Search results for: plaque rupture
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 268

Search results for: plaque rupture

268 The Effect of Three-Dimensional Morphology on Vulnerability Assessment of Atherosclerotic Plaque

Authors: M. Zareh, H. Mohammadi, B. Naser

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Atherosclerotic plaque rupture is the main trigger of heart attack and brain stroke which are the leading cause of death in developed countries. Better understanding of rupture-prone plaque can help clinicians detect vulnerable plaques- rupture prone or instable plaques- and apply immediate medical treatment to prevent these life-threatening cardiovascular events. Therefore, there are plenty of studies addressing disclosure of vulnerable plaques properties. Necrotic core and fibrous tissue are two major tissues constituting atherosclerotic plaque; using histopathological and numerical approaches, many studies have demonstrated that plaque rupture is strongly associated with a large necrotic core and a thin fibrous cap, two morphological characteristic which can be acquired by two-dimensional imaging of atherosclerotic plaque present in coronary and carotid arteries. Plaque rupture is widely considered as a mechanical failure inside plaque tissue; this failure occurs when the stress within plaque excesses the strength of tissue material; hence, finite element method, a strong numerical approach, has been extensively applied to estimate stress distribution within plaques with different compositions which is then used for assessment of various vulnerability characteristics including plaque morphology, material properties and blood pressure. This study aims to evaluate significance of three-dimensional morphology on vulnerability degree of atherosclerotic plaque. To reach this end, different two-dimensional geometrical models of atherosclerotic plaques are considered based on available data and named Main 2D Models (M2M). Then, for each of these M2Ms, two three-dimensional idealistic models are created. These two 3D models represent two possible three-dimensional morphologies which might exist for a plaque with similar 2D morphology to one of M2Ms. Finite element method is employed to estimate stress, von-Mises stress, within each 3D models. Results indicate that for each M2Ms stress can significantly varies due to possible 3D morphological changes in that plaque. Also, our results show that an atherosclerotic plaque with thick cap may experience rupture if it has a critical 3D morphology. This study highlights the effect of 3D geometry of plaque on its instability degree and suggests that 3D morphology of plaque might be necessary to more effectively and accurately assess atherosclerotic plaque vulnerability.

Keywords: atherosclerotic plaque, plaque rupture, finite element method, 3D model

Procedia PDF Downloads 308
267 Destruction of Atherosclerotic Plaque Using Pulse Ultrasound with a Planar Rectangular Ultrasound Transducer

Authors: Christakis Damianou, Christos Christofi, Nicos Mylonas

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The aim of the proposed study was to evaluate mechanical mode ultrasound using a flat rectangular (3x10 mm2) MRI compatible transducer operating at 5 MHz for destroying atherosclerotic plaque. The system was tested initially in a Hydroxyapatite-polyalactide (HA/PLA) model. An optimized protocol was decided and then applied in atherosclerotic plaque of a rabbit. The plaque in the rabbit was created using a high cholesterol diet. The atherosclerotic plaque was imaged using MRI. This study shows that the destruction of atherosclerotic plaque is feasible.

Keywords: mri, ultrasound, atherosclerotic, plaque, pulse

Procedia PDF Downloads 303
266 Analysis of Wall Deformation of the Arterial Plaque Models: Effects of Viscoelasticity

Authors: Eun Kyung Kim, Kyehan Rhee

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Viscoelastic wall properties of the arterial plaques change as the disease progresses, and estimation of wall viscoelasticity can provide a valuable assessment tool for plaque rupture prediction. Cross section of the stenotic coronary artery was modeled based on the IVUS image, and the finite element analysis was performed to get wall deformation under pulsatile pressure. The effects of viscoelastic parameters of the plaque on luminal diameter variations were explored. The result showed that decrease of viscous effect reduced the phase angle between the pressure and displacement waveforms, and phase angle was dependent on the viscoelastic properties of the wall. Because viscous effect of tissue components could be identified using the phase angle difference, wall deformation waveform analysis may be applied to predict plaque wall composition change and vascular wall disease progression.

Keywords: atherosclerotic plaque, diameter variation, finite element method, viscoelasticity

Procedia PDF Downloads 215
265 A Comparative CFD Study on the Hemodynamics of Flow through an Idealized Symmetric and Asymmetric Stenosed Arteries

Authors: B. Prashantha, S. Anish

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The aim of the present study is to computationally evaluate the hemodynamic factors which affect the formation of atherosclerosis and plaque rupture in the human artery. An increase of atherosclerosis disease in the artery causes geometry changes, which results in hemodynamic changes such as flow separation, reattachment, and adhesion of new cells (chemotactic) in the artery. Hence, geometry plays an important role in the determining the nature of hemodynamic patterns. Influence of stenosis in the non-bifurcating artery, under pulsatile flow condition, has been studied on an idealized geometry. Analysis of flow through symmetric and asymmetric stenosis in the artery revealed the significance of oscillating shear index (OSI), flow separation, low WSS zones and secondary flow patterns on plaque formation. The observed characteristic of flow in the post-stenotic region highlight the importance of plaque eccentricity on the formation of secondary stenosis on the arterial wall.

Keywords: atherosclerotic plaque, oscillatory shear index, stenosis nature, wall shear stress

Procedia PDF Downloads 350
264 Effects of the Non-Newtonian Viscosity of Blood on Flow Field in a Constricted Artery with a Porous Plaque

Authors: Maedeh Shojaeizadeh, Amirreza Yeganegi

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Nowadays many people lose their lives due to cardiovascular diseases. Inappropriate food habits and lack of exercise expedite deposit process of fatty substances on inner surface of blood arteries. This abnormal lump disturbs uniform blood flow and reduces oxygen delivery to active organs. This work presents a numerical simulation of Non-Newtonian blood flow in a stenosis vessel. The vessel is considered as two dimensional channel and plaque area is modelled as a homogenous porous medium. To simulate blood flow reaction around stenosis region, we use C++ code and solve coupled Cauchy, Darcy, governing continuity and energy equations. The analyses results show that viscosity power (n) plays an important role in flow separation and the size of the eddy at the downstream edge of the plaque. It is also observed that with increasing (n) value, temperature discontinuity and likelihood of vessel rupture declined.

Keywords: blood flow, computational fluid dynamic, porosity, power law fluid

Procedia PDF Downloads 459
263 Feasibility Study for Removing Atherosclerotic Plaque Using the Thermal Effects of a Planar Rectangular High Intensity Ultrasound Transducer

Authors: Christakis Damianou, Christos Christofi, Nicos Mylonas

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The aim of this paper was to conduct a feasibility study using a flat rectangular (3x10 mm2) MRI compatible transducer operating at 5 MHz for destroying atherosclerotic plaque using the thermal effects of ultrasound in in vitro models. A parametric study was performed where the time needed to ablate the plaque was studied as a function of Spatial Average Temporal Average (SATA) intensity, and pulse duration. The time needed to ablate plaque is directly related to intensity, and pulse duration. The temperature measured close to the artery is above safe limits and therefore thermal ultrasound does not have a place in removing plaques in arteries.

Keywords: ultrasound, atherosclerotic, plaque, pulse

Procedia PDF Downloads 293
262 Plaque Removal Efficacy of Different Dental Care Products during Fixed Orthodontic Appliance Therapy

Authors: Zeynep Karakoc, Hasan Ilhan Mutaf

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Plaque removal efficacy of different dental brushes and mouth wash during fixed orthodontic appliance therapy was evaluated in this single-blind, crossover and prospective study. Thirty orthodontic patients aged 18 and over undergoing fixed appliance therapy at the end of leveling stage were divided into three groups. Subjects brushed their teeth with a toothbrush under standardized conditions for a period of 30 days prior to inter-dental care products. The same procedure was repeated each time with a different, randomly assigned inter-dental care products in a crossover design. (Inter-dental brush, powered inter-dental brush and mouth wash). At start and end of each removal period, plaque indexes of participants were scored. Each brush achieved statistically significant plaque removal; however, there were no statistical differences among groups for all surfaces of teeth when the plaque score was evaluated. The mouth wash group presented significant improvement in reduction of visible plaque on mesial and distal surfaces of posterior teeth. (-60.9 %, P< .001) Plaque removal for right and left side of mouth showed no significant differences within groups, only mouth wash was more efficient in right side than left side. It is concluded that effectiveness of plaque removal may not be related to the kind of inter-dental products directly. However, toothbrush when used with inter-dental care products is significantly better at removing plaque deposits from fixed appliance patients.

Keywords: orthodontics, dental care, brush, plaque

Procedia PDF Downloads 243
261 Honey: A Remedy Rediscovered in the Treatment of Oral Diseases

Authors: Muhammad Mansoor Majeed, Imtiaz Ahmed

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For centuries, honey has been used for the management and cure of different diseases for the treatment of wound, ulcers, burns, cough, and sore throat, etc. It has also been proved to decrease inflammation, edema, and exudates in different body tissues. This study is performed to find out the effectiveness of honey in the treatment and prevention of gingivitis, gingival bleeding, and accumulation of plaque. Randomized control trial was performed on two subject groups. Honey provided to one subject group to apply on their gums and tooth and then gargle with water and drink. Frequency of the procedure is thrice a day for a month. Another group was given a placebo. Before and after, readings were taken according to Loe and Silness Plaque and Gingival Index. Initially, the mean plaque index, Gingival index and the percentage of sites which were bleeding in the honey group was 0.910, 0.800 and 58.71% respectively which has reduced to 0.313, 0.296 and 27.6% in 30 ± 3 days whereas the control group did not show signs of improvement. Visible changed has observed in the honey group from 0.910 to 0.313 in mean plaque index, 0.800 to 0.296 in Gingival Index, and the percentage of bleeding sited decreased from 58.71% to 27.6%. No significant changes observed in another group. We can conclude that honey reduces the formation/accumulation of plaque and decreases gingival bleeding as well as it has therapeutic effects.

Keywords: honey, gingivitis, Pakistan, bleeding gums

Procedia PDF Downloads 136
260 Shear Stress and Effective Structural Stress ‎Fields of an Atherosclerotic Coronary Artery

Authors: Alireza Gholipour, Mergen H. Ghayesh, Anthony Zander, Stephen J. Nicholls, Peter J. Psaltis

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A three-dimensional numerical model of an atherosclerotic coronary ‎artery is developed for the determination of high-risk situation and ‎hence heart attack prediction. Employing the finite element method ‎‎(FEM) using ANSYS, fluid-structure interaction (FSI) model of the ‎artery is constructed to determine the shear stress distribution as well ‎as the von Mises stress field. A flexible model for an atherosclerotic ‎coronary artery conveying pulsatile blood is developed incorporating ‎three-dimensionality, artery’s tapered shape via a linear function for ‎artery wall distribution, motion of the artery, blood viscosity via the ‎non-Newtonian flow theory, blood pulsation via use of one-period ‎heartbeat, hyperelasticity via the Mooney-Rivlin model, viscoelasticity ‎via the Prony series shear relaxation scheme, and micro-calcification ‎inside the plaque. The material properties used to relate the stress field ‎to the strain field have been extracted from clinical data from previous ‎in-vitro studies. The determined stress fields has potential to be used as ‎a predictive tool for plaque rupture and dissection.‎ The results show that stress concentration due to micro-calcification ‎increases the von Mises stress significantly; chance of developing a ‎crack inside the plaque increases. Moreover, the blood pulsation varies ‎the stress distribution substantially for some cases.‎

Keywords: atherosclerosis, fluid-structure interaction‎, coronary arteries‎, pulsatile flow

Procedia PDF Downloads 172
259 Binding of Avian Excreta-Derived Enteroccoci to a Streptococcocus mutans: Implications for Avian to Human Transmission

Authors: Richard K. Jolley, Jonathan A. Coffman

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Since Enterococci has been implicated in oral disease, we hypothesized the transmission of avian Enterococci to humans via fecal-oral transmission facilitated by adherence to dental plaque. To demonstrate the capability of Enterococci to bind to a dental plaque we filtered avian excreta and incubated the filtrate on a sucrose-induced, Streptococcus mutans biofilm. The biofilm was washed several times with a detergent to remove bacteria binding non-specifically to the biofilm, DNA was isolated from the biofilm, 16S rDNA was amplified, sequenced by Ion Torrent DNA sequencing and analyzed with bioinformatics. Enterococci and other known bacterial pathogens were shown to adhere to the biofilm. Culturing the washed biofilm with Bile Esculin Azide (BEA) agar also confirmed the presence of Enterococci as verified with Sanger sequencing. The results suggest that Enteroccoci in avian excreta has the ability to adhere to human dental plaque and may be a mechanism of entry when humans encounter contaminated aerosols, water or food.

Keywords: Enterococci, avian excreta, dental plaque, NGS

Procedia PDF Downloads 160
258 Physics-Based Earthquake Source Models for Seismic Engineering: Analysis and Validation for Dip-Slip Faults

Authors: Percy Galvez, Anatoly Petukhin, Paul Somerville, Ken Miyakoshi, Kojiro Irikura, Daniel Peter

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Physics-based dynamic rupture modelling is necessary for estimating parameters such as rupture velocity and slip rate function that are important for ground motion simulation, but poorly resolved by observations, e.g. by seismic source inversion. In order to generate a large number of physically self-consistent rupture models, whose rupture process is consistent with the spatio-temporal heterogeneity of past earthquakes, we use multicycle simulations under the heterogeneous rate-and-state (RS) friction law for a 45deg dip-slip fault. We performed a parametrization study by fully dynamic rupture modeling, and then, a set of spontaneous source models was generated in a large magnitude range (Mw > 7.0). In order to validate rupture models, we compare the source scaling relations vs. seismic moment Mo for the modeled rupture area S, as well as average slip Dave and the slip asperity area Sa, with similar scaling relations from the source inversions. Ground motions were also computed from our models. Their peak ground velocities (PGV) agree well with the GMPE values. We obtained good agreement of the permanent surface offset values with empirical relations. From the heterogeneous rupture models, we analyzed parameters, which are critical for ground motion simulations, i.e. distributions of slip, slip rate, rupture initiation points, rupture velocities, and source time functions. We studied cross-correlations between them and with the friction weakening distance Dc value, the only initial heterogeneity parameter in our modeling. The main findings are: (1) high slip-rate areas coincide with or are located on an outer edge of the large slip areas, (2) ruptures have a tendency to initiate in small Dc areas, and (3) high slip-rate areas correlate with areas of small Dc, large rupture velocity and short rise-time.

Keywords: earthquake dynamics, strong ground motion prediction, seismic engineering, source characterization

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257 The Three-dimensional Response of Mussel Plaque Anchoring to Wet Substrates under Directional Tensions

Authors: Yingwei Hou, Tao Liu, Yong Pang

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The paper explored the three-dimensional deformation of mussel plaques anchor to wet polydimethylsiloxane (PDMS) substrates under tension stress with different angles. Mussel plaques exhibiting natural adhesive structures, have attracted significant attention for their remarkable adhesion properties. Understanding their behavior under mechanical stress, particularly in a three-dimensional context, holds immense relevance for biomimetic material design and bio-inspired adhesive development. This study employed a novel approach to investigate the 3D deformation of the PDMS substrates anchored by mussel plaques subjected to controlled tension. Utilizing our customized stereo digital image correlation technique and mechanical mechanics analyses, we found the distributions of the displacement and resultant force on the substrate became concentrated under the plaque. Adhesion and sucking mechanisms were analyzed for the mussel plaque-substrate system under tension until detachment. The experimental findings were compared with a developed model using finite element analysis and the results provide new insights into mussels’ attachment mechanism. This research not only contributes to the fundamental understanding of biological adhesion but also holds promising implications for the design of innovative adhesive materials with applications in fields such as medical adhesives, underwater technologies, and industrial bonding. The comprehensive exploration of mussel plaque behavior in three dimensions is important for advancements in biomimicry and materials science, fostering the development of adhesives that emulate nature's efficiency.

Keywords: adhesion mechanism, mytilus edulis, mussel plaque, stereo digital image correlation

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256 The Rupture Potential of Nerve Tissue Constrained Intracranial Saccular Aneurysm

Authors: M. Alam, P. Seshaiyer

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The rupture predictability of intracranial aneurysm is one of the most important parameters for physicians in surgical treatment. As most of the intracranial aneurysms are asymptomatic, still the rupture potential of both symptomatic and asymptomatic lesions is relatively unknown. Moreover, an intracranial aneurysm constrained by a nerve tissue might be a common scenario for a physician to deal with during the treatment process. Here, we perform a computational modeling of nerve tissue constrained intracranial saccular aneurysm to show a protective role of constrained tissue on the aneurysm. A comparative parametric study of the model also performs taking long constraint, medium constraint, short constraint, point contact, narrow neck aneurysm, wide neck aneurysm as parameters for the analysis. Results show that contact constraint aneurysm generates less stress near the fundus compared to no constraint aneurysm, hence works as a protective wall for the aneurysm not to be ruptured.

Keywords: rupture potential, intracranial saccular aneurysm, anisotropic hyper-elastic material, finite element analysis

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255 Renal Angiomyolipoma Rupture Following COVID-19 Infection: A Case Report

Authors: Mohammed Abdurabu, Akram Al-Warqi, Ebrahim M. A. Ebrahim, Jouhar Kollari, Salman Mirza

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The novel coronavirus (COVID-19) is one of the most recent pandemics that invaded earth that left and still leaving hundreds of thousands of patients and ended with high morbidity and mortality rates with no clear cure till this moment. COVID-19 has been proven to be associated with pathologic changes in coagulation, characterized by either thromboembolic or bleeding events. We present this case of a 44-year-old male patient that presented to our Emergency Department with flank pain that later was found to have renal angiomyolipoma (AML) rupture during his COVID-19 infection, ultimately requiring admission for hemorrhage control via Interventional Radiology (IR) drainage. Here, we discuss the role of the front-line physicians and how they should keep a low threshold for the different presentations that could be associated with COVID-19 infection.

Keywords: angiomyolipoma, COVID-19, renal, rupture

Procedia PDF Downloads 131
254 The Rupture of Tendon Achilles During the Recreative and Sports Activities

Authors: Jasmin S. Nurkovic, Ljubisa Dj. Jovasevic, Zana C. Dolicanin, Zoran S. Bajin

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Ruptured muscles and tendons very often must be repatriated by open operation in young persons. In young, muscles are ruptured more often than tendons, at the sane time in older persons are more exposed to rupture than muscles. Ruptured of the calcaneus are the most present of all ruptures. Sometime the rupture is complete, but very often the incomplete rupture can be noticed. During six years, from 2006 to 2012, we treated nineteen male patients and three female patients with the rupture of tendon Achilles. The youngest patient was aged thirty two, and the oldest was also managed sixty four. The youngest female patient was forty one and the oldest was forty six. One of our patients who was under corticosteroid treatment did not take any part in sport activities but she was, as she told us, going for a long walk, the same was with other two patients one man and one woman. We had nineteen male patients age 32 to 64 and three female patients age 41, 44 and 46. Conservative treatment by cast was applied in five patients and very good results were in three of them. In two patients surgical treatment failed in patient’s age 53 and 64. Only one of all patients treated by surgery had healing problems because of necrotic changes of the skin where incision was made. One of our female patients age 45 was under steroid treatment for almost 20 years because of asthmatic problems. We suggested her wearing boots with 8cm long heels by day and by night eight weeks. The final results were satisfactory and all the time she was able to work and to walk. It was the only case we had with bilateral tendon rupture. After eight weeks the cast is removed and psychiatric treatment started, patient is using crutches with partial weight bearing over a period of two weeks. Quite the same treatment conservative treatment, only the cast is not removed after two but after four weeks. Everyday activities after the surgical treatment started ten weeks and sport activities can start after fourteen to sixteen weeks. An increased activity of our patient without previous preparing for forces activity can result, as we already see, with tendon rupture. Treatment is very long and very often surgical. We find that surgical treatment resulted as safer and better solution for patients. We also had a patient with spontaneous rupture of tendon during longer walking but this patient was under prolonged corticosteroid treatment.

Keywords: tendon, Achilles, rupture, sport

Procedia PDF Downloads 247
253 Creep Analysis and Rupture Evaluation of High Temperature Materials

Authors: Yuexi Xiong, Jingwu He

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The structural components in an energy facility such as steam turbine machines are operated under high stress and elevated temperature in an endured time period and thus the creep deformation and creep rupture failure are important issues that need to be addressed in the design of such components. There are numerous creep models being used for creep analysis that have both advantages and disadvantages in terms of accuracy and efficiency. The Isochronous Creep Analysis is one of the simplified approaches in which a full-time dependent creep analysis is avoided and instead an elastic-plastic analysis is conducted at each time point. This approach has been established based on the rupture dependent creep equations using the well-known Larson-Miller parameter. In this paper, some fundamental aspects of creep deformation and the rupture dependent creep models are reviewed and the analysis procedures using isochronous creep curves are discussed. Four rupture failure criteria are examined from creep fundamental perspectives including criteria of Stress Damage, Strain Damage, Strain Rate Damage, and Strain Capability. The accuracy of these criteria in predicting creep life is discussed and applications of the creep analysis procedures and failure predictions of simple models will be presented. In addition, a new failure criterion is proposed to improve the accuracy and effectiveness of the existing criteria. Comparisons are made between the existing criteria and the new one using several examples materials. Both strain increase and stress relaxation form a full picture of the creep behaviour of a material under high temperature in an endured time period. It is important to bear this in mind when dealing with creep problems. Accordingly there are two sets of rupture dependent creep equations. While the rupture strength vs LMP equation shows how the rupture time depends on the stress level under load controlled condition, the strain rate vs rupture time equation reflects how the rupture time behaves under strain-controlled condition. Among the four existing failure criteria for rupture life predictions, the Stress Damage and Strain Damage Criteria provide the most conservative and non-conservative predictions, respectively. The Strain Rate and Strain Capability Criteria provide predictions in between that are believed to be more accurate because the strain rate and strain capability are more determined quantities than stress to reflect the creep rupture behaviour. A modified Strain Capability Criterion is proposed making use of the two sets of creep equations and therefore is considered to be more accurate than the original Strain Capability Criterion.

Keywords: creep analysis, high temperature mateials, rapture evalution, steam turbine machines

Procedia PDF Downloads 290
252 Haemodynamics Study in Subject Specific Carotid Bifurcation Using FSI

Authors: S. M. Abdul Khader, Anurag Ayachit, Raghuvir Pai, K. A. Ahmed, V. R. K Rao, S. Ganesh Kamath

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The numerical simulation has made tremendous advances in investigating the blood flow phenomenon through elastic arteries. Such study can be useful in demonstrating the disease progression and haemodynamics of cardiovascular diseases such as atherosclerosis. In the present study, patient specific case diagnosed with partially stenosed complete right ICA and normal left carotid bifurcation without any atherosclerotic plaque formation is considered. 3D patient specific carotid bifurcation model is generated based on CT scan data using MIMICS-4.0 and numerical analysis is performed using FSI solver in ANSYS-14.5. The blood flow is assumed to be incompressible, homogenous and Newtonian, while the artery wall is assumed to be linearly elastic. The two-way sequentially-coupled transient FSI analysis is performed using FSI solver for three pulse cycles. The haemodynamic parameters such as flow pattern, Wall Shear Stress, pressure contours and arterial wall deformation are studied at the bifurcation and critical zones such as stenosis. The variation in flow behavior is studied throughout the pulse cycle. Also, the simulation results reveals that there is a considerable increase in the flow behavior in stenosed carotid in contrast to the normal carotid bifurcation system. The investigation also demonstrates the disturbed flow pattern especially at the bifurcation and stenosed zone elevating the haemodynamics, particularly during peak systole and later part of the pulse cycle. The results obtained agree well with the clinical observation and demonstrates the potential of patient specific numerical studies in prognosis of disease progression and plaque rupture.

Keywords: fluid-structure interaction, arterial stenosis, wall shear stress, carotid artery bifurcation

Procedia PDF Downloads 571
251 First Cracking Moments of Hybrid Fiber Reinforced Polymer-Steel Reinforced Concrete Beams

Authors: Saruhan Kartal, Ilker Kalkan

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The present paper reports the cracking moment estimates of a set of steel-reinforced, Fiber Reinforced Polymer (FRP)-reinforced and hybrid steel-FRP reinforced concrete beams, calculated from different analytical formulations in the codes, together with the experimental cracking load values. A total of three steel-reinforced, four FRP-reinforced, 12 hybrid FRP-steel over-reinforced and five hybrid FRP-steel under-reinforced concrete beam tests were analyzed within the scope of the study. Glass FRP (GFRP) and Basalt FRP (BFRP) bars were used in the beams as FRP bars. In under-reinforced hybrid beams, rupture of the FRP bars preceded crushing of concrete, while concrete crushing preceded FRP rupture in over-reinforced beams. In both types, steel yielding took place long before the FRP rupture and concrete crushing. The cracking moment mainly depends on two quantities, namely the moment of inertia of the section at the initiation of cracking and the flexural tensile strength of concrete, i.e. the modulus of rupture. In the present study, two different definitions of uncracked moment of inertia, i.e. the gross and the uncracked transformed moments of inertia, were adopted. Two analytical equations for the modulus of rupture (ACI 318M and Eurocode 2) were utilized in the calculations as well as the experimental tensile strength of concrete from prismatic specimen tests. The ACI 318M modulus of rupture expression produced cracking moment estimates closer to the experimental cracking moments of FRP-reinforced and hybrid FRP-steel reinforced concrete beams when used in combination with the uncracked transformed moment of inertia, yet the Eurocode 2 modulus of rupture expression gave more accurate cracking moment estimates in steel-reinforced concrete beams. All of the analytical definitions produced analytical values considerably different from the experimental cracking load values of the solely FRP-reinforced concrete beam specimens.

Keywords: polymer reinforcement, four-point bending, hybrid use of reinforcement, cracking moment

Procedia PDF Downloads 140
250 Microscale observations of a gas cell wall rupture in bread dough during baking and confrontation to 2/3D Finite Element simulations of stress concentration

Authors: Kossigan Bernard Dedey, David Grenier, Tiphaine Lucas

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Bread dough is often described as a dispersion of gas cells in a continuous gluten/starch matrix. The final bread crumb structure is strongly related to gas cell walls (GCWs) rupture during baking. At the end of proofing and during baking, part of the thinnest GCWs between expanding gas cells is reduced to a gluten film of about the size of a starch granule. When such size is reached gluten and starch granules must be considered as interacting phases in order to account for heterogeneities and appropriately describe GCW rupture. Among experimental investigations carried out to assess GCW rupture, no experimental work was performed to observe the GCW rupture in the baking conditions at GCW scale. In addition, attempts to numerically understand GCW rupture are usually not performed at the GCW scale and often considered GCWs as continuous. The most relevant paper that accounted for heterogeneities dealt with the gluten/starch interactions and their impact on the mechanical behavior of dough film. However, stress concentration in GCW was not discussed. In this study, both experimental and numerical approaches were used to better understand GCW rupture in bread dough during baking. Experimentally, a macro-scope placed in front of a two-chamber device was used to observe the rupture of a real GCW of 200 micrometers in thickness. Special attention was paid in order to mimic baking conditions as far as possible (temperature, gas pressure and moisture). Various differences in pressure between both sides of GCW were applied and different modes of fracture initiation and propagation in GCWs were observed. Numerically, the impact of gluten/starch interactions (cohesion or non-cohesion) and rheological moduli ratio on the mechanical behavior of GCW under unidirectional extension was assessed in 2D/3D. A non-linear viscoelastic and hyperelastic approach was performed to match the finite strain involved in GCW during baking. Stress concentration within GCW was identified. Simulated stresses concentration was discussed at the light of GCW failure observed in the device. The gluten/starch granule interactions and rheological modulus ratio were found to have a great effect on the amount of stress possibly reached in the GCW.

Keywords: dough, experimental, numerical, rupture

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249 Isolation and Elimination of Latent and Productive Herpes Simplex Virus from the Sacral and Trigeminal Ganglions

Authors: Bernard L. Middleton, Susan P. Cosgrove

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There is an immediate need for alternative anti-herpetic treatment options effective for both primary infections and reoccurring reactivations of herpes simplex virus types 1 (HSV-1) and 2 (HSV-2). Alternatives currently approved for the purposes of clinical administration includes antivirals and a reduced set of nucleoside analogues. The present article tests a treatment based on a systemic understanding of how the herpes virus affects cell inhibition and breakdown and targets different phases of the viral cycle, including the entry stage, reproductive cross mutation, and cell-to-cell infection. The treatment consisted of five immunotherapeutic core compounds (5CC), which were hypothesized to be capable of neutralizing human monoclonal antibodies. The tested 5CC were noted as being functional in the application of eliminating the DNA synthesis of herpes viral interferon (IFN) - induced cellular antiviral response. They were here found to neutralize antiviral reproduction by blocking cell-to-cell infection. The activity of the 5CC was tested on RC-37 in vitro using an assay plaque reduction and in vivo against HSV-1 and HSV-2. The 50% inhibitory concentration (IC50) of 5CC was 0.0009% for HSV-1 plaque formation and 0.0008% for HSV-2 plaque formation. Further tests were performed to evaluate the susceptibility of HSV-1 and HSV-2 to anti-herpetic drugs in Vero cells after virus entry. There were high-level markers of the 5CC virucidal activity in the viral suspension of HSV-1 and HSV-2. These concentrations of the 5CC are nontoxic and reduced plaque formation by 98.2% for HSV-1 and 93.0% for HSV-2. Virus HSV-1 and HSV-2 titers were reduced significantly by 5CC to the point of being negative, ranging 0.01–0.09 in 72%. The results concluded the 5CC as being an effective treatment option for the herpes simplex virus.

Keywords: synergy pharmaceuticals, herpes treatment, herpes cure, synergy pharmaceuticals treatment

Procedia PDF Downloads 241
248 Effects of Oxidized LDL in M2 Macrophages: Implications in Atherosclerosis

Authors: Fernanda Gonçalves, Karla Alcântara, Vanessa Moura, Patrícia Nolasco, Jorge Kalil, Maristela Hernandez

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Introduction: Atherosclerosis is a chronic disease where two striking features are observed: retention of lipids and inflammation. Understanding the interaction between immune cells and lipoproteins involved in atherogenesis are urgent challenges, since cardiovascular diseases are the leading cause of death worldwide. Macrophages are critical to the development of atherosclerotic plaques and in the perpetuation of inflammation in these lesions. These cells are also directly involved in unstable plaque rupture. Recently different populations of macrophages are being identified in atherosclerotic lesions. Although the presence of M2 macrophages (macrophages activated by the alternative pathway, eg. The IL-4) has been identified, the function of these cells in atherosclerosis is not yet defined. M2 macrophages have a high endocytic capacity, they promote remodeling of tissues and to have anti-inflammatory activity. However, in atherosclerosis, especially unstable plaques, severe inflammatory reaction, accumulation of cellular debris and intense degradation of the tissue is observed. Thus, it is possible that the M2 macrophages have altered function (phenotype) in atherosclerosis. Objective: Our aim is to evaluate if the presence of oxidized LDL alters the phenotype and function of M2 macrophages in vitro. Methods: For this, we will evaluate whether the addition of lipoprotein in M2 macrophages differentiated in vitro with IL -4 induces 1) a reduction in the secretion of anti-inflammatory cytokines (CBA and ELISA), 2) secretion of inflammatory cytokines (CBA and ELISA), 3) expression of cell activation markers (Flow cytometry), 4) alteration in gene expression of molecules adhesion and extracellular matrix (Real-Time PCR) and 5) Matrix degradation (confocal microscopy). Results: In oxLDL stimulated M2 macrophages cultures we did not find any differences in the expression of the cell surface markers tested, including: HLA-DR, CD80, CD86, CD206, CD163 and CD36. Also, cultures stimulated with oxLDL had similar phagocytic capacity when compared to unstimulated cells. However, in the supernatant of these cultures an increase in the secretion of the pro-inflammatory cytokine IL-8 was detected. No significant changes where observed in IL-6, IL-10, IL-12 and IL-1b levels. The culture supernatant also induced massive extracellular matrix (produced by mouse embryo fibroblast) filaments degradation. When evaluating the expression of 84 extracellular matrix and adhesion molecules genes, we observed that the stimulation of oxLDL in M2 macrophages decreased 47% of the genes and increased the expression of only 3% of the genes. In particular we noted that oxLDL inhibit the expression of 60% of the genes constituents of extracellular matrix and collagen expressed by these cells, including fibronectin1 and collagen VI. We also observed a decrease in the expression of matrix protease inhibitors, such as TIMP 2. On the opposite, the matricellular protein thrombospondin had a 12 fold increase in gene expression. In the presence of native LDL 90% of the genes had no altered expression. Conclusion: M2 macrophages stimulated with oxLDL secrete the pro-inflammatory cytokine IL-8, have an altered extracellular matrix constituents gene expression, and promote the degradation of extracellular matrix. M2 macrophages may contribute to the perpetuation of inflammation in atherosclerosis and to plaque rupture.

Keywords: atherosclerosis, LDL, macrophages, m2

Procedia PDF Downloads 335
247 Geometrical Analysis of an Atheroma Plaque in Left Anterior Descending Coronary Artery

Authors: Sohrab Jafarpour, Hamed Farokhi, Mohammad Rahmati, Alireza Gholipour

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In the current study, a nonlinear fluid-structure interaction (FSI) biomechanical model of atherosclerosis in the left anterior descending (LAD) coronary artery is developed to perform a detailed sensitivity analysis of the geometrical features of an atheroma plaque. In the development of the numerical model, first, a 3D geometry of the diseased artery is developed based on patient-specific dimensions obtained from the experimental studies. The geometry includes four influential geometric characteristics: stenosis ratio, plaque shoulder-length, fibrous cap thickness, and eccentricity intensity. Then, a suitable strain energy density function (SEDF) is proposed based on the detailed material stability analysis to accurately model the hyperelasticity of the arterial walls. The time-varying inlet velocity and outlet pressure profiles are adopted from experimental measurements to incorporate the pulsatile nature of the blood flow. In addition, a computationally efficient type of structural boundary condition is imposed on the arterial walls. Finally, a non-Newtonian viscosity model is implemented to model the shear-thinning behaviour of the blood flow. According to the results, the structural responses in terms of the maximum principal stress (MPS) are affected more compared to the fluid responses in terms of wall shear stress (WSS) as the geometrical characteristics are varying. The extent of these changes is critical in the vulnerability assessment of an atheroma plaque.

Keywords: atherosclerosis, fluid-Structure interaction modeling, material stability analysis, and nonlinear biomechanics

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246 Effect of Salvadora Persica Gel on Clinical and Microbiological Parameters of Chronic Periodontitis

Authors: Tahira Hyder, Saima Quraeshi, Zohaib Akram

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Salvadora Persica (SP) is known to have anti-inflammatory, antioxidant, anti-coagulant and anti-bacterial properties that may provide therapeutic benefits in the treatment of chronic periodontitis (CP). The current clinical trial was designed to investigate the clinical and anti-microbial effects of SP gel as an adjunct to scaling and root planning (SRP) in subjects with generalized CP. Sixty-six subjects with CP were randomized allocated into two groups: SRP + SP gel (test group) and SRP only (control group). Clinical parameters (periodontal pocket depth, gingival recession, clinical attachment level, bleeding score and plaque score) were recorded at baseline before SRP and at 6 weeks. At baseline and 6 weeks subgingival plaque samples were collected and periodontopathogen Porphyromonas Gingivalis (Pg) quantified using Real-time Polymerase Chain Reaction (RT-PCR). Both therapies reduced the mean periodontal pocket depth (PPD), plaque score (PS) and bleeding score (BOP) and improved the mean clinical attachment level (CAL) between baseline and 6 weeks. In subjects receiving adjunctive SP gel a statistically significant improvement was observed in BOP at follow-up compared to control group (15.01±3.47% and 22.81±6.81% respectively, p=0.001), while there was no statistically significant difference in periodontal pocket depth, gingival recession, clinical attachment level and plaque score between both groups. The test group displayed significantly greater Pg reduction compared to the control group after 6 weeks. The current study establishes that local delivery of SP gel into periodontal pocket in CP stimulated a significant reduction in bacteria Pg level and an improvement in gingival health, as evident from a reduced bleeding score, when used as an adjunct to SRP.

Keywords: miswak, scaling and root planing, porphyromonas gingivalis, chronic periodontitis

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245 Simultaneous Bilateral Patella Tendon Rupture: A Systematic Review

Authors: André Rui Coelho Fernandes, Mariana Rufino, Divakar Hamal, Amr Sousa, Emma Fossett, Kamalpreet Cheema

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Aim: A single patella tendon rupture is relatively uncommon, but a simultaneous bilateral event is a rare occurrence and has been scarcely reviewed in the literature. This review was carried out to analyse the existing literature on this event, with the aim of proposing a standardised approach to the diagnosis and management of this injury. Methods: A systematic review was conducted using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Three independent reviewers conducted searches in PubMed, OvidSP for Medline and Embase, as well as Cochrane Library using the same search strategy. From a total of 183 studies, 45 were included, i.e. 90 patellas. Results: 46 patellas had a Type 1 Rupture equating to 51%, with Type 3 being the least common, with only 7 patellas sustaining this injury. The mean Insall-Salvio ratio for each knee was 1.62 (R) and 1.60 (L) Direct Primary Repair was the most common surgical technique compared to Tendon Reconstruction, with End to End and Transosseous techniques split almost equally. Brace immobilisation was preferred over cast, with a mean start to weight-bearing of 3.23 weeks post-op. Conclusions: Bilateral patellar tendon rupture is a rare injury that should be considered in patients with knee extensor mechanism disruption. The key limitation of this study was the low number of patients encompassed by the eligible literature. There is space for a higher level of evidence study, specifically regarding surgical treatment choice and methods, as well as post-operative management, which could potentially improve the outcomes in the management of this injury.

Keywords: trauma and orthopaedic surgery, bilateral patella, tendon rupture, trauma

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244 Roller Pump-Induced Tubing Rupture during Cardiopulmonary Bypass

Authors: W. G. Kim, C. H. Jo

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We analyzed the effects of variations in the diameter of silicone rubber and polyvinyl chloride (PVC) tubings on the likelihood of tubing rupture during modeling of accidental arterial line clamping in cardiopulmonary bypass with a roller pump. A closed CPB circuit constructed with a roller pump was tested with both PVC and silicone rubber tubings of 1/2, 3/8, and 1/4 inch internal diameter. Arterial line pressure was monitored, and an occlusive clamp was placed across the tubing distal to the pressure monitor site to model an accidental arterial line occlusion. A CCD camera with 512(H) x 492(V) pixels was installed above the roller pump to measure tubing diameters at pump outlet, where the maximum deformations (distension) of the tubings occurred. Quantitative measurement of the changes of tubing diameters with the change of arterial line pressure was performed using computerized image processing techniques. A visible change of tubing diameter was generally noticeable by around 250 psi of arterial line pressure, which was already very high. By 1500 psi, the PVC tubings showed an increase of diameter of between 5-10 %, while the silicone rubber tubings showed an increase between 20-25 %. Silicone rubber tubings of all sizes showed greater distensibility than PVC tubings of equivalent size. In conclusion, although roller-pump induced tubing rupture remains a theoretical problem during cardiopulmonary bypass in terms of the inherent mechanism of the pump, in reality such an occurrence is impossible in real clinical conditions.

Keywords: roller pump, tubing rupture, cardiopulmonary bypass, arterial line

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243 Alloy Design of Single Crystal Ni-base Superalloys by Combined Method of Neural Network and CALPHAD

Authors: Mehdi Montakhabrazlighi, Ercan Balikci

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The neural network (NN) method is applied to alloy development of single crystal Ni-base Superalloys with low density and improved mechanical strength. A set of 1200 dataset which includes chemical composition of the alloys, applied stress and temperature as inputs and density and time to rupture as outputs is used for training and testing the network. Thermodynamic phase diagram modeling of the screened alloys is performed with Thermocalc software to model the equilibrium phases and also microsegregation in solidification processing. The model is first trained by 80% of the data and the 20% rest is used to test it. Comparing the predicted values and the experimental ones showed that a well-trained network is capable of accurately predicting the density and time to rupture strength of the Ni-base superalloys. Modeling results is used to determine the effect of alloying elements, stress, temperature and gamma-prime phase volume fraction on rupture strength of the Ni-base superalloys. This approach is in line with the materials genome initiative and integrated computed materials engineering approaches promoted recently with the aim of reducing the cost and time for development of new alloys for critical aerospace components. This work has been funded by TUBITAK under grant number 112M783.

Keywords: neural network, rupture strength, superalloy, thermocalc

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242 Total Plaque Area in Chronic Renal Failure

Authors: Hernán A. Perez, Luis J. Armando, Néstor H. García

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Background and aims Cardiovascular disease rates are very high in patients with renal failure (CRF), but the underlying mechanisms are incompletely understood. Traditional cardiovascular risk factors do not explain the increased risk, and observational studies have observed paradoxical or absent associations between classical risk factors and mortality in dialysis patients. A large randomized controlled trial, the 4D Study, the AURORA and the ALERT study found that statin therapy in CRF do not reduce cardiovascular events. These results may be the results of ‘accelerated atherosclerosis’ observed on these patients. The objective of this study was to investigate if carotid total plaque area (TPA), a measure of carotid plaque burden growth is increased at progressively lower creatinine clearance in patients with CRF. We studied a cohort of patients with CRF not on dialysis, reasoning that risk factor associations might be more easily discerned before end stage renal disease. Methods: The Blossom DMO Argentina ethics committee approved the study and informed consent from each participant was obtained. We performed a cohort study in 412 patients with Stage 1, 2 and 3 CRF. Clinical and laboratory data were obtained. TPA was determined using bilateral carotid ultrasonography. Modification of Diet in Renal Disease estimation formula was used to determine renal function. ANOVA was used when appropriate. Results: Stage 1 CRF group (n= 16, 43±2yo) had a blood pressure of 123±2/78±2 mmHg, BMI 30±1, LDL col 145±10 mg/dl, HbA1c 5.8±0.4% and had the lowest TPA 25.8±6.9 mm2. Stage 2 CRF (n=231, 50±1 yo) had a blood pressure of 132±1/81±1 mmHg, LDL col 125±2 mg/dl, HbA1c 6±0.1% and TPA 48±10mm2 ( p< 0.05 vs CRF stage 1) while Stage 3 CRF (n=165, 59±1 yo) had a blood pressure of 134±1/81±1, LDL col 125±3 mg/dl, HbA1c 6±0.1% and TPA 71±6mm2 (p < 0.05 vs CRF stage 1 and 2). Conclusion: Our data indicate that TPA increases along the renal function deterioration, and it is not related with the LDL cholesterol and triglycerides levels. We suggest that mechanisms other than the classics are responsible for the observed excess of cardiovascular disease in CKD patients and finally, determination of total plaque area should be used to measure effects of antiatherosclerotic therapy.

Keywords: hypertension, chronic renal failure, atherosclerosis, cholesterol

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241 Influence of Surface Fault Rupture on Dynamic Behavior of Cantilever Retaining Wall: A Numerical Study

Authors: Partha Sarathi Nayek, Abhiparna Dasgupta, Maheshreddy Gade

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Earth retaining structure plays a vital role in stabilizing unstable road cuts and slopes in the mountainous region. The retaining structures located in seismically active regions like the Himalayas may experience moderate to severe earthquakes. An earthquake produces two kinds of ground motion: permanent quasi-static displacement (fault rapture) on the fault rupture plane and transient vibration, traveling a long distance. There has been extensive research work to understand the dynamic behavior of retaining structures subjected to transient ground motions. However, understanding the effect caused by fault rapture phenomena on retaining structures is limited. The presence of shallow crustal active faults and natural slopes in the Himalayan region further highlights the need to study the response of retaining structures subjected to fault rupture phenomena. In this paper, an attempt has been made to understand the dynamic response of the cantilever retaining wall subjected to surface fault rupture. For this purpose, a 2D finite element model consists of a retaining wall, backfill and foundation have been developed using Abaqus 6.14 software. The backfill and foundation material are modeled as per the Mohr-Coulomb failure criterion, and the wall is modeled as linear elastic. In this present study, the interaction between backfill and wall is modeled as ‘surface-surface contact.’ The entire simulation process is divided into three steps, i.e., the initial step, gravity load step, fault rupture step. The interaction property between wall and soil and fixed boundary condition to all the boundary elements are applied in the initial step. In the next step, gravity load is applied, and the boundary elements are allowed to move in the vertical direction to incorporate the settlement of soil due to the gravity load. In the final step, surface fault rupture has been applied to the wall-backfill system. For this purpose, the foundation is divided into two blocks, namely, the hanging wall block and the footwall block. A finite fault rupture displacement is applied to the hanging wall part while the footwall bottom boundary is kept as fixed. Initially, a numerical analysis is performed considering the reverse fault mechanism with a dip angle of 45°. The simulated result is presented in terms of contour maps of permanent displacements of the wall-backfill system. These maps highlighted that surface fault rupture can induce permanent displacement in both horizontal and vertical directions, which can significantly influence the dynamic behavior of the wall-backfill system. Further, the influence of fault mechanism, dip angle, and surface fault rupture position is also investigated in this work.

Keywords: surface fault rupture, retaining wall, dynamic response, finite element analysis

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240 Oat βeta Glucan Attenuates the Development of Atherosclerosis and Improves the Intestinal Barrier Function by Reducing Bacterial Endotoxin Translocation in APOE-/- MICE

Authors: Dalal Alghawas, Jetty Lee, Kaisa Poutanen, Hani El-Nezami

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Oat β-glucan a water soluble non starch linear polysaccharide has been approved as a cholesterol lowering agent by various food safety administrations and is commonly used to reduce the risk of heart disease. The molecular weight of oat β-glucan can vary depending on the extraction and fractionation methods. It is not clear whether the molecular weight has a significant impact at reducing the acceleration of atherosclerosis. The aim of this study was to investigate three different oat β-glucan fractionations on the development of atherosclerosis in vivo. With special focus on plaque stability and the intestinal barrier function. To test this, ApoE-/- female mice were fed a high fat diet supplemented with oat bran, high molecular weight (HMW) oat β-glucan fractionate and low molecular weight (LMW) oat β-glucan fractionate for 16 weeks. Atherosclerosis risk markers were measured in the plasma, heart and aortic tree. Plaque size was measured in the aortic root and aortic tree. ICAM-1, VCAM-1, E-Selectin, P-Selectin, protein levels were assessed from the aortic tree to determine plaque stability at 16 weeks. The expression of p22phox at the aortic root was evaluated to study the NADPH oxidase complex involved in nitric oxide bioavailability and vascular elasticity. The tight junction proteins E-cadherin and beta-catenin from western blot analyses were analysed as an intestinal barrier function test. Plasma LPS, intestinal D-lactate levels and hepatic FMO gene expression were carried out to confirm whether the compromised intestinal barrier lead to endotoxemia. The oat bran and HMW oat β-glucan diet groups were more effective than the LMW β-glucan diet group at reducing the plaque size and showed marked improvements in plaque stability. The intestinal barrier was compromised for all the experimental groups however the endotoxemia levels were higher in the LMW β-glucan diet group. The oat bran and HMW oat β-glucan diet groups were more effective at attenuating the development of atherosclerosis. Reasons for this could be due to the LMW oat β-glucan diet group’s low viscosity in the gut and the inability to block the reabsorption of cholesterol. Furthermore the low viscosity may allow more bacterial endotoxin translocation through the impaired intestinal barrier. In future food technologists should carefully consider how to incorporate LMW oat β-glucan as a health promoting food.

Keywords: Atherosclerosis, beta glucan, endotoxemia, intestinal barrier function

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239 Genotypic Identification of Oral Bacteria Using 16S rRNA in Children with and without Early Childhood Caries in Kelantan, Malaysia

Authors: Zuliani Mahmood, Thirumulu Ponnuraj Kannan, Yean Yean Chan, Salahddin A. Al-Hudhairy

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Caries is the most common childhood disease which develops due to disturbances in the physiological equilibrium in the dental plaque resulting in demineralization of tooth structures. Plaque and dentine samples were collected from three different tooth surfaces representing caries progression (intact, over carious lesion and dentine) in children with early childhood caries (ECC, n=36). In caries free (CF) children, plaque samples were collected from sound tooth surfaces at baseline and after one year (n=12). The genomic DNA was extracted from all samples and subjected to 16S rRNA PCR amplification. The end products were cloned into pCR®2.1-TOPO® Vector. Five randomly selected positive clones collected from each surface were sent for sequencing. Identification of the bacterial clones was performed using BLAST against GenBank database. In the ECC group, the frequency of Lactobacillus sp. detected was significantly higher in the dentine surface (p = 0.031) than over the cavitated lesion. The highest frequency of bacteria detected in the intact surfaces was Fusobacterium nucleatum subsp. polymorphum (33.3%) while Streptococcus mutans was detected over the carious lesions and dentine surfaces at a frequency of 33.3% and 52.7% respectively. Fusobacterium nucleatum subsp. polymorphum was also found to be highest in the CF group (41.6%). Follow up at the end of one year showed that the frequency of Corynebacterium matruchotii detected was highest in those who remained caries free (16.6%), while Porphyromonas catoniae was highest in those who developed caries (25%). In conclusion, Streptococcus mutans and Porphyromonas catoniae are strongly associated with caries progression, while Lactobacillus sp. is restricted to deep carious lesions. Fusobacterium nucleatum subsp. polymorphum and Corynebacterium matruchotii may play a role in sustaining the healthy equilibrium in the dental plaque. These identified bacteria show promise as potential biomarkers in diagnosis which could help in the management of dental caries in children.

Keywords: early childhood caries, genotypic identification, oral bacteria, 16S rRNA

Procedia PDF Downloads 275