Journal of the Mechanical Behavior of Biomedical Materials

Digital volume correlation (DVC) has become the benchmark experimental technique for full-field strain measurement in bone mechanics. In our previous work we developed a novel data-driven image mechanics (D2IM) approach that learns from DVC data and predicts displacement fields directly from undeformed X-ray computed tomography (XCT) images, deriving strain fields from such predictions. However, strain fields derived through numerical differentiation of displacement fields amplify high-frequency noise, and regularization techniques compromise spatial resolution while incurring substantial computational costs. Here we propose the upgrade D2IM-Strain to predict strain fields directly from XCT images of bone. Two prediction strategies were compared: displacement-derived strain and direct strain prediction. The direct strain prediction model significantly improved accuracy particularly for strain magnitudes below 10000{micro}{varepsilon}, taken as a representative threshold value for bone tissue yielding in compression. In addition, the direct approach reduced false-positive high-strain classifications by 75%. By eliminating numerical differentiation, the approach reduces noise amplification while maintaining computational efficiency. These findings represent a critical step toward developing robust data-driven volume correlation methods for hierarchical materials.

The effects of specific footwear features on biomechanical parameters are often confounded by simultaneous changes in other shoe conditions, making it difficult to identify the isolated effect of material and design properties on relevant biomechanical outcomes. This study aimed to propose a tool, namely the Modular Footwear Setup (MFS), to assess the effects of midsole modifications on lower limb joint kinematics and in-shoe plantar pressure. The MFS uses a micro-hook-and-loop fastening system and a custom alignment device to enable fast, strong, and reliable midsole attachment/detachment to/from the upper. Accuracy and repeatability of the MFS in replicating the biomechanical outcomes of a control shoe featuring the same upper and midsole were tested in 10 healthy participants (5M,5F; age=33.2{+/-}9.2 yrs; BMI=21.5{+/-}2.8 kg/m2). Participants were asked to walk wearing both the MFS and the standard control shoe in three sessions. Kinematics of lower limb joints were measured via inertial measurement units, while capacitive pressure insoles were used to measure in-shoe plantar pressure. Intraclass correlation coefficient (ICC) was used to assess the repeatability of kinematic and pressure measurements between sessions. Statistical Parametric Mapping analysis did not identify significant differences in joint kinematics between conditions. While the MFS exhibited slightly lower peak pressure at the rearfoot, pressure parameters were not statistically different in the other foot regions. The MFS demonstrated good-to-excellent inter-session repeatability (ICC 0.84-0.97) for peak and mean pressure. Participants reported similar levels of comfort and stability in both shoes. The findings of the present study suggest the MFS has the potential to be a reliable and accurate tool for evaluating the effect of midsole features on relevant biomechanical parameters. This modular approach may improve data-driven footwear design by providing a consistent platform for testing the effects of midsole designs and materials across various applications, including therapeutic, safety, and athletic shoes.

Pathologic vertebral fractures are a major complication in metastatic spine disease. However, current clinical scores, such as Spinal Instability Neoplastic Score (SINS), show limited predictive capability, particularly within the indeterminate range where most clinical uncertainty lies. This study aimed to develop and evaluate quantitative computed tomography (qCT)-based subject-specific finite element (SSFE) models to predict vertebral strength in presence of different metastatic lesion types. Twelve ex vivo human spine segments, each containing one metastatic (n=12) and one adjacent control vertebra (n=12), were scanned using qCT and calibrated using a calibration phantom. Homogenised nonlinear finite element models were developed with spatially heterogeneous, isotropic, density-dependent material properties and loaded under uniaxial compression corresponding to 1.9% apparent strain. Ultimate failure load, stiffness, and strain distributions were compared between metastatic and control vertebrae. Predicted failure load ranged from 0.2 kN to 6.2 kN (mean. {+/-} standard deviation: 1.8 {+/-} 1.6 kN metastatic; 1.7 {+/-} 1.5 kN control), with no statistically significant difference between groups (p > 0.05). Normalised failure load varied widely, reflecting lesion-specific mechanical heterogeneity. Lytic lesions generally weakened vertebrae, whereas mixed and blastic lesions occasionally enhanced strength, likely due to localised sclerosis or reactive bone formation. High compressive axial strains (greater than 0.019) were frequently concentrated near the endplates, particularly in lytic vertebrae. qCT-derived bone mineral density strongly correlated with failure load (R{superscript 2} = 0.74-0.77). These findings highlight the complexity of metastatic vertebral mechanics and demonstrate that qCT-based SSFE modelling provides a quantitative framework for assessing fracture risk, complementing conventional imaging-based tools.

Dysphagia, difficulty swallowing due to irritation or damage to the esophagus, is one of the most common complications following anterior cervical discectomy and fusion (ACDF), the most frequently performed cervical spine procedure in the United States. Surgical retraction hardware imposes sustained compression on the esophagus during surgery, generating nonuniform stress and strain fields that may contribute to temporary postoperative soft tissue damage. Current intraoperative assessment relies on visual inspection and manual inspection by the surgical team and does not provide quantitative measures of esophageal deformation, strain, or retraction displacement. Here, we present a comprehensive mechanics analysis of esophageal compression during ACDF that integrates experiments on esophageal phantoms, nonlinear finite element modeling, and theoretical thick-wall scaling relationships. Modeling results quantify peak contact pressures and corresponding stress distributions, identifying conditions under which circumferential strain in the compressed esophageal wall increases sharply as localized pressures approach the upper physiological range ([~]6-17 kPa). Parametric investigation of retractor blade width, placement depth, and polymeric biocompatible coating properties demonstrates that targeted, yet mechanically simple, design modifications can help to attenuate strain concentrations. In particular, the introduction of compliant polymeric coatings redistributes contact loads and reduces peak wall stress by up to 20% relative to unbuffered blades (17 kPa to 13.5 kPa). Increasing blade width from 20 mm to 50 mm further decreases peak interface stress from 2.48 kPa to 0.45 kPa, corresponding to an 82% reduction. Reducing these stresses may help limit mechanically induced complications such as postoperative dysphagia. Experiments performed on esophageal phantoms with embedded pressure sensors replicate surgical ACDF retraction protocols under displacement-controlled conditions. This setup establishes physiologically relevant loading and enables quantitative validation of computational predictions by correlating measured voltage output with contact pressure and esophageal deformation. Measured relationships between applied retraction displacement, contact pressure, and tissue deformation govern stress amplification during ACDF retraction. Together, these results establish a predictive mechanics framework that links retractor blade design variables to esophageal stress fields, providing quantitative criteria to mitigate soft tissue damage during ACDF. HIGHLIGHTSO_LI2D and 3D finite element models quantify esophageal wall stress during anterior cervical discectomy and fusion (ACDF) retraction. C_LIO_LIRetractor blade geometry influences stress distribution, with wider blades reducing localized tissue loading by up to 82% likely associated with post-surgical dysphagia. C_LIO_LICompliant polymeric buffer layers attenuate pressure and smoothen stress gradients to reduce peak tissue loading by up to 20% during retraction. C_LI

IntroductionArteries, like other soft tissues, exhibit viscoelastic mechanical behavior, meaning their response to stress and strain is time dependent. This implies that the way arteries deform depends not only on the amount of force applied but also on the rate at which the force is applied. This study investigates the effects of different loading rates on the mechanical behavior of human femoropopliteal arteries (FPAs) to understand their rate-dependent characteristics. MethodsHuman FPA specimens were collected from 14 donors, including 7 males and 7 females, aged 45-55 years. A 10x10 mm segment was isolated, mounted onto a biaxial testing device, and subjected to varying loading rates (10 to 50 mN/s). Mechanical responses were recorded, and stress-stretch curves were analyzed. Statistical analyses, including mixed-design ANOVA, assessed the impact of sex and loading rates on tissue stiffness. ResultsResults indicated significant loading-rate dependency, particularly in the circumferential direction. Stretch values decreased with increasing loading rates, more prominently in the circumferential than in the longitudinal direction (p-value<0.01). Statistical analyses revealed no significant interaction between sex and loading rate, though male arteries exhibited slightly higher compliance than female arteries. DiscussionThe findings demonstrate that the mechanical response of FPAs is highly dependent on the loading rate, with more pronounced effects observed in the circumferential direction. At higher loading rates, the human FPAs demonstrated a stiffer response in the circumferential direction. DedicationWe dedicate this work to the memory of our late student, Ali Zolfaghari Sichani, who passed away tragically during his doctoral studies. Ali performed the majority of the experiments and the initial analysis reported in this paper. His passion, dedication, and hard work were the foundation of this research, and he is deeply missed.

Spectral similarity is often judged with a single metric such as RMSE, yet this can be misleading: physically different errors can produce similar scores. This is a critical limitation for computational biomechanics, where spectral agreement underpins both model validation and machine-learning loss design. Here, we develop a multi-metric framework for objective spectral biofidelity and test whether it better captures meaningful disagreement across complex frequency-domain responses. We evaluated 12 complementary similarity metrics, including CORA and ISO/TS 18571, using controlled spectral perturbations that mimic common real-world deviations such as resonance shifts, localized spikes, and broadband tilts. We then applied the framework to an SBI-tuned finite-element middle-ear model to assess convergence with training dataset size and robustness to measurement noise across repeated stochastic runs. No single metric performed reliably across all distortion types. Shape-based metrics tracked resonance morphology but could miss vertical scaling, whereas MaxError remained important for narrowband anomalies that smoother metrics underweighted. CORA and ISO 18571 did not consistently outperform simpler metrics. Rank aggregation using Borda count provided a robust consensus across metrics, enabling objective identification of training-data saturation and noise thresholds beyond which similarity rankings became unstable. These results show that spectral biofidelity cannot be reduced to a single norm. A multi-metric consensus provides a clearer and more physically meaningful basis for comparing experimental and simulated spectra, and offers a more defensible foundation for data-fidelity terms in physics-informed and simulation-based machine learning.

The structural integrity of spinal cord tissue and the transmission of mechanical stimuli across the different levels of tissue microarchitecture and varying spatial scales of mechanical loading challenge experimental and computational efforts to accurately model, simulate and interpret tissue mechanics, leading to conflicting findings in existing literature. Here, we demonstrate that the bead size used in spherical indentation tests significantly affects the stiffness ratio of spinal cord gray to white matter, a dependence which we only observe on the transverse plane and not the coronal plane of the tissue. Our study reveals a shift in stiffness ratio such that for smaller spherical indenters gray matter is stiffer than white matter, while for larger indenters, white matter is stiffer than gray matter. The mean relative change from the 100 {micro}m bead to the 500 {micro}m bead differed between anatomical planes, with transverse sections showing a decrease in gray matter (-13.3%) and an increase in white matter stiffness (+26.9%), accompanied by a reduction in the gray-to-white matter stiffness ratio from 1.07 to 0.76, whereas coronal sections exhibited increases in both gray (+21.0%) and white matter (+33.8%), along with a change in the ratio from 0.99 to 1.14. These findings contribute to explaining previously contradictory results in the literature and underscore the relevance of spatial scales in mechanical characterization studies.

Intervertebral disc degeneration (IVDD) compromises disc structures and mechanics, yet systematic evaluations of the mechanical responses and their relationship to morphological changes in preclinical models remain limited. This systematic review and meta-analysis synthesized mechanical and morphological alterations following experimental disc injury in in vivo animal models. Searches of MEDLINE, EMBASE and Web of Science databases were conducted in accordance with PRISMA guidelines. Study quality and risk of bias were assessed using modified CAMARADES and SYRCLE tools. Twenty-eight studies were included. Pooled analyses showed significant reductions in stiffness, Youngs modulus, and disc height, and significant increases in range of motion and degeneration grade, indicating both mechanical and structural deterioration. Youngs modulus appeared to be the most sensitive marker of functional degeneration. By contrast, creep and other viscoelastic responses showed non-significant changes. High heterogeneity was evident across studies, reflecting variability in injury models, species, timepoints, and testing methods. Evidence of publication bias was detected in several domains, and moderate methodological quality was noted with overall insufficient blinding and lack of sample size calculations. In vivo animal models of IVDD demonstrate robust and consistent mechanical and morphological degeneration after injury. Youngs modulus is a sensitive mechanical indicator, supporting its use in future preclinical research. Standardization of outcome definitions, methodology, and reporting is essential to improve comparability and enhance translation of preclinical findings to clinical research.

The human femoral neck is particularly vulnerable to fracture, with failure most often initiating in the superior region. While age-related microstructural changes such as cortical thinning and increased porosity are well established, the contribution of material properties at the lamellar and mineralised collagen fibril (MCF) levels remains poorly understood. Here, regional differences in nanostructural properties of cortical bone from 78 femoral necks obtained from 44 donors aged 54-96 are investigated using a combined 2D and 3D X-ray scattering imaging approach. This approach quantifies MCF orientation and structure averaged over multiple lamellae in large fields of view, capturing tissue heterogeneity through the hierarchical scales. We identified misalignment between the scattering signals arising from the MCF bundles -- specifically those associated with mineral inclusions in the collagen fibril gap regions, the mineral nanostructure, and the mineral crystal lattice -- suggesting the presence of distinct mineral phases within and around the collagen fibers. Despite substantial intra-sample variability, the superior region displays on average more oblique MCF orientations, larger and thicker mineral platelets arranged in a less-ordered structure, greater misalignment between mineral and collagen at the MCF level, and possibly stiffer collagen fibres, with no significant trends observed with donor age or sex. The cumulative effect of these material property differences may contribute to the increased susceptibility of the superior cortex to compressive failure.

The osteochondral junction is a specialized region ensuring the biomechanical and biological integration of the unmineralized articular cartilage with the subchondral bone through an intermediate layer of mineralized cartilage. This location is of clinical relevance, being the target of osteoarthritis. While aging is considered a risk factor for osteoarthritis, the interplay between microstructural and material changes during aging and predisposing to joint degeneration is not fully clear. This is especially true for mineralized cartilage, which remains understudied despite its critical role in load transfer from unmineralized articular cartilage to bone. We investigate age-related alterations of mineralized cartilage and subchondral bone in rat tibiae of adult and aged animals using a multimodal, high-resolution, correlative analysis. Our approach includes micro-computed tomography to measure microstructural features, second harmonic generation imaging to visualize collagen organization, quantitative backscattered electron imaging to map local mineral content, and nanoindentation to obtain mechanical properties. Mineralized cartilage and subchondral bone exhibited distinct age-related modifications. At the architectural level, the subchondral plate thickened and the trabecular network became coarser, those changes being different from those observed in the metaphysis. At the tissue level, mineralized cartilage was less mineralized than bone but exhibits a greater relative increase of mineral content with age, underlying differences in mineralization. A central observation is that aging led to an abrupt transition in mineral content and mechanical properties across the interface between unmineralized and mineralized cartilage, with a conceivable impact on stress localization. Overall, these changes may alter load transfer and contribute to age-related joint degeneration.

IntroductionTrabecular bone exhibits brittle behaviour governed by microscale deformation and damage processes, yet quantitative characterisation of crack progression remains challenging because classical fracture mechanics approaches do not apply to architecturally discontinuous porous tissues. This study evaluates whether synchrotron X-ray computed tomography (XCT) combined with digital volume correlation (DVC) can provide a practical experimental approach for quantifying crack opening behaviour in human trabecular bone. MethodSemicylindrical specimens harvested from femoral heads of hip-fracture donors (n = 5) and non-fracture controls (n = 5) underwent stepwise three-point-bending during XCT imaging. Full-field displacement maps enabled direct measurement of crack mouth opening displacement (CMOD), crack length (a), and their ratio, CMOD/a, used here as a geometry-normalised comparative descriptor of brittle response. Automated crack segmentation using phase-congruency crack detection (PCCD) was compared against manual measurements. ResultsXCT-DVC successfully resolved three-dimensional displacement discontinuities during crack initiation and propagation in all specimens. Hip-fracture donors exhibited significantly lower critical crack-opening ratios (CMOD/a)* than Controls (0.31 vs 0.47; p = 0.008) and reached mechanical instability at lower applied loads, consistent with a more brittle structural response under this test configuration. Despite these differences, total crack extension ({Delta}a*) was similar between groups. Automated crack tracking using phase-congruency-based segmentation showed excellent agreement with manual measurements (r{superscript 2} = 0.98), confirming reliable extraction of crack geometry from DVC displacement fields. DiscussionThese results indicate that XCT-DVC can provide a practical approach for quantifying crack-opening behaviour in trabecular bone when classical fracture-mechanics parameters are not applicable in anatomically constrained specimens. The reduced critical crack-opening ratios and earlier instability observed in Hip-fracture donors are consistent with a more brittle comparative mechanical response that is not captured by crack extension alone. The strong agreement between automated and manual crack measurements further supports displacement-based descriptors as reliable comparative indicators of brittle behaviour in porous, architecturally discontinuous tissues. O_FIG O_LINKSMALLFIG WIDTH=200 HEIGHT=76 SRC="FIGDIR/small/714043v1_ufig1.gif" ALT="Figure 1"> View larger version (28K): org.highwire.dtl.DTLVardef@31c5d7org.highwire.dtl.DTLVardef@1b3d9a4org.highwire.dtl.DTLVardef@95df7borg.highwire.dtl.DTLVardef@1834216_HPS_FORMAT_FIGEXP M_FIG O_FLOATNOGraphical abstractC_FLOATNO C_FIG

PurposeHuman anatomy remains foundational to clinical practice, yet reduced instructional hours raise concerns about graduate competence and preparedness for patient care. Although trainees often report confidence, supervisors may perceive deficiencies, creating a gap between self-assessment and external evaluation. This study examined stakeholder perspectives on anatomical competence within physical therapy education to identify areas of discordance in perceived capability. MethodsA cross-sectional web-based survey collected responses from 165 stakeholders associated with an entry-level Doctor of Physical Therapy program featuring a 16-week dissection curriculum. Participants rated four domains of anatomical competence using a 5-point ordinal scale. Group differences were analyzed with the Kruskal-Wallis test appropriate for ordinal data. This methodology ensured robust assessment of stakeholder perceptions and comparative analysis. ResultsMedian ratings of preparedness and capability were 4 of 5 (quite prepared). Significant discordance emerged in three domains: recent graduates rated their foundational knowledge and ability to explain complex concepts to lay audiences higher than faculty or clinical instructors, whereas faculty expressed lower confidence in graduates ability to explain patient symptoms using anatomical principles. No significant differences were observed in the ability to describe structures by location, suggesting shared perceptions of basic anatomical understanding despite variation in applied reasoning. ConclusionsStakeholders generally viewed graduates as well prepared, yet disagreement persisted regarding clinical application of anatomical knowledge. Faculty skepticism about symptom explanation indicates that mastery of anatomy alone does not guarantee clinical reasoning. Curricular strategies emphasizing vertical integration and explicit connections between anatomical science and patient-centered reasoning may help bridge perception gaps and enhance professional competence.

Understanding the mechanical properties of brain tissue may provide crucial insights into brain development, injury, disease and surgical planning. Conventionally, these properties are measured ex vivo or in vivo during surgical procedures, while non-invasive in vivo alternatives are sparse. This study investigates whether fractional anisotropy (FA) derived from diffusion-weighted magnetic resonance imaging can serve as a surrogate marker for brain tissue stiffness in healthy human brains. MRI data were collected from three body donor brains, 28 healthy adults, and a publicly available independent dataset of 26 adults. FA values were compared with mechanical properties from ex vivo mechanical testing of brain tissue. Statistical analysis revealed a strong negative correlation between FA and the mechanical response for small strains expressed as shear modulus of a one-term hyperelastic Ogden model, indicating that higher FA values are associated with lower tissue stiffness. The nonlinearity parameter alpha exhibited a qualitatively similar, but considerably weaker correlation with FA. These findings were consistent across datasets. The findings suggest that FA can be a robust, non-invasive marker for estimating mechanical properties of brain tissue, with potential applications in clinical diagnosis and computational modeling of brain mechanics and the study of brain development. Further research is needed to clarify the relationship in lesional tissues and to optimize clinical utility.

The fibrous microstructure of tendons and ligaments is an important determinant of their mechanical behavior and integrity. Diffusion tensor imaging (DTI) is a magnetic resonance imaging (MRI) technique that enables the inference of microstructural features within fibrous tissues and has recently been used to characterize the microstructure of dense connective tissues such as tendon and ligament. However, the effect of microstructural variations in tendon and ligament on DTI metrics remains unclear. To address this gap, we simulated diffusion MRI of second harmonic generation (SHG) image-informed square lattice fiber networks to determine which microstructural features have the strongest influence on DTI metrics. Then, we performed a second set of diffusion MRI simulations for randomly dispersed fibers within synthetic tendon volumes to relate DTI metrics to the influential microstructural features, including fiber dispersion. All DTI metrics were insensitive to collagen fiber crimp. Fiber dispersion did not affect mean diffusivity, decreased axial diffusivity, increased radial diffusivity, and decreased fractional anisotropy. These results provide valuable insight into the relationships between DTI metrics and microstructural properties of tendon and ligament, which is particularly relevant for inferring microstructural changes in impaired tissue using DTI. Furthermore, our findings are an important step in the translation of DTI for clinical and computational studies of dense connective tissues such as tendon and ligament.

Traumatic brain injury (TBI) remains a global health challenge with mechanisms that are still insufficiently understood. While neuroimaging has been used to probe microstructural alterations and their association with head kinematics, findings remain heterogeneous. Finite element (FE) head modelling offers a more robust alternative, demonstrating a superior correlation with observed microstructural changes compared to traditional impact exposure metrics. However, most existing FE models are derived from single-subject scans or generic atlases, which often fail to represent specific study cohorts and introduce significant output variability. This study presents a reproducible computational framework that generates a cohort-specific template brain from MRI scans of adolescent male rugby players to produce a representative FE head model. The model was validated against cadaveric head experiments, demonstrating strong agreement with observed nodal displacements. Furthermore, simulations comparing the template-based model to subject-specific FE models with the identical impact conditions revealed significant differences in brain response. These results underscore the critical necessity of subject-specific modelling for the personalised characterisation of brain biomechanics. Our framework utilizes open-access tools, ensuring full reproducibility for research groups seeking to develop population-, sex-, or ethnicity-specific models. By providing a more accurate representation of cohort-average and individual brain responses, this work contributes to the improved mapping of mechanical strain to clinical findings and neurological alterations.

Background: Peak height velocity (PHV) is a critical indicator of pubertal growth timing and is widely used in orthodontics to determine optimal timing for growth modification interventions. Secular trends toward earlier maturation have been reported, but a quantitative synthesis of PHV age reduction across generations is lacking. Objective: To systematically review and quantitatively synthesize evidence for secular trends in age at PHV and to estimate the pooled mean difference in PHV age between historical and contemporary cohorts. Methods: A systematic search was conducted in PubMed and Google Scholar from January 1990 to December 2021. The Directory of Open Access Journals (DOAJ) was also searched but yielded no eligible studies due to the specificity of the search string. Studies were included if they reported age at PHV in two or more birth cohorts separated by at least 20 years, used objective methods to determine PHV (longitudinal growth data with curve fitting), and reported means with standard deviations or standard errors. Risk of bias was assessed using the Newcastle-Ottawa Scale. A random-effects quantitative synthesis (meta-analytic approach) was performed to calculate the pooled mean difference in PHV age between historical and contemporary cohorts. Between-study variance (tau-squared) was estimated using the restricted maximum likelihood (REML) method. Heterogeneity was assessed using I-squared statistics. Given the limited number of eligible studies, findings should be interpreted as preliminary. Results: Two high-quality longitudinal studies met inclusion criteria, comprising 171 participants from historical cohorts (1969-1973) and 71 participants from contemporary cohorts (1996-2000). The pooled mean difference in PHV age was -0.48 years (95% CI: -0.72 to -0.24, P < 0.001), indicating that contemporary children reach PHV approximately 0.5 years earlier than their historical counterparts. PHV velocity showed a pooled increase of 0.71 cm/year (95% CI: 0.48 to 0.94, P < 0.001). Heterogeneity was low (I-squared = 0% for both analyses). Both studies were rated as low risk of bias. These findings are based on a limited number of studies and should be interpreted as preliminary. Conclusions: This preliminary quantitative synthesis provides evidence of a secular decline in age at peak height velocity of approximately 0.5 years in contemporary children compared to historical cohorts, accompanied by an increase in growth velocity. These findings suggest that orthodontic growth modification strategies may need to be initiated earlier than traditionally recommended. However, given the limited evidence base, results should be interpreted with caution and require confirmation in large-scale longitudinal studies.

It has been broadly recognized that the crosstalk between cells and their extracellular matrix (ECM) is crucial for the proper function of biological tissues. Relatively recently the role of ECM came in focus in the context of neuronal development and regeneration, where the effects of the ECM mechanics on the migration of neurons and neurite growth are still incompletely understood. Here we present an in silico twin framework for neurite growth focusing on its biophysical interactions with the ECM. This coarsegrained model accounts for viscoelastic liquid- and solid-like ECMs and neurite growth by ECM-mediated traction forces. Resulting growth trajectories can be rationalized based on the theory of random walks and polymer physics. To critically assess models predictive power, we performed experiments on neurites of hippocampal rat neurons growing in 3D collagen gels and observed a more persistent axon outgrowth in denser matricies. The model fully recapitulated the effect, thereby underpinning the central role of mechanical interactions with ECM as guiding principle of axonal growth. We argue that a combination our model with optical microscopy may provide an is silico twin helping to disentangle the contributions of "passive" physics from more complex effects of chemical queues or an apparent mechanosensing.

This study uses a previously reported 3D-printed variable-height flow cell to investigate the viscoelastic properties of chondrocytes from 2D monolayer and 3D alginate cultures. It was hypothesized that chondrocytes could be distinguished by phenotype associated with their culture environment using viscoelastic recovery time, owing to variation in the pericellular matrix (PCM) produced by chondrocytes from different culture methods. The PCM surrounding the chondrocytes was imaged with confocal microscopy during applied deformation and subsequent recovery. The projected cell area was fitted with a Burgers mechanical model to extract the viscoelastic recovery time. No difference between bovine and primary OA cells from monolayer cultures was observed. However, a statistically significant difference in recovery time was observed between cells from monolayer and alginate cultures in both the bovine (31 s vs. 13 s) and primary OA (34 s vs. 13 s) groups. This work shows that viscoelastic recovery time is influenced by the culture method used for chondrocytes and further demonstrates the role of the PCM as a mechanical protector of chondrocytes.

Background: Trauma from occlusion (TFO) is a frequently under-recognized clinical entity. While narrative reviews exist, no prior systematic review has quantitatively synthesized the prevalence of TFO signs in orthodontic patients, the distribution of the Akerly classification for deep traumatic overbite, the efficacy of orthodontic intrusion, or the outcomes of immediate orthodontic repositioning of traumatized incisors. Furthermore, the knowledge-practice gap among orthodontists regarding trauma management has not been meta-analyzed. Methods: Systematic review and meta-analysis of observational and interventional studies, including cross-sectional studies, randomized controlled trials, and before-after studies. We searched PubMed (n=57), PubMed Central (n=538), the Cochrane Library (n=11: 2 reviews, 9 trials), and Google Scholar (~3,930) up to December 2025. Studies reporting prevalence of TFO signs, Akerly classification distribution, overbite reduction following orthodontic intrusion, success of immediate orthodontic repositioning, or orthodontist knowledge/practice were included. Random-effects meta-analyses were performed using the 'meta' package in R (DerSimonian-Laird estimation for tau-squared). The protocol was not registered due to the exploratory nature of this multi-domain synthesis; however, the methodology strictly adhered to PRISMA 2020 guidelines. Results: Twenty-seven studies (n=8,432 participants) were included. The pooled prevalence of any TFO sign was 34% (95% CI: 27-42%, I-squared = 86%), with wide prediction intervals indicating substantial between-study variability. TFO was variably defined across studies as the presence of at least one of the following: fremitus, increased mobility, occlusal interference, soft tissue trauma, or CR-CO discrepancy. Higher prevalence was observed in Class II malocclusion (46% vs. 22%). Among deep traumatic overbite cases classified using the Akerly system, Type II was most common (52%, 95% CI: 44-60%), followed by Type I (31%) and Type III (17%). Orthodontic intrusion reduced overbite by a mean of 2.8 mm (95% CI: 2.1-3.5, I-squared = 72%); TAD-assisted intrusion produced greater reduction (3.4 mm) than conventional archwires (2.1 mm, p < 0.001). Immediate orthodontic repositioning of traumatized incisors with light forces ([&le;] 50 g) achieved 91% success (95% CI: 84-96%) at 12 months, comparable to splinting (84%), with no statistically significant difference between groups. The orthodontic group required fewer visits and reported better comfort. Meta-analysis of orthodontist knowledge showed correct awareness of specific trauma management protocols was below 40% in most domains, indicating a substantial evidence-practice gap. Conclusion: This first systematic review and meta-analysis on TFO in orthodontics provides preliminary quantitative benchmarks. One-third of orthodontic patients exhibit TFO signs; Akerly Type II is the dominant deep overbite pattern; orthodontic intrusion effectively reduces overbite by approximately 3 mm; immediate light-force repositioning is comparable to splinting in success and superior in efficiency. However, the disconnect between high clinical efficacy (e.g., 91% success of repositioning) and low practitioner awareness (<40%) represents a substantial translational gap in clinical practice. Assessment of publication bias was limited due to the small number of studies in several analyses (<10), precluding reliable funnel plot interpretation.

Background: Friction at the bracket-archwire interface is traditionally considered a key determinant of orthodontic tooth movement efficiency. However, clinical evidence remains inconsistent despite advances in low-friction systems, including self-ligating brackets, coated archwires, and frictionless mechanics. Objective: To evaluate the clinical impact of friction-related interventions on tooth movement, anchorage control, and patient-centered outcomes. Methods: A scoping review with supplementary meta-analysis was conducted following PRISMA-ScR guidelines. Electronic searches of the Cochrane Library (1 systematic review: CD003453), PubMed (128 primary studies), and Google Scholar (approximately 2,500 results, screened to 45 relevant studies) were performed. Randomized controlled trials comparing friction-modifying interventions were included. Primary outcomes included rate of tooth movement, anchorage loss, and molar rotation. Secondary outcomes included pain and treatment duration. Random-effects meta-analysis (DerSimonian-Laird method) was performed using RevMan 5.4; this method was chosen due to expected clinical heterogeneity. Risk of bias was assessed using Cochrane RoB 2, and certainty of evidence was evaluated using GRADE. Given the small number of studies, pooled estimates should be interpreted cautiously due to potential small-study effects. Results: Nineteen RCTs were included in quantitative synthesis. Frictionless mechanics did not significantly increase the rate of space closure (MD = 0.15 mm/month; 95% CI: -0.08 to 0.38; P = 0.20; I-squared = 68%) but resulted in significantly greater molar rotation (MD = 6.1 degrees; 95% CI: 4.8 to 7.4; P < 0.001; I-squared = 45%). Self-ligating brackets showed no consistent advantage in treatment duration or pain reduction. Active self-ligating brackets demonstrated slightly faster alignment than passive systems (MD = 10.24 days; 95% CI: 2.80 to 17.68). Low-friction ligatures and coated archwires did not improve clinical efficiency. Surgical acceleration methods reduced treatment time by 25-50% but increased early discomfort. Low-level laser therapy showed potential for accelerating tooth movement and reducing pain. Conclusions: High-level clinical evidence does not support the long-held assumption that reducing friction accelerates orthodontic tooth movement. The evidence fails to demonstrate a clinically meaningful acceleration effect from friction reduction alone. Resistance to sliding appears to be predominantly governed by binding and biological patient response, not friction alone--necessitating a shift in biomechanical strategy. A proposed evidence-informed conceptual model and clinical algorithm are presented to guide decision-making.