Search results for: Behzad Momahed Heravi

Authors: Behzad Panahirad, UğUr Atikol

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The current study is based on a combined heat and power system with multi-objectives, driven by biomass. The system consists of a combustion chamber (CC), a single effect absorption cooling system (SEACS), an air conditioning unit (AC), a reheat steam Rankine cycle (RRC), an organic Rankine cycle (ORC) and an electrolyzer. The purpose of this system is to produce hydrogen, electricity, heat, cooling, and air conditioning. All the simulations had been performed by Engineering Equation Solver (EES) software. Pine sawdust is the selected biofuel for the combustion process. The overall utilization factor (εₑₙ) and exergetic efficiency (ψₑₓ) were calculated to be 2.096 and 24.03% respectively. The performed renewable and environmental impact analysis indicated a sustainability index of 1.316 (SI) and a specific CO2 emission of 353.8 kg/MWh. The parametric study is conducted based on the variation of ambient (sink) temperature, biofuel mass flow rate, and boilers outlet temperatures. The parametric simulation showed that the increase in biofuel mass flow rate has a positive effect on the sustainability of the system.

Keywords: biomass, exergy assessment, multi-objective plant, CO₂ emission, irreversibility

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Authors: Saman Momeni, Abolghassem Zabihollah, Mehdi Behzad

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Non-uniform laminated composite structures are being used in many engineering applications where the structures are subjected to unpredicted vibration. To mitigate the vibration response of these structures, recently, magnetorheological fluid (MR), is added to non-uniform (tapered) thickness laminated composite structures to achieve a new generation of the smart composite as MR tapered beam. However, due to the nature of MR fluid, especially the low stiffness, MR tapered beam exhibit lower stiffness and in turn, lower natural frequencies. To achieve the basic design requirements of the structure without MR fluid, one may need to apply a predefined magnetic energy to the structures, requiring a constant source of energy. In the present work, a passive initial stiffness control of MR tapered beam has been studied. The effects of adding nanoparticles on the dynamic response of MR tapered beam has been investigated. It is observed that adding nanoparticles up to 3% may significantly modify the natural frequencies of the structures and achieve dynamic behavior of the structures before addition of MR fluid. Two Models of tapered structures have been taken into consideration. It is observed that adding only 3% of nanoparticles backs the structures to its initial dynamic behavior.

Keywords: non uniform laminated structures, MR fluid, nanoparticles, vibration, stiffness

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Authors: Mehrnaz Alibeikloo, Hadi Khabbaz, Behzad Fatahi

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The spectral random field method is one of the widely used methods to obtain more reliable and accurate results in geotechnical problems involving material variability. Karhunen-Loeve (K-L) expansion method was applied to perform random field discretization of cross-correlated creep parameters. Karhunen-Loeve expansion method is based on eigenfunctions and eigenvalues of covariance function adopting Kernel integral solution. In this paper, the accuracy of Karhunen-Loeve expansion was investigated to predict long-term settlement of soft soils adopting elastic visco-plastic creep model. For this purpose, a parametric study was carried to evaluate the effect of K-L expansion terms and spatial correlation length on the reliability of results. The results indicate that small values of spatial correlation length require more K-L expansion terms. Moreover, by increasing spatial correlation length, the coefficient of variation (COV) of creep settlement increases, confirming more conservative and safer prediction.

Keywords: Karhunen-Loeve expansion, long-term settlement, reliability analysis, spatial correlation length

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Authors: Mehrnaz Alibeikloo, Hadi Khabbaz, Behzad Fatahi

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Probabilistic analysis has become one of the most popular methods to quantify and manage geotechnical risks due to the spatial variability of soil input parameters. The correlation length is one of the key factors of quantifying spatial variability of soil parameters which is defined as a distance within which the random variables are correlated strongly. This paper aims to assess the impact of correlation length on the long-term settlement of soft soils improved with preloading. The concept of 'worst-case' spatial correlation length was evaluated by determining the probability of failure of a real case study of Vasby test fill. For this purpose, a finite difference code was developed based on axisymmetric consolidation equations incorporating the non-linear elastic visco-plastic model and the Karhunen-Loeve expansion method. The results show that correlation length has a significant impact on the post-construction settlement of soft soils in a way that by increasing correlation length, probability of failure increases and the approach to asymptote.

Keywords: Karhunen-Loeve expansion, probability of failure, soft soil settlement, 'worst case' spatial correlation length

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Authors: Hadi Abdollahi, Bijan Iraj, Maryam Mirpourian, Behzad Shariatifar

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Background: The aim of the present study was to determine the relationship between neck circumferences (NC), as an indicator of upper body obesity, with anthropometric and cardio-metabolic factors among the first degree relatives of diabetes patients. Materials and Methods: This cross-sectional study was performed on first degree relatives of diabetes patients (n = 213). Weight, height, waist circumference (WC), hip circumference (HC), systolic blood pressure (SBP), diastolic blood pressure (DBP) and NC were measured. Laboratory data included oral glucose tolerance test (OGTT) results, high density lipoprotein (HDL), low density lipoprotein, triglyceride (TG) and total cholesterol. Results: There was no difference in NC among different results of OGTT in men or women. Factors including weight, body mass index (BMI), WC and HC were strongly associated with NC in both genders (r = 0.420-0.711). NC was weakly associated with SBP in women (r = 0.195) and moderately with DBP in men (r = 0.314). Regarding lipid profile, HDL and TG were associated with NC only in women (r = −0.268-0.325). Conclusions: NC has a significant correlation with gender and anthropometric variables, including BMI, weight and waist and HCs in both men and women, but it does not differ significantly in patients with different status in OGTT.

Keywords: body mass index, cardiovascular, diabetes, neck circumference, obesity

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Authors: Roham Rafiee, Behzad Mazhari

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Composite structures, having incredible properties, have gained considerable popularity in the last few decades. Among all types, polymer matrix composites are being used extensively due to their unique characteristics including low weight, convenient fabrication process and low cost. Having polymer as matrix, these type of composites show different creep behavior when compared to metals and even other types of composites since most polymers undergo creep even in room temperature. One of the most challenging topics in creep is to introduce new techniques for predicting long term creep behavior of materials. Depending on the material which is being studied the appropriate method would be different. Methods already proposed for predicting long term creep behavior of polymer matrix composites can be divided into five categories: (1) Analytical Modeling, (2) Empirical Modeling, (3) Superposition Based Modeling (Semi-empirical), (4) Rheological Modeling, (5) Finite Element Modeling. Each of these methods has individual characteristics. Studies have shown that none of the mentioned methods can predict long term creep behavior of all PMC composites in all circumstances (loading, temperature, etc.) but each of them has its own priority in different situations. The reason to this issue can be found in theoretical basis of these methods. In this study after a brief review over the background theory of each method, they are compared in terms of their applicability in predicting long-term behavior of composite structures. Finally, the explained materials are observed through some experimental studies executed by other researchers.

Keywords: creep, comparative study, modeling, composite materials

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Authors: Isha Saxena, Behzad Kazemtabrizi, Matthias C. M. Troffaes, Christopher Crabtree

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The calculations done at the beginning of the life of a wind farm are rarely reliable, which makes it important to conduct research and study the failure and repair rates of the wind turbines under various conditions. This miscalculation happens because the current models make a simplifying assumption that the failure/repair rate remains constant over time. This means that the reliability function is exponential in nature. This research aims to create a more accurate model using sensory data and a data-driven approach. The data cleaning and data processing is done by comparing the Power Curve data of the wind turbines with SCADA data. This is then converted to times to repair and times to failure timeseries data. Several different mathematical functions are fitted to the times to failure and times to repair data of the wind turbine components using Maximum Likelihood Estimation and the Posterior expectation method for Bayesian Parameter Estimation. Initial results indicate that two parameter Weibull function and exponential function produce almost identical results. Further analysis is being done using the complex system analysis considering the failures of each electrical and mechanical component of the wind turbine. The aim of this project is to perform a more accurate reliability analysis that can be helpful for the engineers to schedule maintenance and repairs to decrease the downtime of the turbine.

Keywords: reliability, bayesian parameter inference, maximum likelihood estimation, weibull function, SCADA data

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Authors: Maryam Solgi, Behzad Shahmohammadi, Morteza Raissi Dehkordi

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One of the main steps for seismic retrofitting of buildings is to determine the vulnerability of structures. While current procedures for evaluating existing buildings are complicated, and there is no limitation between short, middle-high, and tall buildings. This research utilizes a simplified method for assessing structures, which is adequate for existing reinforced concrete buildings. To approach this aim, Simple Lateral Mechanisms Analysis (SLaMA) procedure proposed by NZSEE (New Zealand Society for Earthquake Engineering) has been carried out. In this study, three RC moment-resisting frame buildings are determined. First, these buildings have been evaluated by inelastic static procedure (Pushover) based on acceptance criteria. Then, Park-Ang Damage Index is determined for the whole members of each building by Inelastic Time History Analysis. Next, the Simple Lateral Mechanisms Analysis procedure, a hand method, is carried out to define the capacity of structures. Ultimately, existing procedures are compared with Peak Ground Acceleration caused to fail (PGAfail). The results of this comparison emphasize that the Pushover procedure and SLaMA method define a greater value of PGAfail than the Park-Ang Damage model.

Keywords: peak ground acceleration caused to fail, reinforced concrete moment-frame buildings, seismic vulnerability analysis, simple lateral mechanisms analysis

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Authors: Dorsa Rahi, Arghavan Tonkanbonbi, Soheila Manifar, Behzad Jafvarnejad

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Background and Aim: Intraoral manipulation is performed during endotracheal intubation for general anesthesia, which can traumatize the soft and hard tissue in the oral cavity and cause postoperative pain and discomfort. Dental trauma is the most common complication of intubation. This study aimed to assess the prevalence of dental complications due to intubation in patients hospitalized in Imam Khomeini Hospital during 2018-2019. Materials and Methods: A total of 805 patients presenting to the Cancer Institute of Imam Khomeini Hospital for preoperative anesthesia consultation were randomly enrolled. A dentist interviewed the patients and performed a comprehensive clinical oral examination preoperatively. The patients underwent clinical oral examination by another dentist postoperatively. Results: No significant correlation was found between dental trauma (tooth fracture, tooth mobility, or soft tissue injury) after intubation with the age or gender of patients. According to the Wilcoxon test and McNemar-Bowker Test, the rate of mobility before the intubation was significantly different from that after the intubation (P=0.000). Maxillary central incisors, maxillary left canine and mandibular right and left central incisors had the highest rate of fracture. Conclusion: Mobile teeth before the intubation are at higher risk of avulsion and aspiration during the procedure. Patients with primary temporomandibular joint disorders are more susceptible to post-intubation trismus.

Keywords: oral trauma, dental trauma, intubation, anesthesia

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Authors: Behzad Hajalilou, Nasim Hajalilou, Saeid Ansari

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The study area is located in East Azerbaijan province, north of Ahar city, and 1/100000 geological map of Varzgan. This region is located in the middle of Iran zone. Ali Javad Porphyry copper-gold ore deposit has been created in a magmatic complex containing intrusive masses, combining Granodiorite and quartz Monzonite that penetrates into the Eocene volcanic aggregate. The most important mineralization includes primary oxides minerals (magnetite), sulfide (pyrite, chalcopyrite, Molybdenite, Bornite, Chalcocite, Covollite), secondary oxide or hydroxide minerals (hematite, goethite, limonite), and carbonate (malachite and Azurite). The mineralization forms into the vein-veinlets and scattered system. The alterations observed in the region include intermediate Argillic, advanced Argillic, Phyllic, silica, Propylitic, chlorite and Potassic. The 3D model of mineralization of the Alijavad is provided by Data DATAMINE software and based on the study of 700 polished sections of 32 drilled boreholes in the region. This model is completely compatible with the model provided by Lowell and Gilbert for the mineralization of porphyry copper deposits of quartz Monzonite type. The estimated cumulative residual value of copper for Ali Javad deposit is 81.5 million tons with 0.75 percent of copper, and for gold is 8.37 million tons with 1.8 ppm.

Keywords: porphyry copper, mineralization, Ali Javad, modeling, reserve estimation

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Authors: Behzad Ahdiharab, Senol Baskaya, Tamer Calisir

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Heat exchangers are one of the most widely used systems in factories, refineries etc. In this study, natural convection heat transfer using nano-fluids in between two cylinders is numerically investigated. The inner and outer cylinders are kept at constant temperatures. One of the most important assumptions in the project is that the working fluid is non-Newtonian. In recent years, the use of nano-fluids in industrial applications has increased profoundly. In this study, nano-Newtonian fluids containing metal particles with high heat transfer coefficients have been used. All fluid properties such as homogeneity has been calculated. In the present study, solutions have been obtained under unsteady conditions, base fluid was water, and effects of various parameters on heat transfer have been investigated. These parameters are Rayleigh number (103 < Ra < 106), power-law index (0.6 < n < 1.4), aspect ratio (0 < AR < 0.8), nano-particle composition, horizontal and vertical displacement of the inner cylinder, rotation of the inner cylinder, and volume fraction of nanoparticles. Results such as the internal cylinder average and local Nusselt number variations, contours of temperature, flow lines are presented. The results are also discussed in detail. From the validation study performed it was found that a very good agreement exists between the present results and those from the open literature. It was found out that the heat transfer is always affected by the investigated parameters. However, the degree to which the heat transfer is affected does change in a wide range.

Keywords: heat transfer, circular space, non-Newtonian, nano fluid, computational fluid dynamics.

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Authors: Seyyed Farzad Motevalli-Haghi, Javad Rafinejad, Mahboobeh Hosseni, Jamshid Yazdani-Charati, Behzad Parsi

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Background and purpose: Pediculosis is a worldwide public health concern. This descriptive study was performed on primary-school-aged children to determine the prevalence of pediculosis and its risk factors in Mazandaran Province, Iran, on basis of geographic information system (GIS). Materials and methods: A random sampling method was used to select 45237 school-aged children from Sari to Ramsar cities during September 2012 to June 2013. Data were collected from the selected schools by five trained nursing inspectors. A detailed questionnaire was filled for each child prior to hair examination following which examination was carried out to detect head lice as well as eggs/nits. Data were analyzed chi-square test. Finally, the GIS map was obtained in province informational chart. Results: 823 primary-school children (of 45237) were infected with lice in Mazandaran Province. The mean infection prevalence was 1.4% in cities 5.64% in rural area from Sari to Ramsar. There were significant relationships between pediculosis and some factors (P<0.05). GIS map revealed that the contamination was less in west than in east and central regions. Conclusion: Increasing awareness and training of teachers and parents, as well as improving standards of personal health can significantly reduce the prevalence of pediculosis.

Keywords: pediculosis capitis, primary school children, epidemiology, geographic information system (GIS), Mazandaran, Iran

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Authors: Quoc Van Nguyen, Behzad Fatahi, Aslan S. Hokmabadi

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Performance based seismic design is a modern approach to earthquake-resistant design shifting emphasis from “strength” to “performance”. Soil-Structure Interaction (SSI) can influence the performance level of structures significantly. In this paper, a fifteen storey moment resisting frame sitting on a shallow foundation (footing) with different sizes is simulated numerically using ABAQUS software. The developed three dimensional numerical simulation accounts for nonlinear behaviour of the soil medium by considering the variation of soil stiffness and damping as a function of developed shear strain in the soil elements during earthquake. Elastic-perfectly plastic model is adopted to simulate piles and structural elements. Quiet boundary conditions are assigned to the numerical model and appropriate interface elements, capable of modelling sliding and separation between the foundation and soil elements, are considered. Numerical results in terms of base shear, lateral deformations, and inter-storey drifts of the structure are compared for the cases of soil-structure interaction system with different foundation sizes as well as fixed base condition (excluding SSI). It can be concluded that conventional design procedures excluding SSI may result in aggressive design. Moreover, the size of the foundation can influence the dynamic characteristics and seismic response of the building due to SSI and should therefore be given careful consideration in order to ensure a safe and cost effective seismic design.

Keywords: soil-structure-interaction, seismic response, shallow foundation, abaqus, rayleigh damping

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Authors: Andrew Gryguć, Seyed Behzad Behravesh, Hamid Jahed, Mary Wells, Wojciech Macek, Bruce Williams

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This extended abstract investigates the influence of the multiaxial loading on the fatigue behavior of forged magnesium through quantitative analysis of its fracture surface topography and mesoscopic cracking orientation. Fatigue tests were performed on hollow tubular sample geometries extracted from closed-die forged AZ80 Mg components, with three different multiaxial strain paths (axial/shear), proportional, 45° out of phase, and 90° out of phase. Regardless of the strain path, fatigue cracks are initiated at the outer surface of the specimen where the combined stress state is largest. Depending on the salient mode of deformation, distinctive features in the fracture surface manifested themselves with different topographic amplitudes, surface roughness, and mesoscopic cracking orientation in the vicinity of the initiation site. The dominant crack propagation path was in the circumferential direction of the hollow tubular specimen (i.e., cracking transverse to the sample axis, with little to no branching), which is congruent with previous findings of low to moderate shear strain energy density (SED) multiaxial loading. For proportional loading, the initiation zone surface morphology was largely flat and striated, whereas, at phase angles of 45° and 90°, the initiation surface became more faceted and inclined. Overall, both a qualitative and quantitative link was developed between the fracture surface morphology and the level of non-proportionality in the loading providing useful insight into the fracture mechanics of forged magnesium as a relevant focus for future study.

Keywords: fatigue, fracture, magnesium, forging, fractography, anisotropy, strain energy density, asymmetry, multiaxial fatigue

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Authors: Fatemeh Rasooli, Behzad Simiari, Pooya Payandemehr, Amir Nejati, Maryam Bahreini, Atefeh Abdollahi

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Introduction: Pain is a complex physiological reaction to tissue injury. In the course of painful procedures such as nerve block, ice has been shown to be a feasible and inexpensive material to control pain. It delays nerve conduction, actives other senses and reduces inflammatory and painful responses. This study assessed the effect of ice in reducing pain caused by needling and infiltration during digital block. Patient satisfaction recorded as a secondary outcome. Methods: This study was designed as a non-blinded randomized clinical trial approved by Tehran University of Medical Sciences Ethical Committee. Informed consent was taken from all the participants who were then randomly divided into two groups. Digital block performed by standard approach in selected patients. Tubes of ice were prepared in gloves and were fragmented at a time of application for circling around the finger. Tubes were applied for 6 minutes before digital nerve block in the site of needling in the case group. Patients in the control group underwent digital nerve block with the conventional method without ice administration. Numeric Rating Scale (NRS) used for grading pain. 0 used for no pain and 10 for the worst pain that patient had experienced until now. Scores were analyzed by Wilcoxon Rank Sum test and compared in case and control groups. Results: 100 patients aged 16-50 years were enrolled. Mean NRS scores with and without ice were 1.5 mm (S.D ± 1.44) and 6.8 mm (S.D ± 1.40) for needling pain and for infiltration pain were 2.7mm ( S.D ±1.65) and 8.5mm ( S.D ± 1.47), respectively (p<0.001). Besides, patients’ satisfactions were significantly higher in the ice group (p<0.001). Conclusion: Application of ice for 6 minutes significantly reduced pain of needling and infiltration in digital nerve block; thus, it seems to be a feasible and inexpensive material which acts effectively to decrease pain and stress before the procedure.

Keywords: digital block, ice, needle, pain

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Authors: Andrea Tonoli, Nicola Amati, Maria Cavatorta, Reza Mirsanei, Behzad Mozaffari, Hamed Ahani, Akbar Karamihafshejani, Mohammad Ghazivakili, Mohammad Abuabiah

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The vibrations transmitted to the drivers and passengers through vehicle seat seriously effect on the level of their attention, fatigue and physical health and reduce the comfort and efficiency of the occupants. Recently, some researchers have focused on vibrations at low excitation frequency(0.5-5 Hz) which are considered to be the main risk factors for lumbar part of the backbone but they were not applicable to A and B-segment cars regarding to the size and weight. A semi-active system with two symmetric negative stiffness structures (NSS) in parallel to a positive stiffness structure and actuators has been proposed to attenuate low frequency excitation and makes system flexible regarding to different weight of passengers which is applicable for A and B-Segment cars. Here, the 3 degree of freedom system is considered, dynamic equation clearly is presented, then simulated in MATLAB in order to analysis of performance of the system. The design procedure is derived so that the resonance peak of frequency–response curve shift to the left, the isolating range is increased and especially, the peak of the frequency–response curve is minimized. According to ISO standard different class of road profile as an input is applied to the system to evaluate the performance of the system. To evaluate comfort issues, we extract the RMS value of the vertical acceleration acting on the passenger's body. Then apply the band-pass filter, which takes into account the human sensitivity to acceleration. According to ISO, this weighted acceleration is lower than 0.315 m/s^2, so the ride is considered as comfortable.

Keywords: low frequency excitation, negative stiffness, seat vehicle, vibration isolation

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Authors: Behzad Behnia, Noah LaRussa-Trott

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In recent years, fibers have been successfully used as an additive to reinforce asphalt concrete materials and to enhance the sustainability and resiliency of transportation infrastructure. Roads covered with fiber-reinforced asphalt concrete (FRAC) require less frequent maintenance and tend to have a longer lifespan. The present work investigates the application of sasobit-coated aramid fibers in asphalt pavements and employs machine learning to develop prediction models to evaluate the cracking performance of FRAC materials. For the experimental part of the study, the effects of several important parameters such as fiber content, fiber length, and testing temperature on fracture characteristics of FRAC mixtures were thoroughly investigated. Two mechanical performance tests, i.e., the disk-shaped compact tension [DC(T)] and indirect tensile [ID(T)] strength tests, as well as the non-destructive acoustic emission test, were utilized to experimentally measure the cracking behavior of the FRAC material in both macro and micro level, respectively. The experimental results were used to train the supervised machine learning approach in order to establish prediction models for fracture performance of the FRAC mixtures in the field. Experimental results demonstrated that adding fibers improved the overall fracture performance of asphalt concrete materials by increasing their fracture energy, tensile strength and lowering their 'embrittlement temperature'. FRAC mixtures containing long-size fibers exhibited better cracking performance than regular-size fiber mixtures. The developed prediction models of this study could be easily employed by pavement engineers in the assessment of the FRAC pavements.

Keywords: fiber reinforced asphalt concrete, machine learning, cracking performance tests, prediction model

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Authors: Shabnam Abdi, Behzad Toosi

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Background: Melanoma is the most lethal type of malignant skin cancer in humans and dogs since it spreads rapidly throughout the body. Despite significant advances in treatment, cancer at an advanced stage has a poor prognosis. Hence, more effective treatments are needed to enhance outcomes with fewer side effects. Erythropoietin-producing hepatocellular receptors are the largest family of receptor tyrosine kinases and are divided into two subfamilies, EphA and EphB, both of which play a significant role in disease, especially cancer. Due to their association with proliferation and invasion in many aggressive types of cancer, Eph receptor tyrosine kinases (Eph RTKs) are promising cancer therapy molecules. Because these receptors have not been studied in canine melanoma, we investigated how EphA2 influences survival and tumorigenicity of melanoma cells. Methods: Expression of EphA2 protein in canine melanoma cell lines and human melanoma cell line was evaluated by Western blot. Melanoma cells were transduced with lentiviral particles encoding Eph-targeting shRNAs or non-silencing shRNAs (control) for silencing the expression of EphA2 receptor, and silencing was confirmed by Western blotting and immunofluorescence. The effect of siRNA treatment on cellular proliferation, colony formation, tumorsphere assay, invasion was analyzed by Resazurin assay Matrigel invasion assay, respectively. Results: Expression of EphA2 was detected in canine and human melanoma cell lines. Moreover, stably silencing EphA2 by specific shRNAs significantly and consistently decreased the expression of EphA2 protein in both human and canine melanoma cells. Proliferation, colony formation, tumorsphere and invasion of melanoma cells were significantly decreased in EphA2 siRNA-treated cells compared to control. Conclusion: Our data provide the first functional evidence that the EphA2 receptor plays a critical role in the malignant cellular behavior of melanoma in both human and dogs.

Keywords: ephA2, targeting, melanoma, human, canine

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Authors: Mende Mensa Sorato, Majid Davari, Abbas Kebriaeezadeh, Nizal Sarrafzadegan, Tamiru Shibru, Behzad Fatemi

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Markov model, like cardiovascular disease (CVD) policy model based simulation, is being used for evaluating the cost-effectiveness of hypertension treatment. Stroke, angina, myocardial infarction (MI), cardiac arrest, and all-cause mortality were included in this model. Hypertension is a risk factor for a number of vascular and cardiac complications and CVD outcomes. Objective: This systematic review was conducted to evaluate the comprehensiveness of this model across different regions globally. Methods: We searched articles written in the English language from PubMed/Medline, Ovid/Medline, Embase, Scopus, Web of Science, and Google scholar with a systematic search query. Results: Thirteen cohort studies involving a total of 2,165,770 (1,666,554 hypertensive adult population and 499,226 adults with treatment-resistant hypertension) were included in this scoping review. Hypertension is clearly associated with coronary heart disease (CHD) and stroke mortality, unstable angina, stable angina, MI, heart failure (HF), sudden cardiac death, transient ischemic attack, ischemic stroke, subarachnoid hemorrhage, intracranial hemorrhage, peripheral arterial disease (PAD), and abdominal aortic aneurism (AAA). Association between HF and hypertension is variable across regions. Treatment resistant hypertension is associated with a higher relative risk of developing major cardiovascular events and all-cause mortality when compared with non-resistant hypertension. However, it is not included in the previous CVD policy model. Conclusion: The CVD policy model used can be used in most regions for the evaluation of the cost-effectiveness of hypertension treatment. However, hypertension is highly associated with HF in Latin America, the Caribbean, Eastern Europe, and Sub-Saharan Africa. Therefore, it is important to consider HF in the CVD policy model for evaluating the cost-effectiveness of hypertension treatment in these regions. We do not suggest the inclusion of PAD and AAA in the CVD policy model for evaluating the cost-effectiveness of hypertension treatment due to a lack of sufficient evidence. Researchers should consider the effect of treatment-resistant hypertension either by including it in the basic model or during setting the model assumptions.

Keywords: cardiovascular disease policy model, cost-effectiveness analysis, hypertension, systematic review, twelve major cardiovascular events

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Authors: Behzad Babaei, B. Gangadhara Prusty

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The objective of this study is to assess the hypotheses that a restored tooth with a class II occlusal-distal (OD) cavity can be strengthened by designing an optimized cavity geometry, as well as selecting the composite restoration with optimized elastic moduli when there is a sharp de-bonded edge at the interface of the tooth and restoration. Methods: A scanned human maxillary molar tooth was segmented into dentine and enamel parts. The dentine and enamel profiles were extracted and imported into a finite element (FE) software. The enamel rod orientations were estimated virtually. Fifteen models for the restored tooth with different cavity occlusal depths (1.5, 2, and 2.5 mm) and internal cavity angles were generated. By using a semi-circular stone part, a 400 N load was applied to two contact points of the restored tooth model. The junctions between the enamel, dentine, and restoration were considered perfectly bonded. All parts in the model were considered homogeneous, isotropic, and elastic. The quadrilateral and triangular elements were employed in the models. A mesh convergence analysis was conducted to verify that the element numbers did not influence the simulation results. According to the criteria of a 5% error in the stress, we found that a total element number of over 14,000 elements resulted in the convergence of the stress. A Python script was employed to automatically assign 2-22 GPa moduli (with increments of 4 GPa) for the composite restorations, 18.6 GPa to the dentine, and two different elastic moduli to the enamel (72 GPa in the enamel rods’ direction and 63 GPa in perpendicular one). The linear, homogeneous, and elastic material models were considered for the dentine, enamel, and composite restorations. 108 FEA simulations were successively conducted. Results: The internal cavity angles (α) significantly altered the peak maximum principal stress at the interface of the enamel and restoration. The strongest structures against the contact loads were observed in the models with α = 100° and 105. Even when the enamel rods’ directional mechanical properties were disregarded, interestingly, the models with α = 100° and 105° exhibited the highest resistance against the mechanical loads. Regarding the effect of occlusal cavity depth, the models with 1.5 mm depth showed higher resistance to contact loads than the model with thicker cavities (2.0 and 2.5 mm). Moreover, the composite moduli in the range of 10-18 GPa alleviated the stress levels in the enamel. Significance: For the class II OD cavity models in this study, the optimal geometries, composite properties, and occlusal cavity depths were determined. Designing the cavities with α ≥100 ̊ was significantly effective in minimizing peak stress levels. The composite restoration with optimized properties reduced the stress concentrations on critical points of the models. Additionally, when more enamel was preserved, the sturdier enamel-restoration interface against the mechanical loads was observed.

Keywords: dental composite restoration, cavity geometry, finite element approach, maximum principal stress

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