Computation of incompressible viscous flows through artificial heart devices with moving boundaries

The extension of computational fluid dynamics techniques to artificial heart flow simulations is illustrated. Unsteady incompressible Navier-Stokes equations written in 3-D generalized curvilinear coordinates are solved iteratively at each physical time step until the incompressibility condition is satisfied. The solution method is based on the pseudo compressibility approach and uses an implicit upwind differencing scheme together with the Gauss-Seidel line relaxation method. The efficiency and robustness of the time accurate formulation of the algorithm are tested by computing the flow through model geometries. A channel flow with a moving indentation is computed and validated with experimental measurements and other numerical solutions. In order to handle the geometric complexity and the moving boundary problems, a zonal method and an overlapping grid embedding scheme are used, respectively. Steady state solutions for the flow through a tilting disk heart valve was compared against experimental measurements. Good agreement was obtained. The flow computation during the valve opening and closing is carried out to illustrate the moving boundary capability

Simulation of blood flow through an artificial heart

A numerical simulation of the incompressible viscous flow through a prosthetic tilting disk heart valve is presented in order to demonstrate the current capability to model unsteady flows with moving boundaries. Both steady state and unsteady flow calculations are done by solving the incompressible Navier-Stokes equations in 3-D generalized curvilinear coordinates. In order to handle the moving boundary problems, the chimera grid embedding scheme which decomposes a complex computational domain into several simple subdomains is used. An algebraic turbulence model for internal flows is incorporated to reach the physiological values of Reynolds number. Good agreement is obtained between the numerical results and experimental measurements. It is found that the tilting disk valve causes large regions of separated flow, and regions of high shear

Evaluation of virulence factors in enterococcus species

Enterococci have recently become important due to their increased isolation rates in community-based and nosocomial infections and resistance to many antibiotics, including glycopeptides. The aim of this study was to evaluate the antimicrobial susceptible patterns and virulence factors of various clinical specimens; urine (n= 149), blood (n= 38), wound (n= 17), stool (n= 13), and other (n= 12) with a total of 229 enterococci including 138 E. faecalis and 91 E. faecium isolates. Aggregation factor (AF), enterococcus surface protein (esp), cytolysins and gelatinase encoding genes (asa1, esp, cylM, cylBcyl A, cylll, cylls, gelE, respectively) were investigated by molecular methods. Haemolysin production and gelatinase were studied phenotypically. A total of 30 isolates, 29 of E. faecium and one of E. faecalis isolates were resistant to vancomycin. High-level gentamicin and high-level streptomycin resistance in E. faecalis were 40.7% and 63.7% however, they were 47.1% and 55.8% in E. faecalis isolates. All strains were susceptible to linezolid. Ampicillin, penicillin and vancomycin resistance in E. faecium isolates were found to be higher than E. faecalis isolates (p= 0.001, p= 0.008 and p< 0.001). Asa1 (p< 0.001), cylll (p= 0.002) and cylls (p< 0.001) as well as gelatinase activity in isolates of E. faecalis were significantly higher than the isolates of E. faecium (p< 0.001). The most common virulence genes in our study were asa1 gene (45%), cyLs gene (33.2%) and esp gene (32.3%). Ciprofloxacin resistance in cylLL and cyLs gene positive isolates of E. faecalis were significantly higher compared to isolates that do not contain these genes (p= 0.035 and p= 0.047). Likewise, haemolysin producing E. faecium isolates were significantly more resistant to vancomycin compared to isolates that do not produce hemolysin (p< 0.001). When the virulence factors of vancomycin resistant and susceptible isolates were compared, the esp gene level in VRE E. faecium isolates was found to be 24.1%, while no esp gene was found in VRE E. faecalis isolates. The existence of asa1was negative in both VRE E. faecium and VRE E. faecalis isolates. The activity of hemolysin was found 42.3% for E. faecalis and 19.3% for E. faecium. In vancomycin-sensitive enterococcus (VSE) species, esp gene activity was 35.1% for E. faecalis, 29.4% for E. faecium, asa1 gene activity was 60.8% for E. faecalis and 47.1% for E. faecium, hemolysin activity was 52.8% for E. faecalis and 23.5% for E. faecium. In our study, it was found that VSE isolates have more virulence genes than VRE isolates. It should be kept in mind that VRE can causeinfections which are difficult-to-treat especially in hospitalized patients and VSE have significant virulence factors that can cause severe infections

International Consensus Statement on Rhinology and Allergy: Rhinosinusitis

Background: The 5 years since the publication of the first International Consensus Statement on Allergy and Rhinology: Rhinosinusitis (ICAR‐RS) has witnessed foundational progress in our understanding and treatment of rhinologic disease. These advances are reflected within the more than 40 new topics covered within the ICAR‐RS‐2021 as well as updates to the original 140 topics. This executive summary consolidates the evidence‐based findings of the document. Methods: ICAR‐RS presents over 180 topics in the forms of evidence‐based reviews with recommendations (EBRRs), evidence‐based reviews, and literature reviews. The highest grade structured recommendations of the EBRR sections are summarized in this executive summary. Results: ICAR‐RS‐2021 covers 22 topics regarding the medical management of RS, which are grade A/B and are presented in the executive summary. Additionally, 4 topics regarding the surgical management of RS are grade A/B and are presented in the executive summary. Finally, a comprehensive evidence‐based management algorithm is provided. Conclusion: This ICAR‐RS‐2021 executive summary provides a compilation of the evidence‐based recommendations for medical and surgical treatment of the most common forms of RS

Gamma ray and neutron shielding properties of some concrete materials

Shielding of gamma-rays and neutrons by 12 concrete samples with and without mineral additives has been studied. The total mass attenuation and linear attenuation coefficients, half-value thicknesses, effective atomic numbers, effective electron densities and atomic cross-sections at photons energies of 59.5 and 661 keV have been measured and calculated. The measured and calculated values were compared and a reasonable agreement has been observed. Also the recorded values showed a change with energy and composition of the concrete samples. In addition, neutron shielding has been treated in terms of macroscopic removal cross-section (?R, cm-1) concept. The WinXCom and NXcom programs were employed to calculate the attenuation coefficients of gamma-rays and neutrons, respectively. © 2011 Elsevier Ltd. All rights reserved

Factors affecting epilepsy development and epilepsy prognosis in cerebral palsy

PubMedID: 21763948A study was conducted between November 2006 and October 2009 to determine the factors predicting the presence and prognosis of epilepsy in patients with cerebral palsy. We enrolled 2 groups of patients: 42 with cerebral palsy in group 1 and 56 patients with cerebral palsy and epilepsy in group 2. The subjects in group 2 were considered to have good epilepsy prognosis if they were free of seizures for the previous year; otherwise they were considered to have poor epilepsy prognosis. In group 2, neonatal epilepsy, family history of epilepsy, and moderate to severe mental retardation were significantly higher than in group 1 (P < 0.05). In univariate analysis, neonatal seizures, epileptic activity as measured by electroencephalography, and polytherapy were found to be predictors of poor epilepsy prognosis. Additionally, the need for long-term medication to control seizures unfavorably affects prognosis. In logistic regression analysis, neonatal seizure and interictal epileptic activity in electroencephalography were found to be independent predictors of poor epilepsy outcome. In addition, logistic regression analysis revealed that increasing age reduces the success of epilepsy treatment. Neonatal seizures, family history of epilepsy, and mental retardation were found to be important and independent predictors of development of epilepsy in patients with cerebral palsy. © 2011 Elsevier Inc. All rights reserved