Branching of the Falkner-Skan solutions for λ < 0

The Falkner-Skan equation f'" + ff" + λ(1 - f'^2) = 0, f(0) = f'(0) = 0, is discussed for λ < 0. Two types of problems, one with f'(∞) = 1 and another with f'(∞) = -1, are considered. For λ = 0- a close relation between these two types is found. For λ < -1 both types of problem allow multiple solutions which may be distinguished by an integer N denoting the number of zeros of f' - 1. The numerical results indicate that the solution branches with f'(∞) = 1 and those with f'(∞) = -1 tend towards a common limit curve as N increases indefinitely. Finally a periodic solution, existing for λ < -1, is presented.

Transrectus sheath pre-peritoneal (TREPP) procedure versus totally extraperitoneal (TEP) procedure and Lichtenstein technique:a propensity-score-matched analysis in Dutch high-volume regional hospitals

PURPOSE: Results of the most commonly used inguinal hernia repair techniques often originate from expert centers or from randomized controlled studies. In this study, we portray daily-practice results of a high-volume, regional surgical group in the Netherlands, comparing TREPP (open (posterior) transrectus sheath pre-peritoneal) with Lichtenstein (open anterior) and TEP (endoscopic (posterior) totally extraperitoneal). We hypothesize that the TREPP shows more favorable outcome compared to the current gold standard procedures: TEP and Lichtenstein. METHODS: Between January 2016 and December 2018, 3285 consecutive patients underwent surgical treatment and were included for analysis. The outcome measures were postoperative pain, recurrence rate and other surgical complications. Propensity-score matching was used to address potential selection bias. RESULTS: After propensity-score matching, there was no statistically significant difference in postoperative pain in the TREPP group compared to the Lichtenstein group (TREPP 7.3% versus Lichtenstein 6.3%; p = 0.67) nor in TREPP compared to TEP (TREPP 7.4% versus TEP 4.1%; p = 0.064). There was no statistically significant difference in recurrences in the TREPP group compared to Lichtenstein (3.8% vs 2.5%; p = 0.42), nor in the TREPP versus TEP comparison (3.9% vs 2.8%; p = 0.55) CONCLUSION: This study compares TREPP with Lichtenstein and TEP in the presence of postoperative pain, recurrences and other adverse outcomes. After propensity-score matching, no statistically significant difference in postoperative pain or recurrences remained between either TREPP compared to Lichtenstein, or TREPP compared to TEP. Based on these results, TREPP, Lichtenstein and TEP showed comparable results in postoperative pain, recurrences and other surgical site complications

Incident Gallstones During Somatostatin Analog Treatment are Associated with Acute Biliary Complications Especially After Discontinuation

INTRODUCTION: Gallstones are a known adverse effect of somatostatin analogs, but the exact incidence and clinical implications are unknown. OBJECTIVES: The aim of this study was to investigate the incidence of gallstones on imaging and related complications in unbiased trial data. METHODS: Data from the DIPAK 1 trial, in which 305 polycystic kidney disease patients were randomized to standard of care (SoC) or lanreotide for 120 weeks, were used. Magnetic resonance imaging (MRI) was performed at baseline and end of treatment and was assessed for the presence, number, and size of gallstones. For all patients who had gallstones at the end of the trial, we obtained follow-up after the trial. RESULTS: Of 249 patients with data available, 11 patients randomized to lanreotide and four randomized to SoC had gallstones at baseline. During the study, new gallstones were formed in 19/124 patients using lanreotide (15%) and 1/125 patients receiving SoC (1%). The odds ratio for gallstone formation with lanreotide use was 25.9 (95% confidence interval 3.37–198.8; p  20 stones in 69% of patients) and small (≤ 3 mm in 63% of patients). Of the 19 patients with incident gallstones during lanreotide treatment, 9 experienced gallstone-associated complications, 8 of whom experienced gallstone-associated complications after discontinuation of treatment (median time after discontinuation 2.5 years). In patients with gallstones at baseline and in patients receiving SoC, no complications occurred. CONCLUSIONS: Treatment with a somatostatin analog leads to the formation of multiple, small gallstones that are associated with severe complications, especially after discontinuation of therapy. CLINICAL TRIAL REGISTRY WEBSITE AND TRIAL NUMBER: ClinicalTrials.gov (https://clinicaltrials.gov); NCT01616927. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s40268-021-00342-7

On the elastic beam-fluid intreaction based on structural mode shapes

The concept of fluid-structure interaction(FSI) has a vast range of practical engineering applications. Since the analytical solution for such a systems is not available, numerical methods are adopted. Two main approaches are monolithic and partitioned methods. Treating the coupled system of fluid and structure simultaneously as in monolithic approach will limit the flexibility, in the other hand this property is maintained by decomposing the physical system into fluid and structure. Using a partitioned approach, the solution is separately advanced in time over each partition. Interaction effects are accounted for by transmission and synchronization of coupled state variables. The strength of the coupling is traditionally maintained by correcting the interaction effects iteratively. Besides convergence’s high computational cost, the physics of the interaction can also jeopardize an iterative procedure. For two-way physically coupled systems the information exchange among two partitions (fluid and structure) is relaxed to avoid numerical instabilities. In this paper, the idea of preserving coupling strength by catching the presence of the structure through an interaction law is studied and formulated. The structural modal representation is utilized to derive the interaction boundary at the fluid-structure interface. Since this approach strongly enforces the information exchange on the fluid-structure interface, the source of instabilities is abolished. As a test case, a 1D Euler-Bernoulli beamlocated at the bottom of a 2D tank is strongly coupled with a fluid above by means of iterative under-relaxed coupling results and also the weak coupling. The results are shown and then discussed