Biomechanics and Modeling in Mechanobiology

Tumor spheroid mechanics arise from both the mechanical properties of individual cells and the adhesive interactions that organize them into tissues. The relative contribution of these two factors to the bulk mechanical behavior, however, remains difficult to disentangle experimentally. Here, we develop a computational model of micropipette aspiration to compare the mechanical response of isolated cells and multicellular spheroids within a common computational framework. By independently varying single-cell stiffness and cell-cell adhesion, we quantify their effects on aspiration dynamics, effective elastic modulus, and viscoelastic relaxation. Our results show that increasing single-cell stiffness substantially alters the mechanics of isolated cells but has limited influence on the effective elastic modulus of multicellular spheroids. In contrast, changes in cell-cell adhesion produce pronounced effects on spheroid effective elastic modulus. Nevertheless, both parameters increase the retardation time governing the transition from the initial elastic response to long-time viscous deformation. These findings suggest that multicellular elasticity is governed primarily by intercellular mechanical coupling, whereas the dynamical response to applied stress depends jointly on cell-scale mechanics and cell-cell adhesion.

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.

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.

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.

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.

The mechanical properties of the nucleus are critical for maintaining nuclear integrity and function. We previously showed that chromatin dominates short-extension mechanics whereas lamins provide long-extension strain stiffening. To distinguish the roles of lamin isoforms, micromanipulation nucleus force measurements were performed on isolated nuclei from lamin A/C (Lmna-/-) and lamin B1 (Lmnb1-/-) knockout mouse embryonic fibroblast cells. Lamin A/C knockout does not alter short-extension nuclear stiffness but is essential for strain stiffening at longer extensions. Oppositely, lamin B1 loss reduced short-extension stiffness due to facultative heterochromatin loss while long-extension strain stiffening was slightly increased. Loss of lamin A/C and B1 resulted in similar lamin-chromatin linkers effects as LBR did not change and LAP2{beta} decreased in both. A simulation model of a polymeric lamin shell with stiff lamin A/C and softer lamin B1 subunits can qualitatively recapitulate experimental measurements of lamin knockout cells. Lamin A/C knockout resulted in abnormal nuclear shape but not nuclear blebbing or rupture whereas lamin B1 knockout, similar to other perturbations that cause heterochromatin loss, resulted in increased nuclear blebbing and rupture. This work illuminates the distinct mechanical roles of lamin A/C and B1 in determining nuclear structure and integrity.

The development of neural connections in the brain results from a complex interplay between biological processes and mechanical forces. A key question in neuroscience is how physical forces and the mechanical properties of brain tissue influence the formation of structural connections. Here, we demonstrate that mechanical forces play an essential role in shaping the emergence of short-range connections, particularly U-shaped fibers that link neighboring regions of the cortex. Using a computational model that incorporates our "stress-dependent axon reorientation" hypothesis, we simulate how growing axons respond to the mechanical stress field generated by cortical folding. Our results suggest that axonal growth and reorientation may be strongly influenced by local mechanical cues, helping establish the organization of these short-range pathways. Supported by in vivo diffusion tensor imaging and histological observations, our findings provide a physical explanation for why these fibers predominantly adopt U-shaped trajectories, and why connections between gyri (ridges) are more prevalent than those between sulci (valleys) or spanning gyri and sulci. These results suggest that understanding the mechanics of brain folding is critical for fully explaining the formation of brain connectivity and its variations in health and disorder. Teaser: Mechanical forces during cortical folding guide the formation of short association fibers in the brain.

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.

BackgroundPlatelet activation in flowing blood is a multiscale process in which vessel-scale hemodynamics, red blood cell (RBC) mechanics, adhesive receptor interactions, and intracellular signalling jointly determine thrombotic risk. Individual components are well studied, but a single reduced description that carries each explicitly from vessel-scale flow to mechanosensitive calcium entry, with dimensionally consistent couplings, remains uncommon. ObjectivesWe develop and analyse a reduced, six-module mechanobiological framework for platelet priming spanning the cascade from hemodynamic shear to mechanosensitive calcium entry, and we delineate which elements are supported by existing evidence and which are new, testable hypotheses. MethodsThe framework comprises six coupled modules: (I) hemodynamic forcing from the incompressible Navier-Stokes equations, with an objective principal-strain-rate measure for extensional flow; (II) RBC-mediated platelet margination and near-wall delivery, closed by a near-wall arrival flux; (III) von Willebrand factor (VWF) activation with a bounded kernel and glycoprotein Ib (GPIb) catch-slip capture, resolved through an explicit contact area and a bond-dependent mobility that progressively immobilises wall-interacting platelets; (IV) a single-load membrane-stimulus formulation; (V) mechanosensitive gating and a dimensionally consistent cytosol-store calcium model with extracellular influx; and (VI) a phenomenological mechanical-memory state. We formally derive that the single-platelet stochastic dynamics and the continuum population balance form a Fokker-Planck pair, with the spatially varying diffusivity handled by an explicit drift correction. ResultsThe framework yields a family of mechanochemical dimensionless groups delineating priming regimes. Its central prediction is reformulated as a falsifiable, history-sensitive signature: in a conditioning-test protocol, a low-tension conditioning block charges the memory state, and a fixed sub-threshold test pulse then reports a delay-dependent calcium facilitation that decays on the memory time{tau} m and is distinguishable from no-memory gating, channel adaptation, and residual-calcium priming. We show explicitly that the previously proposed pulsatile-versus-monotone contrast is a nonlinear convexity/thresholding effect of the gating nonlinearity--its difference-in-differences is approximately zero-- and is therefore not a valid test of memory; the conditioning-test signature is. A second prediction links RBC stiffening to reduced near-wall delivery and captured-platelet calcium response, upstream of intrinsic platelet signalling. ConclusionsThe framework provides a dimensionally consistent, mechanistically grounded and hypothesis-generating description linking hemodynamic forcing to mechanosensitive calcium entry. It demonstrates how history-dependent platelet priming may arise from a phenomenological sensitisation state and proposes a conditioning-test protocol for comparison against adhesive, channel and intracellular-store persistence. The framework is calibratable rather than validated, and the quantitative outputs shown use representative uncalibrated parameters.

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.

Endothelial dysfunction is a hallmark of numerous vascular pathologies and is strongly influenced by mechanobiological forces within the vascular microenvironment. While the effects of shear stress have been extensively investigated, the mechanisms by which elevated hydrostatic pressure regulates endothelial junctional organisation remain sparsely investigated. Here, we employed a microfluidic platform to investigate the combined effects of low shear stress (1.4 dyne/cm2) and elevated hydrostatic pressure (~3972 Pa) on endothelial junctional dynamics. Elevated hydrostatic pressure induced marked remodelling of VE-cadherin junctions, characterised by formation of serrated, finger-like structures accompanied by increased YAP1 nuclear localisation and reduced YAP1-VE-cadherin cytoplasmic colocalisation compared to shear stress alone conditions. Further, elevated hydrostatic pressure also demonstrated an increase in cytoplasmic accumulation of EPS8, an actin adaptor protein, and increased cytoplasmic EPS8-VE-cadherin colocalisation. These observations were accompanied by functional changes marked by increased endothelial permeability, and enhanced THP-1 monocyte adhesion, thus suggesting activation of mechanosensitive pathways linked to dynamic junctional reorganisation. Inhibition of PI3K at elevated hydrostatic pressure exhibited a thin VE-cadherin patterning and increased cytoplasmic EPS8-VE-cadherin colocalisation, thus demonstrating a prominent role for PI3K signalling in regulating the junction organisation. Interestingly, Piezo-1 activation using Yoda1 produced context-dependent effects. Under shear stress alone, Yoda1 promoted YAP1 nuclear translocation, reduced YAP1-VE-cadherin colocalisation, increased endothelial permeability but strikingly did not impact THP-1 adhesion compared to shear stress alone conditions. In contrast, under elevated hydrostatic pressure conditions, Yoda1 significantly reduced both endothelial permeability and THP-1 adhesion while increasing YAP1-VE-cadherin colocalisation and decreasing YAP1 nuclear accumulation. Collectively, these findings identify a previously underappreciated elevated hydrostatic pressure-Piezo-1-PI3K signalling axis that regulates endothelial barrier integrity and pro-adhesive endothelial activation through coordinated regulation of VE-cadherin, YAP1, and EPS8. These results highlight elevated hydrostatic pressure as a unique mechanobiological stimulus, distinct from that of shear stress alone and provide novel insights into mechanisms underlying microvascular dysfunction.

Ankle stiffness is decreased during movement compared to posture; however, the etiology of this decrease remains unknown. Determining what gives rise to this decrease is critical for understanding how humans successfully interact with their physical world and how that ability is compromised by functional impairments. While the triceps surae and Achilles tendon primarily dictate ankle stiffness, the relative contributions across posture and movement remain unknown. Therefore, our study sought to quantify the relative contributions of the muscle and tendon to ankle stiffness and how those contributions differ between posture and movement. We used our technique, which combines B-mode ultrasound imaging with joint-level perturbations, to quantify ankle, muscle, and tendon stiffness simultaneously. Since ankle, muscle, and tendon stiffness all scale with torque, participants matched torque between posture and movement tasks. During posture, the Achilles tendon is the dominant contributor to ankle stiffness. However, during movement, the triceps surae and Achilles tendon contribute more equally to ankle stiffness, which can be attributed to a significant decrease in muscle stiffness during movement. Here, we provide the first empirical data on how state-dependent properties of the triceps surae and Achilles tendon contribute to ankle stiffness in conditions relevant to locomotion.

Mechanical homeostasis plays a central role in promoting and preserving optimal structure and function in the adult aorta. Although pathogenic variants can compromise homeostatic processes, it appears that intramural cells yet attempt to compensate for some genetically induced changes. In particular, lysyl oxidase is higher in the adult Marfan aorta compared with the age-matched control aorta. Here, we block lysyl oxidase in adult Fbn1C1041G/+ Marfan syndrome mice after stimulating aortic disease progression via induced hypertension. Whereas hypertension alone increases aortic dilatation, concurrent blocking of lysyl oxidase results in a dramatic increase in disease severity, driving an otherwise mild aortic phenotype in adult male Fbn1C1041G/+ Marfan mice to aneurysmal dilatations as well as dissection and rupture, with frequent premature death. Deposition and cross-linking of fibrillar collagens, among other extracellular matrix constituents, can represent a protective compensation against severe disease in the Marfan aorta. The present study emphasizes the need clinically to avoid compromising new collagen deposition and suggests that strategies to augment collagen cross-linking could be beneficial.

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.

Mechanical properties of biological tissues, driven by passive and active forces, play a vital role in several processes ranging from development to cancer metastasis. However, the dynamical responses of cells in tissues, subject to mechanical deformations such as shear and the associated rheological properties, are not well characterized. Here, we use three-dimensional agent-based models for normal and cancer tissues to investigate their responses to simple shear as a function of cell stiffness and stochastic active forces. In the normal epithelium, with uniform strength of active force, the yield stress as a function of shear rate follows the Herschel-Bulkley form over a range of cell volume fraction. Strikingly, the shear rate dependence and the elasticity-dependent changes in the yield stress fall on master curves upon suitable scaling. To model cancer-like behavior, a certain fraction (Np) of cells was chosen to have enhanced activity and decreased stiffness. As Np increases, the extent of collective cell movement decreases, transitioning from affine (collective) to non-affine (individualistic) movement, a finding that is in accord with imaging experiments. Simulations of a model of a stiff solid tumor, with radius Rs embedded in normal tissue, show that as Rs increases, the yield stress increases. Interestingly, the cells migrate collectively as Rs increases. A Gaussian Mixture Model (GMM) and a mean field theory quantitatively account for the simulation as well as experimental results on cancerous, non-cancerous, and a mixture of these two types. The combined theoretical and experimental study establishes that heterogeneity in stiffness and activity determines non-affine movements in normal and cancer tissues.

Purpose: Identifying head impacts linked to brain injury in sport remains challenging. Instrumented mouthguards quantify head-impact kinematics, and finite element (FE) modelling can transform these data into brain strain estimates, which may better reflect injury risk than kinematics alone. Here, we examined associations between mouthguard-measured kinematics, FE-derived strain, and plasma brain injury biomarker GFAP following head impacts. Methods: We analysed 41 video-verified impacts from male Australian football players, including 22 assessed for concussion (17 diagnosed) and 19 unassessed. Instrumented mouthguards recorded peak linear acceleration (PLA), peak rotational acceleration, and peak rotational velocity (PRV). Brain strain was estimated using the Imperial College FE brain model, and plasma GFAP was quantified using Simoa. Biomechanical-GFAP associations were examined using Spearman correlations and segmented regression. Results: For impacts overall, plasma GFAP was moderately correlated with PLA ({rho}=0.46, 95% CI: 0.20-0.66), PRV ({rho}=0.53, 95% CI: 0.20-0.78), and strain ({rho}=0.60, 95% CI: 0.32-0.80). Associations were stronger within concussion cases for strain ({rho}=0.86, 95% CI: 0.58-0.97) and PRV ({rho}=0.64, 95% CI: 0.15-0.93). Piecewise regression identified strain levels above which strain-GFAP relationships steepened across the whole-brain and brainstem. In concussion cases, supra-threshold brainstem strain was associated with greater symptoms. Conclusion: Finite element brain strain may better predict brain injury risk following a sport-related head impact than peak acceleration metrics. Stronger associations with plasma GFAP, particularly among concussion cases, and evidence of a biomechanical threshold, support the use of biomarker-informed strain measures in future risk modelling and the development of brain injury screening thresholds.

Objectives To analyse the long-term effects of a cruciate ligament (CL) injury on health and socioeconomic outcomes. Methods We used a comprehensive national injury insurance database to identify CL injuries occurring in New Zealand between 2009 and 2022, and employed a doubly robust staggered difference-in-differences research design to identify the effects of these injuries on outcomes up to 10 years after injury. The outcomes of interest were healthcare use (hospitalisations, emergency department visits, medications, knee replacement surgery for osteoarthritis), associated healthcare costs, and labour market outcomes (employment rates, income, and government benefit payments). Results We identified 61 344 CL injuries for inclusion in the analysis. Over 10-year follow-up, a CL injury resulted in increased healthcare use (0.6 more hospitalizations [95%CI 0.4 to 0.7], 1.7 more days spent in hospital [95%CI 1.3 to 2.1], 0.4 more emergency department visits [95%CI 0.3 to 0.6], 2.5 more outpatient visits [95%CI 1.8 to 3.2], and 4.7 more medications dispensed [95%CI -1.8 to 11.2]) and public healthcare costs ($7 537; 95%CI 5 888 to 9 186), reduced income (-$6 060; 95%CI -11 644 to -475), and increased benefit payments ($1 152; 95%CI 542 to 1 761). Conclusion CL injuries have long-term impacts on healthcare use and socioeconomic outcomes. Strategies to reduce the incidence of CL injuries have the potential to realise large health and economic benefits.

IntroductionWhile placental perfusion and pathology jointly affect pregnancy outcomes, cotyledon-specific perfusion across gestation and its correlation with local injury is not yet well understood. Ferumoxytol dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) offers a promising way to noninvasively identify cotyledons across gestation and quantify longitudinal cotyledon-specific perfusion changes. Additionally, intraplacental injection of bioactive fibrin sealant allows us to model thrombotic placental injury and further assess cotyledon-level relationships between perfusion and significant injury. MethodsPregnant rhesus macaques (N=13) received intrauterine saline or fibrin sealant injections at gestational day (GD) [~]101 and underwent ferumoxytol DCE-MRI at GDs [~]100, 115, and 145. Placental perfusion domains derived from contrast arrival time were segmented at each imaging time point and matched to cotyledons identified following tissue collection by cesarean section, with cotyledon perfusion quantified longitudinally and correlated with cotyledon-specific quantitative histopathology. ResultsAll pregnancies were successfully carried to term. Fibrin sealant injections induced significantly higher levels of placental pathology compared to saline controls. MRI-derived perfusion domains were largely consistent across gestation and showed predominantly one-to-one correspondence with term cotyledons, with successful perfusion-pathology pairing achieved in 153 cotyledons. Longitudinal cotyledon perfusion changes showed significant positive correlations with villous agglutination injuries. ConclusionsFeasibility of noninvasively tracking placental cotyledon perfusion using ferumoxytol DCE-MRI was demonstrated, and the efficacy of the rhesus macaque thrombotic injury model was confirmed. The positive perfusion-pathology correlations suggested intrinsic placental regulatory mechanisms and functional plasticity. This new framework is promising for future translational studies and validation of ex vivo cotyledon perfusion models. HighlightsO_LILongitudinal tracking of placental perfusion domains with ferumoxytol MRI C_LIO_LISuccessful matching of cotyledons and MRI-derived perfusion domains C_LIO_LIConfirmed thrombotic injury-model induced cotyledon pathology C_LIO_LIMaternal perfusion compensation in presence of villous pathology C_LI

Tissue shape and function are defined by the mechanical interactions of cellular and extracellular components. Lymph nodes cyclically remodel in response to immune challenges whilst preserving essential stromal structures. However, the relative contributions of the fibroblastic reticular stromal cell network and the ensheathed extracellular matrix, remain undefined. We quantified the contribution of ECM to the viscoelastic properties of lymph nodes to parameterise an in silico model exploring the FRC network's adaptation to pressure-driven tissue expansion. The balance between tissue pressure, FRC contractility and ECM stiffness permit robust remodelling and growth, while maintaining physiological geometries and balancing force distribution. Local perturbation of ECM stiffness or FRC contractility disrupts force distribution globally and impacts FRC proliferation and tissue expansion. Spatially dispersed perturbations exert higher impact on tissue architecture than equivalent localised perturbations, with effects propagating across the network. The integration of cellular and extracellular mechanics thereby enables robust lymph node remodelling.

Wound repair is an important mechanism to preserve tissue integrity in organisms after injury. However, why different tissues exhibit different mechanisms to repair wounds is a long-standing question that remains unanswered. In this work, we theoretically explore the role of the purse string, an actomyosin contractile cable used by tissues to close small wounds. Does the tissue 3D geometry influence the efficiency of the purse string in driving wound closure? Using a 3D biophysical model, we study in silico tissues with the same cell volumes but different aspect ratios, ranging from squamous to thick and tall tissues. The model predicts that taller cells are easily deformed by the purse string. In contrast, very squamous cells require a very strong purse string that might demand additional cellular mechanisms to close the gap. These findings establish a theoretical framework to predict the optimal biophysical mechanisms of wound healing in different tissues. Graphical abstractCells of different aspect ratios can be observed in a range of organisms with different function and mechanics. The wound healing efficiency of the purse string increases with the cell aspect ratio in our theoretical exploration. O_FIG O_LINKSMALLFIG WIDTH=200 HEIGHT=135 SRC="FIGDIR/small/743165v1_ufig1.gif" ALT="Figure 1"> View larger version (23K): org.highwire.dtl.DTLVardef@d44ab0org.highwire.dtl.DTLVardef@1737cbaorg.highwire.dtl.DTLVardef@101b5d4org.highwire.dtl.DTLVardef@1487f26_HPS_FORMAT_FIGEXP M_FIG C_FIG