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Advances in Intelligent Systems and Computing 1223
Marek Gzik · Zbigniew Paszenda ·

Ewa Pietka · Ewaryst Tkacz ·
Krzysztof Milewski Editors
Innovations
in Biomedical
Engineering
Advances in Intelligent Systems and Computing
Volume 1223
Series Editor
Janusz Kacprzyk, Systems Research Institute, Polish Academy of Sciences,
Warsaw, Poland
Advisory Editors
Nikhil R. Pal, Indian Statistical Institute, Kolkata, India
Rafael Bello Perez, Faculty of Mathematics, Physics and Computing,
Universidad Central de Las Villas, Santa Clara, Cuba
Emilio S. Corchado, University of Salamanca, Salamanca, Spain
Hani Hagras, School of Computer Science and Electronic Engineering,
University of Essex, Colchester, UK
László T. Kóczy, Department of Automation, Széchenyi István University,
Gyor, Hungary
Vladik Kreinovich, Department of Computer Science, University of Texas
at El Paso, El Paso, TX, USA
Chin-Teng Lin, Department of Electrical Engineering, National Chiao
Tung University, Hsinchu, Taiwan
Jie Lu, Faculty of Engineering and Information Technology,
University of Technology Sydney, Sydney, NSW, Australia
Patricia Melin, Graduate Program of Computer Science, Tijuana Institute
of Technology, Tijuana, Mexico
Nadia Nedjah, Department of Electronics Engineering, University of Rio de Janeiro,
Rio de Janeiro, Brazil
Ngoc Thanh Nguyen , Faculty of Computer Science and Management,
Wrocław University of Technology, Wrocław, Poland
Jun Wang, Department of Mechanical and Automation Engineering,
The Chinese University of Hong Kong, Shatin, Hong Kong
The series “Advances in Intelligent Systems and Computing” contains publications
on theory, applications, and design methods of Intelligent Systems and Intelligent
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More information about this series at http://www.springer.com/series/11156

Marek Gzik Zbigniew Paszenda
• •
Ewa Pietka Ewaryst Tkacz

• •
Krzysztof Milewski
Editors
Innovations in Biomedical
Engineering
123
Editors
Marek Gzik Zbigniew Paszenda
Faculty of Biomedical Engineering/ Faculty of Biomedical Engineering/
Department of Biomechatronics Department of Biomaterials
Silesian University of Technology and Medical Devices Engineering
Zabrze, Poland Silesian University of Technology
Zabrze, Poland
Ewa Pietka
Faculty of Biomedical Engineering/ Ewaryst Tkacz
Department of Informatics Faculty of Biomedical Engineering/
and Medical Devices Department of Biosensors
Silesian University of Technology and Processing of Biomedical Signals
Zabrze, Poland Silesian University of Technology
Zabrze, Poland
Krzysztof Milewski
American Heart of Poland
Katowice, Poland
The Jerzy Kukuczka Academy
of Physical Education
Katowice, Poland
ISSN 2194-5357 ISSN 2194-5365 (electronic)

Advances in Intelligent Systems and Computing
ISBN 978-3-030-52179-0 ISBN 978-3-030-52180-6 (eBook)
https://doi.org/10.1007/978-3-030-52180-6
© The Editor(s) (if applicable) and The Author(s), under exclusive license to Springer Nature
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Contents
Modelling and Simulations in Biomechanics

Three-Dimensional Printing of Bone Models . . . . . . . . . . . . . . . . . . . . . 3
Angela Andrzejewska
Isogeometric Shell Analysis of the Human Abdominal Wall . . . . . . . . . 11
Bartosz Borzeszkowski, Thang X. Duong, Roger A. Sauer,
and Izabela Lubowiecka
Comparison of the Bone Segments Displacement Between Two Sides
of the Mandible After BSSO . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19
Dominik Pachnicz and Agnieszka Szust
Evaluation of Transverse Abdominal Muscles Impact on Body
Posture . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 29
Bożena Gzik-Zroska, Janusz Kocjan, Katarzyna Nowakowska,
Patrycja Purgoł, Michał Burkacki, Sławomir Suchoń, Kamil Joszko,
Robert Michnik, and Mariusz Adamek
A Comparative Study of Biclustering Algorithms of Gait Data . . . . . . . 39
Katarzyna Minta-Bielecka, Jolanta Pauk, and Agnieszka Wasilewska
Assessment of Changing the Radial Forces of Biodegradable Stent
in One Month Time Interval . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 47
Kamil Joszko, Bożena Gzik-Zroska, Marek Gzik, Wojciech Wolański,
Agata Iskra, Michał Burkacki, Sławomir Suchoń, Robert Sobota,
and Arkadiusz Szarek
Examination of the Impact of Vertebral Displacement on the Surface
Area of Intervertebral Foramina . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 55
Paweł Drapikowski, Jakub Otworowski, Adam Gramala,
and Żaneta Kurowska
v
vi Contents
The Use of Hyperelastic Material Models for Estimation of Pig Aorta

Biomechanical Behavior . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 63
Sylwia Łagan and Aneta Liber-Kneć
Initial Report on Numerical Modeling of Blood Flow in Myocardial
Bridge Region of Coronary Artery: Concept of Model Validation . . . . . 71
Bartłomiej Melka, Marcin Nowak, Marek Rojczyk, Maria Gracka,
Wojciech Adamczyk, Ziemowit Ostrowski, and Ryszard Białecki
Analysis of Displacements Within the Base of Mandible
and Mandibular Angle . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 81
Anna Wybraniec and Agnieszka Szust
Simulation Investigation of Occlusal Loads Transfer in Personalized
Titanium Plates in the Case of Jaw Osteotomy . . . . . . . . . . . . . . . . . . . 89
Grzegorz Bobik, Jarosław Żmudzki, and Tomasz Tański
Experimental Research in Biomedical Engineering

Innovations of Wireless Capsule Robots in Gastrointestinal
Endoscopy: A Review . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 99
Ahmad Athif Mohd Faudzi, Yaser Sabzehmeidani,
and Naif Khalaf Al-Shammari
Analysis of Dynamics of the Blast Mitigation Seat . . . . . . . . . . . . . . . . . 111
Sławomir Kciuk, Grzegorz Bienioszek, and Edyta Krzystała
Separation of Cancer Cells on Graphene Coated Micro-Sieves . . . . . . . 121
Barbara Nasiłowska, Artur Kowalik, Zdzisław Bogdanowicz,
Krzysztof Gruszyński, Kinga Hińcza, Aneta Bombalska, Antoni Sarzyński,
Zygmunt Mierczyk, and Stanisław Góźdź
Variability of Postural Stability Parameters Under the Influence
of School Backpack Load in Children Aged 10 Years . . . . . . . . . . . . . . 131
Szyszka Paulina, Małgorzata Lichota, and Krystyna Górniak
Use of 3D Printing in Designing Sensor Overlays Used to Determine
the Foot Pressure Distribution on the Ground . . . . . . . . . . . . . . . . . . . . 139
Sławomir Duda, Grzegorz Gembalczyk, Tomasz Machoczek,
and Przemysław Szyszka
Impact of Footwear Used in Orthoses on the Kinematics of Locomotor
Functions and Energy Expenditure—Case Study . . . . . . . . . . . . . . . . . . 147
Katarzyna Jochymczyk-Woźniak, Katarzyna Nowakowska,
Anna Zakałużna-Żerebecka, and Robert Michnik
Changes in Thickness Versus Shear Modulus in Ultrasound Lateral
Abdominal Muscle Measurements During Isometric Contraction:
A Case Report . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 157
Paweł Linek and Tomasz Wolny
Contents vii
Analysis of Ground Reaction Forces and Kinematic Response

to Gait Perturbation During Mid- to Terminal Stance Phase
of the Gait Cycle . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 165
Barbara Łysoń-Uklańska, Joanna Ścibek, Katarzyna Bienias,
and Andrzej Wit
Hand Grip Strength and Suppleness as Progress Determinants
in Female Pole Dancers’ Training . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 175
Barbara Mikula, Sabina Wolny, Katarzyna Nowakowska,
Agata Guzik-Kopyto, Iwona Chuchnowska, and Robert Michnik
Interactive Mat an Innovative Implementation for the Rehabilitation
of Disabled Children . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 185
Bartłomiej Burlaga, Monika Osińska, Paulina Gembara,
Ewelina Smółkowska, Tomasz Merda, and Maciej Gorzkowski
Analysis of the Ability to Maintain the Balance of Veterans
of Stabilization Missions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 197
Piotr Wodarski, Jacek Jurkojć, Marta Chmura, Andrzej Bieniek,
Agata Guzik-Kopyto, and Robert Michnik
Influence of Body Tattoo on Thermal Image—A Case Report . . . . . . . . 209
Bartłomiej Zagrodny, Łukasz Kaczorowski, and Jan Awrejcewicz
Technology as a Support for Rehabilitation Patients After Stroke . . . . . 215
Damian Kania, Patrycja Romaniszyn, Anna Mańka, Daniel Ledwoń,
Anna Łysień, Agnieszka Nawrat–Szołtysik, Marta Danch–Wierzchowska,
Robert Michnik, Andrzej Mitas, and Andrzej Myśliwiec
Engineering of Biomaterials
The Surface Topography and Physicochemical and Mechanical
Properties of Pure Titanium (CP Ti) Manufactured by Selective
Laser Melting (SLM) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 229
Anna Woźniak, Marcin Adamiak, and Bogusław Ziębowicz
Evaluation of Mechanical Properties of Hernia Surgical Mesh
Implants . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 239
Julia Lisoń, Marcin Basiaga, Zbigniew Paszenda, Damian Nakonieczny,
Witold Walke, and Magdalena Antonowicz
Investigation of the Mechanical Properties of PLA as a Material
for Patient-Specific Orthopaedic Equipment . . . . . . . . . . . . . . . . . . . . . . 247
Adam Gramala, Jakub Otworowski, Adam Patalas, Piotr Kulczewski,
and Paweł Drapikowski
viii Contents
Study of Physicochemical Properties of CoCrMo Alloy with PLCL

Polymer Coating Intended for Urology . . . . . . . . . . . . . . . . . . . . . . . . . 259
Wojciech Kajzer, Paulina Niścior, Anita Kajzer, Marcin Basiaga,
Janusz Szewczenko, Joanna Jaworska, Katarzyna Jelonek,
and Janusz Kasperczyk
Study of Strength and Fatigue of Stainless Steel and Titanium
Plates . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 269
Anita Kajzer, Sabina Niedźwiedź, Wojciech Kajzer, Jan Marciniak,
Bożena Gzik-Zroska, Kamil Joszko, Marcin Kaczmarek,
and Zbigniew Pilecki
Effect of Carbon Layers Deposited by PACVD and RMS Methods
on Corrosion Resistance of Ni-Ti Alloy . . . . . . . . . . . . . . . . . . . . . . . . . 279
Marcin Kaczmarek, Przemysław Kurtyka, Zbigniew Paszenda,
and Marcin Basiaga
Characterization of 3D Printed PLA Scaffolds Through Experimental
and Modeling Approaches . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 289
Aneta Liber-Kneć, Sylwia Łagan, Agnieszka Chojnacka-Brożek,
and Szymon Gądek
Shockwave-Generating Interdisciplinary Methods Used to Elaborate
Acellular Tissue Origin Extracellular Matrix . . . . . . . . . . . . . . . . . . . . . 299
Gabriela Imbir, Roman Major, Aldona Mzyk, Piotr Wilczek, Marek Sanak,
Marek Strzelec, Roman Ostrowski, and Antoni Rycyk
The Study of Electrochemical Properties of Surface Modified Casting
Alloys Used in Dental Prosthetics . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 311
Anna Ziębowicz, Anna Woźniak, Bogusław Ziębowicz,
Grzegorz Chladek, Paulina Boryło, and Witold Walke
Informatics and Signal Analysis in Medicine

Automated Classification of Axial CT Slices Using Convolutional
Neural Network . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 329
Paweł Badura, Jan Juszczyk, Paweł Bożek, and Michał Smoliński
rsfMRI Study of Sensimotor Cortex in Multiple Sclerosis (MS)
Using Independent Component Analysis (ICA) in GIFT Toolbox
with Infomax Algorithm . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 337
Ilona Karpiel and Zofia Drzazga
Reconstruction of True Fetal Heart Rate Signals Obtained
via Ultrasound Bedside Monitor in Relation to Fetal
Electrocardiography . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 351
Tomasz Kupka, Adam Matonia, Krzysztof Horoba, Janusz Wrobel,
and Slawomir Graczyk
Contents ix
Segmentation and Registration of High-Frequency Ultrasound Images

of Superficial Veins . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 361
Bartłomiej Pyciński and Joanna Czajkowska
3D Thermal Volume Reconstruction from 2D Infrared
Images—a Preliminary Study . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 371
Agata Sage, Daniel Ledwoń, Jan Juszczyk, and Paweł Badura
Influence of Music on HRV Indices Derived from ECG and SCG . . . . . 381
Szymon Sieciński and Paweł Kostka
Author Index . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 391

Modelling and Simulations
in Biomechanics
Three-Dimensional Printing of Bone
Models
Angela Andrzejewska
Abstract The trabecular bone occurs, for example, in the femoral heads. Under-
standing the phenomenon of bone tissue degeneration can be the basis for the possi-
bility of looking for alternative methods of surgical treatment of bone loss. The paper
presents the results of the trabecular bone model, which was produced in additive
manufacturing method with fused filament fabrication technology. The verification
of the mechanical behavior of the trabecular bone model was based on the analysis of
uniaxial compression test. The model was also conditioned under degradation pro-
cess to determine the influence of the physiological fluid environment due to changes
in the mechanical response of the modeled bone. The obtained results showed that the
mechanical strength of the proposed spongy bone model and the method of its pro-
duction allow to obtain strength values close to the natural spongy bone. In addition,
the strength did not change during the 4-week degradation process.
Keywords 3D printing · Bone · Mechanical testing · Hydrolytic degradation
1 Introduction
Bones in terms of architecture aren’t homogeneous tissues. The surface part of the
long bone shaft is a compacted bone, while in the heads of long bones, as well as
in the interior of flat, irregular bone and short bones, the trabecular tissue is located.
The trabecular tissue spongy consists of a network of connecting beams. The beams
are crossed by arcs, which are significantly different in terms of thickness and shape.
The architecture of bone beams allows the transfer of loads in the backbone system.
A. Andrzejewska (B)
Institution is Gdansk University of Technology, Narutowicza 11/12, 80-233 Gdansk, Poland
e-mail: angela.andrzejewska@pg.edu.pl
© The Editor(s) (if applicable) and The Author(s), under exclusive license 3
to Springer Nature Switzerland AG 2021
M. Gzik et al. (eds.), Innovations in Biomedical Engineering,
Advances in Intelligent Systems and Computing 1223,
https://doi.org/10.1007/978-3-030-52180-6_1
4 A. Andrzejewska
The authors of the study [12] have shown that certain factors, e.g., menopause,
can significantly contribute to a faster loss of trabecular bone tissue. Resorption of
the trabecular bone tissue, in this case follow into the interruption of connections
between structural elements. This phenomenon causes a disproportionate loss of
strength, in which only the beams with a larger thickness can partially compensate
for the transferred loads.
The persistent and irreversible degradation of natural bone tissue observed for
years has meant that many researchers are now looking for new methods of replacing
bone defects. Currently, research on the possibilities of replacing bone defects are
carried out in orthopedics and traumatology [8, 22], dentistry [23], reconstructive
surgery [10], pharmacy [13], or tissue engineering [20, 21].
The possibility of using the techniques of Additive Manufacturing of materials
for filling bone defects is very popular. Due to the type of transferred loads, these
3D printed structures can be made of metal materials, such as titanium [7], polymers
[15, 16] or ceramic–polymer composites [6, 24].
The research plan proposed in this paper is based on the application of additive
manufacturing of biodegradable polymer technology. The trabecular bone models
were made with the Fused Filament Fabrication method. Therefore, an overview of
the current state of knowledge in the production of bone models was limited to the
analysis of works in which scaffolds made of polymers were tested.
In paper [14], scaffolds with dimensions of 10 mm × 10 mm × 3 mm were tested.
The investigated scaffolds were made of both polylactic acid (PLA) and acrylonitrile
butadiene styrene (ABS). The volume of scaffolds contained 0.7 mm × 0.7 mm ×
3.5 mm pores. These constructs were used for research with chondrocytes, which
were carried out for a period of 21 days. The work showed that the proposed scaf-
folds were characterized by good mechanical properties, and the cultured cells were
characterized by high durability.
Whereas in work [17] the orthogonal scaffolds were used, in which the distances
between single layers were 0.5 mm and their diameter was 0.07 mm. Scaffolds with a
displaced double structure were also tested. In the second case, the distance between
the layers was 0.25 mm. Scaffolds made of PLA were tested for structural, mechanical
and surface properties. The adhesion of cells cultured on their surface was also
evaluated. The study proved that scaffolds functionality depends not only on the
fabrication technique. In this case, it is also important the type of material which was
used to build the 3D structure. Besides, the geometry and inner architecture of the
structure influence the final surface properties.
In the next study [1], bone scaffolds were made of polycaprolactone (PCL). Scaf-
folds were made using electrohydrodynamic (EHD) technology. Scaffolds with nom-
inal dimensions of 60 mm × 60 mm × 2 mm was used for the investigation. The
porosity of the tested model was determined at 78%, and the pore size was approxi-
mately 0.3 mm. The study proved that using PCL scaffolds it was possible to become
a matrix with considerable porosity. Also thanks to the proposed structure, the high
survivability of osteoblast-like cells (MG63) has been maintained. Nevertheless, the
EHD method has some technical limitations. In connection with the use of an electric
charge, previously produced layers of material may be destroyed.
Three-Dimensional Printing of Bone Models 5
The paper [9] presents the results of tests carried out on scaffolds made with
using the Stereolithography (SLA) technique. Two types of scaffolds with geometry
10 mm × 10 mm × 3 mm were tested, where the thickness of a single layer was
0.3 mm. The first type of scaffolds had square pores sized from 0.4 mm to 1 mm,
while the second type of scaffolds were constructs with hexagonal pores with a
radius of 0.6 mm. Three materials were used for the scaffolds production, where
biomaterial was poly(propylene fumarate) (PPF), solvent—diethyl fumarate (DEF)
and the photoinitiator—bisacrylphosphrine oxide (BAPO). The optimal production
conditions for the biomaterial were determined on the basis of the conducted tests, and
the SLA method brought promising results in the manufacturing field of biomedical
solutions. The disadvantage of the technology used was the fact that excess resin was
not always effectively removed. As a result, the scaffolds pore size was reduced.
The accomplished review of the current state of knowledge showed that researchers
in their investigations a square scaffolding with various geometry. The side lengths
were ranging from 0.7 to 60 mm. Also, the total thickness of the tested scaffolds
ranged from 2 to 3 mm. Various polymeric materials such as PLA, ABS, PCL, or
PPF were used for the tests. In the presented cases, the proposed pore sizes ranging
from 0.3 to 1 mm were easily obtained with each presented manufacturing method.
Furthermore, in tests conducted with the use of live cells, their high survival rate was
achieved.
Based on the review of the current research results, the purpose of the work
was defined. The purpose of the work was to determine how the behavior of the
mechanical trabecular bone model changes under the influence of the simulated
physiological fluid environment in the compression load conditions.
2 Materials and Methods
The implementation of the work objective was possible by applying the proposed
research methodology. The trabecular bone models were made in Additive Man-
ufacturing technology in process of Fused Filament Fabrication (FFF) from the
biodegradable PLA filament called 3DXPLA007 (Sigma-Aldrich, St. Louis, MO,
USA). Bone models with geometry according to patent-pending P.427872 (Patent
Office of the Republic of Poland, 11/23/2018) were made on the 3D Kreator Motion
device (Krakow, Poland).
The trabecular bone model was printed on the raft, and the geometry of the physical
model was characterized by one contour path and one layer of bottom and one layer
of top. The interior of the bone model was characterized by free spaces, divided by
thin-film channels between upper and bottom hexagonal holes.
The manufacturing process was run at 65◦ C of table temperature and at 200◦ C
of extrusion temperature. Other important parameters of the printing were a nozzle
diameter of 1.75 mm and a single layer height of 0.1 mm. In Fig. 1 is schematic
presented the examined trabecular bone model . The dimensions of the tested model
6 A. Andrzejewska
Fig. 1 Schematic representation of investigated trabecular bone model
were 20 mm × 20 mm × 4 mm, and the hexagonal holes were inscribed in a circle

with a diameter of 2 mm.
The physical trabecular bone models made in the FFF process were conditioned
under hydrolytic degradation in vitro for a period of 1–4 weeks. The degradation
medium was buffered sodium chloride with pH = 7.1 was used. The degradation
medium was heated to a temperature of 37 ± 1◦ C [2, 3].
The models of the trabecular bone before placement in the degradation medium,
followed by mechanical tests, were subjected to geometry and mass change evalua-
tion.
The mass control was carried out with the analytical balance AS 220.X2, RAD-
WAG (Radom, Poland). Based on mass changes of the trabecular bone models, the
percentage of medium uptake was determined [5]. Before measurements, each spec-
imen was dried with a paper towel no longer than 10 min.
The trabecular bone models were subjected to a monotonic compression test
before degradation (T0) and its subsequent stages, designated T1, T2, T3, and T4
respectively. Five specimens were tested in each study group. Mechanical tests were
carried out on the INSTRON ElectroPuls E3000 testing machine (Norwood, MA,
USA) equipped with an electromagnetic actuator with a load range of ±3 kN. The
traverse speed of the testing machine during the test was 1 mm/min. Direction of the
compression according to Fig. 1. was in the z-axis. Mechanical tests were carried out
to completely destroy the specimen.
The calculation of the statistical significance of the test results was prepared in
GraphPad Prism. The comparison of mass change (water uptake) and compressive
strength of the trabecular bone models was determined by the one-way ANOVA
test and post-hoc NIR test (LS Fisher’s LSD). The analysis was carried out at the
significance level of p < 0.05.
3 Results and Discussion
The average value of the cross section of the compressed specimen was 403 mm 2 .
Also, the obtained mean values of the initial mass (m 0 ), mean values of the specimen’s
mass after degradation (m 1 ), and the mean values of the percentage change in their
mass (Δm) are presented in Table 1.
The differences of mass change (water uptake) between the trabecular bone mod-
els were statistically significant at each degradation level (p = 0.0001).
The calculated values of differences between groups were ranging from 0.97% up to
7%. Based on the post-hoc test, it was noted that only for the comparison of results
reached in T0 versus T3, T1 versus T4, T2 versus T3 and T2 versus T4 the difference
between groups were statistically insignificant.
Also, to characterize the changes in the mechanical behavior of trabecular bone
models, they were investigated under static compression test. The compressive
strength of the trabecular bone models was determined based on the maximum value
of the compressive load. Obtained results of the compressive strength in MPa, its
standard deviation, median of values, minimum (Min.), and maximum (Max.) value
in the tested group and percentage coefficient of variation (VC) are summarized in
Table 2.
In the compression test, five trabecular bone models before and for each degra-
dation time were used. The percentage coefficient of variation (VC) of the results in
each investigated group of trabecular bone models was compared. In each investi-
gated group of trabecular bone models, the coefficient of the variation of the results
was less than 5%. Therefore, if the differences between individual measurements are
Table 1 Mean values of mass changes measurements of trabecular bone models, n = 5

Week m0, g m1, g Δm, %
T0 0.687 N/A 0.00
T1 0.694 0.742 6.88
T2 0.693 0.717 3.46
T3 0.695 0.710 2.20
T4 0.693 0.734 5.92
Table 2 Calculated values of compressive strength of trabecular bone models, Rc [MPa], n = 5

Week Mean ± STD Median Min. Max. VC
T0 5.90 ± 0.13 5.89 5.73 6.08 0.02
T1 5.84 ± 0.32 5.91 5.34 6.17 0.05
T2 5.86 ± 0.18 5.87 5.61 6.05 0.03
T3 5.63 ± 0.12 5.63 5.47 5.80 0.02
T4 5.81 ± 0.21 5.80 5.58 6.06 0.04
8 A. Andrzejewska
Fig. 2 Changes of compressive strength of trabecular bone models during hydrolytic degradation
smaller than 10%, then it should be considered that the differences between bone
models in the same group are statistically insignificant.
Furthermore, at the significance level α= 0.05, it was shown that the results
obtained in the compressive test were characterized by normal distribution. In Fig. 2
are shown box plots that present the distribution of statistical features of the deter-
mined compressive strength values.
The differences of results of compressive strength between the trabecular bone
models were statistically insignificant at each degradation level (p = 0.1587). The
calculated values of differences were smaller than 0.3 MPa. Based on the post-hoc
test, it was noted that only for the comparison of results reached in T1 versus T3
(p = 0.0374) the difference between groups were statistically significant.
4 Summary
The presented investigation of trabecular bone models gives promising results in

designing the synthetic bone models in additive manufacturing technology. The cal-
culated values of the proposed bone models are convergent with the results of natural
bone. The calculation values were based on the compressive strength of trabecular
bone which is ranging from 5 to 10 MPa [11, 18]. In further research, the proposed
bone model should be evaluated with fatigue test and compared to the results of
natural trabecular bone presented in [19].
Additionally the degradation studies of biodegradable polymer material, despite
a minimal decrease in compressive strength values, showed no statistically signif-
icant differences over the 4-week degradation time. The statistically insignificant
differences in compressive strength may be related to the fact that a biodegradable

polymer with a long degradation time was used for the investigation.
Also, the determined results of mass changes (water uptake) show that the parame-
ter can be strongly related to the manufacturing process and degradation time. A high
value of percentage water uptake determined in investigation of porous biomaterial,
in contrast to solid structures investigated in [2, 3], can be related to the method
of drying before measurements. In order to unequivocally confirm the amount of
the absorbed medium, it would be necessary to carry out absorption tests like was
presented in work [4].
The knowledge gained in the field of material behavior after degradation may
contribute to the design of further research, e.g., under changing environmental con-
ditions, where in addition to the degradation medium, cartilage, or bone cells and
substances affecting their survival may be used. Based on the presented research
results, the influence of the degradation medium based on changes in the mechanical
behavior of biodegradable trabecular bone models can potentially be excluded.
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Isogeometric Shell Analysis of the
Human Abdominal Wall
Bartosz Borzeszkowski, Thang X. Duong, Roger A. Sauer,

and Izabela Lubowiecka
Abstract In this paper, a nonlinear isogeometric Kirchhoff–Love shell model of the

human abdominal wall is proposed. Its geometry is based on in vivo measurements
obtained from a polygon mesh that is transformed into a NURBS surface, and then
used directly for the finite element analysis. The passive response of the abdominal
wall model under uniform pressure is considered. A hyperelastic membrane model
based on the Gasser–Ogden–Holzapfel tissue model is used together with the Koiter
bending model to describe the material behavior. Due to the mixed material formula-
tion, different sets of constitutive parameters are examined such that the influence of
each term is analyzed. The membrane contribution of the material model has a major
influence on the displacement magnitude and reflects more reliably the nonlinear
character of the deformation.
Keywords Abdominal wall · Biomechanics · Constitutive modeling ·

Isogeometric analysis · Kirchhoff–Love shell theory
B. Borzeszkowski (B) · I. Lubowiecka

Faculty of Civil and Environmental Engineering, Gdańsk University of Technology,
ul. Narutowicza 11/12, 80-233 Gdańsk, Poland
e-mail: bartosz.borzeszkowski@pg.edu.pl
I. Lubowiecka
e-mail: izabela.lubowiecka@pg.edu.pl
T. X. Duong · R. A. Sauer
Aachen Institute for Advanced Study in Computational Engineering Science (AICES),
RWTH Aachen University, Templergraben 55, 52056 Aachen, Germany
e-mail: duong@aices.rwth-aachen.de
R. A. Sauer
e-mail: sauer@aices.rwth-aachen.de
https://doi.org/10.1007/978-3-030-52180-6_2
12 B. Borzeszkowski et al.
1 Introduction
The abdominal wall has been investigated intensively during the past two decades,
especially in the context of hernia repair [1]. The mechanical complexity of this struc-
ture includes incompressible hyperelastic anisotropy [2–4], active–passive muscle
behavior [5], residual stresses [6], composite structure [7, 8], complex geometry with
nontrivial boundary conditions [9, 10], and many more, including patient-specific
variables, like tissue properties.
Different finite element and constitutive models have been considered so far, e.g.,
linear elastic orthotropic membranes [11] as well as 3D electromechanical continuum
models for the passive and active finite strain response of muscles [5]. CT and MRI
scans for detailed segmented geometry and ABAQUS® 3D hexahedral/tetrahedral
finite elements for the analysis is the primary modeling approach. [9, 12–14]. On the
other hand, the future need of patient-specific solutions in hernia repairs and potential
accessibility to the full-field in vivo optical measurements of the abdomen’s defor-
mation mean that efficient and computationally less expensive shell models of the
abdominal wall are necessary. This coincides with the renaissance of rotation-free
Kirchhoff–Love shell formulations in the context of Isogeometric Analysis (IGA)
[15, 16]. The isogeometric paradigm (same NURBS functions used both for CAD
modeling and FE analysis) induces high efficiency in the geometry-analysis work-
flow and novel refinement strategies, coherent with patient-specific applications [17].
With the use of Bézier extraction [18], isogeometric elements can be adapted to exist-
ing FE codes with no significant changes.
To the authors’ knowledge, it is the first time that the abdominal wall is modeled
with isogeometric shell finite elements. This approach matches the idea of patient-
specific modeling and is expected to be more practical than time consuming and
computationally expensive 3D solid models. Additionally, a novel mixed-material
model, described in the following section, is used, such that the membrane and shell
behavior can be distinguished.
2 A Constitutive Model for Biological Shell
The theoretical and computational shell formulation presented in [19, 20] is used. The
formulation is based on a fully nonlinear rotation-free Kirchhoff–Love shell model,
discretized with quadratic isogeometric finite elements. The constitutive relation
can be either obtained via projection of 3D material laws onto a two-dimensional
manifold [21], or directly derived from a 2D strain energy density function in the
form
W = W (aαβ , bαβ ) = W M (aαβ ) + W B (bαβ ) , (1)
where W M is the membrane part dependent on the surface metric aαβ and W B is
the bending part dependent on the curvature tensor bαβ [22]. Therefore, different
Isogeometric Shell Analysis of the Human Abdominal Wall 13
stress–strain relationships can be assigned for bending and stretching separately.

In this work, for a single biological shell layer with two families of embedded
fibers, a mixed formulation that combines the bending energy of the 2-parameter
(μK , ) Koiter model [23] and the membrane strain energy of the incompressible 5-
parameter (μGOH , k1 , k2 , κ, γ) Gasser–Ogden–Holzapfel (GOH) model [24] is used
such that

2
αβ αβ a αβ αβ a αβ αβ
τ = μGOH A − 2 +2 E i κ A − 2 + (1 − 3κ) L i , (2)
J i=1
J
αβ T2
M0 = trKAαβ + 2 μK K αβ , (3)
12
αβ
where τ αβ are the contra-variant components of the Kirchhoff stress tensor, M0
are the contra-variant bending moment components, μGOH/K is the 2D surface shear
modulus, K is the relative curvature tensor with contra-variant components K αβ ,
Aαβ are the contra-variant metric components of the undeformed surface, J is the
surface area change, T is the undeformed shell thickness, is a 2D Lamé constant, κ
is the fibers dispersion parameter, and L αβ are the contra-variant components of the
preferred fiber direction tensor, which is described in the local coordinates. Detailed
derivations of Eqs. (2) and (3) and their components can be found in [21] and [25],
respectively.
3 Abdominal Wall Analysis
3.1 Geometry of the Model
The considered model is based on the geometry obtained in [26], where the front part
of the human abdominal wall was measured in vivo. A net of points was transformed
into a polygon mesh, which was further modified into a single-patch NURBS surface.
The control point data was then transferred into the finite element code, where the
Bézier extraction procedure provided 7 × 7 quadratic isogeometric finite element
mesh (see Fig. 1). All boundary nodes were fixed and the load acting on the model
was a deformation following uniform pressure.
3.2 Constitutive and Model Parameters
Even though the GOH model has been used in abdominal wall modeling [14], its
parameters are not well calibrated in these structures. Therefore, parameters that were
Fig. 1 Geometry transfer from experimental data polygon mesh (left), via NURBS surface (middle)
to isogeometric FE shell model (right)
Table 1 Selection of parameters

Variable Definition Unit Value/range
GOH term
μ̃GOH 3D shear modulus kPa 0.5–10
k̃1 3D stress-like parameter kPa 1–10 000
k2 Fibers dimensionless parameter – 400
κ Fibers dispersion parameter – 1/3
γ Angle between fiber families deg 45
Koiter term
μ̃K 3D shear modulus kPa 1–20
˜ 3D Lamé constant kPa 330
Other
p IAP level Pa 1600
T Thickness cm 3.0
found, through a series of analyses, to have less influence on the deformation were
˜ while the remaining parameters μ̃GOH/K , k̃1 were chosen, such
fixed (T, κ, k2 , ),
that membrane-dominated and bending-dominated behavior could be observed. The
angle γ was chosen, such that two fiber families are orthogonal to each other (2γ =
90o ) and oriented along the linea alba. The thickness, from the reported range 3.0–
4.5 cm [10, 11, 27], was set to a constant 3 cm, while the pressure p was set to 1600
Pa, which is the reported intra-abdominal pressure (IAP) level (12 mmHG) during
laparoscopic surgery [9, 27]. The 3D shear modulus μ̃GOH/K and the Lamé constant
˜ were calculated from linear elasticity, based on the Young modulus range found
in [7, 10, 11, 27] and Poisson’s ratio ν = 0.49. The final selection of parameters is
presented in Table 1 and sets of parameters for the analysis are collected in Table 2.
Table 2 Considered sets of parameters

No. μ̃K (kPa) μ̃GOH (kPa) k̃1 (kPa)
Membrane-dominated
set1 1 0.5 1000
set2 1 5 1000
set3 1 5 10 000
set4 1 5 100
set5 1 10 10
set6 1 10 1000
Bending-dominated
set7 8 0.5 1
set8 20 0.5 1
set9 10 1 10
Balanced
set10 8 8 10
set11 8 8 100
set12 8 8 1000
set13 8 8 10 000
3.3 Results
The monitored node, the linea alba profile, and fiber orientation are shown in Fig. 2.
The finite element results for selected parameter sets are presented in Figs. 3 and 4.
Maximum displacement u max varies between 10 and 30 mm (sets 1–6, membrane-
dominated), 50–60 mm (sets 7–8, bending-dominated), and 10–40 mm (sets 10–13,
balanced). For comparison, u max reported in [9] was 19.9 mm (for IAP = 2260
Pa, 3D solid model, fiber-reinforced hyperelastic material), where the numerically
calculated deformation was in agreement with the evidenced one on physiological
abdomens in [11], i.e., u max = 16.7 mm (for IAP = 981 Pa, membrane model, linear
orthotropic material). A direct comparison is impossible due to different IAP levels,
geometry, material models and FE modeling considered by researchers. Therefore,
the obtained results serve as an overview of the material model capabilities in the
specific application of abdominal wall modeling.
4 Discussion and Conclusions
The isogeometric finite element shell model of the abdominal wall, based on in
vivo measurements is analyzed with the use of the mixed GOH/Koiter material
model. It is shown that the Koiter bending part only has a minor influence on the
Fig. 2 Deformed configuration (set4) with marked linea alba profile and the monitored node (left),
with plotted fiber directions L 1 , L 2 (right)
Fig. 3 Load–displacement curves for the monitored node (left) and the displacement profile along
the linea alba (right) for the membrane-dominated parameter sets
deformation, in comparison to the GOH membrane. It can thus be viewed merely

as a membrane-stabilizing term. This is beneficial in contrast to pure membranes,
where a pre-stretch is needed in order to stabilize them, which can interfere in the
analysis of the residual stresses. The initial stiffness (in the linear elastic regime) is
characterized by μ̃ (ground matrix), while the nonlinear stiffening effect is mainly
characterized by k̃1 (fibers), which is the typical behavior of fiber-reinforced soft
tissues. In order to judge if the proposed model of the composite structure of the
abdominal wall is reasonable, experimental load–displacement curves should be
examined and compared with computations. Also, a more detailed material model,
that accounts for the different material behaviors of various tissue layers, should be
Fig. 4 Load–displacement curves for the monitored node (left) and the displacement profile along
the linea alba (right) for the bending-dominated and balanced parameter sets
chosen. Future work should also focus on defining a heterogeneous distribution of

the parameters and identification method, e.g., via an inverse analysis [28, 29].
Acknowledgements This work has been partially supported by the National Science Centre
(Poland) under [Grant No. 2017/27/B/ST8/02518] and the German Science Foundation (DFG)
under grant GSC 111. Calculations have been carried out at the Academic Computer Centre in
Gdańsk.
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Comparison of the Bone Segments
Displacement Between Two Sides of the
Mandible After BSSO
Dominik Pachnicz and Agnieszka Szust
Abstract The aim of this study was to compare displacements on both sides of
the mandible after BSSO. Three different types of osteosynthesis were taken into
consideration: A, 6-hole closed miniplate; B, two 6-hole straight miniplates; and C,
8-hole open miniplate. Fixations were performed using conventional monocortical
screws. The distal segment of the mandible was advanced 4 mm forward. Model
loading was carried out on compressive test unit, simulation of 3-point biomechanical
model was performed. For all three methods, differences in displacement values on
both sides of the mandible appeared. The greatest dislocation values were observed
in proximal segments in transverse, horizontal axis. The differences in displacement
between sides of the bone reached 49, 115, and 354% for methods C, B, and A,
respectively. We found that asymmetrical work of bone fragments after orthognathic
procedure may result in postoperative complications.
Keywords BSSO · Miniplate · Monocortical fixation · Digital image correlation ·

Displacement
1 Introduction
Orthognathic surgeries are common procedures performed for the correction of

the maxillofacial skeleton deformities. Orthognathic procedures are carried out to
improve the dysfunction of the masticatory system, joint disorders, as well as for an
D. Pachnicz (B) · A. Szust

Wroclaw University of Science and Technology, W10/K4, Smoluchowskiego 25,
50-370 Wroclaw, Poland
e-mail: dominik.pachnicz@pwr.edu.pl
A. Szust
e-mail: agnieszka.szust@pwr.edu.pl
https://doi.org/10.1007/978-3-030-52180-6_3
20 D. Pachnicz and A. Szust
aesthetic reasons. For health-improvement treatments for the majority of patients

relief or stability in signs and symptoms are noticed [8]. Bilateral sagittal split
osteotomy (BSSO) is a basic procedure allowing on the repositioning of the dis-
tal segment of the mandible in three directions. The procedure consists of setting the
segment to the proper occlusal profile, keeping the proximal fragments in the correct
position within the glenoid fossa [9]. This versatile technique is usually utilized in the
treatment of microgenia and progenic mandible [8]. However, previous studies have
reported utilization of this method also in the correction of the mandible’s asymme-
try [6, 13, 15]. Similarly to all orthognathic surgeries, BSSO alters the geometry of
the bone. Therefore, it results in changes in the mandible’s biomechanics. Modifica-
tions, concerning temporomandibular joint loading conditions and jaw muscle work,
can lead to alteration in corresponding structures. Excessive pressure on the articular
disc and different position of the condylar process can be distinguished among the
negative effects on the temporomandibular joint (TMJ) [14].
During the procedure of BSSO, surgeon aims to ensure the final, correct relative
position of upper jaw and mandible. Nevertheless, asymmetrical work of fragments
on both sides after is highly possible. It could, therefore, be concluded that orthog-
nathic procedures affect the left and right side of the mouth with varying degrees.
Abgaje et al. [1] point on the link between the side of the mandible and frequency
occurrence of postsurgical complications. The authors associate possible explanation
of those differences with a surgeon’s varying performance, depending on side of the
jaw. Right-handed surgeons encounter difficulties assessing a patient’s left side and
vice versa. Additionally, differences between displacements can result from asymme-
try in bone geometry itself. All of those factors eventually may lead to abnormalities
in the treatment process, which may further result in malocclusion and complications.
Miniplates and screws for the past decades have been the gold standard in
osteosynthesis methods. This kind of fixation can provide sufficient stabilization
significant for the proper bone healing process, early recovery of mandibular func-
tion [10–12, 18]. A considerable amount of literature has been published on BSSO
fixations efficiency in vitro tests [10, 11, 21–23, 25, 26]. Previous studies, however,
mainly have based their criteria for selection on parameters like fixation stiffness,
yield load, and loading point displacement. The study offers some important, prelim-
inary insights into mandible segments dislocation analysis. The aim of this in vitro
study was to compare displacements on both sides of the mandible for 3 different
osteosynthesis methods after bilateral sagittal split osteotomy.
2 Materials and Methods
The main assumption during models preparation was recreating of the osteotomies
on both sides of the bone as precise as possible. Synthetic polyurethane replicas of
the human mandible Synbone 8951, which has been successfully used in a number
of researches were used in this study [5]. Models were pre-cut along lines coincided
with the Obwegeser osteotomy lines with Dal Pont modification. In all models, the
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From this thought I somehow got back to my previous ones, and the
longer I lay wakeful the more pronouncedly stern did they become. I am as
loyal and loving a son of the Fatherland as it will ever in all human
probability beget, but what son after a proper period of probation does not
like the ring on the finger, the finer raiment, the paternal embrace, and the
invitation to dinner? In other words (and quitting parable), what son after
having served his time among such husks as majors does not like promotion
to the fatted calves of colonels? For some time past I have been expecting it
every day, and if it is not soon granted it is possible that my patience may be
so changed to anger that I shall refuse to remain at my post and shall send in
my resignation; though I must say I should like a hit at the English first.
Once embarked on these reflections I could not again close my eyes, and
lay awake for the remaining hours of the night with as great a din going on
as ever I heard in my life. I have described this—the effect of heavy rain
when you are in a caravan—in that portion of the narrative dealing with the
night on Grip’s Common, so need only repeat that it resembles nothing so
much as a sharp pelting with unusually hard stones. Edelgard, if she did
indeed sleep, must be of an almost terrifying toughness, for the roof on
which this pelting was going on was but a few inches from her head.
As the cold dawn crept in between the folds of our window-curtains and
the noise had in no way abated, I began very seriously to wonder how I
could possibly get up and go out and eat breakfast under such conditions.
There was my mackintosh, and I also had galoshes, but I could not appear
before Frau von Eckthum in the sponge bag, and yet that was the only
sensible covering for my head. But what after all could galoshes avail in
such a flood? The stubble field, I felt, could be nothing by then but a lake; no
fire could live in it; no stove but would be swamped. Were it not better, if
such was to be the weather, to return to London, take rooms in some water-
tight boarding-house, and frequent the dryness of museums? Of course it
would be better. Better? Must not anything in the world be better than that
which is the worst?
But, alas, I had been made to pay beforehand for the Elsa, and had taken
the entire responsibility for her and her horse’s safe return and even if I
could bring myself to throw away such a sum as I had disbursed one cannot
leave a caravan lying about as though it were what our neighbours across the
Vosges call a mere bagatelle. It is not a bagatelle. On the contrary, it is a
huge and complicated mechanism that must go with you like the shell on the
poor snail’s back wherever you go. There is no escape from it, once you
have started, day or night. Where was Panthers by now, Panthers with its
kind and helpful little lady? Heaven alone knew, after all our zigzagging.
Find it by myself I certainly could not, for not only had we zigzagged in
obedience to the caprices of Mrs. Menzies-Legh, but I had walked most of
the time as a man in a dream, heeding nothing particularly except my
growing desire to sit down.
I wondered grimly as six o’clock drew near, the hour at which the rest of
the company usually burst into activity, whether there would be many
exclamations of healthy and jolly that day. There is a point, I should say, at
which a thing or a condition becomes so excessively healthy and jolly that it
ceases to be either. I drew the curtain of my bunk together—for a great
upheaval over my head warned me that my wife was going to descend and
dress—and feigned slumber. Sleep seemed to me such a safe thing. You
cannot make a man rise and do what you consider his duty if he will not
wake up. The only free man, I reflected with my eyes tightly shut, is the man
who is asleep. Pushing my reflection a little further I saw with a slight start
that real freedom and independence are only, then, to be found in the
unconscious—a race (or sect; call it what you will) of persons untouched by
and above the law. And one step further and I saw with another slight start
that perfect freedom, perfect liberty, perfect deliverance from trammels, are
only to be found in a person who is not merely unconscious but also dead.
These, of course, as I need not tell my hearers, are metaphysics. I do not
often embark on their upsetting billows for I am, principally, a practical man.
But on this occasion they were not as fruitless as usual, for the thought of a
person dead suggested at once the thought of a person engaged in going
through the sickness preliminary to being dead, and a sick man is also to a
certain extent free—nobody, that is, can make him get up and go out into the
rain and hold his umbrella over Jellaby’s back while he concocts his terrible
porridge. I decided that I would slightly exaggerate the feelings of
discomfort which I undoubtedly felt, and take a day off in the haven of my
bed. Let them see to it that the horse was led; a man in bed cannot lead a
horse. Nor would it even be an exaggeration, for one who has been wakeful
half the night cannot be said to be in normal health. Besides, if you come to
that, who is in normal health? I should say no one. Certainly hardly any one.
And if you appeal to youth as an instance, what could be younger and yet
more convulsed with apparent torment than the newly born infant? Hardly
any one, I maintain, is well without stopping during a single whole day. One
forgets, by means of the anodynes of work or society or other excitement;
but cut off a person’s means of doing anything or seeing any one and he will
soon find out that at least his head is aching.
When, therefore, Edelgard had reached the stage of tidying the caravan,
arranging my clothes, and emptying the water out of the window preparatory
to my dressing, I put the curtains aside and beckoned to her and made her
understand by dint of much shouting (for the rain still pelted on the roof) that
I was feeling very weak and could not get up.
She looked at me anxiously, and pushing up the sponge bag—at which
she stared rather stupidly—laid her hand on my forehead. I thought her hand
seemed hot, and hoped we were not both going to be ill at the same time.
Then she felt my pulse. Then she looked down at me with a worried
expression and said—I could not hear it, but knew the protesting shape her
mouth assumed: “But Otto——”
I just shook my head and closed my eyes. You cannot make a man open
his eyes. Shut them, and you shut out the whole worrying, hurrying world,
and enter into a calm cave of peace from which, so long as you keep them
shut no one can possibly pull you. I felt she stood there awhile longer
looking down at me before putting on her cloak and preparing to face the
elements; then the door was unbolted, a gust of wet air came in, the caravan
gave a lurch, and Edelgard had jumped into the stubble.
Only for a short time was I able to reflect on her growing agility, and how
four days back she could no more jump into stubble or anything else than
can other German ladies of good family, and how the costume she had
bought in Berlin and which had not fitted her not only without a wrinkle but
also with difficulty, seemed gradually to be turning into a misfit, to be
widening, to be loosening, and those parts of it which had before been
smooth were changing every day into a greater bagginess—I was unable, I
say, to think about these things because, worn out, I at last fell asleep.
How long I slept I do not know, but I was very roughly awakened by
violent tossings and heavings, and looking hastily through my curtains saw a
wet hedge moving past the window.
So we were on the march.
I lay back on my pillow and wondered who was leading my horse. They
might at least have brought me some breakfast. Also the motion was
extremely disagreeable, and likely to give me a headache. But presently,
after a dizzy swoop round, a pause and much talking showed me we had
come to a gate, and I understood that we had been getting over the stubble
and were now about to rejoin the road. Once on that the motion was not
unbearable—not nearly so unbearable, I said to myself, as tramping in the
rain; but I could not help thinking it very strange that none of them had
thought to give me breakfast, and in my wife the omission was more than
strange, it was positively illegal. If love did not bring her to my bedside with
hot coffee and perhaps a couple of (lightly boiled) eggs, why did not duty? A
fasting man does not mind which brings her, so long as one of them does.
My impulse was to ring the bell angrily, but it died away on my
recollecting that there was no bell. The rain, I could see, had now lightened
and thinned into a drizzle, and I could hear cheerful talk going on between
some persons evidently walking just outside. One voice seemed to be
Jellaby’s, but how could it be he who was cheerful after the night he must
have had? And the other was a woman’s—no doubt, I thought bitterly,
Edelgard’s, who, warmed herself and invigorated by a proper morning meal,
cared nothing that her husband should be lying there within a stone’s throw
like a cold, neglected tomb.
Presently, instead of the hedge, the walls and gates of gardens passed the
window, and then came houses, singly at first, but soon joining on to each
other in an uninterrupted string, and raising myself on my elbow and putting
two and two together, I decided that this must be Wadhurst.
It was. To my surprise about the middle of the village the caravan
stopped, and raising myself once more on my elbow I was forced
immediately to sink back again, for I encountered a row of eager faces
pressed against the pane with eyes rudely staring at the contents of the
caravan, which, of course, included myself as soon as I came into view from
between the curtains of the berth.
This was very disagreeable. Again I instinctively and frantically sought
the bell that was not there. How long was I to be left thus in the street of a
village with my window-curtains unclosed and the entire population looking
in? I could not get out and close them myself, for I am staunch to the night
attire, abruptly terminating, that is still, thank heaven, characteristic during
the hours of darkness of every honest German gentleman: in other words, I
do not dress myself, as the English do, in a coat and trousers in order to go to
bed. But on this occasion I wished that I did, for then I could have leaped out
of my berth and drawn the curtains in an instant myself, and the German
attire allows no margin for the leaping out of berths. As it was, all I could do
was to lie there holding the berth-curtains carefully together until such time
as it should please my dear wife to honour me with a visit.
This she did after, I should say, at least half an hour had passed, with the
completely composed face of one who has no reproaches to make herself,
and a cup of weak tea in one hand and a small slice of dry toast on a plate in
the other, though she knows I never touch tea and that it is absurd to offer a
large-framed, fine man one piece of toast with no butter on it for his
breakfast.
“What are we stopping for?” I at once asked on her appearing.
“For breakfast,” said she.
“What?”
“We are having it in the inn to-day because of the wet. It is so nice, Otto.
Table-napkins and everything. And flowers in the middle. And nothing to
wash up afterward. What a pity you can’t be there! Are you better?”
“Better?” I repeated, with a note of justified wrath in my voice, for the
thought of the others all enjoying themselves, sitting at a good meal on
proper chairs in a room out of the reach of fresh air, naturally upset me. Why
had they not told me? Why, in the name of all that was dutiful, had she not
told me?
“I thought you were asleep,” said she when I inquired what grounds she
had for the omission.
“So I was, but that——”
“And I know you don’t like being disturbed when you are,” said she,
lamely as I considered, for naturally it depends on what one is disturbed for
—of course I would have got up if I had known.
“I will not drink such stuff,” I said, pushing the cup away. “Why should I
live on tepid water and butterless toast?”
“But—didn’t you say you were ill?” she asked, pretending to be
surprised. “I thought when one is ill——”
“Kindly draw those curtains,” I said, for the crowd was straining every
nerve to see and hear, “and remove this stuff. You had better,” I added, when
the faces had been shut out, “return to your own breakfast. Do not trouble
about me. Leave me here to be ill or not. It does not matter. You are my wife,
and bound by law to love me, but I will make no demands on you. Leave me
here alone, and return to your breakfast.”
“But, Otto, I couldn’t stay in here with you before. The poor horse would
never——”
“I know, I know. Put the horse before your husband. Put anything and
anybody before your husband. Leave him here alone. Do not trouble. Go
back to your own, no doubt, excellent breakfast.”
“But Otto, why are you so cross?”
“Cross? When a man is ill and neglected, if he dare say a word he is
cross. Take this stuff away. Go back to your breakfast. I, at least, am
considerate, and do not desire your omelettes and other luxuries to become
cold.”
“It isn’t omelettes,” said Edelgard. “Why are you so unreasonable? Won’t
you really drink this?” And again she held out the cup of straw-coloured tea.
Then I turned my face to the wall, determined that nothing she could say
or do should make me lose my temper. “Leave me,” was all I said, with a
backward wave of the hand.
She lingered a moment, as she had done in the morning, then went out.
Somebody outside took the cup from her and helped her down the ladder,
and a conviction that it was Jellaby caused such a wave of just anger to pass
over me that, being now invisible to the crowd, I leaped out of my berth and
began quickly and wrathfully to dress. Besides, as she opened the door a
most attractive odour of I do not know what, but undoubtedly something to
do with breakfast in the inn, had penetrated into my sick chamber.
“ ’Ere ’e is,” said one of the many children in the crowd, when I emerged
dressed from the caravan and prepared to descend the steps; “ ’ere’s ’im out
of the bed.”
I frowned.
“Don’t ’e get up late?” said another.
I frowned again.
“ ’Ere ’e is”
“Don’t ’e look different now?” said a third.

I deepened my frown.
“Takes it easy ’e do, don’t ’e,” said a fourth, “in spite of pretendin’ to be
a poor gipsy.”
I got down the steps and elbowed my way sternly through them to the
door of the inn. There I paused an instant on the threshold and faced them,
frowning at them as individually as I could.
“I have been ill,” I said briefly.
But in England they have neither reverence nor respect for an officer. In
my own country if any one dared to speak to me or of me in that manner in
the street I would immediately draw my sword and punish him, for he would
in my person have insulted the Emperor’s Majesty, whose uniform I wore;
and it would be useless for him to complain, for no magistrate would listen
to him. But in England if anybody wants to make a target of you, a target
you become for so long as his stock of wit (heaven save the mark!) lasts. Of
course the crowd in Wadhurst must have known. However much my
mackintosh disguised me it was evident that I was an officer, for there is no
mistaking the military bearing; but for their own purposes they pretended
they did not, and when therefore turning to them with severe dignity I said:
“I have been ill,” what do you think they said? They said, “Yah.”
For a moment I supposed, with some surprise I confess, that they were
acquainted with the German tongue, but a glance at their faces showed me
that the expression must be English and rude. I turned abruptly and left these
boors: it is not part of my business to teach a foreign nation manners.
My frowns, however, were smoothed when I entered the comfortable
breakfast-room and was greeted with a pleasant chorus of welcome and
inquiries.
Frau von Eckthum made room for me beside her, and herself ministered
to my wants. Mrs. Menzies-Legh laughed and praised me for my
sensibleness in getting up instead of giving way. The breakfast was abundant
and excellent. And I discovered that it was the ever kind and thoughtful Lord
Sigismund who had helped Edelgard out of the caravan, Jellaby being
harmlessly occupied writing picture postcards to (I suppose) his constituents.
By the time I had had my third cup of coffee—so beneficial is the effect
of that blessed bean—I was able silently to forgive Edelgard and be ready to
overlook all her conduct since the camp by the Medway and start fresh
again; and when toward eleven o’clock we resumed the march, a united and
harmonious band (for the child Jumps was also that day restored to health
and her friends) we found the rain gone and the roads being dried up with all
the efficiency and celerity of an unclouded August sun.
That was a pleasant march. The best we had had. It may have been the
weather, which was also the best we had had, or it may have been the
country, which was undeniably pretty in its homely unassuming way—
nothing, of course, to be compared with what we would have gazed at from
the topmost peak of the Rigi or from a boat on the bosom of an Italian lake,
but very nice in its way—or it may have been because Frau von Eckthum
walked with me, or because Lord Sigismund told me that next day being
Sunday we were going to rest in the camp we got to that night till Monday,
and dine on Sunday at the nearest inn, or, perhaps it was all this mingled
together that made me feel so pleasant.
Take away annoyances and worry, and I am as good-natured a man as you
will find. More, I can enjoy anything, and am ready with a jest about almost
anything. It is the knowledge that I am really so good-humoured that
principally upsets me when Edelgard or other circumstances force me into a
condition of vexation unnatural to me. I do not wish to be vexed. I do not
wish ever to be disagreeable. And it is, I think, down-right wrong of people
to force a human being who does not wish it to be so. That is one of the
reasons why I enjoyed the company of Frau von Eckthum. She brought out
what was best in me, what I may be pardoned for calling the perfume of my
better self, because though it contains the suggestion that my better self is a
flower-like object it also implies that she was the warming and vivifying and
scent-extracting sun.
There is a dew-pond at the top of one of the hills we walked up that day
(at least Mrs. Menzies-Legh said it was a dew-pond, and that the water in it
was not water at all but dew, though naturally I did not believe her—what
sensible man would?) and by its side in the shade of an oak tree Frau von
Eckthum and I sat while the three horses went down to fetch up the third
caravan, nominally taking care of those already up but really resting in that
pretty nook without bothering about them, for of all things in the world a
horseless caravan is surely most likely to keep quiet. So we rested, and I
amused her. I really do not know about what in particular, but I know I
succeeded, for her oh’s became quite animated, and were placed with such
dexterous intelligence that each one contained volumes.
She was interested in everything, but especially so in what I said about
Jellaby and his doctrines, of which I made great fun. She listened with the
most earnest attention to my exposure of the fallacies with which he is
riddled, and became at last so evidently convinced that I almost wished the
young gentleman had been there too to hear me.
Altogether an agreeable, invigorating day; and when, about three o’clock,
we found a good camping ground in a wide field sheltered to the north by a
copse and rising ground, and dropping away in front of us to a most
creditable and extensive view, for the second time since I left Panthers I was
able to suspect that caravaning might not be entirely without its
commendable points.
CHAPTER XII
W E supped that night beneath the stars with the field dropping
downward from our feet into the misty purple of the Sussex Weald.
What we had for supper was chicken and rice and onions, and very
excellent it was. The wind had gone, and it was cold. It was like a night in
North Germany, where the wind sighs all day long and at sunset it suddenly
grows coldly and clearly calm.
These are quotations from a conversation I overheard between Frau von
Eckthum (oddly loquacious that night) and Jellaby, who both sat near where
I was eating my supper, supposed to be eating theirs but really letting it spoil
while they looked down at the Sussex Weald (I wish I knew what a Weald is:
Kent had one too) and she described the extremely flat and notoriously dull
country round Storchwerder.
Indeed I would not have recognized it from her description, and yet I
know it every bit as well as she can. Blue air, blue sky, blue water, and the
flash of white wings—that was how she described it, and poor Jellaby was
completely taken in and murmured “Beautiful, beautiful” in his foolish slow
voice, and forgot to eat his chicken and rice while it was hot, and little
guessed that she had laughed at him with me a few hours before.
I listened, amused but tolerant. We must not keep a pretty lady too
exactly to the truth. The first part of this chapter is a quotation from what I
heard her say (excepting one sentence), but my hearers must take my word
for it that it did not sound anything like as silly as one might suppose.
Everything depends on the utterer. Frau von Eckthum’s quasi-poetical way
of describing the conduct of our climate had an odd attractiveness about it
that I did not find, for instance, in my dear wife’s utterances when she too,
which she at this time began to do with increasing frequency, indulged in the
quasi-poetic. Quasi-poetic I and other plain men take to be the violent
tearing of such a word as rolling from its natural place and applying it to the
plains and fields round Storchwerder. A ship rolls, but fields, I am glad to
say, do not. You may also with perfect propriety talk about a rolling-pin in
connection with the kitchen, or of a rolling stone in connection with moss.
Of course I know that we all on suitable occasions make use of exclamations
of an appreciative nature, such as colossal and grossartig, but that is brief
and business-like, it is what is expected of us, and it is a duty quickly
performed and almost perfunctory, with one eye on the waiter and the
restaurant behind; but slow raptures, prolonged ones, raptures beaten out
thin, are not in my way and had not till then been in Edelgard’s way either.
The English are flimsier than we are, thinner blooded, more feminine, more
finnicking. There are no restaurants or Bierhalle wherever there is a good
view to drown their admiration in wholesome floods of beer, and not being
provided with this natural stopper it fizzles on to interminableness. Why,
Jellaby I could see not only let his supper get stone cold but forgot to eat it at
all in his endeavour to outdo Frau von Eckthum’s style in his replies, and
then Edelgard must needs join in too, and say (I heard her) that life in
Storchwerder was a dusty, narrow life, where you could not see the liebe
Gott because of other people’s chimney-pots.
Greatly shocked (for I am a religious man) I saved her from further
excesses by a loud call for more supper, and she got up mechanically to
attend to my wants.
Jellaby, however, whose idea seemed to be that a woman is never to do
anything (I wonder who is to do anything, then?) forestalled her with the
sudden nimbleness he displayed on such occasions, so surprising in
combination with his clothes and general slackness, and procured me a fresh
helping.
I thanked him politely, but could not repress some irony in my bow as I
apologized for disturbing him.
“Shall I hold your plate while you eat?” he said.
“Why, Jellaby?” I asked, mildly astonished.
“Wouldn’t it be even more comfortable if I did?” he asked; and then I
perceived that he was irritated, no doubt because I had got most of the
cushions, and he, Quixotic as he is, had given up his to my wife, on whom it
was entirely thrown away for she has always assured me she actually prefers
hard seats.
Well, of course there were few things in the world quite so unimportant as
Jellaby’s irritation, so I just looked pleasant and at the food he had brought
me; but I did not get another evening with Frau von Eckthum. She sat
immovable on the edge of the slope with my wife and Jellaby, talking in
tones that became more and more subdued as dusk deepened into night and
stars grew hard and shiny.
They all seemed subdued. They even washed up in whispers. And
afterward the very nondescripts lay stretched out quite quietly by the
glowing embers of Lord Sigismund’s splendid fire listening to Menzies-
Legh’s and Lord Sidge’s talk, in which I did not join for it was on the subject
they were so fond of, the amelioration of the condition of those dull and
undeserving persons, the poor.
I put my plate where somebody would see it and wash it, and retired to
the shelter of a hedge and the comfort of a cigar. The three figures on the
edge of the hill became gradually almost mute. Not a leaf in my hedge
stirred. It was so still that people talking at the distant farm where we had
procured our chickens could almost be understood, and a dog barking
somewhere far away down in the Weald seemed quite threateningly near. It
was really extraordinarily still; and the stillest thing of all was that strange
example of the Englishwoman grafted on what was originally such excellent
German stock, Mrs. Menzies-Legh, sitting a yard or two away from me, her
hands clasped round her knees, her face turned up as though she were
studying astronomy.
I do not suppose she moved for half an hour. Her profile seemed to shine
white in the dusk with lines that reminded me somehow of a cameo there is
in a red velvet case lying on the table in our comfortable drawing-room at
Storchwerder, and the remembrance brought a slight twinge of home-
sickness with it. I shook this off, and fell to watching her, and for the
amusement of an idle hour lazily reconstructed from the remnants before me
what her appearance must have been ten years before in her prime, when
there were at least undulations, at least suggestions that here was a woman
and not a kind of elongated boy.
The line of her face is certainly quite passable; and that night in the half
darkness it was quite as passable as any I have seen on a statue—objects in
which I have never been able to take much interest. It is probable she used to
be beautiful. Used to be beautiful? What is the value of that? Just a snap of
the fingers, and nothing more. If women would but realize that once past
their first youth their only chance of pleasing is to be gentle and rare of
speech, tactful, deft—in one word, apologetic, they would be more likely to
make a good impression on reasonable men such as myself. I did not wish to
quarrel with Mrs. Menzies-Legh and yet her tongue and the way she used it
put my back up (as the British say) to a height it never attains in the placid
pools of feminine intercourse in Storchwerder.
To see her sit so silent and so motionless was unusual. Was she regretting,
perhaps, her lost youth? Was she feeling bitter at her inability to attract me, a
man within two yards of her, sufficiently for me to take the trouble to engage
her in conversation? No doubt. Well—poor thing! I am sorry for women, but
there is nothing to be done since Nature has decreed they shall grow old.
I got up and shook out the folds of my mackintosh—a most useful
garment in those damp places—and threw away the end of my cigar. “I am
now going to retire for the night,” I explained, as she turned her head at my
rustling, “and if you take my advice you will not sit here till you get
rheumatism.”
She looked at me as though she did not hear. In that light her appearance
was certainly quite passable: quite as passable as that of any of the statues
they make so much fuss about; and then of course with proper eyes instead
of blank spaces, and eyes garnished with that speciality of hers, the
ridiculously long eyelashes. But I knew what she was like in broad day, I
knew how thin she was, and I was not to be imposed upon by tricks of light;
so I said in a matter of fact manner, seizing the opportunity for gentle malice
in order to avenge myself a little for her repeated and unjustified attacks on
me, “You will not be wise to sit there longer. It is damp, and you and I are
hardly as young as we were, you know.”
Any normal woman, gentle as this was, would have shrivelled. Instead
she merely agreed in an absent way that it was dewy, and turned up her face
to the stars again.
“Looking for the Great Bear, eh?” I remarked, following her gaze as I
buttoned my wrap.
She continued to gaze, motionless. “No, but—don’t you see? At Christ
Whose glory fills the skies,” she said—both profanely and senselessly, her
face in that light exactly like the sort of thing one sees in the windows of
churches, and her voice as though she were half asleep.
So I hied me (poetry being the fashion) to my bed, and lay awake in it for
some time being sorry for Menzies-Legh, for really no man can possibly like
having a creepy wife.
But (luckily) autres temps autres mœurs, as our unbalanced but
sometimes felicitous neighbours across the Vosges say, and next morning the
poetry of the party was, thank heaven, clogged by porridge.
It always was at breakfast. They were strangely hilarious then, but never
poetic. Poetry developed later in the day as the sun and their spirits sank
together, and flourished at its full growth when there were stars or a moon.
That morning, our first Sunday, a fresh breeze blew up from the Weald
below and a cloudless sun dazzled us as it fell on the white cloth of the table
set out in the middle of the field by somebody—I expect it was Mrs.
Menzies-Legh—who wanted to make the most of the sun, and we had to
hold on our hats with one hand and shade our eyes with the other while we
ate.
Uncomfortable? Of course it was uncomfortable. Let no one who loves to
be comfortable ever caravan. Neither let any one who loves order and
decency do so. They may take it from me that there is never any order, and
even less frequently is there any decency. I can give you an example from
that Sunday morning. I was sitting at the table with the ladies, on a seat (as
usual) too low for me, and that (also as usual) slanted on the uneven ground,
with my feet slightly too cold in the damp grass and my head slightly too hot
in the bright sun, and the general feeling of subtle discomfort and ruffledness
that is one of the principal characteristics of this form of pleasure-taking,
when I saw (and so did the ladies) Jellaby emerge from his tent—in his shirt
sleeves if you please—and fastening up a mirror on the roof of his canvas
lair proceed then and there in the middle of the field to lather his face and
then to shave it.
Edelgard, of course, true to her early training, at once cast down her eyes
and was careful to keep them averted during the remainder of the meal, but
nobody else seemed to mind; indeed, Mrs. Menzies-Legh got out her camera
and focussing him with deliberate care snap-shotted him.
Were these people getting blunted as the days passed to the refinements
and necessary precautions of social intercourse? I had been stirred to much
silent indignation by the habit of the gentlemen of walking in their shirt
sleeves, and had not yet got used to that, but to see Jellaby dressing in an
open field was a little more than I could endure in silence. For if, I asked
myself rapidly, Jellaby dresses (shaving being a part of dressing) out-of-
doors in the morning, what is to prevent his doing the opposite in the
evening? Where is the line? Where is the logical limit? We had now been
three days out, and we had already got to this. Where, I thought, should we
have got to in another six? Where should we be by, say, the following
Sunday?
I cannot think a promiscuous domesticity desirable, and am one of those
who strongly disapprove of that worst example of it, the mixed bathing or
Familienbad which blots with practically unclothed Jews of either sex our
otherwise decent coasts. Never have I allowed Edelgard to indulge in it, nor
have I done so myself. It is a deplorable spectacle. We used to sit and watch
it for hours, in a condition of ever-increasing horror and disgust—it was
quite difficult to find seats sometimes, so many of our friends were there
being disgusted too.
But these denizens of the deep at the points where the deep was a
Familienbad were, as I have said, chiefly Jews and their Jewesses, and what
can you expect? Jellaby, however, in spite of his other infirmities, was not
yet a Jew; he was everything else I think, but that crowning infamy had up to
then been denied him.
But not to be one and yet to behave with the laxness of one within view
of the rest of the party was very inexcusable. “Are there no hedges to this
field?” I cried in indignant sarcasm, looking pointedly at each of its four
hedges in turn and raising my voice so that he could hear.
“Oh, Baron dear, it’s Sunday,” said Mrs. Menzies-Legh, no longer a
rather nice-looking if irreverent cameo in a velvet case, but full of morning
militancy. “Don’t be cross till to-morrow. Save it up, or what will you do on
Monday?”
“Be, I trust, just as capable of distinguishing between the permitted and
the non-permitted as I am to-day,” was my ready retort.
“Oh, oh,” said Mrs. Menzies-Legh, shaking her head and smiling as
though she were talking to a child or a feeble-minded; and turning her
camera on to me she took my photograph.
“Pray why,” I inquired with justifiable heat, “should I be photographed
without my consent?”
“Because,” she said, “you look so deliciously cross. I want to have you in
my scrap-book like that. You looked then exactly like a baby I know.”
“Which baby?” I asked, frowning and at a loss how to meet this kind of
thing conversationally. And there was Edelgard, all ears; and if a wife sees
her husband being treated disrespectfully by other women is it not very
likely that she soon will begin to treat him so herself? “Which baby?” I
asked; but knew myself inadequate.
“Oh, a perfectly respectable baby,” said Mrs. Menzies-Legh carelessly,
putting her camera down and going on with her breakfast, “but irritable and
exacting about things like bottles.”
“But I do not see what I have to do with bottles,” I said nettled.
“Oh, no—you haven’t. Only it looks at its nurse just like you did then if
they’re late, or not full enough.”
“But I did not look at its nurse,” I said angrily, becoming still more so as
they all (including my wife) laughed.
I rose abruptly. “I will go and smoke,” I said.
Of course I saw what she meant about the nurse the moment I had
spoken, but it is inexcusable to laugh at a man because he does not
immediately follow the sense (or rather the senselessness) of a childishly
skipping conversation. I am as ready as any one to laugh at really amusing
phrases or incidents, but being neither a phrase nor an incident myself I do
not see why I should be laughed at. Surely it is unworthy of grown men and
women to laugh at each other in the way silly children do? It is ruin to the
graces of social intercourse, to the courtliness that should uninterruptedly
distinguish the well-born. But there was a childish spirit pervading the whole
party (with the exception of myself) that seemed to increase as the days went
by, a spirit of unreasoning glee and mischievousness which I believe is
characteristic of very young and very healthy children. Even Edelgard was
daily becoming more calf-like, as we say, daily descending nearer to the
level occupied at first only by the two nondescripts, that level at which you
begin to play idiotic and heating games like the one the English call Blind
Man’s Buff (an obviously foolish name, for what is buff?) and which we so
much more sensibly call Blind Cow. Therefore I, having no intention at my
age and in my position of joining in puerilities or even of seeming to
countenance them by my presence, said abruptly, “I will smoke”—and
strode away to do it.
One of the ladies called after me to inquire if I were not going to church
with them, but I pretended not to hear and strode on toward the shelter of the
hedge, giving Jellaby as I passed him such a look as would have caused any
one not overgrown with the leather substitute for skin peculiar to persons
who set order, morals, and religion at defiance, to creep confounded into his
tent and stay there till his face was ready and his collar on. He, however,
called out with the geniality born of brazenness, that it was a jolly morning;
of which, of course, I took no notice.
In the dry ditch beneath the hedge on the east side of the field sat Lord
Sigismund beside his batterie de cuisine, watching over, with unaccountable
and certainly misplaced kindness, the porridge and the coffee that were
presently to be Jellaby’s. While he watched he smoked his pipe, stroked his
dog, and hummed snatches of what I supposed were psalms with the
pleasant humming of the good, the happy, and the well-born.
Near him lay Menzies-Legh, his dark and sinister face bent over a book.
He nodded briefly in response to my lifted hat and morning salutation, while
Lord Sigismund, full as ever of the graciousness of noble birth, asked me if I
had had a good night.
“A good night, and an excellent breakfast, thanks to you, Lord Sidge,” I
replied; the touch of playfulness contained in the shortened name lightening
the courteous correctness of my bow as I arranged myself next to him in the
ditch.
Menzies-Legh got up and went away. It was characteristic of him that he
seemed always to be doing that. I hardly ever joined him but he was
reminded by my approach of something he ought to be doing and went away
to do it. I mentioned this to Edelgard during the calm that divided one
difference of opinion from another, and she said he never did that when she
joined him.
“Dear wife,” I explained, “you have less power to remind him of
unperformed duties than I possess.”
“I suppose I have,” said Edelgard.
“And it is very natural that it should be so. Power, of whatever sort it may
be, is a masculine attribute. I do not wish to see my little wife with any.”
“Neither do I,” said she.
“Ah—there speaks my own good little wife.”
“I mean, not if it is that sort.”
“What sort, dear wife?”
“The sort that reminds people whenever I come that it is time they went.”
She looked at me with the odd look that I observed for the first time
during our English holiday. Often have I seen it since, but I cannot recollect
having seen it before. I, noticing that somehow we did not understand each
other, patted her kindly on the shoulder, for, of course, she cannot always
quite follow me, though I must say she manages very creditably as a rule.
“Well, well,” I said, patting her, “we will not quibble. It is a good little
wife, is it not?” And I raised her chin by means of my forefinger, and kissed
her.
This, however, is a digression. I suppose it is because I am unfolding my
literary wings for the first time that I digress so frequently. At least I am
aware of it, which is in itself, I should say, a sign of literary instinct. My
Muse has been, so to speak, kept in bed without stopping till middle age, and
is now suddenly called upon to get up and go for a walk. Such a muse must
inevitably stagger a little at first. I will, however, endeavour to curb these
staggerings, for I perceive that I have already written more than can be
conveniently read aloud in one evening, and though I am willing the same
friends should come on two, I do not know that I care to see them on as
many as three. Besides, think of all the sandwiches.
(This last portion of the narrative, from “one evening” to “sandwiches”
will, of course, be omitted in public.)
I will, therefore, not describe my conversation with Lord Sigismund in
the ditch beyond saying that it was extremely interesting, and conducted on
his side (and I hope on mine) with the social skill of a perfect gentleman.
It was brought to an end by the arrival of Jellaby and his dog, which was
immediately pounced on by Lord Sigismund’s dog, who very properly
resented his uninvited approach, and they remained inextricably mixed
together for what seemed an eternity of yells, the yells rending the Sabbath
calm and mingling with the distant church bells, and all proceeding from
Jellaby’s dog, while Lord Sigismund’s, a true copy of his master, did that
which he had to do with the silent self-possession of, if I may so express it, a
dog of the world.
The entire company of caravaners, including old James, ran up with cries
and whistling to try to separate them, and at last Jellaby, urged on I suppose
to deeds of valour by knowing the eyes of the ladies upon him, made a
mighty effort and tore them asunder, himself getting torn along his hand as
the result.
Menzies-Legh helped Lord Sigismund to drag away the naturally
infuriated bull-terrier, and Jellaby, looking round, asked me to hold his dog
while he went and washed his hand. I thought this a fair instance of the

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Innovations in Biomedical Engineering

Nanophotonics in Biomedical Engineering Xiangwei Zhao

Applications of Biomedical Engineering in Dentistry

3D Printing in Biomedical Engineering Sunpreet Singh

The Biomedical Engineering Handbook Third Edition 3

Basic Transport Phenomena in Biomedical Engineering

Renewable Energy Sources: Engineering, Technology,

Biomedical Information Technology Biomedical

Current Trends in Biomedical Engineering and Bioimages

Marek Gzik · Zbigniew Paszenda ·

More information about this series at http://www.springer.com/series/11156

Ewa Pietka Ewaryst Tkacz

ISSN 2194-5357 ISSN 2194-5365 (electronic)

Modelling and Simulations in Biomechanics

The Use of Hyperelastic Material Models for Estimation of Pig Aorta

Experimental Research in Biomedical Engineering

Analysis of Ground Reaction Forces and Kinematic Response

Study of Physicochemical Properties of CoCrMo Alloy with PLCL

Informatics and Signal Analysis in Medicine

Segmentation and Registration of High-Frequency Ultrasound Images

Author Index . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 391

Keywords 3D printing · Bone · Mechanical testing · Hydrolytic degradation

2 Materials and Methods

Fig. 1 Schematic representation of investigated trabecular bone model

were 20 mm × 20 mm × 4 mm, and the hexagonal holes were inscribed in a circle

3 Results and Discussion

Table 1 Mean values of mass changes measurements of trabecular bone models, n = 5

Table 2 Calculated values of compressive strength of trabecular bone models, Rc [MPa], n = 5

The presented investigation of trabecular bone models gives promising results in

differences in compressive strength may be related to the fact that a biodegradable

Bartosz Borzeszkowski, Thang X. Duong, Roger A. Sauer,

Abstract In this paper, a nonlinear isogeometric Kirchhoff–Love shell model of the

Keywords Abdominal wall · Biomechanics · Constitutive modeling ·

B. Borzeszkowski (B) · I. Lubowiecka

2 A Constitutive Model for Biological Shell

stress–strain relationships can be assigned for bending and stretching separately.

3 Abdominal Wall Analysis

3.1 Geometry of the Model

3.2 Constitutive and Model Parameters

Table 1 Selection of parameters

Table 2 Considered sets of parameters

4 Discussion and Conclusions

deformation, in comparison to the GOH membrane. It can thus be viewed merely

chosen. Future work should also focus on defining a heterogeneous distribution of

Dominik Pachnicz and Agnieszka Szust

Keywords BSSO · Miniplate · Monocortical fixation · Digital image correlation ·

Orthognathic surgeries are common procedures performed for the correction of

D. Pachnicz (B) · A. Szust

aesthetic reasons. For health-improvement treatments for the majority of patients

2 Materials and Methods

“Don’t ’e look different now?” said a third.

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