Automated flow rate calculation based on digital analysis of flow convergence proximal to regurgitant orifice

AbstractObjectives. The purpose of the study was to develop and validate an automated method for calculating regurgitant flow rate using color Doppler echocardiography.Background. The proximal flow convergence method is a promising approach to quantitate valvular regurgitation noninvasively because it allows one to calculate regurgitant flow rate and regurgitant orifice area; however, defining the location of the regurgitant orifice is often difficult and can lead to significant error in the calculated flow rates. To overcome this problem we developed an automated algorithm to locate the orifice and calculate flow rate based on the digital Doppler velocity map.Methods. This algorithm compares the observed velocities with the anticipated relative velocities, cos ϑ/μt2. The orifice is localized as the point with maximal correlation between predicted and observed velocity, whereas flow rate is specified as the slope of the regression line. We validated this algorithm in an in vitro model for flow through circular orifices with planar surroundings and a porcine bioprosthesis.Results. For flow through circular orifices, flow rates calculated on individual Doppler maps and on an average of eight velocity maps showed excellent agreement with true flow, with r = 0.977 and ΔQ = −3.7 ± 15.8 cm3/s and r = 0.991 and ΔQ = −4.3 ± 8.5 cm3/s, respectively. Calculated flow rates through the bioprosthesis correlated well but underestimated true flow, with r = 0.97, ΔQ = −10.9 ± 12.5 cm3/s, suggesting flow convergence over an >2π. This systematic underestimation was corrected by assuming an effective convergence angle of 212 δ.Conclusions. This algorithm accurately locates the regurgitant orifice and calculates regurgitant flow rate for circular orifices with planar surroundings. Automated analysis of the proximal flow field is also applicable to more physiologic surfaces surrounding the regurgitant orifice; however, the convergence angle should be adjusted. This automated algorithm should make quantification of regurgitant flow rate and regurgitant orifice area more reproducible and readily available in clinical cardiology practice

Self-Expanding Metal Stenting for Palliation of Patients with Malignant Colonic Obstruction: Effectiveness and Efficacy on 255 Patients with 12-Month's Follow-up

Background. Self-expanding metal stents can alleviate malignant colonic obstruction in incurable patients and avoid palliative stoma surgery. Objective. Evaluate stent effectiveness and safety on palliation of patients with malignant colorectal strictures. Design. Two prospective, one Spanish and one global, multicenter studies. Settings. 39 centers (22 academic, 17 community hospitals) from 13 countries. Patients. A total of 257 patients were enrolled, and 255 patients were treated with a WallFlex uncovered enteral colonic stent. Follow-up was up to 12 months or until death or retreatment. Interventions(s). Self-expanding metal stent placement. Main Outcome Measures. Procedural success, clinical success, and safety. Results. Procedural success was 98.4% (251). Clinical success rates were 87.8% at 30 days, 89.7% at 3 months, 92.8% at 6 months, and 96% at 12 months. Overall perforation rate was 5.1%. Overall migration rate was 5.5%. Overall death rate during follow-up was 48.6% (124), with 67.7% of deaths related to the patient's colorectal cancer, unrelated in 32.3%. Only 2 deaths were related to the stent or procedure. Limitations. No control group. Conclusions. The primary palliative option for patients with malignant colonic obstruction should be self-expanding metal stent placement due to high rates of technical success and efficacy in symptom palliation and few complications

Phase space transport in cuspy triaxial potentials: Can they be used to construct self-consistent equilibria?

(Abridged) This paper studies chaotic orbit ensembles evolved in triaxial generalisations of the Dehnen potential which have been proposed to model ellipticals with a strong density cusp that manifest significant deviations from axisymmetry. Allowance is made for a possible supermassive black hole, as well as low amplitude friction, noise, and periodic driving which can mimic irregularities associated with discreteness effects and/or an external environment. The degree of chaos is quantified by determining how (1) the relative number of chaotic orbits and (2) the size of the largest Lyapunov exponent depend on the steepness of the cusp and the black hole mass, and (3) the extent to which Arnold webs significantly impede phase space transport, both with and without perturbations. In the absence of irregularities, chaotic orbits tend to be extremely `sticky,' so that different pieces of the same chaotic orbit can behave very differently for 10000 dynamical times or longer, but even very low amplitude perturbations can prove efficient in erasing many -- albeit not all -- these differences. The implications thereof are discussed both for the structure and evolution of real galaxies and for the possibility of constructing approximate near-equilibrium models using Schwarzschild's method. Much of the observed qualitative behaviour can be reproduced with a toy potential given as the sum of an anisotropic harmonic oscillator and a spherical Plummer potential, which suggests that the results may be generic.Comment: 18 pages, including 19 figures; Accepted for publication by MNRAS; higher quality figures available from http://www.astro.ufl.edu/~siopis/papers

Estimating Black Hole Masses in Triaxial Galaxies

Most of the super massive black hole mass estimates based on stellar kinematics use the assumption that galaxies are axisymmetric oblate spheroids or spherical. Here we use fully general triaxial orbit-based models to explore the effect of relaxing the axisymmetric assumption on the previously studied galaxies M32 and NGC 3379. We find that M32 can only be modeled accurately using an axisymmetric shape viewed nearly edge-on and our black hole mass estimate is identical to previous studies. When the observed 5 degrees kinematical twist is included in our model of NGC 3379, the best shape is mildly triaxial and we find that our best-fitting black hole mass estimate doubles with respect to the axisymmetric model. This particular black hole mass estimate is still within the errors of that of the axisymmetric model and consistent with the M-sigma relationship. However, this effect may have a pronounced impact on black hole demography, since roughly a third of the most massive galaxies are strongly triaxial.Comment: Accepted for publication in MNRAS. 11 pages, 9 figures. PDFlate

QTL detection for milk production traits in goats using a longitudinal model

Summary Eight paternal half-sib families were used to identify chromosomal regions associated with variation in the lactation curves of dairy goats. DNA samples from 162 animals were amplified by PCR for 37 microsatellite markers, from Capra hircus autosomes CHI3, CHI6, CHI14 and CHI20. Milk samples were collected during 6 years, and there were 897 records for milk yield (MY) and 814 for fat (FP) and protein percentage (PP). The analysis was conducted in two stages. First, a random regression model with several fixed effects was fitted to describe the lactation function, using a scale (α) plus four shape parameters: β and γ, both associated with a decrease in the slope of the curve, and δ and φ that are related to the increase in slope. Predictions of α, β, γ, δ and φ were regressed using an interval mapping model, and F-tests were used to test for quantitative trait loci (QTL) effects. Significant (p < 0.05) QTLs were found for: (i) MY: CHI6 at 70-80 cM for all parameters; CHI14 at 14 cM for δ and φ; (ii) FP: CHI14, at 63 cM was associated with β; CHI20, at 72 cM, showed association with α; (iii) PP: chromosomal regions associated with β were found at 59 cM in CHI3 and at 55 cM in CHI20 with α and γ. Analyses using more families and more animals will be useful to confirm or to reject these findings. © 2008 Blackwell Verlag, Berlin.Fil: Roldán, D.L.. Instituto Nacional de Tecnología Agropecuaria. Centro de Investigación en Ciencias Veterinarias y Agronómicas. Instituto de Genética; ArgentinaFil: Rabasa, Alicia Elvira. Universidad Nacional de Tucumán. Facultad de Agronomía y Zootecnia; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Tucumán; ArgentinaFil: Saldaño, S.. Universidad Nacional de Tucumán. Facultad de Agronomía y Zootecnia; ArgentinaFil: Holgado, F.. Instituto Nacional de Tecnología Agropecuaria. Centro Regional Tucuman-santiago del Estero. Campo Experimental Regional Leales; ArgentinaFil: Poli, M. A.. Instituto Nacional de Tecnología Agropecuaria. Centro de Investigación en Ciencias Veterinarias y Agronómicas. Instituto de Genética; ArgentinaFil: Cantet, Rodolfo Juan Carlos. Universidad de Buenos Aires. Facultad de Agronomía. Departamento de Producción Animal; Argentin

Predictors of complications after endoscopic retrograde cholangiopancreatography: a prognostic model for early discharge

Background: Several studies have evaluated predictors for complications of endoscopic retrograde cholangiopancreatography (ERCP), but their relative importance is unknown. In addition, currently used blood tests to detect post-ERCP pancreatitis are inconsistent. The aim of this study was to determine predictors of post-ERCP complications that could discriminate between patients at highest and lowest risk of post-ERCP complications and to develop a model that is able to identify patients that can safely be discharged shortly after ERCP. Methods: In a single-center, retrospective analysis over the period 2002-2007, predictors of post-ERCP complications were evaluated in a multivariable analysis and compared with those identified from a literature review. A prognostic model was developed based on these risk factors, which was further evaluated in a prospective patient population. Results: From our retrospective analysis and literature review, we selected the eight most important risk factors for post-ERCP pancreatitis and cholangitis. In the prognostic model, the risk factors (precut) sphincterotomy, sphincter of Oddi dysfunction, younger age, female gender, history of pancreatitis, p

Particle acceleration at a reconnecting magnetic separator

While the exact acceleration mechanism of energetic particles during solar flares is (as yet) unknown, magnetic reconnection plays a key role both in the release of stored magnetic energy of the solar corona and the magnetic restructuring during a flare. Recent work has shown that special field lines, called separators, are common sites of reconnection in 3D numerical experiments. To date, 3D separator reconnection sites have received little attention as particle accelerators. We investigate the effectiveness of separator reconnection as a particle acceleration mechanism for electrons and protons. We study the particle acceleration using a relativistic guiding-centre particle code in a time-dependent kinematic model of magnetic reconnection at a separator. The effect upon particle behaviour of initial position, pitch angle and initial kinetic energy are examined in detail, both for specific (single) particle examples and for large distributions of initial conditions. The separator reconnection model contains several free parameters and we study the effect of changing these parameters upon particle acceleration, in particular in view of the final particle energy ranges which agree with observed energy spectra.Comment: 17 pages, 12 figures. Accepted for publication in A&