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Traumatic brain injury is a significant problem worldwide. In the United States of America, around 1.7 million cases are documented annually, displaying the need for a deeper understanding of the effects on the human brain. The tests required for this assessment are very complex. Tests on cadavers may raise serious ethical questions, and in vivo crash tests are not viable. In this context, there is a great need to developing finite element head models (FEHM) to study the biomechanics of the tissues when submitted to a certain impact or acceleration/deceleration scenario. An excellent compromise between accuracy and CPU efficiency is always desirable for a FEHM, For this reason, this work focuses on the improvement of an existing head model, including the study of the behavior of the brain using distinct finite element types. The finite element type and formulation is of utmost importance for the general accuracy and efficiency of the models. Several validations were performed, comparing the simulation results against experimental data. The simulations with hexahedral elements, under specific conditions, obtained more accurate results with a lower computational cost. Using hexahedrals, a comparison was also performed using two material characterizations with more than 10 years apart, using the latest finite element head model validation experiment. Overall, the newer material model displays a less stiff response, although its implementation must always depend on the overall purpose of the model it is being applied to., (© 2024 John Wiley & Sons Ltd.)

Cork composites are byproducts from wine stopper production, resulting from the agglomeration of cork granules with a thermoset resin. The resulting compound is a versatile and durable material with numerous industrial applications. Due to its unique properties, such as low-density, high-strength, excellent energy absorption, and good thermal and acoustic insulators, cork composites find room for application in demanding industries such as automotive, construction, and aerospace. However, agglomerated cork typically has a polyurethane matrix derived from petrochemical sources. This study focuses on developing eco-friendly porous polyurethane biocomposites manufactured with the used cooking oil polyol modified with cork. Since cork and polyurethane foam are typically used for impact shock absorption, the manufactured samples were subjected to impact loading. The assessment of crashworthiness is performed through 100 J impact tests. A finite element numerical model was developed to simulate the compression of these new composites under impact, and the model validation was performed. The highest specific absorbed energy was obtained for petrochemical polyol composites with the 3% addition of natural or modified cork. The research conducted in this study showcased the feasibility of substituting certain petrochemical components used for the synthesis of the polyurethane matrix with ecological waste vegetable oil components.

Background and Objective: Traumatic brain injuries are one of the leading causes of death and disability in the world. To better understand the interactions and forces applied in different constituents of the human head, several finite element head models have been developed throughout the years, for offering a good cost-effective and ethical approach compared to experimental tests. Once validated, the female finite element head model (FeFEHM) will allow a better understanding of injury mechanisms resulting in neuronal damage, which can later evolve into neurodegenerative diseases., Methods: This work encompasses the approached methodology starting from medical images and finite element modelling until the validation process using novel experimental data of brain displacements conducted on human cadavers. The material modelling of the brain is performed using an age-specific characterization of the brain using microindentation at dynamic rates and under large deformation, with a similar age to the patient used to model the FeFEHM., Results: The numerical displacement curves are in good accordance with the experimental data, displaying similar peak times and values, in all three anatomical planes. The case study result shows a similarity between the pressure fields of the FeFEHM compared to another model, highlighting the future potential of the model., Conclusions: The initial objective was met, and a new female finite element head model has been developed with biofidelic brain motion. This model will be used for the assessment of repetitive impact scenarios and its repercussions on the female brain., Competing Interests: Declaration of Competing Interest Authors declare that they have no conflict of interest., (Copyright © 2023 The Author(s). Published by Elsevier B.V. All rights reserved.)

The biomechanics of traumatic injuries of the human body as a consequence of road crashes, falling, contact sports, and military environments have been studied for decades. In particular, traumatic brain injury (TBI), the so-called "silent epidemic", is the traumatic insult responsible for the greatest percentage of death and disability, justifying the relevance of this research topic. Despite its great importance, only recently have research groups started to seriously consider the sex differences regarding the morphology and physiology of women, which differs from men and may result in a specific outcome for a given traumatic event. This work aims to provide a summary of the contributions given in this field so far, from clinical reports to numerical models, covering not only the direct injuries from inertial loading scenarios but also the role sex plays in the conditions that precede an accident, and post-traumatic events, with an emphasis on neuroendocrine dysfunctions and chronic traumatic encephalopathy. A review on finite element head models and finite element neck models for the study of specific traumatic events is also performed, discussing whether sex was a factor in validating them. Based on the information collected, improvement perspectives and future directions are discussed.

Numerical methods are often a robust way to predict how external mechanical loads affect individual biological structures. Computational models of biological systems have been developed over the years, reaching high levels of detail, complexity, and precision. In this study, two cases were analysed, differing in the airbag operation; in the first, the airbag was normally activated, and in the second case, the airbag was disabled. We analysed a model of a disabled person without a left leg who steers a vehicle using a specialized knob on the steering wheel. In both cases, a head-on collision between a car moving at an initial speed of 50 km/h and a rigid obstacle was analysed. We concluded that the activated airbag for a person with disabilities reduces the effects of asymmetries in the positioning of the belts and body support points. Moreover, all the biomechanical parameters, analysed on the 50th percentile dummy, i.e., HIC, seat belt contact force and neck injury criterion (Nij) support the use of an airbag. The resulting accelerations, measured in the head of the dummy, were induced into a finite element head model (YEAHM) to kinematically drive the head and simulate both accidents, with and without the airbag. In the latter, the subsequent head injury prediction revealed a form of contrecoup injury, more specifically cerebral contusion based on the intracranial pressure levels that were achieved. Therefore, based on the in-depth investigation, a frontal airbag can significantly lower the possibility of injuries for disabled drivers, including cerebral contusions.

Physiological changes in GTP levels in live cells have never been considered a regulatory step of RAC1 activation because intracellular GTP concentration (determined by chromatography or mass spectrometry) was shown to be substantially higher than the in vitro RAC1 GTP dissociation constant (RAC1-GTP Kd). Here, by combining genetically encoded GTP biosensors and a RAC1 activity biosensor, we demonstrated that GTP levels fluctuating around RAC1-GTP Kd correlated with changes in RAC1 activity in live cells. Furthermore, RAC1 co-localized in protrusions of invading cells with several guanylate metabolism enzymes, including rate-limiting inosine monophosphate dehydrogenase 2 (IMPDH2), which was partially due to direct RAC1-IMPDH2 interaction. Substitution of endogenous IMPDH2 with IMPDH2 mutants incapable of binding RAC1 did not affect total intracellular GTP levels but suppressed RAC1 activity. Targeting IMPDH2 away from the plasma membrane did not alter total intracellular GTP pools but decreased GTP levels in cell protrusions, RAC1 activity, and cell invasion. These data provide a mechanism of regulation of RAC1 activity by local GTP pools in live cells., (© 2021. The Author(s).)

Background: Staphylococcus aureus is a major pathogen implicated in orthopedic infections worldwide. Preoperative decolonization has been promoted but different strategies present mixed results. Thus, the goals of this study are to determine (1) whether S aureus screening and/or decolonization is effective at reducing surgical site infection in orthopedic surgery, (2) with a special focus on elective total joint arthroplasty (TJA), and (3) which preoperative S aureus screening/treatment strategy is most cost-effective for TJA., Methods: PubMed, Ovid MEDLINE, and Cochrane databases were searched on January 1, 2020, using a systematic strategy. We included papers with data comparing surgical site infection and periprosthetic joint infection rate in orthopedic surgery and/or elective total hip and knee arthroplasty patients before/after S aureus screening and/or decolonization protocol and papers evaluating the cost-effectiveness of different S aureus screening/treatment strategies., Results: A total of 1260 papers were screened, and 32 papers were ultimately included. Results showed an increased risk of developing any infection (relative risk [RR] = 1.71 ± 0.16) and S aureus infection (RR = 2.79 ± 0.45) after orthopedic surgery without previous nares and whole-body decolonization. Focusing exclusively on elective TJA, there was an increased risk of developing any infection (RR = 1.70 ± 0.17) and S aureus infection (RR = 2.18 ± 0.41) if no decolonization is performed. All strategies appeared to be cost-effective, although universal decolonization without screening seemed to be the most advantageous., Conclusion: Preoperative S aureus screening/decolonization protocol lowered the risk of infection after elective orthopedic and TJA surgeries. However, further studies are needed to determine optimal clinical and cost-effective methodologies., (Copyright © 2020 Elsevier Inc. All rights reserved.)

Traumatic brain injury is one of the major causes of death and disability in the world. One of the most frequent and deadly injury resulted from a head trauma is acute subdural haematoma (ASDH), which consists on the rupture of a bridging vein (BV). Given the importance of this type of injury, it is necessary to correctly assess thresholds and damage criteria, which is difficult to perform on human cadavers or animals, due to ethical and economical issues. Finite element (FE) models are a very good and cost-effective alternative. Once properly validated, a finite element head model (FEHM) becomes a valuable tool, that can be used in the development of head protective gear as a design tool and in the reconstruction of head traumas by predicting brain injuries under impact conditions. The YEt Another Head Model (YEAHM) is one example of a FE model that can be used to assist/replace the experimental tests. In this study, the bridging veins model from YEAHM was improved and validated by comparing its results with others reported in literature and estimating the success rate. At the end, it was developed a pressurised tubular shaped FE model of BVs, considering the blood pressure in cerebral veins. Results showed a maximum success rate of 90%, which in comparison with other FE models available in the literature, presents an equal or even better ASDH prediction success rate., (Copyright © 2020 Elsevier Ltd. All rights reserved.)

The human head is a complex multi-layered structure of hard and soft tissues, governed by complex materials laws and interactions. Computational models of the human head have been developed over the years, reaching high levels of detail, complexity, and precision. However, most of the attention has been devoted to the brain and other intracranial structures. The skull, despite playing a major role in direct head impacts, is often overlooked and simplified. In this work, a new skull model is developed for the authors' head model, the YEAHM, based on the original outer geometry, but segmenting it with sutures, diploë, and cortical bone, having variable thickness across different head sections and based on medical craniometric data. These structures are modeled with constitutive models that consider the non-linear behavior of skull bones and also the nature of their failure. Several validations are performed, comparing the simulation results with experimental results available in the literature at several levels: (i) local material validation; (ii) blunt trauma from direct impact against stationary skull; (iii) three impacts at different velocities simulating falls; (iv) blunt ballistic temporoparietal head impacts. Accelerations, impact forces, and fracture patterns are used to validate the skull model.

Background: One of the most severe traumatic brain injuries, the subdural haematoma, is related to damage and rupture of the bridging veins, generating an abnormal collection of blood between the dura mater and arachnoid mater. Current numerical models of these vessels rely on very simple geometries and material laws, limiting its accuracy and bio-fidelity., Methods: In this work, departing from an existing human head numerical model, a realistic geometry for the bridging veins was developed, devoting special attention to the finite elements type employed. A novel and adequate constitutive model including damage behavior was also successfully implemented., Findings: Results attest that vessel tearing onset was correctly captured, after comparison against experiments on cadavers., Interpretation: Doing so, the model allow to precisely predict the individual influence of kinematic parameters such as the pulse duration, linear and rotational accelerations in promoting vessel tearing., (Copyright © 2019 Elsevier Ltd. All rights reserved.)

The use of cork for a variety of applications has been gaining significance due to environmental concerns and political agendas. Consequently, its range of applications is growing rapidly. In this work, aiming to improve its mechanical response for crashworthiness applications, cork agglomerates were enriched by small quantities of graphene oxide or graphene nanoplates in order to observe a resulting improvement of the mechanical behaviour during quasi-static and dynamic compressive loading cases. To produce homogenous cork agglomerates including graphene, the material was previously dispersed into granulated cork using stirrers to achieve a good distribution. Then, the typical procedure of compression and curing was carried out. Magnified images attest a good dispersion of graphene into the cork matrix. Mechanical testing was performed for a variety of graphene concentrations (0.1, 0.5 and 1.0 weight %), becoming clear that the beneficial effect of including graphene (either oxide or nanoplates) is related to a later densification stage while keeping the same stress plateau levels.

This study investigated the structural, biomechanical and fractographic features of rib fractures in a piglet model, to test the hypothesis that fist impact, apart from thoracic squeezing, may result in lateral costal fractures as observed in abused infants. A mechanical fist with an accelerometer was constructed and fixed to a custom jig. Twenty stillborn piglets in the supine position were impacted on the thoracic cage. The resultant force versus time curves from the accelerometer data showed a number of steps indicative of rib fracture. The correlation between impact force and number of fractures was statistically significant (Pearson׳s r=0.528). Of the fractures visualized, 15 completely pierced the parietal pleura of the thoracic wall, and 5 had butterfly fracture patterning. Scanning electron microscopy showed complete bone fractures, at the zone of impact, were normal to the axis of the ribs. Incomplete vertical fractures, with bifurcation, occurred on the periphery of the contact zone. This work suggests the mechanism of rib failure during a fist impact is typical of the transverse fracture pattern in the anterolateral region associated with cases of non-accidental rib injury. The impact events investigated have a velocity of ~2-3m/s, approximately 2×10(4) times faster than previous quasi-static axial and bending tests. While squeezing the infantile may induce buckle fractures in the anterior as well as posterior region of the highly flexible bones, a fist punch impact event may result in anterolateral transverse fractures. Hence, these findings suggest that the presence of anterolateral rib fractures may result from impact rather than manual compression., (Copyright © 2016 Elsevier Ltd. All rights reserved.)

Objective: To report the long-term radiographic and clinical outcome of the BioMedtrix TATE elbow arthroplasty system in dogs. Assessment was via radiographs, a surgeon-based questionnaire, and owner assessment of outcome using the Liverpool osteoarthritis in dogs (LOAD) and canine brief pain inventory (CBPI) questionnaires., Study Design: Retrospective multicenter, case series., Animals: Client-owned dogs undergoing TATE elbow arthroplasty., Methods: Questionnaires were distributed to surgeons in the United Kingdom performing TATE elbow arthroplasty and to the owners of the dogs operated on. Owners completed the LOAD and CBPI questionnaires. All completed questionnaires from surgeons and owners, and radiographs of the dogs were collated and analyzed., Results: Surgeon questionnaires and radiographs were obtained for 33 elbows from 32 dogs, with owner questionnaires obtained for 19 dogs. Perioperative, short-term, and mid-term complication rates were 60%, 15%, and 15%, respectively. Radiographic assessment of component alignment showed 62% of cartridges were valgus or varus malaligned and 56% of cartridges were either translated medially or laterally relative to the long axis of the ulnar. There was no significant association between component alignment and final clinical outcome. Surgeon assessment reported 24% of dogs to have full, 52% acceptable, and 24% unacceptable outcome. Owner assessment showed significant decreases in pain severity and pain interference from preoperative to final status but no change in mobility scores., Conclusions: A high complication rate and variability in component placement was recorded with TATE athroplasty. However, component malalignment did not negatively impact clinical outcome. Final clinical outcome was favorable for most cases with significant reductions in pain severity and interference scores despite no changes in mobility scores., (© Copyright 2016 by The American College of Veterinary Surgeons.)

To study the prevalence of Staphylococcus aureus carriage and the impact of preoperatively treating carriers in prosthetic joint infection (PJI), a prospective randomized trial was organized. From January 2010 to December 2012, 1028 of 1305 total joint arthroplasties performed were screened, and selected carriers underwent preoperative decolonization. We observed a 22.2% (228/1028) S aureus colonization rate and only 0.8% methicillin-resistant S aureus. Prosthetic joint infection rate was higher, albeit not significantly, in S aureus carriers than among noncarriers-3.9% (9/228) vs 2.0% (16/800). Treated and untreated carriers showed no significant differences-3.4% (3/89) vs 4.3% (6/139). Most of the 14 S aureus PJI occurred in noncarriers suggesting a lack of causal relation between nasal and PJI S aureus. No clear benefit in screening/decolonizing carriers before total joint arthroplasty could be demonstrated., (Copyright © 2016 Elsevier Inc. All rights reserved.)

Objectives: Talar neck and body fractures are unusual fractures. The purpose of this study is to determine the prevalence of long term results., Material and Methods: A retrospective analysis was carried out including 11 patients that underwent surgical treatment for body or neck talus fractures between January 1997 and December 2005. Final follow-up examination included a clinical evaluation (AOFAS score) and standard radiographs., Results: The mean follow-up time was 58.5 months. The prevalence of associated fractures was 60% (6/10). Overall AOFAS score averaged 72 [19-100]. Avascular necrosis and post-traumatic arthritis were present in half of the patients. Quality of surgical reduction, body fractures and absence of degenerative changes were correlated with better functional results. Neck fractures, osteonecrosis and posttraumatic arthritis led to inferior results., Conclusion: There is a great potential for long term functional impairment due to posttraumatic arthritis and chronic pain in this kind of fracture. Anatomic surgical reduction is the best chance to avoid them but it is not infallible. The avascular necrosis rate correlates with initial fracture displacement, but its occurrence in each specific case is unpredictable.

Head injuries occur in a great variety of sports. Many of these have been associated with neurological injuries, affecting the central nervous system. Some examples are motorsports, cycling, skiing, horse riding, mountaineering and most contact sports such as football, ice and field hockey, soccer, lacrosse, etc. The outcome of head impacts in these sports can be very severe. The worst-case scenarios of permanent disability or even death are possibilities. Over recent decades, many In recent decades, a great number of head injury criteria and respective thresholds have been proposed. However, the available information is much dispersed and a consensus has still not been achieved regarding the best injury criteria or even their thresholds. This review paper gives a thorough overview of the work carried out by the scientific community in the field of impact biomechanics about head injuries sustained during sports activity. The main goal is to review the head injury criteria, as well as their thresholds. Several are reviewed, from the predictors based on kinematics to the ones based on human tissue thresholds. In this work, we start to briefly introduce the head injuries and their mechanisms commonly seen as a result of head trauma in sports. Then, we present and summarize the head injury criteria and their respective thresholds., (© IMechE 2015.)

Objective: To evaluate the quasi-isometric points (nearest isometric points) between the distal aspect of the femur and fabella and the proximal aspect of the tibia for placement of a lateral suture in cats., Study Design: Radiographic study., Animals: Cadaveric cat stifles (n = 7 cats; 14 stifles)., Methods: Specimens were secured in a mounting frame to maintain rigid fixation of the femur and allow free range of motion of the stifle joint and proximal tibia. Two anatomic landmarks were identified: the center of the lateral fabella (Ff) and a point 4 mm proximal to the insertion of the patellar tendon adjacent to the tibial cortex (Tt). Radiopaque spheres were placed at predefined landmarks in the femur (caudal aspect of the lateral femoral condyle distal [F1] and proximal [F2] to the lateral fabella) and in the tibia (caudal to the proximal aspect of the extensor groove [T1]; cranial to the proximal aspect of the extensor groove [T2]; 2 mm proximal and caudal to the insertion of the patellar tibial tendon [T3] and 3 mm caudal to the insertion of the patellar tibial tendon [T4]. For each stifle, 4 radiographic projections were made: in extension (166°), in flexion (45°), and 2 intermediate stance phases (90°, 130°). ANOVA was used to compare means of the distance between the point pairs and means of the percent change in variation of distance (VOD%) using the 45° measurement as a reference., Results: Mean VOD% nearest to zero, over all the different angles tested, was produced by Ff-Tt, which was statistically significantly different from each of the other point pairs., Conclusion: Ff-Tt provides the best quasi-isometric points for placement of lateral sutures in cats, compared with all combinations tested. Further assessments with biomechanical studies are needed to evaluate the reproducibility of these landmarks for stabilization of CCL rupture in cats., (© Copyright 2014 by The American College of Veterinary Surgeons.)

This paper tries to make an overview of the work carried out by scientific community in the area of road helmets safety. In an area that is constantly being pushed forward by market competition, self-awareness of danger and tighter standards, several research groups around the world have contributed to safety gear improvement. In this work concepts related to head impact protection and energy absorption are explained. It also makes reference to the theories related to the development of helmets, as well as to the different existing types nowadays. The materials that are typically used in impact situations and new design concepts are also approached. In addition, it is presented a literature review of current--and most commonly used--helmet test standards, along with new tests and helmet concepts to assess the effects of rotational motion. In a non-restrictive, and never up-to-date report, a state-of-art review on road helmets safety is done, with a special insight into brain injury, helmet design and standards., (Copyright © 2013 Elsevier Ltd. All rights reserved.)

Objective: The purpose of this study was to review the short- and long-term clinical and radiological results of intramedullary compression screw fixation of proximal fifth metatarsal fractures in athletes., Methods: Eleven male and six female active patients with fifth metatarsal zone II and zone III fractures fixed with a 4.5-mm cannulated compression screw were evaluated by chart review, review of radiographs, and clinical evaluation. Fifteen of the patients were high-level athletes (soccer: n=11; basketball: n=1; track and field: n=3) and two were recreational-level athletes. Mean follow-up from surgery to evaluation was 54 (38-70) months., Results: Mean time to healing as shown on radiographs and mean time to return to full activity after surgery were 7.3 and 7.5 weeks, respectively. All patients were able to return to their previous levels of activity. There were no reports of union delay, nonunion or refracture to date., Conclusion: In our patients, cannulated screw fixation of proximal fifth metatarsal fractures was a reliable procedure with low morbidity associated that provided athletes a quick return to activity. Level of Evidence I, Case Series .

We have mapped the distribution of glucocorticoid receptor (GR) mRNA in the male adult rat brain using T7 RNA polymerase transcripts of a 1155 base pair rat GR cDNA clone comprising the coding region for amino acids 140-525. Strong expression of GR mRNA was found in the neurons of the CA1 and CA2 fields of the hippocampus and in the paraventricular and periventricular hypothalamic nuclei. Moderate to strong hybridization was found in the dorsal thalamic nuclei, layers II and VI of the cerebral cortex, the anterior olfactory nucleus and primary olfactory cortex, the hypothalamic mammillary nuclei, the subthalamus, and the granule and mitral cells of the olfactory bulb. Weak to moderate hybridization was found in many other regions of the tel- and diencephalon. Mes- and rhomboencephalic neurons displayed very low levels of GR mRNA relative to the levels observed in the tel- and diencephalon. In the cerebellum, moderate to strong levels of mRNA were detected in the granule and Purkinje cell layers with very low levels elsewhere. Nonneuronal brain elements, such as glial cells, the pia mater, and the choroid plexus, were found to express low to moderate amounts of GR mRNA. These results confirm and extend mapping studies of steroid receptors in the brain using radiolabeled steroids or monoclonal antibodies against rat liver GR and demonstrate that the relative distribution of GR protein in different brain nuclei reflects differences in GR mRNA levels. The rat GR cDNA clone is also shown to provide suitable probes for mapping GR gene expression in the mouse brain.

Z-DNA affinity adsorption of an Escherichia coli lysate in the presence of excess B-DNA results in a 1000-fold enrichment for three proteins with apparent molecular weights, on SDS/polyacrylamide gel electrophoresis, of 50,000, 90,000 and 100,000. When retention of these proteins on resins constructed with Z-DNA (Br-poly(dG-dC).poly(dG-dC)) was compared with retention on resins constructed with B-DNA or Br-B-DNA, it was found that approximately 100-fold more of the 50,000 Mr protein, 1000-fold more of the 90,000 Mr protein, and greater than 1000-fold more of the 100,000 Mr protein was retained on the Z-DNA resin. No difference in retention on the B-DNA versus brominated B-DNA resin was found, indicating that the increased retention on the Z-DNA resin was not due to bromination of the Z-DNA. This demonstration of Z-DNA-specific binding in vitro makes these proteins candidates for binding to Z-DNA in vivo. In an effort to determine the function of these proteins we have prepared monoclonal antibodies against each protein and isolated its respective gene. Western blot analysis of lysogens carrying these genes confirms their identity and shows that the complete coding region and promoter for each gene has been cloned.