Annals of Biomedical Engineering

Introduction: Metastatic spinal lesions substantially alter vertebral mechanical properties and increase fracture risk. Computed tomography (CT) based finite element (FE) models can estimate vertebral strength, but their accuracy depends on how CT derived material properties are represented. This study evaluated the effect of two material grouping strategies on simulated strength and stiffness in metastatic vertebrae. Methods: We compared Adaptive Clustering (AC) with Uniform fixed width grouping in 44 vertebrae from 11 donors (8 osteolytic, 12 osteoblastic, 12 mixed, 12 no observed lesion (NOL)). FE models were generated based on CT scans with 2 to 500 material groups and compared for material mapping error and simulated strength and stiffness. Overall and lesion stratified agreement with experimental measurements was assessed in an exploratory analysis. Results: AC showed significantly lower Young's modulus root mean square error than Uniform (p < 0.05). Simulated strength and stiffness stabilised by 50 material groups. At 50 groups, simulated strength showed moderate correlation with experimental strength overall (R2 = 0.57), strongest in NOL vertebrae (R2 = 0.82) and lower in lesion-bearing vertebrae (R2 = 0.4-0.59). Stiffness showed weaker correlation overall (R2 = 0.27), highest in NOL vertebrae (R2 = 0.48) and negligible in mixed lesions (R2 = 0.007). Bland Altman analyses indicated systematic underestimation of experimental fracture load. Discussion: AC improved material-mapping fidelity, whereas increasing material groups beyond 50 had little influence on simulated strength or stiffness. Numerical stabilisation therefore did not imply experimental accuracy. Lesion stratified findings were exploratory and should be interpreted cautiously because of limited subgroup sizes.

Maternal thermal strain is associated with adverse pregnancy outcomes, yet fetal temperatures cannot currently be directly measured, limiting quantification of fetal thermal strain. Here, we develop two steady-state models for estimating internal temperatures in a near-term fetus. First, we improve the only previously published human fetal thermoregulation model, deriving a closed-form solution within its simplified uniform-cylinder representation. Second, we introduce a multilayer, anatomically segmented model that resolves tissue-specific temperatures. Both couple the fetal body to central blood pool and amniotic fluid compartments and incorporate a new placenta-umbilical cord heat-exchanger representation. Predictions agree with available intrauterine scalp measurements, with fetal core and head-center temperatures approximately 0.5{degrees}C and 0.8{degrees}C above maternal core, respectively. Physiologically plausible changes in umbilical cord heat-exchanger effectiveness or blood flow increased fetal temperatures by approximately 0.3{degrees}C. These models enable estimation of otherwise inaccessible temperatures, while the multilayer formulation lays a foundation for transient, coupled maternal-fetal thermoregulation modeling.

Purpose: Fibrotic remodeling of the uterus, associated with aging, disease, and environmental exposures, alters collagen organization and tissue stiffness, yet how these changes influence organ-level mechanical behavior remains poorly understood. Glutaraldehyde (GA)-induced collagen crosslinking was used as a controlled surrogate for fibrotic remodeling to determine whether image-informed inverse finite element analysis (iFEA), combined with inflation testing and micro-computed tomography (microCT), could detect and quantify the resulting changes in uterine constitutive behavior. Methods: Murine uteri (n = 6 untreated, n = 6 GA-crosslinked) underwent volume-controlled balloon inflation with simultaneous microCT imaging to quantify deformation of the inner and outer wall boundaries for iFEA. Specimen-specific Gasser-Ogden-Holzapfel (GOH) finite element models were optimized by adjusting model parameters to reproduce experimentally measured wall contours throughout inflation. Model performance was evaluated using contour root mean square error (RMSE), and parameter identifiability was assessed through sensitivity analyses. Results: GA treatment significantly increased inflation work, linear stiffness, and maximum inflation resistance (p < 0.001). The iFEA framework accurately reproduced experimental deformation (RMSE < 3%) and revealed significant increases in the estimated GOH parameters C10 (9.2-fold), k1 (2.0-fold), and k2 (2.7-fold), consistent with increased effective tissue stiffness and a shift toward earlier collagen fiber recruitment. Sensitivity analyses demonstrated unique, well-defined minima for all parameter combinations. Conclusion: Image-informed iFEA provides a quantitative framework for relating collagen remodeling to organ-level uterine mechanics through specimen-specific constitutive parameter estimation. This approach establishes a foundation for investigating the mechanical consequences of uterine fibrosis and other remodeling processes.

Background: Chronic wounds, ulcers, and lacerations require staged debridement and irrigation to promote healing. However, conventional techniques of debridement, such as surgical, chemical, or autolytic, struggle to fully remove residual necrotic tissue, slough, and unhealthy granulation from wound sites, especially when lodged within wound clefts and cavities, and in wounds with exposed structures. This promotes polymicrobial biofilms, delays wound closure, and causes significant discomfort with increased morbidity. Objective: To demonstrate the feasibility of using an indigenously developed tunable flat-jet hydro-debridement device (presently termed as CleanseJet), a frugal wound debridement system designed for deployment in resource-constrained clinical settings. Methods: An open-label, interventional, single-centre, parallel-group pilot randomized controlled trial was conducted to clinically evaluate an indigenously developed tunable flat-jet hydro-debridement device in patients with wounds of varied aetiology. The device provided adjustable spray impact force and coverage area tailored to wound characteristics. Outcomes were compared with a control group receiving standard wound care alone, with time to complete granulation serving as the primary healing endpoint. Outcomes were compared with a control cohort receiving standard of care alone. Results: The removal of loose devitalized tissue, slough, and biofilms from the wound bed improved the healing, which were monitored using the SINBAD scoring system. No adverse events were reported, supporting the feasibility and safety of CleanseJet. Conclusion: While commercial hydro-debridement systems are effective, they are often costly, rely on disposable components, and require specialized training. In contrast, CleanseJet provides a low-cost, easy-to-use alternative that can be operated with minimal training, making it suitable for broader clinical use without observed adverse effects.

Cell therapies involving human adipose-derived stromal cells (hASCs) have shown promise for a range of clinical applications due to their ability to stimulate angiogenesis and dampen inflammation via paracrine mechanisms. However, a major barrier to the successful clinical translation of hASC-based therapies is that standard culture methods for expansion on rigid 2D tissue-culture polystyrene under static conditions diminish the pro-regenerative functionality of the cells. To address these limitations, the current project focused on the development of an in vitro bioreactor system for preconditioning hASCs to augment their capacity to stimulate regeneration through paracrine mechanisms. Specifically, the combined effects of decellularized adipose tissue (DAT) coatings, shear-stress stimulation, and varying oxygen tensions on hASC expansion and paracrine factor secretion were assessed. Additional studies were performed to characterize the effects of stimulating hASCs within the rocking bioreactor system using the pro-inflammatory cytokines IFN-{gamma} and TNF-. Expansion in the bioreactor under all conditions supported hASC growth with no observable morphological differences. However, dynamic culture on DAT coatings enhanced intracellular indoleamine 2,3-dioxygenase (IDO) expression in hASCs cultured under 20% O2. Moreover, culturing under dynamic conditions and/or on DAT coatings significantly increased secretion of the pro-angiogenic factors VEGF, HGF, and angiogenin. When pro-inflammatory cytokine priming was introduced, the expression of all tested paracrine factors was enhanced, particularly the immunomodulatory factors IL-6, IL-8 and MCP-1. Overall, a novel bioreactor system was developed for hASC expansion and preconditioning, demonstrating that the cell microenvironment can be tuned to modulate hASC paracrine factor secretion.

Chronic, mechanically resilient thrombi remain difficult to remove rapidly and safely using existing therapies, which are limited by slow treatment speeds, reduced efficacy against aged clots and risks associated with embolic debris. Here we introduce Constrained Laser-Induced Cavitation (CLIC), a novel approach that confines laser-induced cavitation bubble generation and collapse within a miniaturized waveguide to enhance thrombolysis. Optimized CLIC removed retracted clots at a mass-loss rate of 393.5 mg/min, [~]40-fold higher than reported state-of-the-art sonothrombolysis under similar conditions. Systematic variation of channel length and laser parameters showed that CLIC efficacy depends strongly on treatment geometry and cavitation dynamics. Post-treatment analysis revealed cylindrical channels consistent with clot removal dominated by fluid jetting and suction-driven evacuation, with cavitation shockwaves likely contributing a secondary role. Debris fragment measurements remained predominantly below a 1 mm embolic-risk threshold, consistent with a promising embolic safety profile. These findings establish CLIC as a viable strategy for rapid thrombolysis of chronic, mechanically resistant thrombi.

Muscle architecture shapes muscle function and changes with age, growth, training and disease, yet quantifying three-dimensional (3D) muscle architecture in vivo remains challenging. We introduce a hybrid fascicle tractography approach for freehand 3D ultrasound data that accurately reconstructs 3D muscle fascicles with respect to an objective, anatomically relevant coordinate system defined by the muscle's central aponeurosis. The hybrid approach combines Hessian-based fascicle detection with wavelet-based refinement to generate volumetric fascicle orientations. In a synthetic dataset with known ground truth, fascicle orientations and lengths were estimated with errors of [&le;]2{degrees} and ~1.5%, respectively. In vivo, the approach detected physiologically plausible fascicle lengthening in the human tibialis anterior following a passive plantar flexion rotation, whereas diffusion tensor imaging of the same muscle did not. The proposed method enables anatomically relevant, objective and non-invasive quantification of 3D muscle architecture in vivo, providing a practical framework for applications in clinical and applied muscle physiology.

Cerebrovascular pulsatility drives measurable brain tissue deformation and has been associated with ageing and a range of neurological disorders. Yet how pulsatile haemodynamic forces are transmitted through deformable cerebral arteries into the surrounding brain remains poorly understood, particularly in anatomically realistic vascular geometries. Existing computational approaches have largely treated cerebral fluid and tissue mechanics separately or relied on idealised geometries, limiting our ability to determine how vascular anatomy simultaneously governs intraluminal haemodynamics and extravascular mechanical loading. Here, we develop an image-derived three-dimensional computational framework that jointly resolves pulsatile blood flow, arterial wall deformation and surrounding brain tissue motion in representative cerebral arteries. Four arterial segments, including the middle cerebral artery, middle cerebral artery bifurcation, basilar artery and internal carotid artery, are reconstructed from high-field (5 Tesla) magnetic resonance imaging data of a healthy subject. A finite-deformation fluid-structure interaction model is established by coupling non-Newtonian blood flow, hyperelastic arterial wall and hyper-viscoelastic brain tissue. The predicted tissue response is benchmarked against in vivo magnetic resonance elastography measurements of cardiac-induced volumetric strain over a cardiac cycle. Results reveal spatially localised arterial and tissue deformation whose magnitude and distribution are strongly governed by vascular geometry and wall thickness. Among the segments examined, the internal carotid artery exhibits the largest deformation response, while reduced wall thickness increases strain transmission into the surrounding tissue. Geometrically complex regions also exhibit greater spatial heterogeneity in near-wall haemodynamic metrics. These findings demonstrate that cerebral vascular anatomy simultaneously shapes intraluminal haemodynamics and extravascular mechanical loading. By integrating image-derived vascular anatomy, coupled blood-vessel-brain mechanics and in vivo benchmarking within a unified framework, this study provides a mechanically consistent reference for healthy cerebral pulsatility and establishes a foundation for quantifying how blood-vessel-brain interactions are altered under pathological conditions.

Coronary flow waveforms have a distinct diastolic-dominant shape with periods of low or retrograde flow during systole. While the general waveform shape has been attributed to complex interactions between cardiac and vascular mechanics, there is limited research into the variability in coronary flow waveforms and what this variability may reveal about cardiac function. This work presents a shape analysis of left anterior descending artery (LAD) flow waveforms using Fourier transforms and Singular Value Decomposition (SVD) performed on baseline data collected from 32 pigs. Pigs included in the study reflect two breeds (Ossabaw and Yorkshire) and three different experimental conditions (lean-control, lean-paced, and obese-paced). Fourier transforms were used to decompose the waveforms into 15 harmonics for each pig. An SVD analysis is then used to extract temporal patterns of the waveforms. Correlations between pig-specific coefficients for the SVD modes and clinical metrics were used to investigate physiological explanations of LAD waveform variability. Temporal LAD flow patterns of the second SVD mode are significantly correlated with heart rate. The third SVD mode significantly correlates with mean blood pressure and maximum hyperemic flow. Furthermore, the fourth SVD mode is weakly correlated with left-ventricular end diastolic pressure and endocardial-epicardial flow ratios. This work demonstrates that LAD flow waveforms can be broken down into temporal patterns that correlate with physiological features. Furthermore, this shape-analysis method allows for waveform reconstruction and simplifies visualization of the temporal patterns identified using SVD, an advantage over existing methods that focus on characterizing flow waveforms by points of interest.

Adolescent idiopathic scoliosis (AIS) alters spinal geometry and may influence the biomechanical response of the spine during functional postures. However, posture-dependent changes in spinal loading and paraspinal muscle forces in AIS remain poorly understood. This study investigated the effects of trunk posture on intervertebral loading and paraspinal muscle forces using a subject-specific musculoskeletal model of an adolescent with AIS. The spinal deformity was reconstructed from biplanar radiographs and incorporated into a full-body musculoskeletal model. Flexion, extension, lateral bending, and axial rotation were simulated at three incremental magnitudes, with motion distributed across the thoracolumbar spine. Intervertebral compressive and lateral forces around the curve apex and forces in the erector spinae (ES) and multifidus (MF) muscles were evaluated. Trunk flexion produced the greatest compressive loading, reaching 337 N at the curve apex and 372 N two levels below the apex at 30{degrees} flexion. Lateral bending produced pronounced direction-dependent loading: concave-side bending increased lateral forces, whereas convex-side bending increased compressive forces. Axial rotation produced similar but smaller direction-dependent changes. Paraspinal muscle forces were consistently asymmetric, with concave-side dominance of the ES and convex-side dominance of the MF. Flexion and convex-sided movements generally produced greater muscle imbalance, while increasing posture magnitude amplified spinal loading and muscle forces. These findings demonstrate that trunk posture, movement direction, and magnitude substantially influence the biomechanical environment of the scoliotic spine and should be considered when evaluating spinal mechanics in AIS.

Peripheral artery disease (PAD) spans a continuum from large-vessel obstruction to distal microvascular dysfunction, yet routine non-invasive tests, including the ankle-brachial index (ABI), do not provide structurally resolved assessment of the foot microvascular bed and may be unreliable in the setting of medial arterial calcification or perioperative follow-up. Here we developed a clinic-oriented multispectral compound-scanning photoacoustic tomography system (MCPATS) for compression-free distal toe imaging, and an interpretable photoacoustic tomography distal microcirculation score, termed PACT-DMS, for phenotyping PAD-related distal vascular abnormalities. PACT-DMS was derived from anatomically standardized distal toe sections and integrated seven prespecified vascular features spanning trunk-vessel morphology, microvascular distribution and pulsation-related dynamics through a traceable linear support vector machine. In a prospective single-centre cohort of 45 participants, the bilateral fusion PACT-DMS model distinguished patients with PAD from healthy controls with an area under the receiver operating characteristic curve of 0.964 (95% CI, 0.907-1.000) and an accuracy of 91.1% (95% CI, 82.2%-97.8%) under subject-level leave-one-out cross-validation, supported by complementary robustness analyses. Exploratory analyses further showed that PACT-DMS identified abnormal distal vascular phenotypes in 6 of 9 clinically diagnosed PAD limbs with non-abnormal ABI and visualized distal vascular-bed changes before and after revascularization. These findings support MCPATS-enabled interpretable photoacoustic vascular phenotyping as a candidate adjunctive approach for distal microcirculatory assessment in PAD; larger multicentre studies with external validation and prespecified analysis protocols will be required to define its clinical role.

Cerebral hemodynamics are difficult to monitor continuously outside the laboratory. Optical head-worn wearables have been proposed for tracking cerebral blood-flow signals, but they require comparison with an established cerebrovascular reference before they can be interpreted. We evaluated a temple-worn optical wearable, Temple, that outputs a proprietary, dimensionless Brain Flow index, intended as a proxy for relative changes in cerebral hemodynamics, against transcranial Doppler (TCD) ultrasound, which measures blood-flow velocity in the middle cerebral artery (MCAv). Twenty-three healthy adults completed two physiological challenges that elicit distinct and acute cerebral hemodynamic responses: a cycle-ergometer exercise protocol and a stand-to-supine postural transition protocol. Twenty participants were analyzed per protocol. The Brain Flow index tracked MCAv in both protocols, with significant within-subject temporal correlations (median Pearson r = 0.795 and 0.799 for exercise and postural transition; p < 0.001) and directionally concordant, statistically significant transition responses for both increases and decreases in flow. Bland-Altman analysis of the normalized transition responses showed small mean biases between the two devices, consistent with similar relative response shapes. Because both signals were standardized within session before this comparison, it addresses the shape of the relative change rather than agreement in absolute units. The Brain Flow index reproduced the direction and time course of MCAv under both perturbations, including the postural transition, where heart rate moved in the opposite direction. Further studies using complementary modalities and additional cerebrovascular reactivity challenges are required to establish clinical use cases and cerebral specificity of the Brain Flow index.

Pulmonary hypertension (PH) is characterized by progressive structural and mechanical remodeling of the pulmonary vasculature, yet few computational frameworks directly link disease mechanisms to longitudinal progression and therapeutic response. In this study, we utilized a multiscale pulmonary arterial growth and remodeling (G&R) framework to capture evolving functional metrics from rat models of PH. This framework couples morphometric tree hemodynamics, constrained mixture theory-based wall mechanics, and maladaptive cellular remodeling. Disease progression was driven by three mechanistically interpretable parameters governing excess smooth muscle production, remodeling activation, and passive stiffening. These parameters were calibrated to longitudinal monocrotaline (MCT) measurements of pressure, wall thickness, and stiffness from prior work using a multiobjective optimization. To show the predictive value of this model, we simulated therapeutic intervention within the same disease-specific framework by using functional cell-level responses to therapy to inform changes in parameter values. Calibration to the study-specific MCT dataset reproduced the temporal increases in pressure, wall thickness, and stiffness, demonstrating that the model could capture multiple features of vascular remodeling simultaneously, with R2 values of 0.81, 0.83, and 0.95, respectively. Simulated treatment reduced pressure, wall thickness, and stiffness. Predicted pressure and wall-thickness responses agreed closely with the corresponding experimental treatment effects, whereas stiffness recovery was overpredicted, suggesting that additional mechanisms may contribute to persistent vascular stiffening after intervention. The framework also captured the overall progression of pulmonary pressure increases across both aggregated MCT and Sugen-hypoxia datasets, suggesting utility across studies and animal models. This work outlines a physics-based, multiscale framework that simulated quantities of direct clinical interest in a mechanistically interpretable platform for linking pulmonary vascular remodeling and treatment response. It supports comparisons across experimental phenotypes and interventions while identifying where constitutive refinements are needed to improve predictive capability across phenotypes.

Objectives To validate two computational fluid dynamics (CFD) models derived from computed tomography angiography (CTA) for estimating trans-stenotic pressure gradients, using invasive intra-arterial pressure measurements as the reference standard in patients with renal artery stenosis (RAS). Background We assessed whether non-invasive assessment of the pressure gradient using CFD could be a reliable alternative to intra-arterial measurements for identifying hemodynamically significant RAS. Methods We performed intra-arterial measurements at rest and during dopamine-induced hyperemia to assess the trans-stenotic pressure gradient in 28 patients with RAS. A pre-intervention CTA scan was used to simulate the pressure gradient with a CFD model using a strategy based on Murray's law (CFD-Mu) and cortical volume (CFD-C). The agreement between the simulated and measured pressure gradients was assessed using intraclass correlation coefficients (ICC), Bland-Altman analysis and diagnostic agreement on the presence of a hemodynamically significant stenosis. Results In 20 patients, successful measurements and simulations were obtained. The ICC between measured pressure gradient and the CFD pressure gradient was 0.78 and 0.94 during baseline and 0.86 and 0.72 during hyperemia, for CFD-Mu and CFD-C, respectively. The sensitivity of CFD-Mu and CFD-C was 70% for both models at rest and 100% compared to the hyperemic measurements, whereas the specificity was 90% and 70% at rest and 79% and 72% during hyperemia, respectively. Conclusions The results support the use of individualized CFD simulations for hemodynamic assessment of RAS using CTA as input. The CFD models demonstrated high accuracy for the identification of a hemodynamically significant stenosis.

Cerebral aneurysms are abnormal outpouchings of arteries within the brain and occur in [~]1 in 30 adults. Their initiation, growth, and rupture have been linked to focal blood flow abnormalities--often termed "disturbed" or "hostile" hemodynamics--but commonly-used hemodynamic metrics yield conflicting associations with pathology and lack a unifying mechanistic interpretation. Building on a theoretically-grounded link between wall shear stress and near-wall vorticity, we hypothesized that a topology-based description of near-wall flow can operationalize the concept of hostile hemodynamics in a reproducible way. Inspired by atmospheric tornadic phenomena, we sought a principled taxonomy of coherent near-wall fluid structures with potential mechanobiological and clinical implications. Using high-fidelity computational fluid dynamics simulations in anatomically realistic geometries, we identified coherent near-wall fluid structures whose organization mirrors well-studied atmospheric phenomena: tornado-like columnar rotating cores; downburst-like nonrotating wall-impinging jets with tangential outflow, roll-cloud-like tangential vortices; and mixed configurations. These tornadic events on the aneurysm luminal surface were identified from wall shear stress topology, consistent with its theoretical connection to near-wall vorticity kinematics. The presence of tornadic phenomena--and their imprints on the aneurysm wall--was independently observed in vivo using 4D flow magnetic resonance imaging. By translating concepts from atmospheric physics into vascular biomechanics, this topology-based framework yields a unified mechanistic language for describing near-wall hemodynamics, resolving blood flow complexity into interpretable and reproducible coherent fluid structures, enabling standardized hemodynamic phenotyping, and supporting hypothesis-driven studies of aneurysms and other cardiovascular diseases where greater fluid-mechanical specificity and interpretability may strengthen links between mechanobiology and clinical risk.

Musculoskeletal symptoms are frequently reported following silicone breast implantation. However, the biological mechanisms linking implant-derived silicone exposure to skeletal muscle alterations remain poorly understood, partly because the biological effects of silicone have long been debated in the context of its biocompatibility. Here, we chemically characterized the low-molecular-weight fraction of the breast implant silicone exposome, readily released from implant gel through gel bleed, and investigated its potential biological consequences using an integrated approach combining analytical chemistry, clinical transcriptomics and histology, and controlled in vitro muscle experiments. Transcriptomic analyses of periprosthetic tissues associated with silicone implant rupture revealed unexpected myogenic and neuromuscular signatures in tissue conventionally regarded as predominantly fibrous, together with alterations in lipid metabolism and transport. These findings were supported by histological evidence of close interactions between periprosthetic tissue and skeletal muscle. Chemical analysis of the implant-gel extract detected linear siloxane L2 and cyclic siloxanes D3-D8, with tentative assignment of D9. In vitro, C2C12 cells exposed to the implant-gel extract showed up to 30% reduced viability and decreased expression of key neuromyogenic genes. Together, these findings provide convergent chemical, clinical, and experimental evidence that low-molecular-weight constituents of the breast implant silicone exposome may constitute a biologically active exposure capable of affecting skeletal muscle. The associated alterations in lipid metabolism and transport further provide a mechanistic framework for investigating the cellular handling and potential tissue distribution of hydrophobic silicone-derived species. These findings position silicone gel bleed as a biologically relevant source of chemical exposure rather than solely a material-integrity phenomenon.

Endothelial cells (ECs) derived from human induced pluripotent stem cells (hiPSCs) are increasingly used to model vascular diseases and test therapeutic strategies. However, the efficiency and reproducibility of differentiation can vary depending on the culture medium and its supplemented factors and stages. Here, we directly compared two defined media, APEL and BPEL, for iPSC-to-ECs differentiation. iPSCs were differentiated over 10 days with sequential growth factor induction, followed by magnetic-activated cell sorting or flow cytometry for CD31+ cells. Both media produced ECs with similar morphology and marker expression, including CD31 and VE-cadherin. Functional assays demonstrated comparable tube formation, indicating equivalent endothelial functionality. Cost analysis indicated that APEL had a higher total reagent cost but generated a higher total cell yield, resulting in a comparable cost per 10 total cells, whereas BPEL was more cost-efficient for producing CD31/VE-cadherin endothelial-specific cells. Our results suggest that APEL and BPEL media are equally effective for generating iPSC-derived ECs, providing flexibility in method selection for vascular disease modeling and drug discovery applications.

Background Tumor hypoxia and abnormal vasculature are closely associated with aggressiveness in solid tumors. Therefore, noninvasive assessment of these features in primary breast cancer is needed. Photoacoustic (PA) imaging is an emerging modality that enables real-time visualization of vascular architecture and hemoglobin oxygenation. Methods Breast PA imaging was performed in patients with primary breast cancer using a bed-type PA imaging system equipped with a hemispherical sensor and a flat specimen holder enabling mild breast compression. Three independent evaluators assessed predefined characteristics of tumor-associated vasculature: centripetal/disrupted vessels and intratumoral vessel-like signals. Oxygenation (S-factor) of tumor-associated vessels was estimated using dual-wavelength laser irradiation at 756 and 797 nm. Results PA imaging was performed in 9 tumors from 8 patients. Eight tumors were evaluable, after the exclusion of 1 tumor with segmental bloody discharge. Centripetal/disrupted vessels were identified in 7 tumors (87.5%). Intratumoral vessel-like signals were observed in all tumors (100%), with higher signal density than in surrounding tissue in 5 lesions (62.5%). Increased intratumoral signal density was associated with a higher Ki67-labeling index (two-sided P = .01). Mean intratumoral S-factor level (76.9% {+/-} 9.1%) was significantly lower than that of peritumoral vessels at 5 mm (86.4% {+/-} 5.9%) and 20 mm (88.5% {+/-} 4.9%) from the tumor margin (two-sided P < .01). Conclusion PA imaging with a flat specimen holder enables noninvasive visualization of tumor-associated vasculature with reduced oxygenation in primary breast cancer. This approach may provide a novel imaging platform for the early detection and functional assessment of breast cancer.

Microbial fuel cells (MFCs) have been widely investigated as decentralized bioelectrochemical systems capable of converting organic substrates into electricity. However, their long-term autonomous operation is constrained by substrate depletion in the anode compartment, leading to metabolic starvation of electroactive biofilms and a decline in power output. Conventional MFC design treats substrate crossover through the membrane separator as a parasitic loss that reduces coulombic efficiency. In this work, we propose a conceptual inversion of this paradigm by considering controlled cathodic-to-anodic substrate crossover as a passive mechanism to sustain basal microbial metabolism during periods of substrate scarcity. A transport-reaction framework is developed to quantify the balance between membrane-mediated substrate flux and microbial maintenance demand within the anode biofilm. Based on this balance, a dimensionless maintenance crossover Damkohler number (Dam) is introduced to define three operational regimes: starvation-dominated (Dam >> 1), balanced autonomous (Dam {approx} 1), and crossover-dominated (Dam << 1). The framework integrates membrane transport theory with biofilm kinetics to evaluate the effects of separator properties, substrate gradients, and current-dependent electro-osmotic transport on system stability. Order-of-magnitude analysis indicates that achievable crossover fluxes span several orders of magnitude depending on separator characteristics, suggesting that membrane properties critically influence system behavior. This perspective reframes substrate crossover from a loss mechanism to a potential design variable, offering a conceptual tool for enhancing resilience and guiding separator selection in MFCs intended for long-duration, and low-maintenance operation. HighlightsO_LIControlled crossover can sustain microbial metabolism in MFCs C_LIO_LIIntroduces maintenance crossover Damkohler number (Dam) C_LIO_LIIdentifies regimes for autonomous and starvation operation C_LIO_LILinks membrane properties to long-term system stability C_LIO_LIReframes crossover as a design variable, not only a loss C_LI

The relationship between external forces and bone strain in running is often complex and nonintuitive. We used Groucho running (i.e., running with exaggerated knee flexion) as a model to dramatically reduce the vertical ground reaction force (VGRF) and examined the relationship between peak VGRF and finite element (FE)-predicted tibia-fibula bone strain. Nine physically active males ran on an instrumented treadmill at 2.8 m/s with their preferred running technique, increased knee flexion (Groucho), and exaggerated knee flexion (Ex Groucho) in a randomized order. Strains at the tibia-fibula midshaft were calculated using computed-tomography-based FE modeling with loads and boundary conditions calculated from an inverse-dynamics based musculoskeletal model. Pressure-modified von Mises strain was used to quantify the peak strain (90th percentile strain) and strained volume (volume of bone experiencing strains above 3000 {micro}{varepsilon}). We further explored the relationship between peak VGRF, lower leg angle, and FE-predicted strain variables. The results showed that a 15.8% and 22.9% reduction in VGRF during Groucho and Ex Groucho, respectively, had no significant effect on FE-predicted peak strain (p > 0.304) and strained volume (p>0.053). Changes in peak VGRF did not correlate with FE-predicted strain variables (p>0.54) while changes in lower leg angle in the sagittal plane were moderately correlated (r>0.65; p<0.047). Our findings suggest that reductions in peak external forces do not always coincide with reductions in bone strain, especially in cases where running kinematics are dramatically altered. This work has important implications for designing gait retraining interventions based on reductions in external force measures.