Minimally Invasive Approach for Diagnosing TMJ Osteoarthritis

This study’s objectives were to test correlations among groups of biomarkers that are associated with condylar morphology and to apply artificial intelligence to test shape analysis features in a neural network (NN) to stage condylar morphology in temporomandibular joint osteoarthritis (TMJOA). Seventeen TMJOA patients (39.9 ± 11.7 y) experiencing signs and symptoms of the disease for less than 10 y and 17 age- and sex-matched control subjects (39.4 ± 15.2 y) completed a questionnaire, had a temporomandibular joint clinical exam, had blood and saliva samples drawn, and had high-resolution cone beam computed tomography scans taken. Serum and salivary levels of 17 inflammatory biomarkers were quantified using protein microarrays. A NN was trained with 259 other condyles to detect and classify the stage of TMJOA and then compared to repeated clinical experts’ classifications. Levels of the salivary biomarkers MMP-3, VE-cadherin, 6Ckine, and PAI-1 were correlated to each other in TMJOA patients and were significantly correlated with condylar morphological variability on the posterior surface of the condyle. In serum, VE-cadherin and VEGF were correlated with one another and with significant morphological variability on the anterior surface of the condyle, while MMP-3 and CXCL16 presented statistically significant associations with variability on the anterior surface, lateral pole, and superior-posterior surface of the condyle. The range of mouth opening variables were the clinical markers with the most significant associations with morphological variability at the medial and lateral condylar poles. The repeated clinician consensus classification had 97.8% agreement on degree of degeneration within 1 group difference. Predictive analytics of the NN’s staging of TMJOA compared to the repeated clinicians’ consensus revealed 73.5% and 91.2% accuracy. This study demonstrated significant correlations among variations in protein expression levels, clinical symptoms, and condylar surface morphology. The results suggest that 3-dimensional variability in TMJOA condylar morphology can be comprehensively phenotyped by the NN

Predictors of 1-year compliance with adaptive servoventilation in patients with heart failure and sleep disordered breathing: preliminary data from the ADVENT-HF trial

Despite its effectiveness in suppressing sleep disordered breathing (SDB), positive airway pressure therapy (PAP) is not always well tolerated by patients and long-term adherence can be problematic. Recently, two multicentre, randomised clinical trials (RCTs) tested the effects of PAP for patients with cardiovascular disease and co-existing SDB on morbidity and mortality with negative outcomes [1, 2]. Relatively poor adherence to PAP therapy (mean 3.7 and 3.3 h·day-1, respectively) in these two trials might have contributed to their poor results. Indeed, higher PAP use per day is associated with better clinical outcomes than lower use [3]

A non-isothermal thermodynamically consistent phase field framework for structural damage and fatigue

We present a general thermodynamically consistent non-isothermal non-local framework for the evolution of damage, fatigue and fracture in materials under the hypothesis of small deformation. The approach is based on the principle of virtual power (PVP), the balance of energy and the second law of thermodynamics in the form of the generalized Clausius–Duhem inequality for the entropy. In addition to the usual physical fields, the model uses the phase field approach to describe the evolution of both damage and fatigue. The kinematic descriptor (phase field) for damage is considered a continuous dynamical variable whose evolution equation is obtained by the PVP. The kinematic descriptor (another phase field) for fatigue is a continuous internal variable whose evolution equation is considered as a constitutive relation to be determined in a thermodynamically consistent way. The behavior of particular material classes can be specified by their corresponding free-energy potentials (which gives the reversible parts of the involved thermodynamic forces) and their associated pseudo-potentials of dissipation (which gives the irreversible parts of the involved thermodynamic forces). To exemplify our general framework, we present the case of an isotropic linear elastic material with viscous dissipation and constant specific heat. The corresponding case of irreversible damage is also presented by using penalization. The considered damage and fatigue phase field approach is a framework from which other methods in the literature may be recovered. The model is approximated by the nodal high-order finite element method with explicit fourth-order Runge–Kutta time integration. Results for one-dimensional examples are presented and conclusions are addressed312395427CONSELHO NACIONAL DE DESENVOLVIMENTO CIENTÍFICO E TECNOLÓGICO - CNPQCOORDENAÇÃO DE APERFEIÇOAMENTO DE PESSOAL DE NÍVEL SUPERIOR - CAPESFUNDAÇÃO DE AMPARO À PESQUISA DO ESTADO DE SÃO PAULO - FAPESP306182/2014-9330030172013/50238-3; 2015/10310-

Echinodermata das praias de Salvador (Bahia, Brasil) The Echinoderms of Salvador beaches (Bahia, Brazil)

<abstract language="eng">This paper presents 28 species of Echinoderms collected on 5 beaches of Salvador (12º54' to 13º01' S and 38º26' to 38º33' W), Brazil, which are distributed in 19 families. Ophiuroidea represented 53,6% of the collected species, followed by Echinoidea (28,6%), Asteroidea (7,1%), Holothuroidea (7,1%), and Crinoidea (3,6%). Ophiuroidea and Echinoidea were the most frequent groups, occurring at all the studied beaches while Crinoidea occurred only on 20% of them. Most of the species are characterized as belonging to the tropical warm waters, some to the shallow coastal areas and some having a broad bathymetric distribution. The richness of species values on beaches ranged from 7 to 24, at Itapua Beach, and from 2 to 14 among different kinds of habitats, where protected ones showed higher values

Comparison of high order finite element and discontinuous galerkin methods for phase field equations : application to structural damage

Phase field equations are used to model a wide range of multiphase problems such as separation of fluids, solidification, viscous fingering, fracture and fatigue. A wide variety of methods to numerically solve phase field equations can be found in the literature. In particular, high order methods are an effective option when accuracy improvement is desired. In the first part of this work, we analyze the accuracy and computational efficiency of the high order finite element method (FEM) and discontinuous Galerkin (DG) method applied to the second-order Allen–Cahn (AC) and fourth-order Cahn–Hilliard (CH) equations. Several schemes for time integration are used for these equations. The explicit schemes are the forward Euler, classical fourth-order Runge–Kutta (RK4) and the strong stability preserving ten stages fourth-order Runge–Kutta (RKSSP-10,4) described in Gottlieb et al. (2011). The backward Euler and trapezoidal implicit methods are adopted in the full and semi implicit schemes, as proposed in Eyre (unpublished). Manufactured solutions for one dimensional problems are used in order to evaluate the errors and to compare the different numerical methods. By choosing an adequate discretization for AC equations resulting from the previous analysis of the first part of the work, in the second part, we propose a numerical semi implicit scheme to solve the damage and fracture model described in Boldrini et al. (2016). This procedure employs the FEM for spatial discretization, the Newmark method for time integration of the kinematics equation and the backward Euler for the damage phase field evolution. Finally, results for 2D benchmark tests are presented for the fracture phase field model and the convergence to a sharp crack for a small width of the damage phase field layer is verified74715421564CONSELHO NACIONAL DE DESENVOLVIMENTO CIENTÍFICO E TECNOLÓGICO - CNPQCOORDENAÇÃO DE APERFEIÇOAMENTO DE PESSOAL DE NÍVEL SUPERIOR - CAPESFUNDAÇÃO DE AMPARO À PESQUISA DO ESTADO DE SÃO PAULO - FAPESP306182/2014-9.330030172013/50238-3; 2015/10310-2; 2015/20188-

Resultados pós-operatórios de 407 doentes submetidos à desarterialização hemorroidária guiada pelo Doppler

Introduction: The treatment of hemorrhoidal disease by conventional technique is associated with significant morbidity, mainly represented by the postoperative pain and the late return to daily activities. A technique of hemorrhoidal dearterialization associated with rectal mucopexy is a minimal invasive surgical option that has been used to treat the hemorrhoidal disease and reduce its inconveniences. Objective: To analyze the seven-year results of hemorrhoidal dearterialization associated with rectal mucopexy in the treatment of hemorrhoidal disease. Methods: This study analyzed 407 patients with hemorrhoids grade II, III and IV, who underwent the technique of hemorrhoidal dearterialization in the Luzia de Pinho Melo Hospital, during the period between December 2010 and December 2017. Twenty-seven patients (6.6%) had hemorrhoidal disease of the grade II, 240 (59.0%) grade III, and 117 (28.8%) grade IV. In 23 patients (5.7%), the grade was not found. All patients were operated by the same surgeon under spinal anesthesia. The 407 patients underwent dearterialization, with a varying ligation of one to six arterial branches followed by rectal mucopexy by uninterrupted suture. Eighty-two (20.14%) required removal of concomitant perianal piles or external hemorrhoids and/or fibrosed. In the postoperative follow-up the following parameters were evaluated: pain, tenesmus, bleeding, prolapse, thrombosis, and recurrence. Results: The tenesmus was postoperative complaint reported by 93.6% of patients. Forty-three (10.5%) presented intense tenesmus and 44 (22%), moderate to intense pain. Four (0.98%) patients presented more intense bleeding in postoperative follow up; none of the patients required blood transfusions. The prolapse occurred in 18 (4.42%) patients, thrombosis in 11 (2.7%), and there were 19 (4.67%) recurrences that were reoperated in this period. Conclusion: The hemorrhoidal dearterialization technique presents good results, with light and easy-to-resolve complications and little postoperative pain393211216sem informaçãoO tratamento da doença hemorroidária pelas técnicas convencionais cursa com significante redução da qualidade de vida do doente, principalmente relacionada à dor pós-operatória e ao considerável tempo de afastamento do trabalho. A técnica de desarterialização hemorroidária associada à mucopexia retal é uma opc ̧ão cirúrgica pouco invasiva, a qual é utilizada com o objetivo de tratar a doença hemorroidária e reduzir seus inconvenientes. Objetivo: Analisar os resultados encontrados após sete anos de seguimento em doentes submetidos à técnica da desarterialização hemorroidária associada à mucopexia para o tratamento da doença hemorroidária.Método: Foram estudados 407 portadores de doença hemorroidária de graus II, III e IV, sub-metidos à técnica da desarterialização hemorroidária no Hospital das Clínicas Luzia de Pinho Melo de Mogi das Cruzes, durante o período de Dezembro de 2010 a Dezembro de 2017.Vinte e sete doentes (6,6%) apresentavam doença hemorroidária de grau II, 240 (59,0%) do grau III e 117 (28,8%) do grau IV. Em 23 doentes (5,7%) não foram encontradas a classificação nos prontuários. Todos os doentes foram operados pelo mesmo cirurgião e sob anestesia raquidiana. Os 407 doentes foram submetidos à desarterialização, variando de um até seis ramos arteriais seguidos de mucopexia por sutura contínua. Oitenta e dois (20,14%) necessitaram resseções associadas por plicomas ou hemorroidas externas. No pós-operatório foram avaliados os seguintes parâmetros: dor, tenesmo, sangramento, prolapso, trombose e recidiva.Resultados: O tenesmo foi a queixa pós-operatória referida por 93,36% dos doentes. Quarentae três (10,5%) apresentaram tenesmo intenso e 44 (22%) de moderado a intenso. Quatro(0,98%) doentes apresentaram sangramento de maior intensidade no pós-opera tório e em 1 (0,5%) houve necessidade de hemostasia cirúrgica, em nenhum deles houve necessidade de reposição sanguínea. O prolapso ocorreu em 18 (4,42%) doentes, trombose em 11 (2,7%) e houve 19 (4,67%) recidivas reoperados durante o período.Conclusão: A desarterialização hemorroidária apresenta bons resultados, complicações leves e de fácil resolução e pouca dor pós-operatóriasem informaçã