UNASSIGNED: Computational models can help clinicians plan surgeries by accounting for factors such as mechanical imbalances or testing different surgical techniques beforehand. Different levels of modeling complexity are found in the literature, and it is still not clear what aspects should be included to obtain accurate results in finite-element (FE) corneal models. This work presents a methodology to narrow down minimal requirements of modeling features to report clinical data for a refractive intervention such as PRK.
UNASSIGNED: A pipeline to create FE models of a refractive surgery is presented: It tests different geometries, boundary conditions, loading, and mesh size on the optomechanical simulation output. The mechanical model for the corneal tissue accounts for the collagen fiber distribution in human corneas. Both mechanical and optical outcome are analyzed for the different models. Finally, the methodology is applied to five patient-specific models to ensure accuracy.
UNASSIGNED: To simulate the postsurgical corneal optomechanics, our results suggest that the most precise outcome is obtained with patient-specific models with a 100 µm mesh size, sliding boundary condition at the limbus, and intraocular pressure enforced as a distributed load.
UNASSIGNED: A methodology for laser surgery simulation has been developed that is able to reproduce the optical target of the laser intervention while also analyzing the mechanical outcome.
UNASSIGNED: The lack of standardization in modeling refractive interventions leads to different simulation strategies, making difficult to compare them against other publications. This work establishes the standardization guidelines to be followed when performing optomechanical simulations of refractive interventions.

This paper presents comprehensive guidelines for the design and analysis of a thin diaphragm that is used in a variety of microsystems, including microphones and pressure sensors. It highlights the empirical relations that can be utilized for the design of thin diaphragm-based microsystems (TDMS). Design guidelines developed through a Finite Element Analysis (FEA) limit the iterative efforts to fabricate TDMS. These design guidelines are validated analytically, with the assumption that the material properties are isotropic, and the deviation from anisotropic material is calculated. In the FEA simulations, a large deflection theory is taken into account to incorporate nonlinearity, such that a critical dimensional ratio of a/h or 2r/h can be decided to have the linear response of a thin diaphragm. The observed differences of 12% in the deflection and 13% in the induced stresses from the analytical calculations are attributed to the anisotropic material consideration in the FEA model. It suggests that, up to a critical ratio (a/h or 2r/h), the thin diaphragm shows a linear relationship with a high sensitivity. The study also presents a few empirical relations to finalize the geometrical parameters of the thin diaphragm in terms of its edge length or radius and thickness. Utilizing the critical ratio calculated in the static FEA analysis, the basic conventional geometries are considered for harmonic analyses to understand the frequency response of the thin diaphragms, which is a primary sensing element for microphone applications and many more. This work provides a solution to microelectromechanical system (MEMS) developers for reducing cost and time while conceptualizing TDMS designs.

BACKGROUND: To the best of our knowledge, there are no reporting guidelines for design, conduct and reporting of Finite Element studies in health sciences. We intend to propose specific and detailed guidelines for reporting these studies.
METHODS: After recognizing the need to have uniform guidelines for reporting of finite element analysis in medicine and dentistry, a group of 5 researchers working on FEA as their research area met in the summer of 2020 and drafted the methodology for the development of such guidelines. Each researcher individually made a list of major headings required for reporting these studies and met again in September 2020 to finalize the domains. Subsequently, sub headings and details were charted. The draft list of items for reporting the guidelines were presented to a larger team of 15 experts and some changes were further made based on their inputs.
RESULTS: The guidelines entail seven major domains and their sub-domains, including parameters for model structure, segmentation, mesh structure, force application and model validation, etc. This checklist aims to improvise the reporting and consistency of FEA studies.
CONCLUSIONS: We hope that the usage and adoption of these guidelines by the scientific community would result in more thoughtful and uniform documentation. Also, the confidence in the results would be enhanced through model reproducibility, reusability and accountability. The proposed guidelines were named as \'Reporting of in-silico studies using finite element analysis in medicine\' and the term \'RIFEM\' was used as acronym.

This tutorial paper provides a step-by-step guide to developing a comprehensive understanding of the different forms of the deformation gradient used in Abaqus, and outlines a number of key issues that must be considered when developing an Abaqus user defined material subroutine (UMAT) in which the Cauchy stress is computed from the deformation gradient. Firstly, we examine the \"classical\" forms of global and local deformation gradients. We then show that Abaqus/Standard does not use the classical form of the local deformation gradient when continuum elements are used, and we highlight the important implications for UMAT development. We outline the key steps that must be implemented in developing an anisotropic fibre-reinforced hyperelastic UMAT for use with continuum elements and local orientation systems. We also demonstrate that a classical local deformation gradient is provided by Abaqus/Standard if structural (shell and membrane) elements are used, and by Abaqus/Explicit for all element types. We emphasise, however, that the majority of biomechanical simulations rely on the use of continuum elements with a local coordinate system in Abaqus/Standard, and therefore the development of a hyperelastic UMAT requires an in-depth and precise understanding of the form of the non-classical deformation gradient provided as input by Abaqus. Several worked examples and case studies are provided for each section, so that the details and implications of the form of the deformation gradient can be fully understood. For each worked example in this tutorial paper the source files and code (Abaqus input files, UMATs, and Matlab script files) are provided, allowing the reader to efficiently explore the implications of the form of the deformation gradient in the development of a UMAT.

The use of finite element analysis (FEA) has increased rapidly over the last decennia and has become a popular tool to design implants, osteosynthesis plates and prostheses. With increasing computer capacity and the availability of software applications, it has become easier to employ the FEA. However, there seems to be no consensus on the input variables that should be applied to representative FEA models of the human mandible. This review aims to find a consensus on how to define the representative input factors for a FEA model of the human mandible. A literature search carried out in the PubMed and Embase database resulted in 137 matches. Seven papers were included in this current study. Within the search results, only a few FEA models had been validated. The material properties and FEA approaches varied considerably, and the available validations are not strong enough for a general consensus. Further validations are required, preferably using the same measuring workflow to obtain insight into the broad array of mandibular variations. A lot of work is still required to establish validated FEA settings and to prevent assumptions when it comes to FEA applications.

To determine whether patient-specific finite element (FE) computer models are better at assessing fracture risk for femoral bone metastases compared to clinical assessments based on axial cortical involvement on conventional radiographs, as described in current clinical guidelines.
Forty-five patients with 50 femoral bone metastases, who were treated with palliative radiotherapy for pain, were included (64% single fraction (8Gy), 36% multiple fractions (5 or 6x4Gy)) and were followed for six months to determine whether they developed a pathological femoral fracture. All plain radiographs available within a two month period prior to radiotherapy were obtained. Patient-specific FE models were constructed based on the geometry and bone density obtained from the baseline quantitative CT scans used for radiotherapy planning. Femoral failure loads normalized for body weight (BW) were calculated. Patients with a failure load of 7.5 x BW or lower were identified as having high fracture risk, whereas patients with a failure load higher than 7.5 x BW were classified as low fracture risk. Experienced assessors measured axial cortical involvement on conventional radiographs. Following clinical guidelines, patients with lesions larger than 30mm were identified as having a high fracture risk. FE predictions were compared to clinical assessments by means of diagnostic accuracy values (sensitivity, specificity and positive (PPV) and negative predictive values (NPV)).
Seven femurs (14%) fractured during follow-up. Median time to fracture was 8 weeks. FE models were better at assessing fracture risk in comparison to axial cortical involvement (sensitivity 100% vs. 86%, specificity 74% vs. 42%, PPV 39% vs. 19%, and NPV 100% vs. 95%, for the FE computer model vs. axial cortical involvement, respectively).
Patient-specific FE computer models improve fracture risk assessments of femoral bone metastases in advanced cancer patients compared to clinical assessments based on axial cortical involvement, which is currently used in clinical guidelines.

Current biomechanical research of dental implants focuses on the mechanical damage and enhancement mechanism of the implant-abutment interface as well as how to obtain better mechanical strength and longer fatigue life of dental implants. The mechanical properties of implants can be comprehensively evaluated by strain gauge analysis, photo elastic stress analysis, digital image correlation, finite element analysis, implant bone bonding strength test, and measurement of mechanical properties. Finite element analysis is the most common method for evaluating stress distribution in dental implants, and static pressure and fatigue tests are commonly used in mechanical strength test. This article reviews biomechanical research methods and evaluation indices of dental implants. Results provide methodology guidelines in the field of biomechanics by introducing principles, ranges of application, advantages, and limitations, thereby benefitting researchers in selecting suitable methods. The influencing factors of the experimental results are presented and discussed to provide implant design ideas for researchers.
目前牙种植体的生物力学研究主要集中于种植体-骨结合界面及种植牙内各个部件连接界面的力学损伤及增强机制，以及如何获得更好的牙种植体-基台复合体的整体机械强度和服役寿命等方面的研究。目前有关生物力学的研究，主要通过电阻应力测试方法、光弹应力分析法、数字图像相关分析法、有限元分析法、种植体-骨结合强度力学测试和机械性能测试法对实验样本进行综合评价。目前有限元分析法是最常见的牙种植体应力分布研究法，而静态压力实验和疲劳实验是最常见的机械强度测试研究方法。本文通过对这些研究方法的原理、应用范围及特点的介绍和对实验结果影响因素的梳理，给相关领域研究者们提供方法学的指导，并可拓展种植体的设计思路。.

OBJECTIVE: The aim of the present publication was to report on the EAO Workshop group-4 discussions and consensus statements on the five reviews previously prepared. These reviews provided the scientific evidence on the effect of crown-to-implant ratio, on reconstructions with cantilevers in fully and partially edentulous patients, on biological and technical complications of tilted in comparison with straight implants, and on the effects of osseointegrated implants functioning in a residual dentition.
METHODS: The group discussed, evaluated, corrected where deemed appropriate, and made recommendations to the authors regarding the following five reviews submitted: (a) Is there an effect of crown-to-implant ratio on implant treatment outcomes?; (b) Implant-supported cantilevered fixed dental rehabilitations in fully edentulous patients; (c) and in partially edentulous patients; (d) Biological and technical complications of tilted implants in comparison with straight implants supporting fixed dental prostheses; (e) What are the adverse effects of osseointegrated implants functioning among natural teeth of a residual dentition? Based on the five manuscripts and the discussion among the group as well as the plenum members, the major findings were summarized, consensus statements were formulated, clinical recommendations were proposed, and areas of future research were identified.
RESULTS: Crown-to-implant ratios ranging from 0.9 to 2.2 did not influence the occurrence of biological or technical complications also in single-tooth restorations. Reconstructions with cantilevers for the rehabilitation of fully and partially edentulous jaws showed high implant and reconstruction survival rates. In contrast, the rate of complications-in particular associated with veneering material-was high during the observation period of 5-10 years. The data reported were primarily derived from studies with high risk of bias. The data for single-implant reconstructions were small. There was no evidence that distally tilted implants were associated with higher failure rates and increased amounts of marginal bone loss. The data supporting these findings, however, were at high risk of bias and frequently incompletely reported. Frequent positional changes occurred between the natural teeth and the implant-supported restorations. These changes were more pronounced in younger individuals, and even though they were reduced with age, they still occurred in adult patients. Even though these changes were frequent, potential implications for the patient are unclear.
CONCLUSIONS: The use of single-tooth restorations with crown-to-implant ratio in between 0.9 and 2.2 may be considered a viable treatment option. Multiunit reconstructions with cantilevers are a viable treatment option in fully and partially edentulous patients. Clinicians and patients should be aware, however, that complications are frequent and primarily related to resin material used for veneering. There is some evidence that tilting an implant does affect stability of the implant and the surrounding bone. Treatment options to tilted implants should carefully be considered, as the effect on soft tissues and on prosthesis behavior is poorly reported for tilted implants. Positional changes in the dentition in relation to implant-supported restorations occur frequently. The patient should be informed about the possible need for a treatment related to these changes in the long term.

Ultrasound shear wave elastography is emerging as an important imaging modality for evaluating tissue material properties. In its practice, some systematic biases have been associated with ultrasound frequencies, focal depths and configuration, and transducer types (linear versus curvilinear), along with displacement estimation and shear wave speed estimation algorithms. Added to that, soft tissues are not purely elastic, so shear waves will travel at different speeds depending on their spectral content, which can be modulated by the acoustic radiation force (ARF) excitation focusing, duration, and the frequency-dependent stiffness of the tissue. To understand how these different acquisition and material property parameters may affect the measurements of shear wave velocity, the simulations of the propagation of shear waves generated by ARF excitations in viscoelastic media are a very important tool. This paper serves to provide an in-depth description of how these simulations are performed. The general scheme is broken into three components: 1) simulation of the 3-D ARF push beam; 2) applying that force distribution to a finite-element model; and 3) extraction of the motion data for post-processing. All three components will be described in detail and combined to create a simulation platform that is powerful for developing and testing algorithms for academic and industrial researchers involved in making quantitative shear-wave-based measurements of tissue material properties.

This study investigated the relationship between the specific absorption rate and temperature elevation in an anatomically-based model named NORMAN for exposure to radio-frequency far fields in the ICNIRP guidelines (1998 Health Phys. 74 494-522). The finite-difference time-domain method is used for analyzing the electromagnetic absorption and temperature elevation in NORMAN. In order to consider the variability of human thermoregulation, parameters for sweating are derived and incorporated into a conventional sweating formula. First, we investigated the effect of blood temperature variation modeling on body-core temperature. The computational results show that the modeling of blood temperature variation was the dominant factor influencing the body-core temperature. This is because the temperature in the inner tissues is elevated via the circulation of blood whose temperature was elevated due to EM absorption. Even at different frequencies, the body-core temperature elevation at an identical whole-body average specific absorption rate (SAR) was almost the same, suggesting the effectiveness of the whole-body average SAR as a measure in the ICNIRP guidelines. Next, we discussed the effect of sweating on the temperature elevation and thermal time constant of blood. The variability of temperature elevation caused by the sweating rate was found to be 30%. The blood temperature elevation at the basic restriction in the ICNIRP guidelines of 0.4 W kg(-1) is 0.25 degrees C even for a low sweating rate. The thermal time constant of blood temperature elevation was 23 min and 52 min for a man with a lower and a higher sweating rate, respectively, which is longer than the average time of the SAR in the ICNIRP guidelines. Thus, the whole-body average SAR required for blood temperature elevation of 1 degrees C was 4.5 W kg(-1) in the model of a human with the lower sweating coefficients for 60 min exposure. From a comparison of this value with the basic restriction in the ICNIRP guidelines of 0.4 W kg(-1), the safety factor was 11.