While injuries sustained from body armour backface deformation (BFD) have not been well-documented in military injury trauma registries, data from US law enforcement officers, animal tests and currently available data pertaining to military combatants has shown that BFD can not only cause minor injuries, but also result in serious trauma. However, the nature and severity of injuries sustained depends on a multitude of factors including the projectile type, the impact location and velocity, and the specific type of body armour worn. The difficulties involved in current measurement techniques for ballistic testing has led researchers to seek alternative techniques to evaluate the level of protection from body armour, such as the finite element (FE) method. In the current study, a systematic review of the open literature was undertaken using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses methodology. The aim was to summarise the literature pertaining to the development and application of FE models to investigate body armour BFD and behind armour blunt trauma (BABT), and included FE models representing the projectile, clay-based mediums, ballistic gelatine and the human torso. Using the keywords \'behind armour*\', \'ballistic blunt trauma\', \'BABT\', \'backface signature\', \'backface deformation\', \'BFS\', \'BFD\', \'wound ballistic\', \'ballistic impact testing\', \'body armour\', \'bullet proof vest\', \'ballistic vest\', \'Finite Element*\' and \'FE\', an electronic database search of EBSCOhost, Google Scholar, ProQuest, Scopus, Standards, Web of Science and PubMed was conducted, and included peer-reviewed journal articles, review papers, research reports, conference papers, and MSc or PhD theses. While this research demonstrates the potential of FE analysis for recreating realistic blunt impact scenarios and enhancing the current understanding of BABT mechanisms, a common limitation in most studies is the lack of validation. Thus, in order to address this issue, it is proposed that injury predictions from FE models be correlated with trauma data from soldiers who have sustained BABT. Consequently, pressure and energy distributions within the organs can be used to interpret the effects of non-penetrating ballistic impacts on the human torso. Bridging the gap between simulation and real-world data is essential in order to validate FE models and enhance their utility in optimising body armour design and employing injury mitigation strategies.

External Fixators are a common technique used to treat a variety of issues related to bones, predominantly due to its non-intrusive nature and versatility in terms of form and materials. While it is mainly used to treat open fractures, its other uses include limb lengthening, deformity correction, bone grafting, compression of non-unions and stabilization of dislocations. Its earliest use dates as far back as 400 BCE and has undergone significant improvements, focusing on both customization and optimization. These two aspects highlight the significance of complementing the orthopaedic requirements with engineering knowledge and its applications. Hence, this review paper aims to conduct an examination of recent developments of external fixators with a special focus on its structure, the usage of materials and biomechanical investigations using experimental and numerical techniques. The paper presents the existing level of engineering knowledge with regards to these aspects and identifies research gaps, which can improve the quality of the commonly used external fixators.

Pressure ulcers (PUs) are a major public health challenge, having a significant impact on healthcare service and patient quality of life. Computational biomechanical modelling has enhanced PU research by facilitating the investigation of pressure responses in subcutaneous tissue and skeletal muscle. Extensive work has been undertaken on PUs on patients in the seated posture, but research into heel ulcers has been relatively neglected. The aim of this review was to address the key challenges that exist in developing an effective FE foot model for PU prevention and the confusion surrounding the wide range of outputs reported. Nine FE foot studies investigating heel ulcers in bedrest were identified and reviewed. Six studies modelled the posterior part of the heel, two included the calf and foot, and one modelled the whole body. Due to the complexity of the foot anatomy, all studies involved simplification or assumptions regarding parts of the foot structure, boundary conditions and material parameters. Simulations aimed to understand better the stresses and strains exhibited in the heel soft tissues of the healthy foot. The biomechanical properties of soft tissue derived from experimental measurements are critical for developing a realistic model and consequently guiding clinical decisions. Yet, little to no validation was reported in each of the studies. If FE models are to address future research questions and clinical applications, then sound verification and validation of these models is required to ensure accurate conclusions and prediction of patient outcomes. Recommendations and considerations for future FE studies are therefore proposed.

Scoliosis is a deformity of the spine that in severe cases requires surgical treatment. There is still disagreement among clinicians as to what the aim of such treatment is as well as the optimal surgical technique. Numerical models can aid clinical decision-making by estimating the outcome of a given surgical intervention. This paper provided some background information on the modelling of the healthy spine and a review of the literature on scoliotic spine models, their validation, and their application. An overview of the methods and techniques used to construct scoliotic finite element and multibody models was given as well as the boundary conditions used in the simulations. The current limitations of the models were discussed as well as how such limitations are addressed in non-scoliotic spine models. Finally, future directions for the numerical modelling of scoliosis were addressed.

In recent decades, nonlinear damping identification (NDI) in structural dynamics has attracted wide research interests and intensive studies. Different NDI strategies, from conventional to more advanced, have been developed for a variety of structural types. With apparent advantages over classical linear methods, these strategies are able to quantify the nonlinear damping characteristics, providing powerful tools for the analysis and design of complex engineering structures. Since the current trend in many applications tends to more advanced and sophisticated applications, it is of great necessity to work on developing these methods to keep pace with this progress. Moreover, NDI can provide an effective and promising tool for structural damage detection purposes, where the changes in the dynamic features of structures can be correlated with damage levels. This review paper provides an overview of NDI methods by explaining the fundamental challenges and potentials of these methods based on the available literature. Furthermore, this research offers a comprehensive survey of different applications and future research trends of NDI. For potential development and application work for nonlinear damping methods, the anticipated results and recommendations of the current paper can assist researchers and developers worldwide to find out the gaps and unsolved issues in the field of NDI.

Compression therapy is an adjuvant physical intervention providing the benefits of calibrated compression and controlled stretch and consequently is increasingly applied for the treatment of chronic venous insufficiency. However, the mechanism of the compression therapy for chronic venous insufficiency is still unclear. To elaborate the mechanism of compression therapy, in recent years, the computational modelling technique, especially the finite element modelling method, has been widely used. However, there are still many unclear issues regarding the finite element modelling of compression therapy, for example, the selection of appropriate material models, the validation of the finite element predictions, the post-processing of the results. To shed light on these unclear issues, this study provides a state-of-the-art review on the application of finite element modelling technique in the compression therapy for chronic venous insufficiency. The aims of the present study are as follows: (1) to provide guidance on the application of the finite element technique in healthcare and relevant fields, (2) to enhance the understanding of the mechanism of compression therapy and (3) to foster the collaborations among different disciplines. To achieve these aims, the following parts are reviewed: (1) the background on chronic venous insufficiency and the computational modelling approach, (2) the acquisition of medical images and the procedure for generating the finite element model, (3) the definition of material models in the finite element model, (4) the methods for validating the finite element predictions, (5) the post-processing of the finite element results and (6) future challenges in the finite element modelling of compression therapy.

The paper aims to provide a state-of-the-art review of methods for evaluating the effectiveness and effect of unloader knee braces on the knee joint and discuss their limitations and future directions. Unloader braces are prescribed as a non-pharmacological conservative treatment option for patients with medial knee osteoarthritis to provide relief in terms of pain reduction, returning to regular physical activities, and enhancing the quality of life. Methods used to evaluate and monitor the effectiveness of these devices on patients\' health are categorized into three broad categories (perception-, biochemical-, and morphology-based), depending upon the process and tools used. The main focus of these methods is on the short-term clinical outcome (pain or unloading efficiency). There is a significant technical, research, and clinical literature gap in understanding the short- and long-term consequences of these braces on the tissues in the knee joint, including the cartilage and ligaments. Future research directions may complement existing methods with advanced quantitative imaging (morphological, biochemical, and molecular) and numerical simulation are discussed as they offer potential in assessing long-term and post-bracing effects on the knee joint.