Search results for: brachial artery anomalies
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 564

Search results for: brachial artery anomalies

444 Prediction of Coronary Artery Stenosis Severity Based on Machine Learning Algorithms

Authors: Yu-Jia Jian, Emily Chia-Yu Su, Hui-Ling Hsu, Jian-Jhih Chen

Abstract:

Coronary artery is the major supplier of myocardial blood flow. When fat and cholesterol are deposit in the coronary arterial wall, narrowing and stenosis of the artery occurs, which may lead to myocardial ischemia and eventually infarction. According to the World Health Organization (WHO), estimated 740 million people have died of coronary heart disease in 2015. According to Statistics from Ministry of Health and Welfare in Taiwan, heart disease (except for hypertensive diseases) ranked the second among the top 10 causes of death from 2013 to 2016, and it still shows a growing trend. According to American Heart Association (AHA), the risk factors for coronary heart disease including: age (> 65 years), sex (men to women with 2:1 ratio), obesity, diabetes, hypertension, hyperlipidemia, smoking, family history, lack of exercise and more. We have collected a dataset of 421 patients from a hospital located in northern Taiwan who received coronary computed tomography (CT) angiography. There were 300 males (71.26%) and 121 females (28.74%), with age ranging from 24 to 92 years, and a mean age of 56.3 years. Prior to coronary CT angiography, basic data of the patients, including age, gender, obesity index (BMI), diastolic blood pressure, systolic blood pressure, diabetes, hypertension, hyperlipidemia, smoking, family history of coronary heart disease and exercise habits, were collected and used as input variables. The output variable of the prediction module is the degree of coronary artery stenosis. The output variable of the prediction module is the narrow constriction of the coronary artery. In this study, the dataset was randomly divided into 80% as training set and 20% as test set. Four machine learning algorithms, including logistic regression, stepwise regression, neural network and decision tree, were incorporated to generate prediction results. We used area under curve (AUC) / accuracy (Acc.) to compare the four models, the best model is neural network, followed by stepwise logistic regression, decision tree, and logistic regression, with 0.68 / 79 %, 0.68 / 74%, 0.65 / 78%, and 0.65 / 74%, respectively. Sensitivity of neural network was 27.3%, specificity was 90.8%, stepwise Logistic regression sensitivity was 18.2%, specificity was 92.3%, decision tree sensitivity was 13.6%, specificity was 100%, logistic regression sensitivity was 27.3%, specificity 89.2%. From the result of this study, we hope to improve the accuracy by improving the module parameters or other methods in the future and we hope to solve the problem of low sensitivity by adjusting the imbalanced proportion of positive and negative data.

Keywords: decision support, computed tomography, coronary artery, machine learning

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443 Coronary Artery Calcium Score and Statin Treatment Effect on Myocardial Infarction and Major Adverse Cardiovascular Event of Atherosclerotic Cardiovascular Disease: A Systematic Review and Meta-Analysis

Authors: Yusra Pintaningrum, Ilma Fahira Basyir, Sony Hilal Wicaksono, Vito A. Damay

Abstract:

Background: Coronary artery calcium (CAC) scores play an important role in improving prognostic accuracy and can be selectively used to guide the allocation of statin therapy for atherosclerotic cardiovascular disease outcomes and potentially associated with the occurrence of MACE (Major Adverse Cardiovascular Event) and MI (Myocardial Infarction). Objective: This systematic review and meta-analysis aim to analyze the findings of a study about CAC Score and statin treatment effect on MI and MACE risk. Methods: Search for published scientific articles using the PRISMA (Preferred Reporting, Items for Systematic Reviews and Meta-Analysis) method conducted on PubMed, Cochrane Library, and Medline databases published in the last 20 years on “coronary artery calcium” AND “statin” AND “cardiovascular disease” Further systematic review and meta-analysis using RevMan version 5.4 were performed based on the included published scientific articles. Results: Based on 11 studies included with a total of 1055 participants, we performed a meta-analysis and found that individuals with CAC score > 0 increased risk ratio of MI 8.48 (RR = 9.48: 95% CI: 6.22 – 14.45) times and MACE 2.48 (RR = 3.48: 95% CI: 2.98 – 4.05) times higher than CAC score 0 individual. Statin compared against non-statin treatment showed a statistically insignificant overall effect on the risk of MI (P = 0.81) and MACE (P = 0.89) in an individual with elevated CAC score 1 – 100 (P = 0.65) and > 100 (P = 0.11). Conclusions: This study found that an elevated CAC scores individual has a higher risk of MI and MACE than a non-elevated CAC score individual. There is no significant effect of statin compared against non-statin treatment to reduce MI and MACE in elevated CAC score individuals of 1 – 100 or > 100.

Keywords: coronary artery calcium, statin, cardiovascular disease, myocardial infarction, MACE

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442 A Case Study: Remediation of Abandoned Mines for Residential Development

Authors: Issa S. Oweis, Gary Gartenberg, Luma J. Oweis

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The site for a residential apartment building overlies an abandoned iron mine in granitic gneiss in northern New Jersey. The mine stope is about 137 m (450 long) and dipping over 344m (800 feet) at 450 to 500. As the building footprint straddles, the mine site needed remediation. The remediation scheme consisted of compaction grouting a minimum 10 m (30 ft.) depth of the mine stope in rock to establish a buttress for the hanging wall and allow support of the building foundation. The rock strength parameters (friction and cohesion) were established based on Hoek Geologic Strength Index (GSI). The derived strength parameters were used in the wedge analysis to simulate rock cave-in. It was concluded that a cave-in would be unlikely. Verification holes confirmed the effectiveness of grouting. Although post grouting micro gravity survey depicted a few anomalies, no anomalies were found to exist by further drilling and excavation.

Keywords: grout, stope, rock, properties

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441 Blood Flow in Stenosed Arteries: Analytical and Numerical Study

Authors: Shashi Sharma, Uaday Singh, V. K. Katiyar

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Blood flow through a stenosed tube, which is of great interest to mechanical engineers as well as medical researchers. If stenosis exists in an artery, normal blood flow is disturbed. The deposition of fatty substances, cholesterol, cellular waste products in the inner lining of an artery results to plaque formation .The present study deals with a mathematical model for blood flow in constricted arteries. Blood is considered as a Newtonian, incompressible, unsteady and laminar fluid flowing in a cylindrical rigid tube along the axial direction. A time varying pressure gradient is applied in the axial direction. An analytical solution is obtained using the numerical inversion method for Laplace Transform for calculating the velocity profile of fluid as well as particles.

Keywords: blood flow, stenosis, Newtonian fluid, medical biology and genetics

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440 The Evaluation of Gravity Anomalies Based on Global Models by Land Gravity Data

Authors: M. Yilmaz, I. Yilmaz, M. Uysal

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The Earth system generates different phenomena that are observable at the surface of the Earth such as mass deformations and displacements leading to plate tectonics, earthquakes, and volcanism. The dynamic processes associated with the interior, surface, and atmosphere of the Earth affect the three pillars of geodesy: shape of the Earth, its gravity field, and its rotation. Geodesy establishes a characteristic structure in order to define, monitor, and predict of the whole Earth system. The traditional and new instruments, observables, and techniques in geodesy are related to the gravity field. Therefore, the geodesy monitors the gravity field and its temporal variability in order to transform the geodetic observations made on the physical surface of the Earth into the geometrical surface in which positions are mathematically defined. In this paper, the main components of the gravity field modeling, (Free-air and Bouguer) gravity anomalies are calculated via recent global models (EGM2008, EIGEN6C4, and GECO) over a selected study area. The model-based gravity anomalies are compared with the corresponding terrestrial gravity data in terms of standard deviation (SD) and root mean square error (RMSE) for determining the best fit global model in the study area at a regional scale in Turkey. The least SD (13.63 mGal) and RMSE (15.71 mGal) were obtained by EGM2008 for the Free-air gravity anomaly residuals. For the Bouguer gravity anomaly residuals, EIGEN6C4 provides the least SD (8.05 mGal) and RMSE (8.12 mGal). The results indicated that EIGEN6C4 can be a useful tool for modeling the gravity field of the Earth over the study area.

Keywords: free-air gravity anomaly, Bouguer gravity anomaly, global model, land gravity

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439 Eight-Week Exercise for Women: Impact on Anomalies in Width Depth and Environmental Dimension

Authors: Yalcin Kaya, Fatma Arslan, Ahmet Selim Kaya

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This study aimed to determine the undesirable hypertrophic anomalies in the body of females and to investigate how they can be affected by the exercise program according to the applied 8 week individual conditions. The research was carried out on 35 women who did not have any regular previous sports practice and had an approximate age of 30 ± 5.0 at the gymnasium because of their asymmetric structure and weight gain of the body. Measurements of width, depth, and periphery were taken from the participants' body, and the exercise protocol was applied for 8 weeks according to the individual measurements in accordance with the obtained measurements. After 8 weeks, the same measurements were applied again. Measurements were made by using ruler and paper tape. The findings were evaluated and differences were analyzed by paired sample t test. According to the findings obtained, ulnae distal proiecturas width averages were 44.77 ± 3.65 and 43.52 ± 3.47 pre- and post-exercise respectively. Bithorachanteric width averages were 29.3 ± 3.12 before exercise and 26.67 ± 3.27 after exercise. Average abdominal widths were observed as 18.64 ± 4.14 (before exercise) and 18.01 ± 6.27 (after exercise). The distances between the malleolus were measured as 16.98 ± 1.62 (before exercise) and 16.70 ± 1.64 (after exercise). The results were statistically significant (p < 0.05). The mean of pre-exercise Externus abdominis circumference was 93.97 ± 8.91, and the mean of post-exercise mean was 90.82 ± 8.24. The results are statistically significant (p < 0.05). In conclusion, findings of the study show that inactivity, daily uncontrolled activities or erroneous postural postures, malnutrition cause some anomalies in the human body. However, with consciously standardized and regular exercises, these abnormalities are reduced by an eight-week exercise protocol in parallel with the expulsion of excess kilos and can be removed when working much longer and fitter, it is proposed to be healthier and more beautiful in appearance.

Keywords: women, body, circumference-width and depth measurements, hypertrophy, exercise

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438 Demographic Profile, Risk Factors and In-hospital Outcomes of Acute Coronary Syndrome (ACS) in Young Population, in Pakistan-Single Center Real World Experience

Authors: Asma Qudrat, Abid Ullah, Rafi Ullah, Ali Raza, Shah Zeb, Syed Ali Shan Ul-Haq, Shahkar Ahmed Shah, Attiya Hameed Khan, Saad Zaheer, Umama Qasim, Kiran Jamal, Zahoor khan

Abstract:

Objectives: Coronary artery disease (CAD) is the major public health issue associated with high mortality and morbidity rate worldwide. Young patients with ACS have unique characteristics with different demographic profiles and risk factors. The precise diagnosis and early risk stratification is important in guiding treatment and predicting the prognosis of young patients with ACS. To evaluate the associated demographics, risk factors, and outcomes profile of ACS in young age patients. Methods: The research follow a retrospective design, the single centre study of patients diagnosis with the first event of ACS in young age (>18 and <40) were included. Data collection included demographic profiles, risk factors, and in-hospital outcomes of young ACS patients. The patient’s data was retrieved through Electronic Medical Records (EMR) of Peshawar Institute of Cardiology (PIC), and all characteristic were assessed. Results: In this study, 77% were male, and 23% were female patients. The risk factors were assessed with CAD and shown significant results (P < 0.01). The most common presentation was STEMI, with (45%) most in ACS young patients. The angiographic pattern showed single vessel disease (SVD) in 49%, double vessel disease (DVD) in 17% and triple vessel disease (TVD) was found in 10%, and Left Artery Disease (LAD) (54%) was present to be the most common involved artery. Conclusion: It is concluded that the male sex was predominant in ACS young age patients. SVD was the common coronary angiographic finding. Risk factors showed significant results towards CAD and common presentations.

Keywords: coronary artery disease, Non-ST elevation myocardial infarction, ST elevation myocardial infarction, unstable angina, acute coronary syndrome

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437 A Study of a Plaque Inhibition Through Stenosed Bifurcation Artery considering a Biomagnetic Blood Flow and Elastic Walls

Authors: M. A. Anwar, K. Iqbal, M. Razzaq

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Background and Objectives: This numerical study reflects the magnetic field's effect on the reduction of plaque formation due to stenosis in a stenosed bifurcated artery. The entire arterythe wall is assumed as linearly elastic, and blood flow is modeled as a Newtonian, viscous, steady, incompressible, laminar, biomagnetic fluid. Methods: An Arbitrary Lagrangian-Eulerian (ALE) technique is employed to formulate the hemodynamic flow in a bifurcated artery under the effect of the asymmetric magnetic field by two-way Fluid-structure interaction coupling. A stable P2P1 finite element pair is used to discretize thenonlinear system of partial differential equations. The resulting nonlinear system of algebraic equations is solved by the Newton Raphson method. Results: The numerical results for displacement, velocity magnitude, pressure, and wall shear stresses for Reynolds numbers, Re = 500, 1000, 1500, 2000, in the presence of magnetic fields are presented graphically. Conclusions: The numerical results show that the presence of the magnetic field influences the displacement and flows velocity magnitude considerably. The magnetic field reduces the flow separation, recirculation area adjacent to stenosis and gives rise to wall shear stress.

Keywords: bifurcation, elastic walls, finite element, wall shear stress,

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436 Mechanisms of O-1602 Induced Endothelium-Independent Vasorelaxation of Rat Small Mesenteric Artery

Authors: Yousuf Al Suleimani, Ahmed Al Mahruqi

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A typical cannabinoid O-1602 induces vasorelaxation and activates the orphan G protein-coupled receptor GPR55 in human endothelial cells. The aim of this study is to characterize the mechanisms of endothelium-independent relaxation of O-1602 in the rat small mesenteric artery using wire myograph. In endothelium-denuded vessels, O-1602 partially produced concentration-dependent vasorelaxation. In vessels depleted of intracellular Ca2+ (by EGTA and methoxamine), CaCl2 produced concentration-dependent contraction. Preincubation with O-1602 (at 10 µM and 30 µM) abolished the contractile responses (P<0.01). The putative antagonist at novel “endothelial anandamide receptor” O-1918 (10 µM) significantly reversed the inhibitory effect of O-1602 on CaCl2-induced vasoconstriction. It is likely that the mechanism of endothelium-independent vasorelaxation to O-1602 is mediated by interfering with Ca2+ entry via an O-1918-sensitive pathway.

Keywords: O-1602, endothelium, vasorelaxation, calcium

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435 STTS-EAD: Improving Spatio-Temporal Learning Based Time Series Prediction via Embedded Anomaly Detection

Authors: Tianhao Zhang, Cen Chen, Dawei Cheng, Yuqi Liang, Yuanyuan Liang

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Dealing with anomalies is a crucial preprocessing step for multivariate time series prediction. However, existing methods that separate anomaly preprocessing and model training into two stages have certain limitations. Specifically, these methods fail to leverage auxiliary information necessary to distinguish latent anomalies related to spatiotemporal factors during the preprocessing stage. Instead, they solely rely on data distribution for detection which may lead to incorrect processing of many samples that are beneficial for training. To address this, we propose STTS-EAD, an end-to-end method that seamlessly integrates anomaly detection into the training process of multivariate time series forecasting and aims to improve Spatio-Temporal learning based Time Series prediction via Embedded Anomaly Detection. Our proposed STTS-EAD leverages spatio-temporal information for forecasting and anomaly detection, with the two parts alternately executed and optimized for each other. To the best of our knowledge, STTS-EAD is the first to integrate anomaly detection and forecasting tasks in the training phase for improving the accuracy of multivariate time series forecasting. Extensive experiments on a public stock dataset and two real-world sales datasets from a renowned coffee chain enterprise show that our proposed method can effectively process detected anomalies in the training stage to improve forecasting performance in the inference stage and significantly outperform baselines.

Keywords: multivariate time series, anomaly detection, time series forecasting, spatiotemporal feature learning

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434 Finite Element Analysis of Shape Memory Alloy Stents in Coronary Arteries

Authors: Amatulraheem Al-Abassi, K. Khanafer, Ibrahim Deiab

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The coronary artery stent is a promising technology that can treat various coronary diseases. Materials used for manufacturing medical stents should have high biocompatible properties. Stent alloys, in particular, are remarkably promising good clinical outcomes, however, there is threaten of restenosis (reoccurring of artery narrowing due to fatty plaque), stent recoiling, or in long-term the occurrence of stent fracture. However, stents that are made of Nickel-titanium (Nitinol) can bare extensive plastic deformation and resist restenosis. This shape memory alloy has outstanding mechanical properties. Nitinol is a unique shape memory alloy as it has unique mechanical properties such as; biocompatibility, super-elasticity, and recovery to original shape under certain loads. Stent failure may cause complications in vascular diseases and possibly blockage of blood flow. Thus, studying the behaviors of the stent under different medical conditions will help the doctors and cardiologists to predict when it is necessary to change the stent in order to prevent any severe morbidity outcomes. To the best of our knowledge, there are limited published papers that analyze the stent behavior with regards to the contact surfaces of plaque layer and blood vessel. Thus, stent material properties will be discussed in this investigation to highlight the mechanical and clinical differences between various stents. This research analyzes the performance of Nitinol stent in well-known stent design to determine its bearing with stress and its dislocation in blood vessels, in comparison to stents made of different biocompatible materials. In addition, a study of its performance will be represented in the system. Finite Element Analysis is the core of this study. Thus, a physical representative model will be discussed to show the distribution of stress and strain along the interaction surface between the stent and the artery. The reaction of vascular tissue to the stent will be evaluated to predict the possibility of restenosis within the treated area.

Keywords: shape memory alloy, stent, coronary artery, finite element analysis

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433 Spontaneous Rupture of Splenic Artery Pseudoaneurysm; A Rare Presentation of Acute Abdominal Pain in the Emergency Department: Case Report

Authors: Zainab Elazab, Azhar Aziz

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Background: Spontaneous Splenic artery pseudoaneurysm rupture is a rare condition which is potentially life threatening, if not detected and managed early. We report a case of abdominal pain with intraperitoneal free fluid, which turned out to be spontaneous rupture of a splenic artery pseudoaneurysm, and was treated with arterial embolization. Case presentation: A 28-year old, previously healthy male presented to the ED with a history of sudden onset upper abdominal pain and fainting attack. The patient denied any history of trauma or prior similar attacks. On examination, the patient had tachycardia and a low-normal BP (HR 110, BP 106/66) but his other vital signs were normal (Temp. 37.2, RR 18 and SpO2 100%). His abdomen was initially soft with mild tenderness in the upper region. Blood tests showed leukocytosis of 12.3 X109/L, Hb of 12.6 g/dl and lactic acid of 5.9 mmol/L. Ultrasound showed trace of free fluid in the perihepatic and perisplenic areas, and a splenic hypoechoic lesion. The patient remained stable; however, his abdomen became increasingly tender with guarding. We made a provisional diagnosis of a perforated viscus and the patient was started on IV fluids and IV antibiotics. An erect abdominal x-ray did not show any free air under the diaphragm so a CT abdomen was requested. Meanwhile, bedside ultrasound was repeated which showed increased amount of free fluid, suggesting intra-abdominal bleeding as the most probable etiology for the condition. His CT abdomen revealed a splenic injury with multiple lacerations, a focal intrasplenic enhancing area on venous phase scan (suggesting a pseudoaneurysm with associated splenic intraparenchymal, sub capsular and perisplenic hematomas). Free fluid in the subhepatic and intraperitoneal regions along the small bowel was also detected. Angiogram was done which confirmed a diagnosis of pseudoaneurysm of intrasplenic arterial branch, and angio-embolization was done to control the bleeding. The patient was later discharged in good condition with a surgery follow-up. Conclusion: Splenic artery pseudoaneurysm rupture is a rare cause of abdominal pain which should be considered in any case of abdominal pain with intraperitoneal bleeding. Early management is crucial as it carries a high mortality. Bedside ultrasound is a useful tool to help for early diagnosis of such cases.

Keywords: abdominal pain, pseudo aneurysm, rupture, splenic artery

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432 Winter – Not Spring - Climate Drives Annual Adult Survival in Common Passerines: A Country-Wide, Multi-Species Modeling Exercise

Authors: Manon Ghislain, Timothée Bonnet, Olivier Gimenez, Olivier Dehorter, Pierre-Yves Henry

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Climatic fluctuations affect the demography of animal populations, generating changes in population size, phenology, distribution and community assemblages. However, very few studies have identified the underlying demographic processes. For short-lived species, like common passerine birds, are these changes generated by changes in adult survival or in fecundity and recruitment? This study tests for an effect of annual climatic conditions (spring and winter) on annual, local adult survival at very large spatial (a country, 252 sites), temporal (25 years) and biological (25 species) scales. The Constant Effort Site ringing has allowed the collection of capture - mark - recapture data for 100 000 adult individuals since 1989, over metropolitan France, thus documenting annual, local survival rates of the most common passerine birds. We specifically developed a set of multi-year, multi-species, multi-site Bayesian models describing variations in local survival and recapture probabilities. This method allows for a statistically powerful hierarchical assessment (global versus species-specific) of the effects of climate variables on survival. A major part of between-year variations in survival rate was common to all species (74% of between-year variance), whereas only 26% of temporal variation was species-specific. Although changing spring climate is commonly invoked as a cause of population size fluctuations, spring climatic anomalies (mean precipitation or temperature for March-August) do not impact adult survival: only 1% of between-year variation of species survival is explained by spring climatic anomalies. However, for sedentary birds, winter climatic anomalies (North Atlantic Oscillation) had a significant, quadratic effect on adult survival, birds surviving less during intermediate years than during more extreme years. For migratory birds, we do not detect an effect of winter climatic anomalies (Sahel Rainfall). We will analyze the life history traits (migration, habitat, thermal range) that could explain a different sensitivity of species to winter climate anomalies. Overall, we conclude that changes in population sizes for passerine birds are unlikely to be the consequences of climate-driven mortality (or emigration) in spring but could be induced by other demographic parameters, like fecundity.

Keywords: Bayesian approach, capture-recapture, climate anomaly, constant effort sites scheme, passerine, seasons, survival

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431 Vertebral Artery Dissection Complicating Pregnancy and Puerperium: Case Report and Review of the Literature

Authors: N. Reza Pour, S. Chuah, T. Vo

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Background: Vertebral artery dissection (VAD) is a rare complication of pregnancy. It can occur spontaneously or following a traumatic event. The pathogenesis is unclear. Predisposing factors include chronic hypertension, Marfan’s syndrome, fibromuscular dysplasia, vasculitis and cystic medial necrosis. Physiological changes of pregnancy have also been proposed as potential mechanisms of injury to the vessel wall. The clinical presentation varies and it can present as a headache, neck pain, diplopia, transient ischaemic attack, or an ischemic stroke. Isolated cases of VAD in pregnancy and puerperium have been reported in the literature. One case was found to have posterior circulation stroke as a result of bilateral VAD and labour was induced at 37 weeks gestation for preeclampsia. Another patient at 38 weeks with severe neck pain that persisted after induction for elevated blood pressure and arteriography showed right VAD postpartum. A single case of lethal VAD in pregnancy with subsequent massive subarachnoid haemorrhage has been reported which was confirmed by the autopsy. Case Presentation: We report two cases of vertebral artery dissection in pregnancy. The first patient was a 32-year-old primigravida presented at the 38th week of pregnancy with the onset of early labour and blood pressure (BP) of 130/70 on arrival. After 2 hours, the patient developed a severe headache with blurry vision and BP was 238/120. Despite treatment with an intravenous antihypertensive, she had eclamptic fit. Magnesium solfate was started and Emergency Caesarean Section was performed under the general anaesthesia. On the second day after the operation, she developed left-sided neck pain. Magnetic Resonance Imaging (MRI) angiography confirmed a short segment left vertebral artery dissection at the level of C3. The patient was treated with aspirin and remained stable without any neurological deficit. The second patient was a 33-year-old primigavida who was admitted to the hospital at 36 weeks gestation with BP of 155/105, constant headache and visual disturbances. She was medicated with an oral antihypertensive agent. On day 4, she complained of right-sided neck pain. MRI angiogram revealed a short segment dissection of the right vertebral artery at the C2-3 level. Pregnancy was terminated on the same day with emergency Caesarean Section and anticoagulation was started subsequently. Post-operative recovery was complicated by rectus sheath haematoma requiring evacuation. She was discharged home on Aspirin without any neurological sequelae. Conclusion: Because of collateral circulation, unilateral vertebral artery dissections may go unrecognized and may be more common than suspected. The outcome for most patients is benign, reflecting the adequacy of the collateral circulation in young patients. Spontaneous VAD is usually treated with anticoagulation or antiplatelet therapy for a minimum of 3-6 months to prevent future ischaemic events, allowing the dissection to heal on its own. We had two cases of VAD in the context of hypertensive disorders of pregnancy with an acceptable outcome. A high level of vigilance is required particularly with preeclamptic patients presenting with head/neck pain to allow an early diagnosis. This is as we hypothesize, early and aggressive management of vertebral artery dissection may potentially prevent further complications.

Keywords: eclampsia, preeclampsia, pregnancy, Vertebral Artery Dissection

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430 A Rare Case of Dissection of Cervical Portion of Internal Carotid Artery, Diagnosed Postpartum

Authors: Bidisha Chatterjee, Sonal Grover, Rekha Gurung

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Postpartum dissection of the internal carotid artery is a relatively rare condition and is considered as an underlying aetiology in 5% to 25% of strokes under the age of 30 to 45 years. However, 86% of these cases recover completely and 14% have mild focal neurological symptoms. Prognosis is generally good with early intervention. The risk quoted for a repeat carotid artery dissection in subsequent pregnancies is less than 2%. 36-year Caucasian primipara presented on postnatal day one of forceps delivery with tachycardia. In the intrapartum period she had a history of prolonged rupture of membranes and developed intrapartum sepsis and was treated with antibiotics. Postpartum ECG showed septal inferior T wave inversion and a troponin level of 19. Subsequently Echocardiogram ruled out post-partum cardiomyopathy. Repeat ECG showed improvement of the previous changes and in the absence of symptoms no intervention was warranted. On day 4 post-delivery, she had developed symptoms of droopy right eyelid, pain around the right eye and itching in the right ear. On examination, she had developed right sided ptosis, unequal pupils (Rt miotic pupil). Cranial nerve examination, reflexes, sensory examination and muscle power was normal. Apart from migraine, there was no medical or family history of note. In view of Horner’s on the right, she had a CT Angiogram and subsequently MR/MRA and was diagnosed with dissection of the cervical portion of the right internal carotid artery. She was discharged on a course of Aspirin 75mg. By 6 week post-natal follow up patient had recovered significantly with occasional episodes of unequal pupils and tingling of right toes which resolved spontaneously. Cervical artery dissection, including VAD and carotid artery dissection, are rare complications of pregnancy with an estimated annual incidence of 2.6–3 per 100,000 pregnancy hospitalizations. Aetiology remains unclear though trauma during straining at labour, underlying arterial disease and preeclampsia have been implicated. Hypercoagulable state during pregnancy and puerperium could also be an important factor. 60-90% cases present with severe headache and neck pain and generally precede neurological symptoms like ipsilateral Horner’s syndrome, retroorbital pain, tinnitus and cranial nerve palsy. Although rare, the consequences of delayed diagnosis and management can lead to severe and permanent neurological deficits. Patients with a strong index of suspicion should undergo an MRI or MRA of head and neck. Antithrombotic and antiplatelet therapy forms the mainstay of therapy with selected cases needing endovascular stenting. Long term prognosis is favourable with either complete resolution or minimal deficit if treatment is prompt. Patients should be counselled about the recurrence risk and possibility of stroke in future pregnancy. Coronary artery dissection is rare and treatable but needs early diagnosis and treatment. Post-partum headache and neck pain with neurological symptoms should prompt urgent imaging followed by antithrombotic and /or antiplatelet therapy. Most cases resolve completely or with minimal sequelae.

Keywords: postpartum, dissection of internal carotid artery, magnetic resonance angiogram, magnetic resonance imaging, antiplatelet, antithrombotic

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429 Failure Statistics Analysis of China’s Spacecraft in Full-Life

Authors: Xin-Yan Ji

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The historical failures data of the spacecraft is very useful to improve the spacecraft design and the test philosophies and reduce the spacecraft flight risk. A study of spacecraft failures data was performed, which is the most comprehensive statistics of spacecrafts in China. 2593 on-orbit failures data and 1298 ground data that occurred on 150 spacecraft launched from 2000 to 2016 were identified and collected, which covered the navigation satellites, communication satellites, remote sensing deep space exploration manned spaceflight platforms. In this paper, the failures were analyzed to compare different spacecraft subsystem and estimate their impact on the mission, then the development of spacecraft in China was evaluated from design, software, workmanship, management, parts, and materials. Finally, the lessons learned from the past years show that electrical and mechanical failures are responsible for the largest parts, and the key solution to reduce in-orbit failures is improving design technology, enough redundancy, adequate space environment protection measures, and adequate ground testing.

Keywords: spacecraft anomalies, anomalies mechanism, failure cause, spacecraft testing

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428 The Importance of the Fluctuation in Blood Sugar and Blood Pressure of Insulin-Dependent Diabetic Patients with Chronic Kidney Disease

Authors: Hitoshi Minakuchi, Izumi Takei, Shu Wakino, Koichi Hayashi, Hiroshi Itoh

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Objectives: Among type 2 diabetics, patients with CKD(chronic kidney disease), insulin resistance, impaired glyconeogenesis in kidney and reduced degradation of insulin are recognized, and we observed different fluctuational patterns of blood sugar between CKD patients and non-CKD patients. On the other hand, non-dipper type blood pressure change is the risk of organ damage and mortality. We performed cross-sectional study to elucidate the characteristic of the fluctuation of blood glucose and blood pressure at insulin-treated diabetic patients with chronic kidney disease. Methods: From March 2011 to April 2013, at the Ichikawa General Hospital of Tokyo Dental College, we recruited 20 outpatients. All participants are insulin-treated type 2 diabetes with CKD. We collected serum samples, urine samples for several hormone measurements, and performed CGMS(Continuous glucose measurement system), ABPM (ambulatory blood pressure monitoring), brain computed tomography, carotid artery thickness, ankle brachial index, PWV, CVR-R, and analyzed these data statistically. Results: Among all 20 participants, hypoglycemia was decided blood glucose 70mg/dl by CGMS of 9 participants (45.0%). The event of hypoglycemia was recognized lower eGFR (29.8±6.2ml/min:41.3±8.5ml/min, P<0.05), lower HbA1c (6.44±0.57%:7.53±0.49%), higher PWV (1858±97.3cm/s:1665±109.2cm/s), higher serum glucagon (194.2±34.8pg/ml:117.0±37.1pg/ml), higher free cortisol of urine (53.8±12.8μg/day:34.8±7.1μg/day), and higher metanephrin of urine (0.162±0.031mg/day:0.076±0.029mg/day). Non-dipper type blood pressure change in ABPM was detected 8 among 9 participants with hypoglycemia (88.9%), 4 among 11 participants (36.4%) without hypoglycemia. Multiplex logistic-regression analysis revealed that the event of hypoglycemia is the independent factor of non-dipper type blood pressure change. Conclusions: Among insulin-treated type 2 diabetic patients with CKD, the events of hypoglycemia were frequently detected, and can associate with the organ derangements through the medium of non-dipper type blood pressure change.

Keywords: chronic kidney disease, hypoglycemia, non-dipper type blood pressure change, diabetic patients

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427 Precursors Signatures of Few Major Earthquakes in Italy Using Very Low Frequency Signal of 45.9kHz

Authors: Keshav Prasad Kandel, Balaram Khadka, Karan Bhatta, Basu Dev Ghimire

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Earthquakes still exist as a threating disaster. Being able to predict earthquakes will certainly help prevent substantial loss of life and property. Perhaps, Very Low Frequency/Low Frequency (VLF/LF) signal band (3-30 kHz), which is effectively reflected from D-layer of ionosphere, can be established as a tool to predict earthquake. On May 20 and May 29, 2012, earthquakes of magnitude 6.1 and 5.8 respectively struck Emilia-Romagna of Italy. A year back, on August 24, 2016, an earthquake of magnitude 6.2 struck Central Italy (42.7060 N and 13.2230 E) at 1:36 UT. We present the results obtained from the US Navy VLF Transmitter’s NSY signal of 45.9 kHz transmitted from Niscemi, in the province of Sicily, Italy and received at the Kiel Longwave Monitor, Germany for 2012 and 2016. We analyzed the terminator times, their individual differences and nighttime fluctuation counts. We also analyzed trends, dispersion and nighttime fluctuation which gave us a possible precursors to these earthquakes. Since perturbations in VLF amplitude could also be due to various other factors like lightning, geomagnetic activities (storms, auroras etc.) and solar activities (flares, UV flux, etc.), we filtered the possible perturbations due to these agents to guarantee that the perturbations seen in VLF/LF amplitudes were as a precursor to Earthquakes. As our TRGCP path is North-south, the sunrise and sunset time in transmitter and receiver places matches making pathway for VLF/LF smoother and therefore hoping to obtain more natural data. To our surprise, we found many clear anomalies (as precursors) in terminator times 5 days to 16 days before the earthquakes. Moreover, using night time fluctuation method, we found clear anomalies 5 days to 13 days prior to main earthquakes. This exactly correlates with the findings of previous authors that ionospheric perturbations are seen few days to one month before the seismic activity. In addition to this, we were amazed to observe unexpected decrease of dispersion on certain anomalies where it was supposed to increase, thereby not supporting our finding to some extent. To resolve this problem, we devised a new parameter called dispersion nighttime (dispersion). On analyzing, this parameter decreases significantly on days of nighttime anomalies thereby supporting our precursors to much extent.

Keywords: D-layer, TRGCP (Transmitter Receiver Great Circle Path), terminator times, VLF/LF

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426 Computed Tomography Myocardial Perfusion on a Patient with Hypertrophic Cardiomyopathy

Authors: Jitendra Pratap, Daphne Prybyszcuk, Luke Elliott, Arnold Ng

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Introduction: Coronary CT angiography is a non-invasive imaging technique for the assessment of coronary artery disease and has high sensitivity and negative predictive value. However, the correlation between the degree of CT coronary stenosis and the significance of hemodynamic obstruction is poor. The assessment of myocardial perfusion has mostly been undertaken by Nuclear Medicine (SPECT), but it is now possible to perform stress myocardial CT perfusion (CTP) scans quickly and effectively using CT scanners with high temporal resolution. Myocardial CTP is in many ways similar to neuro perfusion imaging technique, where radiopaque iodinated contrast is injected intravenously, transits the pulmonary and cardiac structures, and then perfuses through the coronary arteries into the myocardium. On the Siemens Force CT scanner, a myocardial perfusion scan is performed using a dynamic axial acquisition, where the scanner shuffles in and out every 1-3 seconds (heart rate dependent) to be able to cover the heart in the z plane. This is usually performed over 38 seconds. Report: A CT myocardial perfusion scan can be utilised to complement the findings of a CT Coronary Angiogram. Implementing a CT Myocardial Perfusion study as part of a routine CT Coronary Angiogram procedure provides a ‘One Stop Shop’ for diagnosis of coronary artery disease. This case study demonstrates that although the CT Coronary Angiogram was within normal limits, the perfusion scan provided additional, clinically significant information in regards to the haemodynamics within the myocardium of a patient with Hypertrophic Obstructive Cardio Myopathy (HOCM). This negated the need for further diagnostics studies such as cardiac ECHO or Nuclear Medicine Stress tests. Conclusion: CT coronary angiography with adenosine stress myocardial CTP was utilised in this case to specifically exclude coronary artery disease in conjunction with accessing perfusion within the hypertrophic myocardium. Adenosine stress myocardial CTP demonstrated the reduced myocardial blood flow within the hypertrophic myocardium, but the coronary arteries did not show any obstructive disease. A CT coronary angiogram scan protocol that incorporates myocardial perfusion can provide diagnostic information on the haemodynamic significance of any coronary artery stenosis and has the potential to be a “One Stop Shop” for cardiac imaging.

Keywords: CT, cardiac, myocardium, perfusion

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425 Angiographic Evaluation of ETT (Treadmill) Positive Patients in a Tertiary Care Hospital of Bangladesh

Authors: Syed Dawood Md. Taimur, Saidur Rahman Khan, Farzana Islam

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Objective: To evaluate the factors which predetermine the coronary artery disease in patients having positive Exercise Tolerance Test (ETT) that is treadmill results and coronary artery findings. Methods: This descriptive study was conducted at Department of Cardiology, Ibrahim Cardiac Hospital & Research Institute,Dhaka,Bangladesh from 1st January, 2014 to 31st August, 2014. All patients who had done ETT (treadmill) for chest pain diagnosis were studied. One hundred and four patients underwent coronary angiogram after positive treadmill result. Patients were divided into two groups depending upon the angiographic findings, i.e. true positive and false positive. Positive treadmill test patients who have coronary artery involvement these are called true positive and who have no involvement they are called false positive group. Both groups were compared with each other. Results: Out of 104 patients, 81 (77.9%) patients had true positive ETT and 23 (22.1%) patients had false positive ETT. The mean age of patients in positive ETT was 53.46± 8.06 years and male mean age was 53.63±8.36 years and female was 52.87 ± 7.0 years. Sixty nine (85.19%) male patients and twelve (14.81%) female patients had true positive ETT, whereas 15 (65.21%) males and 8 (34.79%) females had false positive ETT, this was statistically significant (p<0.032)difference in the two groups(sex) in comparison of true and false positive ETT. The risk factors of these patients like diabetes mellitus, hypertension, dyslipidemia, family history and smoking were seen among these patients. Hypertensive patients having true positive which were statically significant (p<0.004) and diabetic, dyslipidaemic patients having true positive which were statically significant (p < 0.032 & 0.030).True positive patients had family history were 68 (83.95%) and smoking were 52 (64.20%), where family history patients had statistically significant(p<0.017) between two groups of patients and smokers were significant (p<0.012). 46 true positive patients achieved THR which was not statistically significant (P<0.138)and 79 true patients had abnormal resting ECG whether it was significant (p<0.036). Amongst the vessels involvement the most common was LAD 55 (67.90%), followed by LCX 42 (51.85%), RCA 36 (44.44%) and the LMCA was 9 (11.11%), .40 patients (49.38%) had SVD, 26 (30.10%) had DVD, 15(18.52%) had TVD and 23 had normal coronary arteries. Conclusion: It can be concluded that among the female patients who have positive ETT with normal resting ECG, who had achieved target heart rate are likely to have a false positive test result. Conversely male patients,resting abnormal ECG who had not achieved THR, symptom limited ETT, have a hypertension, diabetis, dyslipidaemic, family history and smoking are likely to have a true positive treadmill test result.

Keywords: exercise tolerance test, coronary artery disease, coronary angiography, true positive, false positive

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424 Advanced Real-Time Fluorescence Imaging System for Rat's Femoral Vein Thrombosis Monitoring

Authors: Sang Hun Park, Chul Gyu Song

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Artery and vein occlusion changes observed in patients and experimental animals are unexplainable symptoms. As the fat accumulated in cardiovascular ruptures, it causes vascular blocking. Likewise, early detection of cardiovascular disease can be useful for treatment. In this study, we used the mouse femoral occlusion model to observe the arterial and venous occlusion changes without darkroom. We observed the femoral arterial flow pattern changes by proposed fluorescent imaging system using an animal model of thrombosis. We adjusted the near-infrared light source current in order to control the intensity of the fluorescent substance light. We got the clear fluorescent images and femoral artery flow pattern were measured by a 5-minute interval. The result showed that the fluorescent substance flowing in the femoral arteries were accumulated in thrombus as time passed, and the fluorescence of other vessels gradually decreased.

Keywords: thrombus, fluorescence, femoral, arteries

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423 Ultrahigh Thermal Stability of Dielectric Permittivity in 0.6Bi(Mg₁/₂Ti₁/₂)O₃-0.4Ba₀.₈Ca₀.₂(Ti₀.₈₇₅Nb₀.₁₂₅)O₃

Authors: Kaiyuan Chena, Senentxu Lanceros-Méndeza, Laijun Liub, Qi Zhanga

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0.6Bi(Mg1/2Ti1/2)O3-0.4Ba0.8Ca0.2(Nb0.125Ti0.875)O3 (0.6BMT-0.4BCNT) ceramics with a pseudo-cubic structure and re-entrant dipole glass behavior have been investigated via X-ray diffraction and dielectric permittivity-temperature spectra. It shows an excellent dielectric-temperature stability with small variations of dielectric permittivity (± 5%, 420 - 802 K) and dielectric loss tangent (tanδ < 2.5%, 441 - 647 K) in a wide temperature range. Three dielectric anomalies are observed from 290 K to 1050 K. The low-temperature weakly coupled re-entrant relaxor behavior was described using Vogel-Fulcher law and the new glass model. The mid- and high-temperature dielectric anomalies are characterized by isothermal impedance and electrical modulus. The activation energy of both dielectric relaxation and conductivity follows the Arrhenius law in the temperature ranges of 633 - 753 K and 833 - 973 K, respectively. The ultrahigh thermal stability of the dielectric permittivity is attributed to the weakly coupling of polar clusters, the formation of diffuse phase transition (DPT) and the local phase transition of calcium-containing perovskite.

Keywords: permittivity, relaxor, electronic ceramics, activation energy

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422 Numerical Simulation of Magnetohydrodynamic (MHD) Blood Flow in a Stenosed Artery

Authors: Sreeparna Majee, G. C. Shit

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Unsteady blood flow has been numerically investigated through stenosed arteries to achieve an idea about the physiological blood flow pattern in diseased arteries. The blood is treated as Newtonian fluid and the arterial wall is considered to be rigid having deposition of plaque in its lumen. For direct numerical simulation, vorticity-stream function formulation has been adopted to solve the problem using implicit finite difference method by developing well known Peaceman-Rachford Alternating Direction Implicit (ADI) scheme. The effects of magnetic parameter and Reynolds number on velocity and wall shear stress are being studied and presented quantitatively over the entire arterial segment. The streamlines have been plotted to understand the flow pattern in the stenosed artery, which has significant alterations in the downstream of the stenosis in the presence of magnetic field. The results show that there are nominal changes in the flow pattern when magnetic field strength is enhanced upto 8T which can have remarkable usage to MRI machines.

Keywords: magnetohydrodynamics, blood flow, stenosis, energy dissipation

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421 Injection of Bradykinin in Femoral Artery Elicits Cardiorespiratory Reflexes Involving Perivascular Afferents in Rat Models

Authors: Sanjeev K. Singh, Maloy B. Mandal, Revand R.

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The physiology of baroreceptors and chemoreceptors present in large blood vessels of the heart is well known in regulation of cardiorespiratory functions. Since large blood vessels and peripheral blood vessels are of same mesodermal origin, therefore, involvement of the latter in regulation of cardiorespiratory system is expected. Role of perivascular nerves in mediating cardiorespiratory alterations produced after intra-arterial injection of a nociceptive agent (bradykinin) was examined in urethane anesthetized male rats. Respiratory frequency, blood pressure, and heart rate were recorded for 30 min after the retrograde injection of bradykinin/saline in the femoral artery. In addition, paw edema was determined and water content was expressed as percentage of wet weight. Injection of bradykinin produced immediate tachypnoeic, hypotensive and bradycardiac responses of shorter latency (5-8 s) favoring the neural mechanisms involved in it. Injection of equi-volume of saline did not produce any responses and served as time matched control. Paw edema was observed in the ipsilateral hind limb. Pretreatment with diclofenac sodium significantly attenuated the bradykinin-induced responses and also blocked the paw edema. Ipsilateral femoral and sciatic nerve sectioning attenuated bradykinin-induced responses significantly indicating the origin of responses from the local vascular bed. Administration of bradykinin in the segment of an artery produced reflex cardiorespiratory changes by stimulating the perivascular nociceptors involving prostaglandins. This is a novel study exhibiting the role of peripheral blood vessels in regulation of cardiorespiratory system.

Keywords: vasosensory reflex, cardiorespiratory changes, nociceptive agent, bradykinin, VR1 receptors

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420 The Effect of Stent Coating on the Stent Flexibility: Comparison of Covered Stent and Bare Metal Stent

Authors: Keping Zuo, Foad Kabinejadian, Gideon Praveen Kumar Vijayakumar, Fangsen Cui, Pei Ho, Hwa Liang Leo

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Carotid artery stenting (CAS) is the standard procedure for patients with severe carotid stenosis at high risk for carotid endarterectomy (CAE). A major drawback of CAS is the higher incidence of procedure-related stroke compared with traditional open surgical treatment for carotid stenosis - CEA, even with the use of the embolic protection devices (EPD). As the currently available bare metal stents cannot address this problem, our research group developed a novel preferential covered-stent for carotid artery aims to prevent friable fragments of atherosclerotic plaques from flowing into the cerebral circulation, and yet maintaining the flow of the external carotid artery. The preliminary animal studies have demonstrated the potential of this novel covered-stent design for the treatment of carotid atherosclerotic stenosis. The purpose of this study is to evaluate the effect of membrane coating on the stent flexibility in order to improve the clinical performance of our novel covered stents. A total of 21 stents were evaluated in this study: 15 self expanding bare nitinol stents and 6 PTFE-covered stents. 10 of the bare stents were coated with 11%, 16% and 22% Polyurethane(PU), 4%, 6.25% and 11% EE, as well as 22% PU plus 5 μm Parylene. Different laser cutting designs were performed on 4 of the PTFE covert stents. All the stents, with or without the covered membrane, were subjected to a three-point flexural test. The stents were placed on two supports that are 30 mm apart, and the actuator is applying a force in the exact middle of the two supports with a loading pin with radius 2.5 mm. The loading pin displacement change, the force and the variation in stent shape were recorded for analysis. The flexibility of the stents was evaluated by the lumen area preservation at three displacement bending levels: 5mm, 7mm, and 10mm. All the lumen areas in all stents decreased with the increase of the displacement from 0 to 10 mm. The bare stents were able to maintain 0.864 ± 0.015, 0.740 ± 0.025 and 0.597 ± 0.031of original lumen area at 5 mm, 7 mm and 10mm displacement respectively. For covered stents, the stents with EE coating membrane showed the best lumen area preservation (0.839 ± 0.005, 0.7334 ± 0.043 and 0.559 ± 0.014), whereas, the stents with PU and Parylene coating were only 0.662, 0.439 and 0.305. Bending stiffness was also calculated and compared. These results provided optimal material information and it was crucial for enhancing clinical performance of our novel covered stents.

Keywords: carotid artery, covered stent, nonlinear, hyperelastic, stress, strain

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419 A Study on the Magnetic and Submarine Geology Structure of TA22 Seamount in Lau Basin, Tonga

Authors: Soon Young Choi, Chan Hwan Kim, Chan Hong Park, Hyung Rae Kim, Myoung Hoon Lee, Hyeon-Yeong Park

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We performed the marine magnetic, bathymetry and seismic survey at the TA22 seamount (in the Lau basin, SW Pacific) for finding the submarine hydrothermal deposits in October 2009. We acquired magnetic and bathymetry data sets by suing Overhouser Proton Magnetometer SeaSPY (Marine Magnetics Co.), Multi-beam Echo Sounder EM120 (Kongsberg Co.). We conducted the data processing to obtain detailed seabed topography, magnetic anomaly, reduction to the pole (RTP) and magnetization. Based on the magnetic properties result, we analyzed submarine geology structure of TA22 seamount with post-processed seismic profile. The detailed bathymetry of the TA22 seamount showed the left and right crest parts that have caldera features in each crest central part. The magnetic anomaly distribution of the TA22 seamount regionally displayed high magnetic anomalies in northern part and the low magnetic anomalies in southern part around the caldera features. The RTP magnetic anomaly distribution of the TA22 seamount presented commonly high magnetic anomalies in the each caldera central part. Also, it represented strong anomalies at the inside of caldera rather than outside flank of the caldera. The magnetization distribution of the TA22 seamount showed the low magnetization zone in the center of each caldera, high magnetization zone in the southern and northern east part. From analyzed the seismic profile map, The TA22 seamount area is showed for the inferred small mounds inside each caldera central part and it assumes to make possibility of sills by the magma in cases of the right caldera. Taking into account all results of this study (bathymetry, magnetic anomaly, RTP, magnetization, seismic profile) with rock samples at the left caldera area in 2009 survey, we suppose the possibility of hydrothermal deposits at mounds in each caldera central part and at outside flank of the caldera representing the low magnetization zone. We expect to have the better results by combined modeling from this study data with the other geological data (ex. detailed gravity, 3D seismic, petrologic study results and etc).

Keywords: detailed bathymetry, magnetic anomaly, seamounts, seismic profile, SW Pacific

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418 Predictors and 3-Year Outcomes of Compromised Left Circumflex Coronary Artery After Left Main Crossover Stenting

Authors: Hameed Ullah, Karim Elakabawi, Han KE, Najeeb Ullah, Habib Ullah, Sardar Ali Shah, Hamad Haider Khan, Muhammad Asad Khan, Ning Guo, Zuyi Yuan

Abstract:

Background: Predictors of decreased fractional flow reserve at left circumflex coronary artery after left main (LM) crossover stenting are still lacking. The objectives of the present study were to provide the predictors for low Fractional flow reserve (FFR) at coronary artery (LCx) and the possible treatment strategies for the compromised LCx-together with their long term outcomes. Methods: A total of 563 included patients out of 1974 patients admitted to our hospital from February 2015 to November 2020 with significant distal LM-bifurcation lesions. The enrolled patients underwent single-stent cross-over PCI under IVUS guidance with further LCx intervention as indicated by measured FFR. Results: The included patients showed angiographic significant LCx ostial affection after LM-stenting, but only 116 (20.6%) patients had FFR <0.8. The 3-year composite MACE rates were comparable between the high and low FFR groups (16.8% vs. 15.5%, respectively; P=0.744). In a multivariable analysis, a low FFR in the LCx was associated with post-stenting MLA of the LCx (OR: 0.032, P <0.001), post-stenting LCx-plaque burden (OR: 1.166, P <0.001), post-stenting LM-MLA (OR: 0.821, P =0.038) and pre-stenting LCx-MLA (OR: 0.371, P =0.044). In patients with low FFR, management of compromised LCx with DEB had the lowest 3-year MACE rate (8.1%) as compared to either KBI (17.5%) or stenting group (20.5%), P =0.299. Conclusion: FFR-guided LCx intervention can avoid unnecessary LCx intervention. The post-stenting predictors of low FFR include post-stenting MLA and plaque burden of the LCx and MV stent length. The 3-year MACE rates were comparable between high FFR patients and patients who had low FFR and were adequately managed.

Keywords: fractional flow reserve, left main stem, percutaneous coronary interventions, intravascular ultrasound

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417 The Exact Specification for Consumption of Blood-Pressure Regulating Drugs with a Numerical Model of Pulsatile Micropolar Fluid Flow in Elastic Vessel

Authors: Soroush Maddah, Houra Asgarian, Mahdi Navidbakhsh

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In the present paper, the problem of pulsatile micropolar blood flow through an elastic artery has been studied. An arbitrary Lagrangian-Eulerian (ALE) formulation for the governing equations has been produced to model the fully-coupled fluid-structure interaction (FSI) and has been solved numerically using finite difference scheme by exploiting a mesh generation technique which leads to a uniformly spaced grid in the computational plane. Effect of the variations of cardiac output and wall artery module of elasticity on blood pressure with blood-pressure regulating drugs like Atenolol has been determined. Also, a numerical model has been produced to define precisely the effects of various dosages of a drug on blood flow in arteries without the numerous experiments that have many mistakes and expenses.

Keywords: arbitrary Lagrangian-Eulerian, Atenolol, fluid structure interaction, micropolar fluid, pulsatile blood flow

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416 Evidence of Climate Change from Statistical Analysis of Temperature and Rainfall Data of Kaduna State, Nigeria

Authors: Iliya Bitrus Abaje

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This study examines the evidence of climate change scenario in Kaduna State from the analysis of temperature and rainfall data (1976-2015) from three meteorological stations along a geographic transect from the southern part to the northern part of the State. Different statistical methods were used in determining the changes in both the temperature and rainfall series. The result of the linear trend lines revealed a mean increase in average temperature of 0.73oC for the 40 years period of study in the State. The plotted standard deviation for the temperature anomalies generally revealed that years of temperatures above the mean standard deviation (hotter than the normal conditions) in the last two decades (1996-2005 and 2006-2015) were more than those below (colder than the normal condition). The Cramer’s test and student’s t-test generally revealed an increasing temperature trend in the recent decades. The increased in temperature is an evidence that the earth’s atmosphere is getting warmer in recent years. The linear trend line equation of the annual rainfall for the period of study showed a mean increase of 316.25 mm for the State. Findings also revealed that the plotted standard deviation for the rainfall anomalies, and the 10-year non-overlapping and 30-year overlapping sub-periods analysis in all the three stations generally showed an increasing trend from the beginning of the data to the recent years. This is an evidence that the study area is now experiencing wetter conditions in recent years and hence climate change. The study recommends diversification of the economic base of the populace with emphasis on moving away from activities that are sensitive to temperature and rainfall extremes Also, appropriate strategies to ameliorate the scourge of climate change at all levels/sectors should always take into account the recent changes in temperature and rainfall amount in the area.

Keywords: anomalies, linear trend, rainfall, temperature

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415 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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