Search results for: distal radial access for balloon aortic valvuloplasty (DR-BAV)

Authors: Min Jee Lee, Young Sun Park, Shin Ahn, Chang Hwan Sohn, Dong Woo Seo, Jae Ho Lee, Yoon Seon Lee, Kyung Soo Lim, Won Young Kim

Abstract:

Background: Acute myocardial infarction (AMI) concomitant with acute aortic syndrome (AAS) is rare but prompt recognition of concomitant AAS is crucial, especially in patients with ST-segment elevation myocardial infarction (STEMI) because misdiagnosis with early thrombolytic or anticoagulant treatment may result in catastrophic consequences. Objectives: This study investigated the clinical features of patients of STEMI concomitant with AAS that may lead to the diagnostic clue. Method: Between 1 January 2010 and 31 December 2014, 22 patients who were the initial diagnosis of acute coronary syndrome (AMI and unstable angina) and AAS (aortic dissection, intramural hematoma and ruptured thoracic aneurysm) in our emergency department were reviewed. Among these, we excluded 10 patients who were transferred from other hospital and 4 patients with non-STEMI, leaving a total of 8 patients of STEMI concomitant with AAS for analysis. Result: The mean age of study patients was 57.5±16.31 years and five patients were Standford type A and three patients were type B aortic dissection. Six patients had ST-segment elevation in anterior leads and two patients had in inferior leads. Most of the patients had acute onset, severe chest pain but no patients had dissecting nature chest pain. Serum troponin I was elevated in three patients but all patients had D-dimer elevation. Aortic regurgitation or regional wall motion abnormality was founded in four patients. However, widened mediastinum was seen in all study patients. Conclusion: When patients with STEMI have elevated D-dimer and widened mediastinum, concomitant AAS may have to be suspected.

Keywords: aortic dissection, myocardial infarction, ST-segment, d-dimer

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Authors: R. Hassan, J. Duncombe, E. Darke, A. Dias, K. Anderson, R. G. Middleton

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NHS England has set itself the task of delivering a “Net Zero” National Health service by 2040. It is incumbent upon all health care practioners to work towards this goal. Orthopaedic surgeons are no exception. Distal radial fractures are the most common fractures sustained by the adult population. However, studies are shortcoming on individual patient experience. The aim of this study was to assess the patient’s satisfaction and outcomes with woodcast used in the conservative management of distal radius fractures. For all patients managed with woodcast in our unit, we undertook a structured questionnaire that included the Patient Rated Wrist Evaluation (PRWE) score, The EQ-5D-5L score and the pain numerical score at the time of injury and six weeks after. 30 patients were initially managed with woodcast. 80% of patients tolerated woodcast for the full duration of their treatment. Of these, 20% didn’t tolerate woodcast and had their casts removed within 48 hours. Of the remaining, 79.1% were satisfied about woodcast comfort, 66% were very satisfied about woodcast weight, 70% were satisfied with temperature and sweatiness, 62.5% were very satisfied about the smell/odour, and 75% were satisfied about the level of support woodcast provided. During their treatment, 83.3% of patients rated their pain as five or less. For those who completed their treatment in woodcast, none required any further intervention or utilised the open appointment because of ongoing wrist problems. In conclusion, when woodcast is tolerated, patients’ satisfaction and outcome levels were good. However, we acknowledged 20% of patients in our series were not able to tolerate woodacst, Therefore, we suggest a comparison between the widely used synthetic plaster of Paris casting and woodcast to come in order.

Keywords: distal radius fractures, ecological cast, sustainability, woodcast

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Authors: D. Farsi, G. Dokhtvasi, S. Abbasi, S. Shafiee Ardestani, E. Payani

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Background and aim:It has not been well studied whether fentanyl-thiopental (FT) is effective and safe for PSA in orthopedic procedures in Emergency Department (ED). The aim of this trial was to evaluate the effectiveness of intravenous FTversusfentanyl-midazolam (FM)in patients who suffered from shoulder dislocation or distal radial fracture-dislocation. Methods:In this randomized double-blinded study, Seventy-six eligible patients were entered the study and randomly received intravenous FT or FM. The success rate, onset of action and recovery time, pain score, physicians’ satisfaction and adverse events were assessed and recorded by treating emergency physicians. The statistical analysis was intention to treat. Results: The success rate after administrating loading dose in FT group was significantly higher than FM group (71.7% vs. 48.9%, p=0.04); however, the ultimate unsuccess rate after 3 doses of drugs in the FT group was higher than the FM group (3 to 1) but it did not reach to significant level (p=0.61). Despite near equal onset of action time in two study group (P=0.464), the recovery period in patients receiving FT was markedly shorter than FM group (P<0.001). The occurrence of adverse effects was low in both groups (p=0.31). Conclusion: PSA using FT is effective and appears to be safe for orthopedic procedures in the ED. Therefore, regarding the prompt onset of action, short recovery period of thiopental, it seems that this combination can be considered more for performing PSA in orthopedic procedures in ED.

Keywords: procedural sedation and analgesia, thiopental, fentanyl, midazolam, orthopedic procedure, emergency department, pain

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Authors: Muhsin Kizhisseri, Jorg Schluter, Saleh Gharie

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Atherosclerosis is the main reason of stroke, which is one of the deadliest diseases in the world. The carotid artery in the brain is the prominent location for atherosclerotic progression, which hinders the blood flow into the brain. The inclusion of computational fluid dynamics (CFD) into the diagnosis cycle to understand the hemodynamics of the patient-specific carotid artery can give insights into stroke prediction. Realistic outlet boundary conditions are an inevitable part of the numerical simulations, which is one of the major factors in determining the accuracy of the CFD results. The Windkessel model-based outlet boundary conditions can give more realistic characteristics of the distal vascular branches of the carotid artery, such as the resistance to the blood flow and compliance of the distal arterial walls. This study aims to find the most influential distal branches of the carotid artery by using the Windkessel model parameters in the outlet boundary conditions. The parametric study approach to Windkessel model parameters can include the geometrical features of the distal branches, such as radius and length. The incorporation of the variations of the geometrical features of the major distal branches such as the middle cerebral artery, anterior cerebral artery, and ophthalmic artery through the Windkessel model can aid in identifying the most influential distal branch in the carotid artery. The results from this study can help physicians and stroke neurologists to have a more detailed and accurate judgment of the patient's condition.

Keywords: stroke, carotid artery, computational fluid dynamics, patient-specific, Windkessel model, distal vascular branches

Procedia PDF Downloads 182

Authors: R. Hassan, J. Duncombe, E. Darke, A. Dias, K. Anderson, R. G. Middleton

Abstract:

Background: NHS England has set itself the task of delivering a “Net Zero” National Health service by 2040. It is incumbent upon all health care practioners to work towards this goal. Orthopaedic surgeons are no exception. Distal radial fractures are the most common fractures sustained by the adult population. However, studiesare shortcoming on individual patient experience. The aim of this study was to assess the patient’ssatisfaction and outcomes with woodcast used in the conservative management of distal radius fractures. Methods: For all patients managed with woodcast in our unit, we undertook a structured questionnairethat included the Patient Rated Wrist Evaluation (PRWE) score, The EQ-5D-5L score, and the pain numerical score at the time of injury and six weeks after. Results: 30 patients were initially managed with woodcast.80% of patients tolerated woodcast for the full duration of their treatment. Of these, 20% didn’t tolerate woodcast and had their casts removed within 48 hours. Of the remaining, 79.1% were satisfied about woodcast comfort, 66% were very satisfied about woodcast weight, 70% were satisfied with temperature and sweatiness, 62.5% were very satisfied about the smell/odour, and 75% were satisfied about the level of support woodcast provided. During their treatment, 83.3% of patients rated their pain as five or less. Conclusion: For those who completed their treatment in woodcast, none required any further intervention or utilised the open appointment because of ongoing wrist problems. In conclusion, when woodcast is tolerated, patients’ satisfaction and outcome levels were good. However, we acknowledged 20% of patients in our series were not able to tolerate woodacst, Therefore, we suggest a comparison between the widely used synthetic plaster of Pariscasting and woodcast to come in order.

Keywords: distal radius fractures, ecological cast, sustainability, woodcast

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Authors: Won-Gon Kim

Abstract:

A standardized system to describe the pressure-flow characteristics of a given cannula has recently been proposed and has been termed ‘the M-number’. Using three different sizes of aortic cannulas in 50 pediatric cardiac patients on hypothermic cardiopulmonary bypass, we analyzed the correlation between experimentally and clinically derived M-numbers, and found this was positive. Clinical M-numbers were typically 0.35 to 0.55 greater than experimental M-numbers, and correlated inversely with a patient's temperature change; this was most probably due to increased blood viscosity, arising from hypothermia. This inverse relationship was more marked in higher M-number cannulas. The clinical data obtained in this study suggest that experimentally derived M-numbers correlate strongly with clinical performance of the cannula, and that the influence of temperature is significant.

Keywords: cardiopulmonary bypass, M-number, aortic cannula, pressure-flow characteristics

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Authors: Joy Cao, Min Zhou

Abstract:

Purpose: Acute Type A aortic dissection is a well-known cause of extremely high mortality rate. A highly accurate and cost-effective non-invasive predictor is critically needed so that the patient can be treated at earlier stage. Although various CFD approaches have been tried to establish some prediction frameworks, they are sensitive to uncertainty in both image segmentation and boundary conditions. Tedious pre-processing and demanding calibration procedures requirement further compound the issue, thus hampering their clinical applicability. Using the latest physics informed deep learning methods to establish an accurate and cost-effective predictor framework are amongst the main goals for a better Type A aortic dissection treatment. Methods: Via training a novel physics-informed deep residual network, with non-invasive 4D MRI displacement vectors as inputs, the trained model can cost-effectively calculate all these biomarkers: aortic blood pressure, WSS, and OSI, which are used to predict potential type A aortic dissection to avoid the high mortality events down the road. Results: The proposed deep learning method has been successfully trained and tested with both synthetic 3D aneurysm dataset and a clinical dataset in the aortic dissection context using Google colab environment. In both cases, the model has generated aortic blood pressure, WSS, and OSI results matching the expected patient’s health status. Conclusion: The proposed novel physics-informed deep residual network shows great potential to create a cost-effective, non-invasive predictor framework. Additional physics-based de-noising algorithm will be added to make the model more robust to clinical data noises. Further studies will be conducted in collaboration with big institutions such as Cleveland Clinic with more clinical samples to further improve the model’s clinical applicability.

Keywords: type-a aortic dissection, deep residual networks, blood flow modeling, data-driven modeling, non-invasive diagnostics, deep learning, artificial intelligence.

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Authors: Xiaolai Zhang, Haitao Zhang, Qiwen Sun, Weixin Qian, Weiyong Ying

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High temperature Fischer-Tropsch synthesis process use fixed fluidized bed as a reactor. In order to understand the flow behavior in the fluidized bed better, the research of how the radial velocity affect the entire flow field is necessary. Laser Doppler Velocimetry (LDV) was used to study the radial velocity distribution along the diameter direction of the cross-section of the particle in a fixed fluidized bed. The velocity in the cross-section is fluctuating within a small range. The direction of the speed is a random phenomenon. In addition to r/R is 1, the axial velocity are more than 6 times of the radial velocity, the radial velocity has little impact on the axial velocity in a fixed fluidized bed.

Keywords: Fischer-Tropsch synthesis, Fixed fluidized bed, LDV, Velocity

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Authors: Von Jerick Tenorio, Jonald Lucero, Marivic Vestal, Edwin Tiempo

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In patients with hostile aortic neck anatomy, the risks of proximal seal complications and stent migration remain with EVAR despite improved endograft technology. This case report discusses how the technical challenges of the hostile neck anatomy, proximal penetrating atherosclerotic ulcer (PAU) and tortuous femoral access were addressed. The CT aortogram of a 63-year-old hypertensive and diabetic man with recurring abdominal discomfort revealed a fusiform infra-renal aneurysm measuring 8.8 cm in length and 5.7 cm in diameter. The proximal landing zone only has a 3 mm healthy neck with a conicity of > 10% and a thrombus of 4 mm thick. Proximal to the aneurysm is a PAU with a circumferential mural thrombus. The right femoral artery is tortuous with > 90o angulation. A 20% oversized Endurant II endograft and Aptus Heli-FX EndoAnchors were deployed as prophylaxis for type I endoleaks and endograft migration consequent to the conical neck and proximal aneurysm extension consequent to the PAU. A stiff Backup Meier guide wire facilitated the deployment of the endograft. Coil embolization of the right internal iliac artery was performed as prophylaxis for type II endoleaks. EndoAnchors can be used as an adjunct to EVAR as prophylaxis for proximal seal complications and stent migration in patients with hostile aortic aneurysm neck anatomy and concomitant proximal PAU.

Keywords: endoAnchors, endoleaks, EVAR, hostile neck

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Authors: Praveenkumar Natarajan

Abstract:

A 59-year-old male with no known co-morbidities was admitted to a private hospital for complaints of fever and cough and was diagnosed to haveCOVID-19. CT of the thorax revealed the involvement of 50% of the lungs. Screening ECG and ECHO were normal. The patient was treated with oxygen therapy and drugs and was discharged after 12 days of admission. Post-discharge, the patient remained symptom-free and continued his work. After one month, the patient developed a fever for three days, for which he took antipyretics. Subsequently, the patient developed sudden onset breathlessness, which rapidly progressed to grade 4 NYHA, and developed a cough as well. Suspecting COVID-19 reinfection, the patient visited a nearby hospital, where COVID–19 rt-PCR swabs turned out to be positive, and was referred to our hospital. On receiving, the patient had diffuse lung crepitations and a diastolic murmur in the neo-aortic area. CT thorax revealed pulmonary edema with areas of consolidation. ECHO revealed vegetation on the aortic valve with severe aortic regurgitation. Blood cultures were taken, which revealed the growth of Enterococcus faecalis. The diagnosis of infective endocarditis was made, and the patient was started on appropriate treatment. COVID–19 has effects on various systems, including the cardiovascular system. Even though infective endocarditis is common in the elderly with valvular heart disease, this patient had developed infective endocarditis in an apparently normal aortic valve. Infective endocarditis and COVID–19 can have similar presentations leading to diagnostic difficulties. COVID–19, affecting the heart valves causing valvulitis and predisposing them to the development of infective endocarditis, is also an area to be explored.

Keywords: aortic regurgitation, COVID-19, infective endocarditis, valvulitis

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Authors: Aicha Rima Cheniti, Hatem Besbes, Joseph Haggege, Christophe Sintes

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In this paper, we are interested to determine the carbon dioxide pressure in the arterial blood through radial velocity difference. The blood was modeled as a two phase mixture (an aqueous carbon dioxide solution with carbon dioxide gas) by Drift flux model and the Young-Laplace equation. The distributions of mixture velocities determined from the considered model permitted the calculation of the radial velocity distributions with different values of mean mixture pressure and the calculation of the mean carbon dioxide pressure knowing the mean mixture pressure. The radial velocity distributions are used to deduce a calculation method of the mean mixture pressure through the radial velocity difference between two positions which is measured by ultrasound. The mean carbon dioxide pressure is then deduced from the mean mixture pressure.

Keywords: mean carbon dioxide pressure, mean mixture pressure, mixture velocity, radial velocity difference

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Authors: K. Pietrykowski, M. Bialy, M. Duk

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One of the main disadvantages of radial engines is non-uniformity of operating cycles of each cylinder. This paper discusses the results of the kinematic analysis of pistons motion of the ASz-62IR radial engine. The ASz-62IR engine is produced in Poland and mounted in the M-18 Dromader and the An-2. The results are shown as the courses of the motion of the pistons. The discrepancies in the courses for individual pistons can result in different masses of the charge to fill the cylinders. Besides, pistons acceleration of individual cylinders is different, which triggers an additional vibration in the engine.

Keywords: nonuniformity, kinematic analysis, piston motion, radial engine

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Authors: Preeti Aghalayam, Jay Shah

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Underground coal gasification (UCG) is the in-situ gasification of unmineable coals to produce syngas. In UCG, gasifying agents are injected into the coal seam, and a reactive cavity is formed due to coal consumption. The cavity formed is typically hemispherical, and this report consists of the MATLAB model of the UCG cavity to predict the composition of the output gases. There are seven radial and two time-variant ODEs. A MATLAB solver (ode15s) is used to solve the radial ODEs from the above equations. Two for-loops are implemented in the model, i.e., one for time variations and another for radial variation. In the time loop, the radial odes are solved using the MATLAB solver. The radial loop is nested inside the time loop, and the density odes are numerically solved using the Euler method. The model is validated by comparing it with the literature results of laboratory-scale experiments. The model predicts the radial and time variation of the product gases inside the cavity.

Keywords: gasification agent, MATLAB model, syngas, underground coal gasification (UCG)

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Authors: Andrey Boyko

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Nowadays, there is no consensus about the influence of urethral plate (UP) width on the surgical outcomes after distal hypospadias repair. The purpose of the research was to study the association between UP width and surgical outcomes after distal hypospadias repair in children. Materials and methods: The study included 138 patients with distal hypospadias. The mean age at the time of surgery was 4.6 years (6 months – 16 years). We measured UP width at the “midpoint within the glans” and used the HOSE scale to assess postoperative outcomes. The patients were divided into 2 groups: group 1 – the patients (107) with UP < 8mm, group 2 – patients (31) with UP > 8mm. All boys underwent TIP repair. Preincision means UP width after incision means UP width, and the UP ratio was analyzed. Statistical data were obtained using Statistica 10. Results: The findings were preincision mean UP width - 5.4 mm and 9.4 mm; after incision mean UP width - 13mm and 17.5 mm; UP ratio - 0.41 and 0.53 in group 1 and group 2, respectively. Most postoperative complications (fistula, meatal stenosis, and stricture) happened in patients with UP width < 8 mm versus ≥ 8 mm (7/107 versus 2/31, respectively). HOSE results were 15.77 (group 1), 15.65 (group 2). The follow up lasted up to 12 months. Statistical analysis proved the absence of correlation between UP width and postoperative complications. Conclusions: In conclusion, it should be noted that the success of surgical repair mostly depended on the surgical technique.

Keywords: children, distal hypospadias, tip repair, urethral plate width

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Authors: Gehan Hussein, Hala Agha, Rasha Abdelraof, Marina George, Antoine Fakhri

Abstract:

Background: β-Thalassemia major (TM) and sickle cell disease (SCD) are inherited hemoglobin disorders resulting in chronic hemolytic anemia. Cardiovascular involvement is an important cause of morbidity and mortality in these groups of patients. The narrow border is between overt myocardial dysfunction and clinically silent left ventricular (LV) and / or right ventricular (RV) dysfunction in those patients. 3 D Speckle tracking echocardiography (3D STE) is a novel method for the detection of subclinical myocardial involvement. We aimed to study myocardial affection in SCD and TM using 3D STE, comparing it with conventional echocardiography, correlate it with serum ferritin level and lactate dehydrogenase (LDH). Methodology: Thirty SCD and thirty β TM patients, age range 4-18 years, were compared to 30 healthy age and sex matched control group. Cases were subjected to clinical examination, laboratory measurement of hemoglobin level, serum ferritin, and LDH. Transthoracic color Doppler echocardiography, 3D STE, tissue Doppler echocardiography, and aortic speckle tracking were performed. Results: significant reduction in global longitudinal strain (GLS), global circumferential strain (GCS), and global area strain (GAS) in SCD and TM than control (P value <0.001) there was significantly lower aortic speckle tracking in patients with TM and SCD than control (P value< 0.001). LDH was significantly higher in SCD than both TM and control and it correlated significantly positive mitral inflow E, (p value:0.022 and 0.072. r: 0.416 and -0.333 respectively) lateral E/E’ (p value.<0.001and 0.818. r. 0.618 and -0. 044.respectively) and septal E/E’ (p value 0.007 and 0.753& r value 0.485 and -0.060 respectively) in SCD but not TM and significant negative correlation between LDH and aortic root speckle tracking (value 0.681& r. -0.078.). The potential diagnostic accuracy of LDH in predicting vascular dysfunction as represented by aortic root GCS with a sensitivity 74% and aortic root GCS was predictive of LV dysfunction in SCD patients with sensitivity 100% Conclusion: 3D STE LV and RV systolic dysfunction in spite of their normal values by conventional echocardiography. SCD showed significantly lower right ventricular dysfunction and aortic root GCS than TM and control. LDH can be used to screen patients for cardiac dysfunction in SCD, not in TM

Keywords: thalassemia major, sickle cell disease, 3d speckle tracking echocardiography, LDH

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Authors: Rajendra Kumar Kanojia

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Correction of the gap created by the resection of large juxtra-articular tumours of the femur would be difficult to manage, several bone substitutes, bone grafts, and artificial bone granules were tried but the results were not as good as with the distraction osteogensis, by the help of either Ilizarov ring fixator or the mono-rail fixators. We are presenting a small study of five cases of malignant tumours of the distal femur, removed, custom made mega prosthesis was applied and that failed twice in a span of five years. We had no better option left then to apply mono-rail fixator, and start the process of distraction osteogeneis, we got the union, gap was filled with new bone and patient has been made walking in few months.

Keywords: distal femur tumour, resection, defect non-union, mono-rail fixator

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Authors: Jongchul Park, Chan Byon

Abstract:

In this study, the thermal performance of radial heat sinks for LED applications is investigated numerically and experimentally. The effect of geometrical parameters such as inner radius, fin height, fin length, and fin spacing, as well as the Elenbaas number, is considered. In addition, the effects of augmentation of concentric ring, perforation, and duct are extensively explored in order to enhance the thermal performance of conventional radial heat sink. The results indicate that the Elenbaas number and the fin radius have a significant effect on the thermal performance of the heat sink. The concentric ring affects the performance much, but the degree of affection is highly dependent on the orientation. The perforation always brings about higher thermal performance. The duct can effectively prevent the bypass of the natural convection flow, which in turn reduces the thermal resistance of the radial heat sink significantly.

Keywords: heat transfer, radial heat sink, LED, Elenbaas

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Authors: Seppo Kittilä, Sonja Dahlgren

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In this paper, a (morpho)phonological typology of proximal and distal demonstratives is proposed. Only the most basic proximal (‘this’) and distal (‘that’) forms have been considered, potential more fine-grained distinctions based on proximity are not relevant to our discussion, nor are the other functions the discussed demonstratives may have. The sample comprises 82 languages that represent the linguistic diversity of the world’s languages, although the study is not based on a systematic sample. Four different major types are distinguished; (1) Vowel type: front vs. back; high vs. low vowel (2) Consonant type: front-back consonants (3) Additional element –type (4) Varia. The proposed types can further be subdivided according to whether the attested difference concern only, e.g., vowels, or whether there are also other changes. For example, the first type comprises both languages such as Betta Kurumba, where only the vowel changes (i ‘this’, a ‘that’) and languages like Alyawarra (nhinha vs. nhaka), where there are also other changes. In the second type, demonstratives are distinguished based on whether the consonants are front or back; typically front consonants (e.g., labial and dental) appear on proximal demonstratives and back consonants on distal demonstratives (such as velar or uvular consonants). An example is provided by Bunaq, where bari marks ‘this’ and baqi ‘that’. In the third type, distal demonstratives typically have an additional element, making it longer in form than the proximal one (e.g., Òko òne ‘this’, ònébé ‘that’), but the type also comprises languages where the distal demonstrative is simply phonologically longer (e.g., Ngalakan nu-gaʔye vs. nu-gunʔbiri). Finally, the last type comprises cases that do not fit into the three other types, but a number of strategies are used by the languages of this group. The two first types can be explained by iconicity; front or high phonemes appear on the proximal demonstratives, while back/low phonemes are related to distal demonstratives. This means that proximal demonstratives are pronounced at the front and/or high part of the oral cavity, while distal demonstratives are pronounced lower and more back, which reflects the proximal/distal nature of their referents in the physical world. The first type is clearly the most common in our data (40/82 languages), which suggests a clear association with iconicity. Our findings support earlier findings that proximal and distal demonstratives have an iconic phonemic manifestation. For example, it has been argued that /i/ is related to smallness (small distance). Consonants, however, have not been considered before, or no systematic correspondences have been discovered. The third type, in turn, can be explained by markedness; the distal element is more marked than the proximal demonstrative. Moreover, iconicity is relevant also here: some languages clearly use less linguistic substance for referring to entities close to the speaker, which is manifested in the longer (morpho)phonological form of the distal demonstratives. The fourth type contains different kinds of cases, and systematic generalizations are hard to make.

Keywords: demonstratives, iconicity, language typology, phonology

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Authors: Rania Abdulkareem Aboubakr Mahdaly Ammar

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The aortic valve (AV) is a complex mechanical environment that includes flexure, tension, pressure and shear stress forces to blood flow during cardiac cycle. This mechanical environment regulates AV tissue structure by constantly renewing and remodeling the phenotype. In vitro, ex vivo and in vivo studies have explained that pathological states such as hypertension and congenital defects like bicuspid AV ( BAV ) can potentially alter the AV’s mechanical environment, triggering a cascade of remodeling, inflammation and calcification activities in AV tissue. Changes in mechanical environments are first sent by the endothelium that induces changes in the extracellular matrix, and triggers cell differentiation and activation. However, the molecular mechanism of this process is not very well understood. Understanding these mechanisms is critical for the development of effective medical based therapies. Recently, there have been some interesting studies on characterizing the hemodynamics associated with AV, especially in pathologies like BAV, using different experimental and numerical methods. Here, we review the current knowledge of the local AV mechanical environment and its effect on valve biology, focusing on in vitro and ex vivo approaches.

Keywords: aortic valve mechanobiology, bicuspid calcification, pressure stretch, shear stress

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Authors: Sigal Portnoy, Yael Kaufman-Cohen, Yafa Levanon

Abstract:

Introduction: Rehabilitation following wrist fractures often includes exercising flexion-extension movements with a dynamic splint. However, during daily activities, we combine most of our wrist movements with radial and ulnar deviations. Also, the multi-plane wrist motion, named the ‘dart throw motion’ (DTM), was found to be a more stable motion in healthy individuals, in term of the motion of the proximal carpal bones, compared with sagittal wrist motion. The aim of this study was therefore to explore the pathomechanics of the wrist in a common multi-plane movement pattern (DTM) and design a novel splint for rehabilitation following distal radius fractures. Methods: First, a multi-axis electro-goniometer was used to quantify the plane angle of motion of the dominant and non-dominant wrists during various activities, e.g. drinking from a glass of water and answering a phone in 43 healthy individuals. The following protocols were then implemented with a population following distal radius fracture. Two dynamic scans were performed, one of the sagittal wrist motion and DTM, in a 3T magnetic resonance imaging (MRI) device, bilaterally. The scaphoid and lunate carpal bones, as well as the surface of the distal radius, were manually-segmented in SolidWorks and the angles of motion of the scaphoid and lunate bones were calculated. Subsequently, a patient-specific splint was designed using 3D scans of the hand. The brace design comprises of a proximal attachment to the arm and a distal envelope of the palm. An axle with two wheels is attached to the proximal part. Two wires attach the proximal part with the medial-palmar and lateral-ventral aspects of the distal part: when the wrist extends, the first wire is released and the second wire is strained towards the radius. The opposite occurs when the wrist flexes. The splint was attached to the wrist using Velcro and constrained the wrist movement to the desired calculated multi-plane of motion. Results: No significant differences were found between the multi-plane angles of the dominant and non-dominant wrists. The most common daily activities occurred at a plane angle of approximately 20° to 45° from the sagittal plane and the MRI studies show individual angles of the plane of motion. The printed splint fitted the wrist of the subjects and constricted movement to the desired multi-plane of motion. Hooks were inserted on each part to allow the addition of springs or rubber bands for resistance training towards muscle strengthening in the rehabilitation setting. Conclusions: It has been hypothesized that activation of the wrist in a multi-plane movement pattern following distal radius fractures will accelerate the recovery of the patient. Our results show that this motion can be determined from either the dominant or non-dominant wrists. The design of the patient-specific dynamic splint is the first step towards assessing whether splinting to induce combined movement is beneficial to the rehabilitation process, compared to conventional treatment. The evaluation of the clinical benefits of this method, compared to conventional rehabilitation methods following wrist fracture, are a part of a PhD work, currently conducted by an occupational therapist.

Keywords: distal radius fracture, rehabilitation, dynamic magnetic resonance imaging, dart throw motion

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Authors: Ahmed Shaboub, Yusuf Jasim Althawadi, Shadi Alaa Abdelaal, Mohamed Hussein Abdalla, Hatem Amr Elzahaby, Mohamed Mohamed, Hazem S. Ghaith, Ahmed Negida

Abstract:

Objectives: We aimed to compare the safety and outcomes of the minimally invasive approaches versus conventional sternotomy procedures for aortic valve replacement. Methods: We conducted a PRISMA-compliant systematic review and meta-analysis. We ran an electronic search of PubMed, Cochrane CENTRAL, Scopus, and Web of Science to identify the relevant published studies. Data were extracted and pooled as standardized mean difference (SMD) or risk ratio (RR) using StataMP version 17 for macOS. Results: Forty-one studies with a total of 15,065 patients were included in this meta-analysis (minimally invasive approaches n=7231 vs. conventional sternotomy n=7834). The pooled effect size showed that minimally invasive approaches had lower mortality rate (RR 0.76, 95%CI [0.59 to 0.99]), intensive care unit and hospital stays (SMD -0.16 and -0.31, respectively), ventilation time (SMD -0.26, 95%CI [-0.38 to -0.15]), 24-h chest tube drainage (SMD -1.03, 95%CI [-1.53 to -0.53]), RBCs transfusion (RR 0.81, 95%CI [0.70 to 0.93]), wound infection (RR 0.66, 95%CI [0.47 to 0.92]) and acute renal failure (RR 0.65, 95%CI [0.46 to 0.93]). However, minimally invasive approaches had longer operative time, cross-clamp, and bypass times (SMD 0.47, 95%CI [0.22 to 0.72], SMD 0.27, 95%CI [0.07 to 0.48], and SMD 0.37, 95%CI [0.20 to 0.45], respectively). There were no differences between the two groups in blood loss, endocarditis, cardiac tamponade, stroke, arrhythmias, pneumonia, pneumothorax, bleeding reoperation, tracheostomy, hemodialysis, or myocardial infarction (all P>0.05). Conclusion: Current evidence showed higher safety and better operative outcomes with minimally invasive aortic valve replacement compared to the conventional approach. Future RCTs with long-term follow-ups are recommended.

Keywords: aortic replacement, minimally invasive, sternotomy, mini-sternotomy, aortic valve, meta analysis

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Authors: Hanadi Mohamed Shawgi Gamal, Claus Thomas Bues

Abstract:

Wood density is a variable influencing many of the technological and quality properties of wood. Understanding the pattern of wood density radial variation is important for its end-use. The X-ray technique, traditionally applied to softwood species to assess the wood quality properties, due to its simple and relatively uniform wood structure. On the other hand, very limited information is available about the validation of using this technique for hardwood species. The suitability of using the X-ray technique for the determination of hardwood density has a special significance in countries like Sudan, where only a few timbers are well known. This will not only save the time consumed by using the traditional methods, but it will also enhance the investigations of the great number of the lesser known species, the thing which will fill the huge cap of lake information of hardwood species growing in Sudan. The current study aimed to evaluate the validation of using the X-ray densitometry technique to determine the radial variation of wood density of Acacia seyal var. seyal. To this, a total of thirty trees were collected randomly from four states in Sudan. The wood density radial trend was determined using the basic density as well as density obtained by the X-ray densitometry method in order to assess the validation of X-ray technique in wood density radial variation determination. The results showed that the pattern of radial trend of density obtained by X-ray technique is very similar to that achieved by basic density. These results confirmed the validation of using the X-ray technique for Acacia seyal var. seyal density radial trend determination. It also promotes the suitability of using this method in other hardwood species.

Keywords: x-ray densitometry, wood density, Acacia seyal var. seyal, radial variation

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Authors: F. U. Rahman, R. Q. Zhang

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This work aims to develop a systematic numerical technique which can be easily extended to many-body problem. The Lippmann Schwinger equation (integral form of the Schrodinger wave equation) is solved for the nonrelativistic radial wave of hydrogen atom using iterative integration scheme. As the unknown wave function appears on both sides of the Lippmann Schwinger equation, therefore an approximate wave function is used in order to solve the equation. The Green’s function is obtained by the method of Laplace transform for the radial wave equation with excluded potential term. Using the Lippmann Schwinger equation, the product of approximate wave function, the Green’s function and the potential term is integrated iteratively. Finally, the wave function is normalized and plotted against the standard radial wave for comparison. The outcome wave function converges to the standard wave function with the increasing number of iteration. Results are verified for the first fifteen states of hydrogen atom. The method is efficient and consistent and can be applied to complex systems in future.

Keywords: Green’s function, hydrogen atom, Lippmann Schwinger equation, radial wave

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Authors: Ticijana Prijon, Branko Ermenc

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Background: Blunt aortic trauma (BAT) includes various morphological changes that occur during deceleration, acceleration and/or body compression in traffic accidents. The various forms of BAT, from limited laceration of the intima to complete transection of the aorta, depends on the force acting on the vessel wall and the tolerance of the aorta to injury. The force depends on the change in velocity, the dynamics of the accident and of the seating position in the car. Tolerance to aortic injury depends on the anatomy, histological structure and pathomorphological alterations due to aging or disease of the aortic wall.An overview of the literature and medical documentation reveals that different terms are used to describe certain forms of BAT, which can lead to misinterpretation of findings or diagnoses. We therefore, propose a classification that would enable uniform systematic screening of all forms of BAT. We have classified BAT into three morphologycal types: TYPE I (intramural), TYPE II (transmural) and TYPE III (multiple) aortic ruptures with appropriate subtypes. Methods: All car accident casualties examined at the Institute of Forensic Medicine from 2001 to 2009 were included in this retrospective study. Autopsy reports were used to determine the occurrence of each morphological type of BAT in deceased drivers, front seat passengers and other passengers in cars and to define the morphology of BAT in relation to the accident dynamics and the age of the fatalities. Results: A total of 391 fatalities in car accidents were included in the study. TYPE I, TYPE II and TYPE III BAT were observed in 10,9%, 55,6% and 33,5%, respectively. The incidence of BAT in drivers, front seat and other passengers was 36,7%, 43,1% and 28,6%, respectively. In frontal collisions, the incidence of BAT was 32,7%, in lateral collisions 54,2%, and in other traffic accidents 29,3%. The average age of fatalities with BAT was 42,8 years and of those without BAT 39,1 years. Conclusion: Identification and early recognition of the risk factors of BAT following a traffic accident is crucial for successful treatment of patients with BAT. Front seat passengers over 50 years of age who have been injured in a lateral collision are the most at risk of BAT.

Keywords: aorta, blunt trauma, car accidents, morphology, risk factors

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Authors: Qianhui Li, Christoph H. Bruecker

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Atherosclerotic plaques are typically found where flow separation and variations of shear stress occur. Although helical flow patterns and flow separations have been recorded in the aorta, their relation has not been clearly clarified and especially in the condition of artificial heart valve prostheses. Therefore, an experimental study is performed to investigate the hemodynamic performance of different mechanical heart valves (MHVs), i.e. the SJM Regent bileaflet mechanical heart valve (BMHV) and the Lapeyre-Triflo FURTIVA trileaflet mechanical heart valve (TMHV), in a transparent model of the human aorta under a physiological pulsatile right-hand helical flow condition. A typical systolic flow profile is applied in the pulse-duplicator to generate a physiological pulsatile flow which thereafter flows past an axial turbine blade structure to imitate the right-hand helical flow induced in the left ventricle. High-speed particle image velocimetry (PIV) measurements are used to map the flow evolution. A circular open orifice nozzle inserted in the valve plane as the reference configuration initially replaces the valve under investigation to understand the hemodynamic effects of the entered helical flow structure on the flow evolution in the aortic arch. Flow field analysis of the open orifice nozzle configuration illuminates the helical flow effectively delays the flow separation at the inner radius wall of the aortic arch. The comparison of the flow evolution for different MHVs shows that the BMHV works like a flow straightener which re-configures the helical flow pattern into three parallel jets (two side-orifice jets and the central orifice jet) while the TMHV preserves the helical flow structure and therefore prevent the flow separation at the inner radius wall of the aortic arch. Therefore the TMHV is of better hemodynamic performance and reduces the pressure loss.

Keywords: flow separation, helical aortic flow, mechanical heart valve, particle image velocimetry

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Authors: Afshin Veisi

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In this study, the physical properties of wood in poplar wood (Populous sp.) were analyzed in longitudinal and radial directions of the stem. Three Populous Alba tree were cut in chaloos zone and from each tree, 3 discs were selected at 130cm, half of tree and under of crown. The test samples from pith to bark (heartwood to sapwood) were prepared from these discs for measuring the involved properties such as, wet, dry and critical specific gravity, porosity, volume shrinkage and swelling based on the ASTM standard, and data in two radial and longitudinal directions in the trank were statistically analyzed. Such as, variations of wet, dry and critical specific gravity had in radial direction respectively: irregular increase, increase and increase, and in longitudinal direction respectively: irregular decrease, irregular increase and increase. Results of variations to moisture content and porosity show that in radial direction respectively: irregular increasing and decreasing, and in longitudinal direction from down to up respectively: irregular decreasing and stability. Volume shrinkage and swelling variations show in radial direction irregular and in longitudinal axial regular decreasing.

Keywords: poplar wood, physical properties, shrinkage, swelling, critical specific gravity, wet specific gravity, dry specific gravity

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Authors: Elyas Shivanian

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In this paper, the spectral meshless radial point interpolation (SMRPI) technique is applied to the Cauchy problems of two-dimensional elliptic PDEs in doubly connected domains. It is obtained the unknown data on the inner boundary of the domain while overspecified boundary data are imposed on the outer boundary of the domain by using the SMRPI. Shape functions, which are constructed through point interpolation method using the radial basis functions, help us to treat problem locally with the aim of high order convergence rate. In this way, localization in SMRPI can reduce the ill-conditioning for Cauchy problem. Furthermore, we improve previous results and it is revealed the SMRPI is more accurate and stable by adding strong perturbations.

Keywords: cauchy problem, doubly connected domain, radial basis function, shape function

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Authors: A. Suparmi, C. Cari, M. Yunianto, B. N. Pratiwi

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D-dimensional Dirac equations of q-deformed shape invariant potentials were solved using supersymmetric quantum mechanics (SUSY QM) in the case of exact spin symmetry. The D dimensional radial Dirac equation for shape invariant potential reduces to one-dimensional Schrodinger type equation by an appropriate variable and parameter change. The relativistic energy spectra were analyzed by using SUSY QM and shape invariant properties from radial D dimensional Dirac equation that have reduced to one dimensional Schrodinger type equation. The SUSY operator was used to generate the D dimensional relativistic radial wave functions, the relativistic energy equation reduced to the non-relativistic energy in the non-relativistic limit.

Keywords: D-dimensional dirac equation, non-central potential, SUSY QM, radial wave function

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Authors: Fang Li, Xie-Yuan Yin, Xie-Zhen Yin

Abstract:

Instability and breakup of electrified viscoelastic liquid jets are involved in various applications such as inkjet printing, fuel atomization, the pharmaceutical industry, electrospraying, and electrospinning. Studying on the instability of electrified viscoelastic liquid jets is of theoretical and practical significance. We built a one-dimensional electrified viscoelastic model to study the nonlinear instability behavior of a perfecting conducting, slightly viscoelastic liquid jet under a radial electric field. The model is solved numerically by using an implicit finite difference scheme together with a boundary element method. It is found that under a radial electric field a viscoelastic liquid jet still evolves into a beads-on-string structure with a thin filament connecting two adjacent droplets as in the absence of an electric field. A radial electric field exhibits limited influence on the decay of the filament thickness in the nonlinear evolution process of a viscoelastic jet, in contrast to its great enhancing effect on the linear instability of the jet. On the other hand, a radial electric field can induce axial non-uniformity of the first normal stress difference within the filament. Particularly, the magnitude of the first normal stress difference near the midpoint of the filament can be greatly decreased by a radial electric field. Decreasing the extensional stress by a radial electric field may found applications in spraying, spinning, liquid bridges and others. In addition, the effect of a radial electric field on the formation of satellite droplets is investigated on the parametric plane of the dimensionless wave number and the electrical Bond number. It is found that satellite droplets may be formed for a larger axial wave number at a larger radial electric field. The present study helps us gain insight into the nonlinear instability characteristics of electrified viscoelastic liquid jets.

Keywords: non linear instability, one-dimensional models, radial electric fields, viscoelastic liquid jets

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Authors: Abdolreza Memari

Abstract:

In this article in order to estimate the viscosity of crude oil,a numerical method has been used. We use this method to measure the crude oil's viscosity for 3 states: Saturated oil's viscosity, viscosity above the bubble point and viscosity under the saturation pressure. Then the crude oil's viscosity is estimated by using KHAN model and roller ball method. After that using these data that include efficient conditions in measuring viscosity, the estimated viscosity by the presented method, a radial based neural method, is taught. This network is a kind of two layered artificial neural network that its stimulation function of hidden layer is Gaussian function and teaching algorithms are used to teach them. After teaching radial based neural network, results of experimental method and artificial intelligence are compared all together. Teaching this network, we are able to estimate crude oil's viscosity without using KHAN model and experimental conditions and under any other condition with acceptable accuracy. Results show that radial neural network has high capability of estimating crude oil saving in time and cost is another advantage of this investigation.

Keywords: viscosity, Iranian crude oil, radial based, neural network, roller ball method, KHAN model

Procedia PDF Downloads 461