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Background: There is no global agreement on a schoolbag weight limit and little assessment of its utility. The duration of carriage is another factor yet there is no previous systematic assessment of the utility of cut-off values for it in identifying schoolbag-related discomfort., Objectives: The objectives were to establish if there was a threshold for musculoskeletal discomfort based on (i) percentage bodyweight (% BW) of the schoolbag; (ii) duration of carriage; or (iii) combined % BW and duration., Methods: Using data from 462 primary school children, a novel experimental approach was used to explore the utility of conventional schoolbag weight limit guidelines and duration of carriage. A receiver operating characteristic (ROC) curve was constructed to examine the predictive performance of schoolbag weight and duration of carriage., Results: The mean schoolbag weight (4.8±1.43  kg) represented a mean 12.4±4.18% BW. Only 30.7% of the sample carried schoolbags that were ≤10% BW. The majority (76%) carried schoolbags to school for ≤10 minutes. No % BW, duration of carriage or mechanical burden criterion provided a threshold cut-off point for accurately predicting schoolbag-related discomfort., Conclusions: Guidelines for safe schoolbag carriage that are based on mechanical factors alone could not be upheld. The association between duration of carriage and back discomfort warrants further investigation.

Incisional hernia is a severe complication post-laparoscopic/laparotomy surgery that is commonly associated with the linea alba. However, the few studies on the mechanical properties of the linea alba in the literature appear contradictory, possible due to challenges with the physical dimensions of samples and variations in protocol. This study focuses on the tensile mechanical characterisation of the porcine linea alba, as determined by uniaxial and equi-load biaxial testing using image-based strain measurement methods. Results show that the linea alba demonstrated a non-linear elastic, anisotropic behaviour which is often observed in biological soft tissues. The transverse direction (parallel to fibres) was found to be approximately eight times stiffer than the longitudinal (cross-fibre) direction under both uniaxial and equi-load biaxial loading. The equi-load biaxial tensile tests revealed that contraction could occur in the transverse direction despite increasing load, probably due to the anisotropy of the tissue. Optical surface marker tracking and digital image correlation methods were found to greatly improve the accuracy of stretch measurement, resulting in a 75% change in the apparent stiffness compared to using strain derived from machine cross-head displacement. Additionally, a finite element model of the experiments using a combination of an Ogden and fibre exponential power law model for the linea alba was implemented to quantify the effect of clamping and tissue dimensions (which are suboptimal for tensile testing) on the results. The preliminary model results were used to apply a correction factor to the uniaxial experimental data prior to inverse optimisation to derive best fit material parameters for the fibre reinforced Ogden model. Application of the model to the equi-load biaxial case showed some differences compared to the experimental data, suggesting a more complex anisotropic model may be necessary to capture biaxial behaviour. These results provide an improved assessment of the mechanical properties of the porcine linea alba for wound closure and other studies., (Copyright © 2014 Elsevier Ltd. All rights reserved.)

The passive micro-structural mechanical response of muscle tissue is important for numerous medical applications. However, the recently observed tension/compression asymmetry in porcine muscle remains poorly explained. In particular there remains a lack of understanding of how external tension or compression applied in the fibre or cross-fibre direction translates internally to deformation of muscle fibres and the extra-cellular matrix. Accordingly, fresh porcine skeletal muscle tissue was harvested, deformed by 30% in uniaxial tension or compression in both the fibre and cross-fibre directions and prepared for optical microscope, polarised light microscope and SEM analysis. The average deformed specimen results were compared to the average control results in each case. For compressive or tensile stretch applied in the muscle fibre direction the average measured muscle fibre cross-sectional area changes are in close correspondence with predictions based on global Poisson's ratio measurements and these deformation modes did not cause shape changes in the muscle fibre cross-sections. However, muscle tissue reacted to the applied cross-fibre direction deformations as follows: compression flattened muscle fibre cross-sections, aligning them perpendicular to the direction of the applied deformation while tensile deformations stretched the cross-sections of muscle fibres, aligning them parallel to the direction of applied deformation. No evidence of structural reorganisation of endomysium collagen fibres in response to applied stretch was observed. The observed micro-structural responses do not appear to be influenced by the surrounding endomysium, but appear to be significantly influenced by proximity to the perimysium network. It is hypothesised that the perimysium and its interaction with the surrounding muscle fibres is therefore likely to be predominantly responsible for the tension/compression asymmetry observed in macroscopic tests of passive skeletal muscle stress strain behaviour., (Copyright © 2014 Elsevier Ltd. All rights reserved.)

Incisional hernia development is a significant complication after laparoscopic abdominal surgery. Intra-abdominal pressure (IAP) is known to initiate the extrusion of intestines through the abdominal wall, but there is limited data on the mechanics of IAP generation and the structural properties of rectus sheath. This paper presents an explanation of the mechanics of IAP development, a study of the uniaxial and biaxial tensile properties of porcine rectus sheath, and a simple computational investigation of the tissue. Analysis using Laplace׳s law showed a circumferential stress in the abdominal wall of approx. 1.1MPa due to an IAP of 11kPa, commonly seen during coughing. Uniaxial and biaxial tensile tests were conducted on samples of porcine rectus sheath to characterise the stress-stretch responses of the tissue. Under uniaxial tension, fibre direction samples failed on average at a stress of 4.5MPa at a stretch of 1.07 while cross-fibre samples failed at a stress of 1.6MPa under a stretch of 1.29. Under equi-biaxial tension, failure occurred at 1.6MPa with the fibre direction stretching to only 1.02 while the cross-fibre direction stretched to 1.13. Uniaxial and biaxial stress-stretch plots are presented allowing detailed modelling of the tissue either in silico or in a surrogate material. An FeBio computational model of the tissue is presented using a combination of an Ogden and an exponential power law model to represent the matrix and fibres respectively. The structural properties of porcine rectus sheath have been characterised and add to the small set of human data in the literature with which it may be possible to develop methods to reduce the incidence of incisional hernia development., (Copyright © 2014 Elsevier Ltd. All rights reserved.)

Appropriate mechanical representation of passive muscle tissue is crucial for human body impact modelling. In this paper the experimental and modelling results of compressive loading of freshly slaughtered porcine muscle samples using a drop-tower testing rig are reported. Fibre and cross-fibre compression tests at strain rates varying from 11,600%/s to 37,800%/s were performed. Experimental results show a nonlinear stress-stretch relationship as well as a clear rate dependency of the stress. The mean (standard deviation) engineering stress in the fibre direction at a stretch of 0.7 was 22.47 kPa (5.34 kPa) at a strain rate of 22,000%/s and 38.11k Pa (5.41 kPa) at a strain rate of 37,800%/s. For the cross-fibre direction, the engineering stresses were 5.95 kPa (1.12 kPa) at a strain rate of 11,600%/s, 25.52 kPa (5.12 kPa) at a strain rate of 22,000%/s and 43.66 kPa (6.62 kPa) at a strain rate of 37,800%/s. Significant local strain variations were observed, as well as an average mass loss of 8% due to fluid exudation, highlighting the difficulties in these kinds of tests. The inverse analysis shows for the first time that the mechanical response in terms of both applied load and tissue deformation for each of the strain rates can be captured using a 1st order Ogden hyperelastic material law extended with a three-term quasilinear viscoelastic (QVL) expansion to model viscoelastic effects. An optimisation procedure was used to derive optimal material parameters for which the error in the predicted boundary condition force at maximum compression was less than 3% for all three rates of testing (11,600%/s, 22,000%/s and 37,800%/s). This model may be appropriate for whole body impact modelling at these rates., (© 2013 Elsevier Ltd. All rights reserved.)

Passive skeletal muscle derives its structural response from the combination of the titin filaments in the muscle fibres, the collagen fibres in the connective tissue and incompressibility due to the high fluid content. Experiments have shown that skeletal muscle tissue presents a highly asymmetrical three-dimensional behaviour when passively loaded in tension or compression, but structural models predicting this are not available. The objective of this paper is to develop a mathematical model to study the internal mechanisms which resist externally applied deformation in skeletal muscle bulk. One cylindrical muscle fibre surrounded by connective tissue was considered. The collagenous fibres of the endomysium and perimysium were grouped and modelled as tension-only oriented wavy helices wrapped around the muscle fibre. The titin filaments are represented as non-linear tension-only springs. The model calculates the force developed by the titin molecules and the collagen network when the muscle fibre undergoes an isochoric along-fibre stretch. The model was evaluated using a range of literature based input parameters and compared to the experimental fibre-direction stress-stretch data available. Results show the fibre direction non-linearity and tension/compression asymmetry are partially captured by this structural model. The titin filament load dominates at low tensile stretches, but for higher stretches the collagen network was responsible for most of the stiffness. The oblique and initially wavy collagen fibres account for the non-linear tensile response since, as the collagen fibres are being recruited, they straighten and re-orient. The main contribution of the model is that it shows that the overall compression/tension response is strongly influenced by a pressure term induced by the radial component of collagen fibre stretch acting on the incompressible muscle fibre. Thus for along-fibre tension or compression the model predicts that the collagen network contributes to overall muscle stiffness through two different mechanisms: (1) a longitudinal force directly opposing tension and (2) a pressure force on the muscle fibres resulting in an indirect longitudinal load. Although the model presented considers only a single muscle fibre and evaluation is limited to along-fibre loading, this is the first model to propose these two internal mechanisms for resisting externally applied deformation of skeletal muscle tissue., (Copyright © 2013 Elsevier Ltd. All rights reserved.)

Diffusion tensor imaging analysis was applied to fresh and frozen porcine aortas in order to determine fibre orientation. Fresh and stored frozen porcine aortas were imaged in a 7 T scanner with a diffusion weighted spin echo sequence (six gradient directions, matrix 128×128 pixels, 2.8 cm×2.8 cm field of view). The images were taken for different b values, ranging from 200 s/mm(2) to 1600 s/mm(2). For each dataset the diffusion tensor was evaluated, fractional anisotropy (FA) maps were calculated, and the fibres mapped. The arterial fibres resulting were postprocessed and their fibre angle evaluated. The FA maps, the dominant fibre angle, and the fibre pattern in the arterial wall thickness were compared in the fresh and in the stored frozen aortas. The technique was able to determine a fibre pattern in the fresh healthy aorta that is in accordance with the data available in literature and to identify an alteration in the fibre pattern caused by freezing. This study shows that this technique has potential for studying fibre orientation and fibre distribution in humans and could be further developed to diagnose fibre alterations due to cardiovascular diseases. In fact, our results suggest that DTI has the potential to determine the fibrous structure of arteries non-invasively. This capability could be further developed to study the natural remodelling of the aorta in vivo due to age and/or gender or to obtain information on aortic diseases at an early stage of their evolution., (Copyright © 2012 IPEM. Published by Elsevier Ltd. All rights reserved.)

Background: Carrying a schoolbag is a daily activity for most children and much research has been conducted in an effort to identify a safe load limit for children to carry in their schoolbags. Despite this, there is still no consensus about guideline weight and other factors associated with carrying a schoolbag. The objective of this article is to review the literature on schoolbags with particular emphasis on the load limit guidelines and schoolbag-related musculoskeletal pain, and to suggest directions for school health and future research., Methods: Science Direct, PubMed, AMED, CINAHL, OVID, EMBASE, and Scopus were searched for peer-reviewed articles using combinations of the following key words: schoolbag, backpack, rucksack, knapsack, satchel, book bag, book pack and included combinations of children, pain, gait, and posture. Article references were also checked for further citations. All are in English, with the exception of one which is in German but is widely cited., Results: There are conflicting findings in the literature. The recommended load limit for schoolchildren to carry varies from 5% to 20% of their body weight, and the evidence linking backpack weight and back pain is inconclusive., Conclusions: The shortcomings in the current literature should be addressed so that evidence-based guidelines can be provided to schoolchildren, parents, and teachers. It is suggested that general guidance may be more appropriate than a single load limit guideline., (© 2013, American School Health Association.)