FEM thermal assessment of a 3-D irregular tumor with capillaries in magnetic nanoparticle hyperthermia via dissimilar injection points.

In this study, simulation of magnetic nanoparticle hyperthermia is performed on a 3D tumor model constructed based on a CT image of a tumor. In the first step, magnetic nanoparticles are injected into two points of the tumor tissue with the same parameters. Results show that temperature profiles in the vicinity of the injection points are not similar due to the presence of blood capillaries. Therefore, the effects of using dissimilar injection parameters for the two injection points on the heating pattern and damage fraction of the tumor are investigated. The results demonstrate that using dissimilar values for injection parameters such as injection rate, injection time, and nanofluid volume fraction is a way to achieve a higher damage fraction of the tumor cells, but, the asynchronous injections strategy does not lead to more significant damage to the tumor. None of the cases showed significant improvement in the uniformity of the temperature distribution, suggesting that conducting injections under the same conditions is the best way to create an almost uniform temperature profile. The numerical simulation validation results also advocate the accuracy of the model used in this study. This research can serve as a guide for designing parameters for future studies.

Simulation of heat transfer, mass transfer and tissue damage in magnetic nanoparticle hyperthermia with blood vessels.

Numerical simulation of magnetic nanoparticle hyperthermia for cancer treatment has been investigated in this study. The presented simulation did account for the effects of fluid flow, mass flow, and heat transfer during the MNP hyperthermia. The tumor was assumed to be a porous slab, 30% of which had been necrosed previously, with two capillaries, where magnetic nanoparticles were added into the bloodstream and distributed in the tumor by blood flow through capillaries. Fluid flow, mass transfer by capillaries, and interstitial tissues have been coupled in this study. Furthermore, tumor tissue damage has been calculated using a thermal damage indicator. The goal of this research is to find an optimum injection duration and exposure time in order to maximize hyperthermia treatment effectiveness using the BOBYQA optimization method. At the end of the 1-h time hyperthermia treatment, most of the non-necrotic tissue of the tumor were damaged. Moreover, the fraction of damaged tissue increased to more than 90% in some parts of the tumor. Results of this study indicate that MNP hyperthermia with the proposed setup can effectively damage the tumor in just one session, making it more susceptible to complementary therapies such as radiotherapy or chemotherapy.

The Effects of Chronic Ankle Instability on the Biomechanics of the Uninjured, Contralateral Ankle During Gait.

OBJECTIVE: To determine whether unilateral chronic ankle instability (CAI) affects the kinematics of the uninjured contralateral ankle. METHODS: In this case-control study, 15 adult patients with unilateral CAI and 15 healthy controls were studied. Both the unstable and uninjured ankles in patients with unilateral CAI (CAI group, n = 15) were compared with that of healthy individuals (control group, n = 15). Applying body photo-reflective markers, the participant's motion during gait was measured. Biomechanical variables including overall ankle-toe angle, linear velocity, linear acceleration, angular velocity, angular acceleration, range of motion (RoM) in dorsiplantar flexion, and inversion-eversion at initial contact, loading response, mid-stance, terminal stance, pre-swing, and swing phase of the gait were measured. RESULTS: In patients with CAI, the injured and uninjured ankles were significantly different regarding angle-toe angle, inversion-eversion RoM, dorsiplantar flexion in mid-stance, inversion-eversion at initial contact and terminal stance as well as the pre-swing and swing phases (p < 0.01). The uninjured ankles of patients showed lower ankle-toe velocity (p = 0.01) and acceleration (p = 0.01) compared to both the left and right ankles of the controls. In addition, the uninjured ankles of the patients showed decreased ankle dorsiflexion and increased inversion during initial contact, loading response, mid-stance, terminal stance, pre-swing, and swing compared to the control group (p < 0.017). CONCLUSION: The results suggest that unilateral CAI can affect gait biomechanics in the contralateral uninjured ankle. Left unaddressed, unilateral CAI may lead to increased morbidity to the contralateral uninjured side. When surgery is not preferred for the management of unilateral CAI, rehabilitation protocols should focus on both sides.

Using different unit-cell geometries to generate bone tissue scaffolds by additive manufacturing technology.

The design and manufacturing three-dimensional scaffolds are a significant concept in bone tissue engineering (BTE). Firstly, from the perspective of manufacturing, Additive manufacturing (AM) technology has achieved great attraction in the field of BTE during the past few years. In the field of BTE, the possibility of generating complex porous structures with high precision compared to typical manufacturing methods has made AM the leading option for scaffold production. Secondly, from the design perspective, design porous scaffold plays a decisive role in BTE since scaffold design with an appropriate architectures have to lead to proper strength and porosity. The purpose of this research is extraction of optimal architecture to achieve maximum mechanical strength of BTE scaffolds. Hence, the geometry structures of the unit-cell have been selected in Cube, Cylinder and Hexagonal prism. On the other hand, for considering the porosity effects, three different unit-cell size have been chosen, and a total of nine scaffolds have been designed. Designed scaffolds were fabricated using Fused Deposition Modeling (FDM) 3D Printer and dimensional features of scaffolds were evaluated by comparing the designed scaffolds with scanning electron microscope (SEM). The specimens were exposed to mechanical compression test and the results were validated with the finite element analysis (FEA). Verified experimental and FEM results offered an excellent possible unit-cell geometry to be applied in design and manufacturing of BTE scaffolds.

Does ipsilateral chronic ankle instability alter kinematics of the other joints of the lower extremities: a biomechanical study.

PURPOSE: We evaluated and compared kinematics of bilateral ankle, knee, and hip joints in patients with chronic unilateral ankle instability (CAI) with healthy controls. METHODS: Fifteen individuals diagnosed with CAI and a control group of 16 individuals were matched. Different peaks within the gait cycle (at different intervals) for the dorsiplantar, inversion/eversion, and abduction/adduction axis were compared between injured and uninjured sides of patients with CAI with a control group. RESULTS: Comparison of the uninjured ankle in CAI with the control group showed higher dorsiflexion in one peak of the stance phase (p = 0.003), higher inversion in one peak of the stance phase (p = 0.022), and the swing phase (p = 0.004). The hip joint of the uninjured side showed higher extension in one peak of the stance phase (p < 0.001), and two peaks of the swing phase (p < 0.05). Furthermore, it showed higher adduction in one peak of the foot flat to mid-stance phase (p = 0.001), higher abduction in one peak of the late swing phase (p = 0.047), and the swing phase (p = 0.032). The knee joint of the uninjured side showed higher flexion in all measured peaks of the gait cycle (p < 0.05) (except for one peak in the late swing phase) compared to the control group. CONCLUSION: Chronic ankle instability results in altered biomechanics of the ipsilateral knee as well as the contralateral ankle, knee, and hip joints. The alterations caused by CAI may predispose patients to overuse and/or acute injuries of other joints of lower extremities during routine and sporting activity.

Biomechanics Following Anatomic Lateral Ligament Repair of Chronic Ankle Instability: A Systematic Review.

One of the most common orthopedic injuries in the general population, particularly among athletes, is ankle sprain. We investigated the literature to evaluate the known pre- and postoperative biomechanical changes of the ankle after anatomic lateral ligament repair in patients suffering from chronic ankle instability. In this systematic review, studies published till January 2020 were identified by using synonyms for "kinetic outcomes," "kinematic outcomes," "Broström procedure," and "lateral ligament repair." Included studies reported on pre- and postoperative kinematic and/or kinetic data. Twelve articles, including 496 patients treated with anatomic lateral ligament repair, were selected for critical appraisal. Following surgery, both preoperative talar tilt and anterior talar translation were reduced similarly to the values found in the uninjured contralateral side. However, 16 of 152 (10.5%) patients showed a decrease in ankle range of motion after the surgery. Despite the use of these various techniques, there were no identifiable differences in biomechanical postoperative outcomes. Anatomic lateral ligament repair for chronic ankle instability can restore ankle biomechanics similar to that of healthy uninjured individuals. There is currently no biomechanical evidence to support or refute a biomechanical advantage of any of the currently used surgical ligament repair techniques mentioned among included studies.

Synthesis of Core-Shell Magnetic Supramolecular Nanocatalysts based on Amino-Functionalized Calix[4]arenes for the Synthesis of 4H-Chromenes by Ultrasonic Waves.

One of the most common phenol-formaldehyde cyclic oligomers from hydroxyalkylation reactions that exhibit supramolecular chemistry are calixarenes. These macrocyclic compounds are qualified to act as synthetic catalysts due to their specific features including being able to form host-guest complexes, having unique structural scaffolds and their relative ease of chemical modifications with a variety of functions on their upper rim and lower rim. Here, a functional magnetic nanocatalyst was designed and synthesized by using a synthetic amino-functionalized calix[4]arene. Its catalytic activity was evaluated in a one-pot synthesis of 2-amino-4H-chromene derivatives. Besides, this novel magnetic nanocatalyst was characterized by spectroscopic and analytical techniques such as FT-IR, EDX, FE-SEM, TEM VSM, XRD analysis.

Computational simulation of the multiphasic degeneration of the bone-cartilage unit during osteoarthritis via indentation and unconfined compression tests.

It has been experimentally proposed that the discrete regions of articular cartilage, along with different subchondral bone tissues, known as the bone-cartilage unit, are biomechanically altered during osteoarthritis degeneration. However, a computational framework capturing all of the dominant changes in the multiphasic parameters has not yet been developed. This article proposes a new finite element model of the bone-cartilage unit by combining several validated, nonlinear, depth-dependent, fibril-reinforced, and swelling models, which can computationally simulate the variations in the dominant parameters during osteoarthritis degeneration by indentation and unconfined compression tests. The mentioned dominant parameters include the proteoglycan depletion, collagen fibrillar softening, permeability, and fluid fraction increase for approximately non-advanced osteoarthritis. The results depict the importance of subchondral bone tissues in fluid distribution within the bone-cartilage units by decreasing the fluid permeation and pressure (up to a maximum of 100 kPa) during osteoarthritis, supporting the notion that subchondral bones might play a role in the pathogenesis of osteoarthritis. Furthermore, the osteoarthritis composition-based studies shed light on the significant biomechanical role of the calcified cartilage, which experienced a maximum change of 70 kPa in stress, together with relative load contributions of articular cartilage constituents during osteoarthritis, in which the osmotic pressure bore around 70% of the loads after degeneration. To conclude, the new insights provided by the results reveal the significance of the multiphasic osteoarthritis simulation and demonstrate the functionality of the proposed bone-cartilage unit model.

A finite element study on intra-operative corrective forces and evaluation of screw density in scoliosis surgeries.

Scoliosis is an abnormal sideways curvature of the spine and rib cage, which may need surgical treatments. Most of the corrective maneuvers in scoliosis surgeries are based on surgeon's experience; hence, there is great interest of understanding how the correction ratio can be influenced by the magnitude of forces and moments. Therefore, the objective of this study was to develop and validate a detailed finite element model of the thoracolumbar which can be used to simulate the scoliosis surgeries based on patient-specific clinical images. The validated models of five patients were carefully developed, and the surgery procedures were simulated and the corrective forces were estimated using inverse finite element analysis during the surgery. Furthermore, parametric studies including the influences of the corrective force magnitude and screw density were evaluated. The results showed that the maximum estimated correction force and moment were 173 (±55.43) N and 10.67 (±2.02) N m, respectively, which were aligned with measured clinical observations. The sensitivity analysis on the magnitude of applied force to the screws showed that correction ratio was slightly increased in level 1 (i.e. FB = 1.3 × F) but decreased in level 2 (i.e. FB = 1.6 × F). In addition, the parametric study on increasing the number of pedicle screws showed that there was no significant difference between lower and higher screw density. However, the stress distribution was significantly greater using higher screw density during correction maneuvers. In conclusion, this study shows a direct relationship between the applied force/moment and screw density and the correction ratio up to a border line which should be defined accurately. This detailed computational modeling can be used in clinic in hope of achieving the optimum outcome of scoliosis surgery using individual patient-specific characterization.

Plantar Static Pressure Distribution in Normal Feet Using Cotton Socks with Different Structures.

BACKGROUND: The major goal of investigating plantar pressure in patients with pain or those at risk for skin injury is to reduce pressure under prominent metatarsal heads, especially the first and second metatarsals. In research, the insole is used to reduce plantar pressure by increasing the contact area in the midfoot region, which, in turn, induces an uncomfortable feeling near the arch during walking. It is deduced that sock structure can redistribute plantar pressure distribution. METHODS: Seven sock types with seven structures (plain, single cross tuck, mock rib inlay, cross miss, mock rib, double cross tuck, and double cross miss) for the sole area were produced. A plantar pressure measurement device was used to measure plantar static pressure in ten participants. The barefoot plantar pressure distribution was compared with the plantar pressure distribution with socks. RESULTS: In the seven sock samples, the mean plantar pressure of the cross miss and mock rib structures at high plantar pressure zones (toe and first through fourth metatarsal bone regions) were decreased, and, as a result, the pressure shifted to relatively low pressure zones (fifth metatarsal bone and midfoot regions). CONCLUSIONS: These results indicate that wearing socks with cross miss and mock rib structures will reduce mean plantar pressure values compared with the barefoot condition in high plantar pressure zones. In general, the results suggest that mean plantar pressure is redistributed from high to low plantar pressure zones.

Thermal analysis of magnetic nanoparticle in alternating magnetic field on human HCT-116 colon cancer cell line.

PURPOSE: The purpose of this study was to closely investigate the effects of heat dissipation of superparamagnetic nanoparticles on HCT-116 human cancer cell lines cultured under laboratory conditions and also to examine important parameters including size and concentration of nanoparticles, magnetic field frequency, magnetic field intensity, and exposure time. MATERIALS AND METHODS: Conducting experimental tests required special hardware capable of producing an AC magnetic field with various frequencies. The design and construction process for such an experimental set-up is presented here. First, three different Fe3O4 nanoparticle sizes (8, 15 and 20 nm) with different concentrations (d = 10, 20, 40, 80, 160 and 200 µg/ml) were added to cell culture medium and the resulting mixture was exposed to an AC magnetic field with maximum amplitude of 10 kOe for 30 min under three operating frequencies (f = 80, 120 and 180 kHz). The level of intracellular iron was estimated by the ferrozine-based colorimetric assay. Three concentrations including 20, 40 and 80 µg/ml from each of the three nanoparticles sizes were chosen for the study. RESULTS: It was shown that the power dissipation is a function of frequency, time, nanoparticles size and dose. It was also found that the alternating magnetic field with three different frequencies (f = 80, 120 and 180 kHz) and the maximum amplitude of 10 kOe did not have any adverse effect on cell survival. CONCLUSIONS: Our results demonstrate that where thermal dose is equal to 4.5 ± 0.5 °C/30 min from a starting temperature of 37 °C, HCT-116 cell death is initiated when a magnetic nanoparticle electromagnetic field induced.

Effect of heat dissipation of superparamagnetic nanoparticles in alternating magnetic field on three human cancer cell lines in magnetic fluid hyperthermia.

PURPOSE: The purpose of this study was to propose a method for constructing the software setup required for investigating thermal effect of superparamagnetic nanoparticles on three human cell lines. This article aimed to examine the required nanoparticle dose, frequency, field intensity and the exposure time. MATERIALS AND METHODS: In the present study, first some general details were given about design and construction of the setup required for generating a safe magnetic field in order to examine the thermal effect of superparamagnetic nanoparticles on three human cancer cell lines, cultured under laboratory conditions. Next, a series of experimental tests were conducted to study the effect of magnetic field, on the cells. Finally, by applying three types of iron-based nanoparticles with mean diameters of 8, 15 and 20 nm, for 30 min, the temperature rise and specific absorption rate (SAR) were calculated. RESULTS: By conducting experimental tests, the maximum temperature rise at the resonance frequency of the coil was reported to be 80 kHz, and it was observed that all the cells died when temperature of the cells reached 42°C/30 min. Based on the experiments, it was observed that magnetic field with intensity of 8 kA/m within the frequency range of 80-180 kHz did not have any effect on the cells. CONCLUSIONS: Based on the results, it can be concluded that the nanoparticle dose of 80 µg/ml with diameter of 8 nm at the resonance frequency of coil for 30 min was sufficient to destroy all the cancerous cells in the flask.

Case Report: Combination Therapy with Mesenchymal Stem Cells and Granulocyte-Colony Stimulating Factor in a Case of Spinal Cord Injury.

INTRODUCTION: Various neuroregenerative procedures have been recently employed along with neurorehabilitation programs to promote neurological function after Spinal Cord Injury (SCI), and recently most of them have focused on the acute stage of spinal cord injury. In this report, we present a case of acute SCI treated with neuroprotective treatments in conjunction with conventional rehabilitation program. METHODS: A case of acute penetrative SCI (gunshot wound), 40 years old, was treated with intrathecal bone marrow derived stem cells and parenteral Granulocyte-Colony Stimulating Factor (G-CSF) along with rehabilitation program. The neurological outcomes as well as safety issues have been reported. RESULTS: Assessment with American Spinal Injury Association (ASIA), showed neurological improvement, meanwhile he reported neuropathic pain, which was amenable to oral medication. DISCUSSION: In the acute setting, combination therapy of G-CSF and intrathecal Mesenchymal Stem Cells (MSCs) was safe in our case as an adjunct to conventional rehabilitation programs. Further controlled studies are needed to find possible side effects, and establish net efficacy.

Effect of Degeneration on Fluid-Solid Interaction within Intervertebral Disk Under Cyclic Loading - A Meta-Model Analysis of Finite Element Simulations.

The risk of low back pain resulted from cyclic loadings is greater than that resulted from prolonged static postures. Disk degeneration results in degradation of disk solid structures and decrease of water contents, which is caused by activation of matrix digestive enzymes. The mechanical responses resulted from internal solid-fluid interactions of degenerative disks to cyclic loadings are not well studied yet. The fluid-solid interactions in disks can be evaluated by mathematical models, especially the poroelastic finite element (FE) models. We developed a robust disk poroelastic FE model to analyze the effect of degeneration on solid-fluid interactions within disk subjected to cyclic loadings at different loading frequencies. A backward analysis combined with in vitro experiments was used to find the elastic modulus and hydraulic permeability of intact and enzyme-induced degenerated porcine disks. The results showed that the averaged peak-to-peak disk deformations during the in vitro cyclic tests were well fitted with limited FE simulations and a quadratic response surface regression for both disk groups. The results showed that higher loading frequency increased the intradiscal pressure, decreased the total fluid loss, and slightly increased the maximum axial stress within solid matrix. Enzyme-induced degeneration decreased the intradiscal pressure and total fluid loss, and barely changed the maximum axial stress within solid matrix. The increase of intradiscal pressure and total fluid loss with loading frequency was less sensitive after the frequency elevated to 0.1 Hz for the enzyme-induced degenerated disk. Based on this study, it is found that enzyme-induced degeneration decreases energy attenuation capability of disk, but less change the strength of disk.

Recovering the mechanical properties of denatured intervertebral discs through Platelet-Rich Plasma therapy.

Degenerative disc disease is one of the most common causes of low back pain instigating huge socioeconomic costs and posing an immense burden on healthcare systems worldwide. New therapeutic approaches to damaged intervertebral discs are therefore of great interest. Platelet-Rich Plasma (PRP) has been proposed for the repair and regeneration of degenerated discs, but there remains a knowledge gap regarding its effectiveness and influence on disc material properties. The objective of this study was to investigate and quantify the material properties of intact, denatured, and PRP treated discs. A systematic methodology was established in the process, where ex-vivo experiments were conducted and material properties were extracted using an inverse finite element approach. The results showed that PRP is able to recover the mechanical properties of denatured discs, thereby providing a promising effective therapeutic modality.

Cylindrical agar gel with fluid flow subjected to an alternating magnetic field during hyperthermia.

PURPOSE: In magnetic fluid hyperthermia (MFH), nanoparticles are injected into diseased tissue and subjected to an alternating high frequency magnetic field. The process triggers sufficient heat to destroy the cancerous cells. One of the challenging problems during MFH is blood flow in tissue. In real conditions the heat which is transferred by blood flow should be considered in the analysis of MFH. METHODS: In this study, heat transfer was investigated in an agar gel phantom containing fluid flow. Fe3O4 as a nano-fluid was injected into the centre of a gel cylinder which was filled with another gel cylinder and subjected to an alternating magnetic field of 7.3 kA/m and a frequency of 50 kHz for 3600 s. The temperature was measured at three points in the gel. Temperature distributions regarding the time at these three points were experimentally measured. Moreover, the specific absorption rate (SAR) function was calculated with a temperature function. RESULTS: The SAR function was a key asset in the hyperthermia and was obtained on the condition that the fluid flowed through the gel. Finally, a finite element analysis (FEA) was performed to verify the SAR function. The results revealed that there was good agreement between the measured temperature and the one obtained from FEA. In addition, the effects of fluid flow and accuracy of function obtained for heat production in the gel were presented. CONCLUSION: It is believed that the proposed model has the potential ability to get close to reality in this type of investigation. The proposed function has implications for use in further modelling studies as a heat generation source.

The ultrasound elastography inverse problem and the effective criteria.

The elastography (elasticity imaging) is one of the recent state-of-the-art methods for diagnosis of abnormalities in soft tissue. The idea is based on the computation of the tissue elasticity distribution. This leads to the inverse elasticity problem; in that, displacement field and boundary conditions are known, and elasticity distribution of the tissue is aimed for computation. We treat this problem by the Gauss-Newton method. This iterative method results in an ill-posed problem, and therefore, regularization schemes are required to deal with this issue. The impacts of the initial guess for tissue elasticity distribution, contrast ratio between elastic modulus of tumor and normal tissue, and noise level of the input data on the estimated solutions are investigated via two different regularization methods. The numerical results show that the accuracy and speed of convergence vary when different regularization methods are applied. Also, the semi-convergence behavior has been observed and discussed. At the end, we signify the necessity of a clever initial guess and intelligent stopping criteria for the iterations. The main purpose here is to highlight some technical factors that have an influence on elasticity image quality and diagnostic accuracy, and we have tried our best to make this article accessible for a broad audience.

Analysis of different material theories used in a FE model of a lumbar segment motion.

In this study, a nonlinear poroelastic model of intervertebral disc as an infrastructure was developed. Moreover, a new element was defined consisting a disc (Viscoelastic Euler Beam Element) and a vertebra (Rigid Link) as a unit element. Using the new element, three different viscoelastic finite element models were prepared for lumbar motion segment (L4/L5). Prolonged loading (short-term and longterm creep) and cyclic loading were applied to the models and the results were compared with results of in vivo tests. Simplification of the models by using the new element leads to reduction of the runtime of the models in dynamic analyses to few minutes without losing the accuracy in the results.

A meta-model analysis of a finite element simulation for defining poroelastic properties of intervertebral discs.

Finite element analysis is an effective tool to evaluate the material properties of living tissue. For an interactive optimization procedure, the finite element analysis usually needs many simulations to reach a reasonable solution. The meta-model analysis of finite element simulation can be used to reduce the computation of a structure with complex geometry or a material with composite constitutive equations. The intervertebral disc is a complex, heterogeneous, and hydrated porous structure. A poroelastic finite element model can be used to observe the fluid transferring, pressure deviation, and other properties within the disc. Defining reasonable poroelastic material properties of the anulus fibrosus and nucleus pulposus is critical for the quality of the simulation. We developed a material property updating protocol, which is basically a fitting algorithm consisted of finite element simulations and a quadratic response surface regression. This protocol was used to find the material properties, such as the hydraulic permeability, elastic modulus, and Poisson's ratio, of intact and degenerated porcine discs. The results showed that the in vitro disc experimental deformations were well fitted with limited finite element simulations and a quadratic response surface regression. The comparison of material properties of intact and degenerated discs showed that the hydraulic permeability significantly decreased but Poisson's ratio significantly increased for the degenerated discs. This study shows that the developed protocol is efficient and effective in defining material properties of a complex structure such as the intervertebral disc.

Development of a parametric finite element model of lower cervical spine in sagital plane.

A parametric 2D finite element model was developed for lower cervical spine (C3-C7) in sagital plane in this research. Being parametric, this model facilitates making changes in the geometrical sizes as well as omitting or modifying some parts of it in order to build a new model with special purposes. Application of geometrical parameters, the values of which differ from one vertebra to the other one due to each one's morphology, utilizes deriving equations which define geometrical shape of the model of both soft tissue and hard tissue. Then a macro is programmed with Ansys parametric design language (APDL), which runs under FEA software, ANSYS9.0. As the result, a good fit was observed when validated the model with existed experimental results in sagital plane. The comparison shows more reliable results out of this 2D model than cited 3D complex models in flexion and extension.