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Journal of Biomechanical Engineering

ASME International

Preprints posted in the last 7 days, ranked by how well they match Journal of Biomechanical Engineering's content profile, based on 20 papers previously published here. The average preprint has a 0.02% match score for this journal, so anything above that is already an above-average fit.

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Influence of trunk posture on spinal loading and paraspinal muscle forces in adolescent idiopathic scoliosis: a subject-specific musculoskeletal modelling study

Bhattacharya, R.; Garg, B.; Malhotra, R.; Ghosh, R.; Chawla, A.; Mukherjee, K.

2026-09-01 bioengineering 10.64898/2026.08.28.747718 medRxiv
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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.

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Quantifying sprint force-velocity elasticity: implications for individualized training decisions

Li, Z.; Yan, J.; Zhang, X.; Chen, Z.; Li, Q.; Jimenez-Reyes, P.; Janicijevic, D.; garcia-ramos, A.

2026-09-01 biophysics 10.64898/2026.08.29.748040 medRxiv
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This study aimed to (1) develop an elasticity framework for the sprint force-velocity (F-V) relationship and (2) examine how maximal force (F_{0}), maximal velocity (v_{0}), and sprint distance modulate the four derived elasticity metrics, and (3) explore these elasticity metrics' interrelation. After modelling the F-V relationship differential equation, four elasticity metrics were defined as force elasticity (F_{e}), the elasticity of sprint time to F_{0}; velocity elasticity (v_{e}), the elasticity of sprint time to v_{0}; the force-velocity elasticity norm {(\mathrm{F}-\mathrm{V}}_{\mathrm{EN}}=\sqrt{F_{e}^{2}+v_{e}^{2}}), capturing the combined sprint time sensitivity to proportional changes in F_{0} and v_{0}; and the force-velocity elasticity ratio {(\mathrm{F}-\mathrm{V}}_{\mathrm{ER}}=F_{e}{\div v}_{e}), indicating which variable dominates the sprint time response. Model simulations showed that F_{e} decreased with rising F_{0} and increased with rising v_{0}, while v_{e} showed the opposite pattern. With increasing sprint distance, F_{e} decreased and v_{e} increased. Given its negligible effect on sprint time, ignoring air resistance yields a conservation law (2F_{e}+v_{e}\equiv 1), indicating that a gain in one elasticity metric necessarily diminishes the other in a fixed proportion. This framework also identifies a valley distance (d_{valley}) at {\mathrm{F}-\mathrm{V}}_{\mathrm{ER}}=2, where {\mathrm{F}-\mathrm{V}}_{\mathrm{EN}} is minimized (\sqrt{0.2}) and sprint time is least responsive to changes in F-V relationship variables. Empirical data confirmed that the two theoretical laws still hold approximately when air resistance is considered. By linking changes in F_{0} and v_{0} to sprint time across different distances, the elasticity framework provides a quantitative basis for estimating the theoretical sprint time response to documented changes in F-V relationship variables.

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3D ultrasound fascicle tractography for objective muscle architecture analysis.

Tecchio, P.; Schlaffke, L.; Bolsterlee, B.; Hahn, D.; Raiteri, B. J.

2026-09-01 bioengineering 10.64898/2026.08.31.746736 medRxiv
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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 [≤]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.

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Sympathetic activation and the force-frequency relationship in heart failure with reduced ejection fraction

Straw, S.; Gupta, A.; Bretheron, B.; Cole, C. A.; Brown, O. I.; Kamalathasan, S.; Drozd, M.; Lowry, J. E.; Corrigan, J.; Paton, M. F.; Burgess, R.; Kearney, M. T.; Cubbon, R. M.; Witte, K. K.; Gierula, J.

2026-09-01 physiology 10.64898/2026.08.24.746885 medRxiv
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Background Limited heart rate rise contributes to reduced exercise tolerance for people who have heart failure with reduced ejection fraction (HFrEF), yet rate-adaptive pacing does not improve functional capacity due to an attenuated force-frequency relationship (FFR). How the FFR relates to total peripheral resistance and sympathetic tone in HFrEF is unknown. Methods In a prospective, observational study, participants with HFrEF and controls underwent an incremental pacing protocol, during which heart rate was increased from 50 to 140 beats per minute. At each heart rate increment LV contractility was measured by echocardiography to determine the FFR, as well as continuous beat-to-beat measurement of systolic and diastolic blood pressures with a plethysmography device to determine cardiac output, total peripheral resistance and blood pressure variability (BPV). A microneurography study was then conducted to measure muscle sympathetic nerve activity (MSNA) during incremental pacing. Results A total of 157 participants with HFrEF and 55 controls (mean age 71.1{+/-}1.4 years, 172 (81.1%) male) underwent the pacing protocol. We observed single units in seven of 11 participants who participated in the microneurography study. In both groups, LV contractility and cardiac output increased until the peak of the FFR, after which these declined. We observed a reduction in total peripheral resistance, blood pressure variability, MSNA frequency and incidence coinciding with the peak of the FFR, beyond which these increased. Whilst these relationships were present in both groups, they were more evident in participants with HFrEF. Conclusions For people with HFrEF there is a bidirectional relationship between heart rate and sympathetic activation, with a nadir of sympathetic tone occurring at the peak of the FFR. Both excessively low and high heart rates are accompanied by greater sympathetic activation. Taken together, these data suggest that optimal heart rate targets for HFrEF are likely to be individual.

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Low-Density Lipoprotein Modulates Plasma Fibrin Network Architecture and Impairs Fibrinolysis

Nameny, A.; DeSmet, A.; Cai, C.; R. Baker, S.; Bonin, K.; E. Hudson, N.; E. Bannish, B.; Guthold, M.

2026-09-01 biophysics 10.64898/2026.08.31.748310 medRxiv
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Low-density lipoprotein (LDL) is a major atherogenic lipoprotein, yet its potential to directly modify the fibrin scaffold of blood clots is incompletely understood. Here, we investigated how LDL alters plasma fibrin network architecture and internal fibrinolysis across defined fibrinogen/thrombin conditions. Pooled normal human plasma was supplemented with LDL and clotted with controlled concentrations of fibrinogen and thrombin. Fibrin architecture was visualized by confocal microscopy and quantified by pore-size analysis; clot formation and lysis were monitored turbidimetrically in the presence of tissue plasminogen activator (tPA). Increasing LDL produced a pronounced reduction in fibrin-network pore size across the tested fibrinogen/thrombin conditions. The LDL dependence of pore diameter was well described by a power-law relationship, D_pore=(6.54 +/- 0.11)[LDL]^(-0.12 +/- 0.02) , (R^2 = 0.90), with a significant negative LDL exponent (p = 4 x 10^5). Increasing LDL also prolonged clot lysis time and altered turbidity kinetics. These findings extend epidemiologic and clinical associations between ApoB-containing lipoproteins and hypofibrinolytic clot phenotypes by demonstrating, in a controlled plasma system, that LDL itself can modify fibrin network architecture and fibrinolytic susceptibility. The results support a structure-function role for LDL within the fibrin biomaterial and motivate direct tests of LDL incorporation, protofibril packing, fibrinolytic-protein binding, and single-fiber mechanics.

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Concordance Between a Temple-Worn Optical Wearable and Transcranial Doppler During Exercise and Postural Transitions in Healthy Adults

Kumar, A.; van Rosmalen, L.; Gupta, A.; Sharma, S. K.; Gupta, R. C.; Panda, S.; Jain Gupta, N.

2026-09-04 cardiovascular medicine 10.64898/2026.09.02.26362022 medRxiv
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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.

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Multilayered extracellular matrix derived scaffolds direct progenitor cell differentiation in vitro and osteochondral-tissue formation in vivo.

Gonnella, G.; Strong, O.; Sularea, V. M.; Soares Kronemberger, G.; Karam, A. S.; Kelly, D.

2026-08-31 bioengineering 10.64898/2026.08.28.747815 medRxiv
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Osteochondral repair requires restoration of zonally organised articular cartilage and subchondral bone, yet translatable implants rarely reproduce this spatial complexity. Here, we developed an off-the-shelf, cell-free multilayer scaffold comprising a superficial 2% (w/v) articular cartilage extracellular matrix (AC-ECM) phase, an intermediate 5% AC-ECM phase and a basal 6% bone ECM (BN-ECM) phase. The scaffold formed continuous interfaces, displayed regionally distinct pore sizes and resisted permanent deformation during cyclic compression. In vitro, constructs seeded with caprine mesenchymal stromal and articular cartilage progenitor cells supported cell expansion and the accumulation of sulfated glycosaminoglycan- and collagen-rich matrix, with regional differences in collagen I, II and X deposition. Following eight weeks of subcutaneous implantation, cell-seeded scaffolds contained more collagenous matrix than unseeded controls, while vascularisation preferentially localised to the BN-ECM phase. The scaffold was then evaluated against empty defects in a caprine osteochondral model for six months. Scaffold treatment significantly improved macroscopic and histological repair, increased chondral tissue fill (~60% versus ~40%), limited cartilage-like tissue extension into the subchondral region and generated a more native-like superficial collagen organisation. Repair tissue further exhibited greater collagen II immunoreactivity, increased ACAN and COL2A1 expression and reduced COL1A2 expression relative to empty defects, although deeper bone repair was not significantly improved. These findings demonstrate that tissue-specific ECM layering can spatially guide endogenous repair and substantially improve cartilage restoration without exogenous cells or growth factors in a clinically relevant large-animal model, while identifying subchondral bone regeneration as the remaining design challenge for complete osteochondral repair.

8
Feasibility study of gait analysis using a new Wearable Force Plate

Sanz Morere, C. B.; Garrido-Lopez, G.; Hayase, M.; Rueda, J.; An, Q.; Shimoda, S.; Moreno, J. C.; Navarro, E.

2026-09-02 rehabilitation medicine and physical therapy 10.64898/2026.08.30.26361786 medRxiv
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Static force plates (FP) are the gold standard for measuring ground reaction forces (GRF) and computing joint moments through inverse dynamics in gait analysis. However, they are restricted to controlled environments, and the number of steps analyzed is limited by the plates embedded in the floor. To address these limitations, portable solutions such as sensorized insoles, socks, or shoes have emerged. Yet, creating wearable systems capable of measuring three-dimensional GRF in real-world conditions remains challenging. Current sensorized shoes often incorporate thick sensors (up to 2 cm), reducing usability and limiting their application in pathological populations or dynamic tasks like running. This study evaluates the usability of ShokacShoes, a novel sensorized shoe integrating three thin, three-dimensional force sensors, and explores its potential as a Wearable Force Plate (WFP). Eight healthy participants performed slow, natural, and fast walking using two insole configurations. Force and temporal metrics were derived from WFP and FP data. Results indicate that WFP enables accurate step segmentation and detects significant effects of speed and insole type on temporal and force metrics, confirming its reliability under different walking conditions. Comparisons with FP revealed differences in force metrics and signal morphology, though temporal parameters remained consistent. These results are likely due to sensor quantity and positioning. Thereby, ShokacShoes represent a valid solution capable of measuring three-dimensional forces within commercial footwear. Future work will focus on validating the applicability of a new version of ShokacShoes against gold-standard FP in a comprehensive validation study involving diverse real-world scenarios and pathological conditions.

9
Cost-Outcome Variation in Percutaneous Mechanical Circulatory Support: A National Value-of-Care Analysis

Greendyk, J. D.; Allen, W. E.; Hossain, A.; Trichas, Z.

2026-09-02 cardiovascular medicine 10.64898/2026.08.31.26361851 medRxiv
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Background: Percutaneous mechanical circulatory support (pMCS) is increasingly used in critically ill patients, yet its value in relation to cost and outcomes remains unclear. We evaluated national variation in utilization, outcomes, and cost, and introduced a value of care framework integrating risk-adjusted outcomes and expenditures. Methods: We performed a retrospective cohort study using the National Inpatient Sample to identify non-elective hospitalizations of critically ill patients undergoing intra-aortic balloon pump (IABP) or percutaneous left ventricular assist device (pLVAD) placement using ICD-10 codes. Multivariable logistic regression and generalized linear models were used to estimate expected outcomes and costs. Observed-to-expected (O/E) ratios were calculated, and a value index was derived to compare procedural strategies. Results: A total of 57,910 weighted hospitalizations were included (IABP 78%, pLVAD 22%). In-hospital mortality exceeded 30% across regions. Significant regional variation was observed, with the West demonstrating the highest costs and the Midwest the lowest (p<0.001). Mean hospital charges were higher for pLVAD compared with IABP ($403,731 vs $320,769). Both strategies achieved outcomes better than expected after risk adjustment (O/E 0.92); however, costs were higher than expected for both, with greater relative cost inflation observed for IABP (O/E 1.41) and higher absolute costs for pLVAD. In value-of-care analysis, IABP was associated with lower cost and comparable outcomes, while pLVAD demonstrated higher cost without proportional outcome improvement. Conclusion: Substantial variation exists in the cost, outcomes, and value of pMCS strategies. While both IABP and pLVAD achieve favorable risk-adjusted outcomes, pLVAD is associated with higher costs without commensurate clinical benefit.

10
Polarized neutrons for the study of individual and collective fast dynamics in proteins

Nidriche, A.; Ollivier, J.; Stewart, R.; Peters, J.

2026-09-01 biophysics 10.64898/2026.08.30.748099 medRxiv
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Neutron scattering is a powerful technique to investigate atomic structures and molecular dynamics of proteins at the nano-scale. When it comes to dynamics, incoherent and coherent scattering respectively provide information on the single and collective dynamics of nuclei. In proteins, hydrogen has the highest incoherent cross-section, and it is common practice to overlook the contribution of coherent terms stemming from all nuclei. However, the fast collective dynamics of heavier nuclei could also be studied if coherent scattering and incoherent scattering were experimentally separated. The recent advent of polarized neutron spectroscopy with sufficient flux and energy resolution has made it possible, and opens new perspectives to investigate the relative importance of coherent scattering and the information it provides on biological samples. The present study reports on the use of polarized quasi-elastic neutron scattering (QENS) and the application of a minimalistic model adapted to both individual and collective dynamics. Using a perdeuterated green fluorescent protein as a model globular protein, the study provides an interpretation of the dynamical parameters obtained with QENS, and a comparative study of the Elastic Coherent and Incoherent Scattering Factor. Based on both experiments and calculations, we discuss the relative importance of distinct and self components of coherent scattering, which is often wrongly assumed to be representative of collective dynamics only. The results highlight the current impediments rendering complicated a straightforward analysis of fast collective dynamics in hydrated protein samples.

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Clinical Reference Percentiles for AI-derived Epicardial Adipose Tissue: A Multicenter Study

Kamagate, A.; Shanbhag, A.; Buchwald, M.; Miller, R. J. H.; Khanna, S.; Zuhair Kassem, T.; Kwiecinski, J.; Bullock-Palmer, R.; Zhang, W.; Marcinkiewicz, A. M.; Yi, J.; Ramirez, G.; Lemley, M.; Killekar, A.; Kavanagh, P. B.; Liang, J. X.; Slipczuk, L.; Travin, M. I.; Alexanderson, E.; Carvajal-Juarez, I.; Packard, R. R.; Al-Mallah, M.; Ruddy, T. D.; deKemp, R. A.; Buechel, R. R.; Einstein, A. J.; Acampa, W.; Knight, S.; Le, V. T.; Mason, S.; Rosamond, T. L.; Miller, E. J.; Chareonthaitawee, P.; Berman, D. S.; Dey, D.; Di Carli, M. F.; Slomka, P.

2026-08-31 cardiovascular medicine 10.64898/2026.08.28.26360111 medRxiv
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Background and Aims: Epicardial adipose tissue (EAT) has emerged as an important cardiovascular biomarker that reflects both inflammatory and cardiometabolic risk. EAT volume and density vary significantly across populations, yet there is a lack of multicenter studies investigating the predictive value of population-specific EAT percentiles. Methods: In this multicenter study, we retrospectively analyzed low-dose computed tomography correction scans from 42,842 patients undergoing myocardial perfusion imaging. A derivation cohort of 15,082 patients was used to establish sex- and age-specific nomograms for EAT density and EAT volume indexed to body surface area. Percentile-based thresholds were tested for outcome prediction in a validation cohort of 27,760 patients. For clinical implementation, we developed an online EAT percentile calculator. Results: Percentile curves demonstrated increased BSA-indexed EAT volume and decreasing EAT density with age. Over a median follow-up of 3.6 years (IQR: 1.83 - 5.14), 4,956 patients experienced a nonfatal myocardial infarction or death. In multivariable Cox models, patients above the 95th sex- and age-specific percentile had significantly worse outcomes for BSA- indexed EAT volume [adjusted hazard ratio 1.30, 95% CI: 1.14 - 1.49, p < 0.001] and EAT density [adjusted hazard ratio 1.7, 95% CI: 1.51 - 1.92, p<0.001] when compared to patients below the 50th percentile (p<0.001). Conclusion: Age- and sex-specific EAT percentiles provide a clinically interpretable framework for contextualizing automated EAT measurements and identifying patients at increased cardiovascular risk. EAT density was a stronger prognostic marker and identified elevated risk even among patients with normal BMI, supporting its potential to provide information beyond conventional anthropometric assessment.

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Evaluation of paraspinal muscle quality using Hounsfield unit in simple elliptical regions of interest: correlation with magnetic resonance imaging-based intramuscular fat infiltration in spine surgery patients

Segi, N.; Okada, Y.; Takeichi, Y.; Ito, S.; Ouchida, J.; Nagatani, Y.; Kagami, Y.; Tachi, H.; Ohshima, K.; Ogura, K.; Imagama, S.; Nakashima, H.

2026-09-04 orthopedics 10.64898/2026.08.31.26361574 medRxiv
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Study design Retrospective cohort study. Objectives To correlate Hounsfield unit (HU) values, using elliptical regions of interest (ROI), that can be easily defined in routine clinical practice with magnetic resonance imaging (MRI) T2-hyperintense area fraction, as a surrogate for paraspinal muscle fat infiltration and to establish specific HU screening thresholds that may be applied with standard picture archiving and communication system (PACS). Methods We included 136 patients (71 men; 61.0 {+/-} 15.4 years) who underwent preoperative computed tomography (CT) and MRI within an 8-week period. Elliptical ROI HU values were measured at L2/3 and L4/5 for erector spinae, multifidus, and psoas major. MRI T2-hyperintense area fraction (Otsu thresholding) served as the fat infiltration reference. Linear mixed-effects (LME) models were used to assess the HU-T2 association and level-specific receiver operating characteristic (ROC) analyses (lower HU value side; n=136 per muscle-level) to identify thresholds for [&ge;]30% and [&ge;]50% infiltration criteria. Results Intraclass coefficients = 0.709 (HU) and 0.857 (T2 fraction); Goutallier weighted kappa = 0.579. In the overall LME, {beta} was -0.880 HU per 1% T2-fraction increase (95% confidence interval -0.935 to -0.825; marginal R2 =0.502); the association was steeper in multifidus ({beta} = -1.020) than in erector spinae ({beta} = -0.753). Psoas major (R = -0.226) was excluded from ROC analyses. Difference between L2/3 and L4/5 HU cutoffs was ~20 HU. The [&ge;]50% criterion revealed higher discrimination. Conclusions Elliptical ROI-based HU measurements may reliably screen paraspinal muscle fat infiltration in erector spinae and multifidus using standard PACS. Specific thresholds may allow practical preoperative evaluation without additional costs or radiation.

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Inflammation Beyond the Disc: Circulating Inflammatory Biomarkers in Lumbar Disc Herniation and Degeneration--A Case-Control Study

Withanage, N. D.; Perera, S.; Athiththan, L.

2026-08-31 orthopedics 10.64898/2026.08.28.26361607 medRxiv
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Background: Lumbar disc herniation, with or without concomitant disc degeneration, is a major cause of lumbar radiculopathy and low back pain, which also a key public musculoskeletal disorder without an exact pathophysiology. Studies have suggested that inflammatory cells and biochemical markers of inflammation also play an important role in lumbar radiculopathy in addition to nerve compression. The aim of the present study was to assess the association of selected circulatory inflammatory markers (CRP, hs-CRP and E-selectin) in patients with lumbar disc herniation without radiological degeneration (LDH) and lumbar disc herniation with radiological degeneration (LDHD). Materials & methods: This case-control study included 208 participants, comprising 104 patients with lumbar disc pathology and 104 controls. Patients were further stratified into LDH (n=67) and LDHD (n=37). Serum CRP, hs-CRP and E-selectin concentrations were measured. Results: Among the patients, 35.6 % presented with LDHD while 64.4 % had only LDH. Significantly increased median hs-CRP (p<0.001) and CRP (p<0.001) were observed in patients groups compared to controls, while CRP showing a consistent independent association across the combined disease (OR=1.68, 95% CI=1.33-2.14, p<0.001), LDHD (OR=1.62, 95% CI=1.16-2.20, p=0.005) and LDH (OR=1.69, 95% CI=1.30-2.20, p<0.001) multivariable models. No significant difference was observed in serum E-selectin between the study groups. Multivariable models incorporating inflammatory and clinical variables demonstrated substantially greater discriminatory performance than individual biomarkers alone. Conclusion: Elevated circulating CRP and hs-CRP concentrations were associated with lumbar disc pathology, with CRP showing a consistent independent association across the combined disease, LDH and LDHD multivariable models, whereas E-selectin showed no significant association. Multivariable models incorporating inflammatory and clinical variables demonstrated greater discriminatory performance than individual biomarkers. These findings support a potential systemic inflammatory component in lumbar disc pathology, although the cross-sectional nature of the measurements does not establish causality or a local inflammatory response within the disc.

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Comparative Transcriptional Responses of Human Blood to Neutron and Photon Irradiation

Salah, A.; Wollschlaeger, D.; Giesen, U.; Schmidberger, H.; Marini, F.; Zahnreich, S.

2026-09-01 biophysics 10.64898/2026.08.28.747800 medRxiv
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Despite the well-known health risks of neutron exposures, key gaps remain in understanding neutron-induced molecular responses and identifying reliable biodosimetric markers that distinguish neutrons from photon exposure. We provide the first genome-wide analysis of the human blood transcriptional response to an accelerator-derived fission-like spectrum of neutrons versus photons, evaluating transcriptomic relative biological effectiveness (RBE) and radiation quality-discriminating gene signatures. Whole blood from healthy donors was irradiated ex vivo with X-rays (140 kV, 0-4 Gy, n = 3) or neutrons (0.1-8 MeV, 0-1 Gy, n = 2), incubated for 6 h or 24 h, and processed for RNA sequencing from peripheral blood mononuclear cells (PBMCs). Neutrons were markedly more potent than X-rays at inducing differentially expressed genes (DEGs) at equal doses, showing a peak response 6 h post-irradiation followed by a decline. In contrast, X-rays caused a continuous increase in DEGs up to 24 h (neutrons vs. X-rays at 1 Gy: 1,449 vs. 121 DEGs at 6 h; 996 vs. 621 DEGs at 24 h). A universal p53-centered 34-gene signature, including FDXR, EDA2R, GADD45A, and ZMAT3, showed highly monotonic dose responses (Spearman correlation coefficient {approx} 1) across donors, radiation qualities, and timepoints. Additionally, difference-in-differences analysis identified radiation quality-discriminating genes only at 6 h, with transcriptional convergence observed by 24 h, suggesting a very narrow time window for biodosimetric differentiation. We identified a neutron-specific gene signature driven by cGAS-STING-NF-{kappa}B signaling (RELB, NFKB1, C3, MALAT1) and suppression of B-cell and myeloid identity genes (IGHD, TCL1A, CLEC7A, TLR2), defining a biologically coherent neutron quality index with distinct immunomodulatory effects. For the first time, we assessed neutron RBEs at the gene, pathway, and global transcriptomic levels in a human blood model, reporting a global transcriptomic neutron RBE of 1.30 (95% CI: 1.14-1.49) at 6 h and 1.21 (95% CI: 1.14-1.28) at 24 h, providing a valuable basis for biodosimetry in mixed-field exposure scenarios. Our findings advance the mechanistic understanding of neutron radiation responses and support the development of biodosimetric approaches for mixed-field exposure scenarios.

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Integrating mouthguard kinematics, finite element brain strain, and plasma biomarkers to explore brain injury thresholds in collision sport

Hickey, J. W.; Chan, E. Y. K.; Evans, L. J.; O'Brien, W. T.; Xie, B.; Roberts, S. S. H.; Butler, S. E.; Ernst, J.; Zhou, W. J. Q.; Zimmerman, K. A.; Spitz, G.; Parker, T. D.; O'Brien, T. J.; Shultz, S. R.; Sharp, D. J.; Ghajari, M.; McDonald, S. J.

2026-08-31 sports medicine 10.64898/2026.08.26.26360869 medRxiv
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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.

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The Role Of Liquid Crystal Ordering In The Structural Organization Of DNA In Bacteria.

Krupyanskii, Y. F.; Kovalenko, V.; Loiko, N.; Generalova, A.; Tereshkin, E.; Tereshkina, K.; Sokolova, O.; Peters, G.

2026-09-01 biophysics 10.64898/2026.08.31.748243 medRxiv
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This paper presents and critically reviews the results of original and some literature based experimental studies conducted by the authors last years on the structural organization of DNA in dormant (starvation stress), anabiotic dormant (4 HR treatment) E. coli cells, as well as the K12 {Delta}dps strain, which lacks the Dps protein (Dps null E. coli). The experimental data includes small-angle synchrotron radiation diffraction (SAXS) and transmission electron microscopy (TEM) data. Synchrotron radiation diffraction experiments on K12{Delta}dps cells allowed us to conclude that peaks at 44.3, 22.1, and 14.8 angstrom resolutions are associated exclusively with ordered DNA organization. Peaks at 44.3, 22.1, and 14.8 angstrom resolutions are also observed for samples of dormant (starvation stress) cells and anabiotically dormant cells. Therefore, this ordered DNA organization also applies to samples of dormant and anabiotically dormant cells. A model is proposed that considers the ordered DNA organization in the cell as a cholesteric liquid crystal. The powder diffraction pattern calculated based on this model is compared with experimental small angle X ray scattering (SAXS) data obtained on Dps-null cell samples. The model completely reproduces the key features of the experimental diffraction pattern from Dps-null cell samples. Accordingly, the cholesteric liquid crystal model corresponds to DNA packaging in dormant and anabiotically dormant cells. Cholesteric liquid crystal ordering should be further considered in all models of cellular DNA packaging. To address the question of which structural organization of DNA predominates in the cell: the cholesteric liquid crystal or nanocrystalline or whether they coexist and fully manifest themselves under different external conditions, it is necessary to utilize the latest methodological advances in structural analysis.

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Elevated hydrostatic pressure modulates endothelial junctional mechanotransduction through VE-cadherin remodelling and altered association with YAP1, EPS8: an endothelium-on-chip study

Vasanthi Bathrinarayanan, P.; Abadie, T.; Vigolo, D.; Simmons, M. J. H.; Grover, L. M.

2026-09-01 bioengineering 10.64898/2026.08.31.748221 medRxiv
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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.

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Soft-Tissue versus Hematologic Primary Malignant Cardiac Tumors: Demographics and First-Course Treatment Patterns in the SEER Registry

Mathew, Z.; Mehta, R.; Kim, S.; Jeyaraj, J.; Asif, T.

2026-08-31 cardiovascular medicine 10.64898/2026.08.25.26361262 medRxiv
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Background: Primary malignant cardiac tumors (PMCTs) are rare and histologically heterogeneous. Objective: To compare demographics, specific ICD-O-3 morphologies, first-course treatment patterns, annual registered case counts, and unadjusted overall survival between soft-tissue and hematologic PMCTs. Methods: We identified 730 PMCT cases diagnosed from 2000 to 2021 in SEER 18 (ICD-O-3 topography C38.0). Histologic lineage was assigned from ICD-O-3 morphology. Comparative analyses included soft-tissue (n=458) and hematologic (n=212) tumors. First-course variables were primary-site surgery, chemotherapy (yes versus no/unknown), and radiotherapy (radiation versus none/unknown). Groups were compared with chi-square tests. Overall survival was estimated with Kaplan-Meier methods; follow-up was truncated at 120 months. Results: Soft-tissue PMCTs occurred predominantly at ages 45-64 years (67.9%), whereas hematologic PMCTs occurred predominantly at age [&ge;]65 years (63.2%; p<0.001). Men comprised 59.9% of hematologic and 49.3% of soft-tissue cases (p=0.014). The leading soft-tissue morphology was hemangiosarcoma/angiosarcoma (ICD-O-3 9120/3; 201/458, 43.9%); synovial sarcoma accounted for 20/458 cases (4.4%). Diffuse large B-cell lymphoma, NOS, accounted for 131/212 hematologic tumors (61.8%). Any primary-site surgery was recorded in 66.6% of soft-tissue versus 15.6% of hematologic cases (p<0.001). Chemotherapy was recorded in 67.5% versus 51.1% (p<0.001), and radiotherapy in 9.0% versus 20.5% (p<0.001). In exploratory Kaplan-Meier analyses, hematologic patients with recorded chemotherapy had higher unadjusted 120-month overall survival than those without recorded chemotherapy (42.0% versus 12.2%; log-rank p=7.5x10-). Radiation-associated survival differences were not statistically significant in either lineage. Conclusions: Soft-tissue and hematologic PMCTs have distinct age distributions, named histologies, and first-course treatment patterns in SEER. These findings describe registry coding and do not establish treatment effectiveness or population incidence.

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A time-delayed mechanochemical feedback model reconciles stable maintenance and dynamic remodeling of cell-matrix adhesions

Matsumoto, E.; Yokoyama, S.; Matsui, T. S.; Araki, T.; Deguchi, S.

2026-08-30 biophysics 10.64898/2026.08.28.747716 medRxiv
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Focal adhesions maintain force-bearing attachment between cells and the extracellular matrix but can also undergo dynamic remodeling. Their assembly and actomyosin tension are coupled through mechanochemical feedback. The processes underlying this feedback are not instantaneous and therefore involve a time delay. However, how this delayed feedback gives rise to stable adhesion maintenance or dynamic remodeling remains unclear. Here, paired time-lapse measurements of vinculin fluorescence and traction stress revealed distinct local adhesion-force dynamics, including low-fluctuation and recurrent fluctuation patterns. To examine how these patterns could arise, we formulated a minimal mechanochemical model coupling focal adhesion assembly and actomyosin force through delayed reciprocal feedback. The model exhibited stable and oscillatory modes depending on feedback strength, the balance of opposing feedback effects, and the effective feedback delay. Bistability and hysteretic switching also occurred in a subset of parameter space, and the oscillation period followed a power-law relation with the delay. These results suggest that stable adhesion maintenance and dynamic remodeling can emerge from a common mechanochemical feedback architecture.

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Arm Angle Moderates the Association Between Fastball Usage and Elbow/Forearm Injury in MLB Pitchers

Richards, C.; La Salle, D. T.; Vila Dieguez, O.; Ward, S. R.

2026-08-31 sports medicine 10.64898/2026.08.29.26361727 medRxiv
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Background: Newly available arm angle data offers a new dimension to understand rising rates of arm injury in MLB pitchers. Purpose: To evaluate the relationship between arm angle, pitch characteristics, and elbow and forearm injury in MLB pitchers.<br><br> Study Design: Retrospective cohort study; Level of evidence, 3 Methods: Statcast data from 2020 to 2025 and MLB injured list (IL) data were used to evaluate arm angle and pitch characteristics in relation to elbow and forearm injuries. Results are presented with and without requirements on prior season workload and for same-season and next-season injury incidence. A generalized additive model (GAM) was used to capture non-linear dependence and interactions between selected features and injury incidence to the elbow or forearm. Average marginal effect (AME) odds ratios are reported for main effect terms. Results: N = 3,812 pitcher-seasons were included. 29% pitchers who underwent UCLR did so in the same season as a forearm injury (tmean=44, tmedian=27 days to surgery). Arm angle, fastball usage, and their interaction were the three most predictive features. Arm angle was positively related to incidence of injury (ORmeanAME=1.014), fastball usage was inversely related to incidence of injury (ORmeanAME=0.243), and arm angle moderated the effect fastball usage at high arm angle, where increased usage was no longer protective. Slider velocity (ORmeanAME=1.072), spin rate (ORmeanAME=1.001), and usage (ORmeanAME=2.039) also significantly predicted injury risk. Fastball velocity was not significant in any fit, with ORmeanAME=0.999 across all fits. Fit-level Nagelkerke R2 values ranged from .019 to .052. Conclusion: Fastball usage and arm angle, not velocity, predicted elbow and forearm injury risk among MLB pitchers, and arm angle was the single most predictive feature. The heterogeneity of risk factors as a function of arm angle, and the novelty of MLB arm angle data, may explain why fastball usage has been previously underexplored as a risk factor. Keywords: baseball; arm angle; fastball velocity; fastball usage; spin rate; UCL; ulnar collateral ligament; elbow injury; forearm injury; Statcast