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IntroductionThe goal of this cadaver study in cats was to compare the mechanical properties of intact mandibles (C) with mandibles whose simulated fracture was located between the third and fourth premolar teeth and repaired with four possible treatments: (1) Stout multiple loop interdental wiring plus bis-acryl composite intraoral splint (S); (2) modified Risdon interdental wiring plus bis-acryl composite intraoral splint (R); (3) ultrasound-aided absorbable fixation plate (P); and (4) ultrasound-aided absorbable fixation mesh (M).Materials and methodsThirty feline mandibles were randomly assigned to the control and treatment groups. Mandibles were loaded by cantilever bending on the canine tooth, first in non-destructive cyclic loading followed by destructive ramp-to-failure loading.ResultsCyclic loading showed no differences between the treatment groups in angular deflection (a measure of sample flexion under non-destructive loads); however, the R group had significantly higher angular deflection than the C group. In destructive testing, no differences in mechanical properties were found between the treatment groups; however, all treatment groups demonstrated significantly lower maximum bending moment, bending stiffness, energy to failure, and maximum force when compared to the control group. The main mode of failure of the intraoral splint groups (S and R) was fracture of the bis-acryl composite (50%), and the main mode of failure of the absorbable fixation groups (P and M) was fracture of the pins (91.7%).DiscussionIntraoral splint and absorbable fixation methods have low strength and stiffness. The four treatments tested provided similar stabilization of mandibular fractures located between the third and fourth premolar teeth.

Abstract The biological mechanisms regulating tenocyte differentiation and morphological maturation have not been well-established, partly due to the lack of reliable in vitro systems that produce highly aligned collagenous tissues. In this study, we developed a scaffold-free, three-dimensional (3D) tendon culture system using mouse tendon cells in a differentially adherent growth channel. Transforming Growth Factor-β (TGFβ) signaling is involved in various biological processes in the tendon, regulating tendon cell fate, recruitment and maintenance of tenocytes, and matrix organization. This known function of TGFβ signaling in tendon prompted us to utilize TGFβ1 to induce tendon-like structures in 3D tendon constructs. TGFβ1 treatment promoted a tendon-like structure in the peripheral layer of the constructs characterized by increased thickness with a gradual decrease in cell density and highly aligned collagen matrix. TGFβ1 also enhanced cell proliferation, matrix production, and morphological maturation of cells in the peripheral layer compared to vehicle treatment. TGFβ1 treatment also induced early tenogenic differentiation and resulted in sufficient mechanical integrity, allowing biomechanical testing. The current study suggests that this scaffold-free 3D tendon cell culture system could be an in vitro platform to investigate underlying biological mechanisms that regulate tenogenic cell differentiation and matrix organization.

Background & Aims: Glisson’s capsule is the interstitial connective tissue that surrounds the liver. As part of its normal physiology, it withstands significant daily changes in liver size. The pathophysiology of the capsule in disease is not well understood. The aim of this study was to characterise the changes in capsule matrix, cellular composition, and mechanical properties that occur in liver disease and to determine whether these correlate with disease severity or aetiology. Methods: Samples from ten control patients, and six with steatosis, seven with moderate fibrosis, and 37 with cirrhosis were collected from autopsies, intraoperative biopsies, and liver explants. Matrix proteins and cell markers were assessed by staining and second harmonic generation imaging. Mechanical tensile testing was performed on a test frame. Results: Capsule thickness was significantly increased in cirrhotic samples compared with normal controls irrespective of disease aetiology (70.12 ± 14.16 μm and 231.58 ± 21.82 μm, respectively), whereas steatosis and moderate fibrosis had no effect on thickness (90.91 ± 11.40 μm). Changes in cirrhosis included an increase in cell number (fibroblasts, vascular cells, infiltrating immune cells, and biliary epithelial cells). Key matrix components (collagens 1 and 3, hyaluronan, versican, and elastin) were all deposited in the lower capsule, although only the relative amounts per area of hyaluronan and versican were increased. Organisational features, including crimping and alignment of collagen fibres, were also altered in cirrhosis. Unexpectedly, capsules from cirrhotic livers had decreased resistance to loading compared with controls. Conclusions: The liver capsule, similar to the parenchyma, is an active site of disease, demonstrating changes in matrix and cell composition as well as mechanical properties. Impact and implications: We assessed the changes in composition and response to stretching of the liver outer sheath, the capsule, in human liver disease. We found an increase in key structural components and numbers of cells as well as a change in matrix organisation of the capsule during the later stages of disease. This allows the diseased capsule to stretch more under any given force, suggesting that it is less stiff than healthy tissue.

Summary:. At the 2021 annual meeting of the Orthopaedic Trauma Association, the Basic Science Focus Forum hosted its first ever debate-style symposium focused on biomechanics and fracture repair. The 3 subjects of debate were “Mechanics versus Biology—Which is ‘More Important’ to Consider?” “Locked Plate versus Forward Dynamization versus Reverse Dynamization—Which Way Should I Go?” and “Sawbones versus Cadaver Models—What Should I Believe Most?” These debates were held because fracture healing is a highly organized synergistic response between biological factors and the local mechanical environment. Multiple studies have demonstrated that both factors play roles in governing bone healing responses, and the causal relationships between the 2 remain unclear. The lack of clarity in this space has led to a spectrum of research with the common goal of helping surgeons make good decisions. Before reading further, the reader should understand that the questions posed in the debate titles are unanswerable and might represent a false choice. Instead, the reader should appreciate that the debates were held to gain a more thorough understanding of these topics based on the current state of the art of experimental and clinical studies, by using an engaging and thought-provoking format.

Abstract Background Failure of surgical fixation in orthopaedic fractures occurs at a significantly higher rate in osteoporotic patients due to weakened osteoporotic bone. A therapy to acutely improve the mechanical properties of bone during fracture repair would have profound clinical impact. A previous study has demonstrated an increase in mechanical properties of acellular cortical canine bone after immersion in raloxifene. The goal of this study was to determine if similar treatment yields the same results in cancellous fetal bovine bone and whether this translates into a difference in screw pull-out strength in human cadaveric tissue. Methods Cancellous bone from fetal bovine distal femora underwent quasi-static four-point bending tests after being immersed in either raloxifene (20 μM) or phosphate-buffered saline as a control for 7 days (n = 10). Separately, 5 matched pairs of human osteoporotic cadaveric humeral heads underwent the same procedure. Five 3.5 mm unicortical cancellous screws were then inserted at standard surgical fixation locations to a depth of 30 mm and quasi-static screw pull-out tests were performed. Results In the four-point bending tests, there were no significant differences between the raloxifene and control groups for any of the mechanical properties - including stiffness (p = 0.333) and toughness (p = 0.546). In the screw pull-out tests, the raloxifene soaked samples and control samples had pullout strengths of 122 ± 74.3 N and 89.5 ± 63.8 N, respectively. Conclusions Results from this study indicate that cancellous fetal bovine samples did not demonstrate an increase in toughness with raloxifene treatment, which is in contrast to previously published data that studied canine cortical bone. In vivo experiments are likely required to determine whether raloxifene will improve implant fixation.

Abstract. Objectives:. Current surgical fracture treatment paradigms, which use rigid metallic constructs to heal bones, provide reasonable clinical outcomes; however, they do not leverage recent advances in our understanding of bone healing and mechanotransduction throughout bone healing. The objective of this review was to investigate the efficacy and potential clinical applicability of surgical techniques and implants that deliberately introduce interfragmentary motion throughout the healing process. Methods:. The authors searched PubMed and Google Scholar databases for articles reporting on fracture repair using dynamic locking plates, dynamized surgical techniques, and reverse dynamization. Data collection also included assessment of additively manufactured (AM) implants that provide dynamic mechanical behaviors. Results:. Forty articles were included for final review. It was found that accelerated rates of fracture healing can be achieved with staged 2-part surgeries or dynamic implant designs. Temporal dynamization, where static fixation of bones is followed by the introduction of micromotion and controlled loading, has been shown to improve callus volume and accelerate the healing response. Reverse dynamization, where micromotion is encouraged during early callus formation and arrested later, may represent a significant advance for the treatment of critical defect injuries. Advances in AM techniques will likely provide the ability to create high-resolution implants capable of dynamized and reverse dynamized modalities. Conclusions:. There is no one-size-fits-all approach to optimization of fracture healing. However, it has been clearly demonstrated that fracture treatment can be enhanced by systematically altering the construct stiffness throughout the different phases of healing, which may be achieved with AM implant designs.

Category: Sports; Basic Sciences/Biologics Introduction/Purpose: Achilles tendon disorders are among the most common conditions observed by sports medicine physicians and among the most difficult to diagnose using current clinical tools. While qualitative imaging is a validated method to grade the severity of tendinopathy, predicting the risk of these patients progressing or suffering tendon ruptures remains a major clinical need. Therefore, the purpose of this study was to determine the efficacy of quantitative ultrasound imaging to explain in vitro fatigue-induced degradation of Achilles tendon mechanical properties. We hypothesized that decreases in mean echogenicity would be linked to in vitro tendon fatigue characterized by decreased mechanical properties. Methods: In this cadaveric tendon study, we cyclically fatigued 10 cadaveric Achilles tendons (7 donors; sex: 4M, 3F; age: 60+-15 years) and acquired b-mode ultrasound images to determine if stress-imaging biomarkers provide new insight into tendon status. We cut dog-bone shapes to concentrate tendon damage at the mid-substance where we acquired ultrasound images. In a custom- built testing bath, we cyclically applied 10-20 MPa of tendon stress at 1 Hz for 150,00 or until the specimen failed. Every 500th cycle, we applied 2 slow (0.25 Hz) tendon stresses of 10-20 MPa while acquiring ultrasound images using an 18MHz transducer. We calculated the change in tendon echogenicity caused by the applied stress to determine if this stress-imaging biomarker was associated with tendon failure. We compared these stress-imaging biomarkers from the tendons that failed (N=6) and the tendons that survived (N=4) cyclic fatigue damage using an unpaired t-test (p < 0.05). Results: Quantitative analysis of the ultrasound images indicated 2 key differences between tendons that failed during the cyclic loading protocol and those that did not (Figure 1 shows representative data of tendons with similar demographics but one tendon exhibited increased change in echogenicity before failing while the other tendon exhibited smaller changes in echogenicity and did not rupture). First, mean echogenicity decreased before failure. Second, the average change in mean echogenicity was significantly greater in tendons that failed (p = 0.031). For most tendons that did fail, mean echogenicity decreased during the third phase of fatigue life. For the tendons that did not fail, mean echogenicity plateaued along with strain during the second phase of fatigue. Conclusion: This study found detectable differences in image echogenicity during a stress test between tendons that fail during cyclic loading and those that do not. While preliminary, our findings indicate that B-mode ultrasound has potential as a clinically viable tool to predict severe tendon injuries. Our future work is focused on developing computer-based predictive tools to assess Achilles tendon fatigue in patients with tendinopathy following prolonged tendon loading to establish quantitative imaging thresholds that can serve as clinical benchmarks.

Abstract. This manuscript summarizes presentations of a symposium on key considerations in design of biomechanical models at the 2019 Basic Science Focus Forum of the Orthopaedic Trauma Association. The first section outlines the most important characteristics of a high-quality biomechanical study. The second section considers choices associated with designing experiments using finite element modeling versus synthetic bones versus human specimens. The third section discusses appropriate selection of experimental protocols and finite element analyses. The fourth section considers the pros and cons of use of biomechanical research for implant design. Finally, the fifth section examines how results from biomechanical studies can be used when clinical evidence is lacking or contradictory. When taken together, these presentations emphasize the critical importance of biomechanical research and the need to carefully consider and optimize models when designing a biomechanical study.

Tendon mechanical properties respond to altered load in adults, but how load history during growth affects adult tendon properties remains unclear. To address this question, we adopted an avian model in which we altered the mechanical load environment across the growth span. Animals were divided at 2 weeks of age into three groups: (1) an exercise control group given the opportunity to perform high-acceleration movements (EXE, n = 8); (2) a sedentary group restricted from high-intensity exercise (RES, n = 8); and (3) a sedentary group also restricted from high-intensity exercise and in which the gastrocnemius muscles were partially paralyzed using repeated bouts of botulinum toxin-A injections (RES-BTX, n = 8). Video analysis of bird movement confirmed the restrictions eliminated high-intensity exercise and did not alter time spent walking and sitting between groups. At skeletal maturity (33–35 weeks) animals were sacrificed for analysis, consisting of high-field MRI and material load testing, of both the entire free Achilles tendon and the tendon at the bone-tendon junction. Free tendon stiffness, modulus, and hysteresis were unaffected by variation in load environment. Further, the bone-tendon junction cross-sectional area, stress, and strain were also unaffected by variations in load environment. These results suggest that: (a) a baseline level of low-intensity activity (standing and walking) may be sufficient to maintain tendon growth; and (b) if this lower threshold of tendon load is met, non-mechanical mediated tendon growth may override the load-induced mechanotransduction signal attributed to tendon remodeling in adults of the same species. These results are important for understanding of musculoskeletal function and tendon health in growing individuals.

A cadaveric study was performed to investigate the external mechanical forces required to fracture maxillary fourth premolar teeth in domestic dogs and describe a clinically relevant model of chewing forces placed on functionally important teeth in which fracture patterns are consistent with those defined by the American Veterinary Dental College (AVDC). Twenty-four maxillary fourth premolar teeth were harvested from dog cadavers. Samples consisted of teeth with surrounding alveolar bone potted in polycarbonate cylinders filled with acrylic. The cylinders were held by an aluminum device at an angle of 60° with respect to the ground. An axial compression test was performed, creating a force upon the occluso-palatal aspects of the main cusps of the crowns of the teeth. The highest compressive force prior to failure was considered the maximum force sustained by the teeth. Results showed the mean maximum force (± SD) sustained by the tested teeth at the point of fracture was 1,281 N (± 403 N) at a mean impact angle (± SD) of 59.7° (± 5.2°). The most common fracture type that occurred among all samples was a complicated crown fracture (n = 12), followed by an uncomplicated crown fracture (n = 6), complicated crown-root fracture (n = 5), and uncomplicated crown-root fracture (n = 1). There was no statistically significant correlation between dog breed, age, weight, impact angle, crown height or crown diameter, and the maximum force applied at the point of fracture. The only independent variable that remained significantly associated with maximum force was the crown height to diameter ratio (p = 0.005), suggesting that a decreased ratio increases tooth fracture resistance. The methodology described herein has been successful in creating a pattern of fracture of maxillary fourth premolar teeth consistent with that defined by the AVDC under angled compression at forces within the maximum chewing capability of the average domestic dog.

Thaumapsylla Rothschild is a small genus of Old World ischnopsyllid fleas parasitic only on the family Pteropodidae (fruit bats). Despite its widespread record in the Philippines, it has never been reported in the Bicol Region, southern Luzon. In this account, we report the first record of Thaumapsylla breviceps Rothschild in the Bicol Region. It was collected from Eonycteris spelaea (Dobson), a nectarivorous fruit bat native to Southeast Asia. Also, this paper represents the first record of the genus Thaumapsylla on Bicol Region, Luzon Island.

A new species of flea (Siphonaptera: Rhopalopsyllidae) is described from sigmodontine rodents collected during a survey of small mammals in northwestern Argentina. The new species belongs to the subgenus Tetrapsyllus and can be distinguished from all species of the subgenus by characteristics of the modified abdominal segments and genitalia. A phylogenetic analysis of the genus Tetrapsyllus using morphological characters is presented and the analysis supports the erection of this new Tetrapsyllus species in the subgenus Tetrapsyllus. The unique occurrence of a sinus in the caudal margin of the sixth sternite of females that is present only in the subgenus Tetrapsyllus (also unique across the Order Siphonaptera) is provided with a discussion of how this adaptation is mirrored in the parallel development of a spur on the sclerotized inner tube of males. Additional host and locality data are recorded for Tetrapsyllus (P.) bleptus. A key to the genus Tetrapsyllus is provided. The increased diversity of flea fauna bordering a known plague endemic area in northwestern Argentina may prove useful in implementing sustainable control measures in the future. Keywords: Tetrapsyllus, Flea, Phylogenetic analysis, Morphology, New host, Argentina

A redescription of the genus Phalacropsylla Rothschild is provided. Six species are recognized: Phalacropsylla allos Wagner, P. hamata Tipton and Mendez, P. morlani Eads and Campos, P. nivalis Barrera and Traub, P. oregonensis Lewis and Maser, and P. paradisea Rothschild. Phalacropsylla hamata is designated herein as a junior synonym of P. paradisea. The distribution of P. paradisea is more extensive than previously thought, extending from Arizona through southern Colorado, into New Mexico, Texas, and northern Mexico (State of Nuevo León). It is the least host-specific of all species of Phalacropsylla, occurring on 13 different host species including cricetid, heteromyid, murid, and sciurid rodents and several carnivores, although it most commonly occurs on Neotoma albigula Hartley. The range of P. oregonensis is expanded from eastern Oregon to southeastern Idaho. Numerous records are documented for the most common and ubiquitous species, P. allos, which is found in British Columbia, central to northern California, Idaho, Montana, Colorado, Nevada, Utah, Wyoming, Arizona, and New Mexico. Neotoma cinerea Ord is the principal host of P. allos. Phalacropsylla allos is a winter flea west of the Rocky Mountains, but it has been reported in warmer months of the year on the eastern slopes of the Rocky Mountains in Larimer County, Colorado. A distribution map and key are provided for all species in the genus Phalacropsylla.

Lagaropsylla signata (Wahlgren, 1903), previously known only from the Island of Java, Indonesia is redescribed and reported for the first time in Deer Cave, Gunung Mulu National Park, Sarawak, Malaysia (west coast of Borneo). Many were found clinging to the earwig Arixenia esau Jordan, 1909. A similar account of a phoretic flea (Lagaropsylla turba Smit, 1958) on the same species of cave-dwelling earwig has been reported in peninsular Malaysia in a well-documented association with the hairless naked bulldog bat, Cheiromeles torquatus Horsfield, 1824. The association of L. signata with A. esau is parallel to the evolution and co-existence with bats in Deer Cave just as in the case of L. turba, A. esau, and C. torquatus. The evidence suggests that L. turba and L. signata are obligate phoretic parasites whose survival depends on A. esau to access a bat host. Arixenia esau is reported for the first time in Deer Cave and the occurrence of L. signata on the island of Borneo represented a new record, previously being found only on the island of Java. Images of L. signata attached to A. esau are provided. Xeniaria jacobsoni (Burr, 1912), often associated with A. esau in other geographical areas, was not present in the material examined from Deer Cave. The natural history of the earwig genera Arixenia Jordan, 1909 and Xeniaria Maa, 1974 are discussed and summarized relative to their associations with phoretic fleas and their bat hosts.

A new species of flea of the genus Ctenidiosomus Jordan, 1931 (Siphonaptera: Pygiopsyllidae) is described from Phyllotis osilae J. A. Allen, 1901, from Salta Province, Argentina. This is the first time that Ctenidiosomus has been recorded in Argentina. A key to species of males of Ctenidiosomus is presented.

Design and processing capabilities of additive manufacturing (AM) to fabricate complex geometries continues to drive the adoption of AM for biomedical applications. In this study, a validated design methodology is presented to evaluate AM as an effective fabrication technique for reconstruction of large bone defects after tumor resection in pediatric oncology patients. Implanting off-the-shelf components in pediatric patients is especially challenging because most standard components are sized and shaped for more common adult cases. While currently reported efforts on AM implants are focused on maxillofacial, hip and knee reconstructions, there have been no reported studies on reconstruction of proximal humerus tumors. A case study of a 9-year-old diagnosed with proximal humerus osteosarcoma was used to develop a patient-specific AM prosthesis for the humerus following tumor resection. Commonly used body-centered cubic (BCC) structures were incorporated at the surgical neck and distal interface in order to increase the effective surface area, promote osseointegration, and reduce the implant weight. A patient-specific prosthesis was fabricated using electron beam melting method from biocompatible Ti-6Al-4V. Both computational and biomechanical tests were performed on the prosthesis to evaluate its biomechanical behavior under varying loading conditions. Morphological analysis of the construct using micro-computed tomography was used to compare the as-designed and as-built prosthesis. It was found that the patient-specific prosthesis could withstand physiologically-relevant loading conditions with minimal permanent deformation (82 μm after 105 cycles) at the medial aspect of the porous surgical neck. These outcomes support potential translation of the patient-specific AM prostheses to reconstruct large bone defects following tumor resection.