearing PA increases, BMD augment around the integral FN, but with different bone mass gain rates between subregions depending on the magnitude and directions of the hip contact forces; H-I was the type of weight-bearing PA which structurally most favor the gain of bone mass superiorly at the FN while both the H-I and the O-I types of PA promoted the largest bone mass gain rates at the anterior and posterior subregions of the FN. Because these types of weight-bearing PA were associated with a more uniform bone mass spatial distribution at the FN, they should provide a potential basis for targeted PA-based intervention programs for improving hip strength.

Antipersistent behavior of defects in a lyotropic liquid crystal during annihilation.

We report on the dynamical behavior of defects of strength s=±1/2 in a lyotropic liquid crystal during the annihilation process. By following their positions using time-resolved polarizing microscopy technique, we present statistically significant evidence that the relative velocity between defect pairs is Gaussian distributed, antipersistent, and long-range correlated. We further show that simulations of the Lebwohl-Lasher model reproduce quite well our experimental findings.

Permeability analysis of scaffolds for bone tissue engineering.

Porous artificial bone substitutes, especially bone scaffolds coupled with osteobiologics, have been developed as an alternative to the traditional bone grafts. The bone scaffold should have a set of properties to provide mechanical support and simultaneously promote tissue regeneration. Among these properties, scaffold permeability is a determinant factor as it plays a major role in the ability for cells to penetrate the porous media and for nutrients to diffuse. Thus, the aim of this work is to characterize the permeability of the scaffold microstructure, using both computational and experimental methods. Computationally, permeability was estimated by homogenization methods applied to the problem of a fluid flow through a porous media. These homogenized permeability properties are compared with those obtained experimentally. For this purpose a simple experimental setup was used to test scaffolds built using Solid Free Form techniques. The obtained results show a linear correlation between the computational and the experimental permeability. Also, this study showed that permeability encompasses the influence of both porosity and pore size on mass transport, thus indicating its importance as a design parameter. This work indicates that the mathematical approach used to determine permeability may be useful as a scaffold design tool.

Biomechanical analysis of the anterior cervical fusion.

This paper presents a biomechanical analysis of the cervical C5-C6 functional spine unit before and after the anterior cervical discectomy and fusion. The aim of this work is to study the influence of the medical procedure and its instrumentation on range of motion and stress distribution. First, a three-dimensional finite element model of the lower cervical spine is obtained from computed tomography images using a pipeline of image processing, geometric modelling and mesh generation software. Then, a finite element study of parameters' influence on motion and a stress analysis at physiological and different post-operative scenarios were made for the basic movements of the cervical spine. It was confirmed that the results were very sensitive to intervertebral disc properties. The insertion of an anterior cervical plate influenced the stress distribution at the vertebral level as well as in the bone graft. Additionally, stress values in the graft decreased when it is used together with a cage.

Anomalous-diffusion approach applied to the electrical response of water.

We investigate the electrical response of Milli-Q deionized water by using a fractional diffusion equation of distributed order with the interfaces (i.e., the boundary conditions at the electrodes limiting the sample) governed by integrodifferential equations. We also consider that the positive and negative ions have the same mobility and that the electric potential profile across the sample satisfies Poisson's equation. In addition, the good agreement between the experimental data and this approach evidences the presence of anomalous diffusion due to the surface effects in this system.

Wear analysis in anatomical and reversed shoulder prostheses.

This paper describes the development of a computational model to calculate wear rates in total shoulder prostheses, for a 5-150 degrees arm abduction. Anatomical keeled and pegged prosthesis as well as reversed prosthesis were the studied implants. The bone models were built based on computed tomography (CT) images and using a computer aided design-based modelling pipeline. The finite element method was used to solve the contact problem between the surface of the polyethylene (PE) components and the corresponding articular component. The aim of this work was to determine linear and volumetric PE wear, for several radial mismatches, in conditions of pathological (rheumatoid arthritis) and non-pathological bone. Results showed that contact pressures and linear wear developed in anatomical prosthesis were higher than those visualised in reversed prosthesis. However, anatomical prosthesis exhibited a better volumetric wear performance. Moreover, our findings indicated higher values of volumetric wear in higher congruent models and on pathological bone conditions.

A quantitative comparison of a bone remodeling model with dual-energy X-ray absorptiometry and analysis of the inter-individual biological variability of femoral neck T-score.

The development of consistent procedures with the inclusion of patient-specific data is essential in the computational modeling of biological processes, in order to achieve clinical relevant data. In this work, these issues are addressed with the development of a methodology that combines the gold standard technique for bone mineral density measurement and osteoporosis diagnosis, Dual energy X-ray absorptiometry (DXA), with a computational model for bone remodeling simulation. The DXA results were divided in three samples constituted from proximal femur DXA exams of patients in different stages of bone mineral density (normal, osteopenia and osteoporosis). These results were quantitatively compared with computational model results. A correlation study was performed between femoral neck T-score and a parameter from the model to ascertain the hypothesis of adjusting the model accordingly to biological variables. The results evidenced the predictive ability of the computational model in the estimation of femoral neck bone mineral content (BMC), with a maximum relative error of 3.92%. On the other hand, a strong correlation (R=-0.862) was found between the variables in study and a mathematical relationship was obtained to estimate the range of values for a model parameter that leads to biological relevant results. The methodology developed and the results obtained represent a solid and reliable basis to further studies on bone quality, ensuring the validity of the computational model in the simulation of bone remodeling process.