Management of multiple, late onset complications in a 33-year-old female, with a ventriculoperitoneal shunt and crohn\u27s disease

Numerous complications can occur after the placement of a venticuloperitoneal shunt. The late onset of an autoimmune disease such as Crohn\u27s disease can be the disruptive factor for a previously well functioning shunt. A 33-year-old female with a ventriculo-peritoneal shunt since the age of 7, as well as Crohn\u27s disease since the age of 25, presented in the ER with dysuria, long-lasting fever and intermittent severe headache. The patient underwent a CT scan of the chest, abdomen and brain. An enlargement of the ventricular system was revealed, suggesting malfunction of the shunt. Simultaneously, the abdominal scan revealed an abnormal course of the peritoneal catheter of the shunt in the lower abdomen, inside the bladder. The existence of the catheter inside the bladder was confirmed and filmed during a cystoscopy and was attributed to the several inflammations and surgeries performed for the treatment of Crohn\u27s disease.The absence of an obvious stenosis of the aqueduct, the early immunodeficiency due to Azathioprine and the multiple abdominal surgeries made the treatment selection a complex algorithm for the neurosurgeon

Optical-microphysical properties of Saharan dust aerosols and composition relationship using a multi-wavelength Raman lidar, in situ sensors and modelling: a case study analysis

A strong Saharan dust event that occurred over the city of Athens, Greece (37.9° N, 23.6° E) between 27 March and 3 April 2009 was followed by a synergy of three instruments: a 6-wavelength Raman lidar, a CIMEL sun-sky radiometer and the MODIS sensor. The BSC-DREAM model was used to forecast the dust event and to simulate the vertical profiles of the aerosol concentration. Due to mixture of dust particles with low clouds during most of the reported period, the dust event could be followed by the lidar only during the cloud-free day of 2 April 2009. The lidar data obtained were used to retrieve the vertical profile of the optical (extinction and backscatter coefficients) properties of aerosols in the troposphere. The aerosol optical depth (AOD) values derived from the CIMEL ranged from 0.33–0.91 (355 nm) to 0.18–0.60 (532 nm), while the lidar ratio (LR) values retrieved from the Raman lidar ranged within 75–100 sr (355 nm) and 45–75 sr (532 nm). Inside a selected dust layer region, between 1.8 and 3.5 km height, mean LR values were 83 ± 7 and 54 ± 7 sr, at 355 and 532 nm, respectively, while the Ångström-backscatter-related (ABR<sub>355/532</sub>) and Ångström-extinction-related (AER<sub>355/532</sub>) were found larger than 1 (1.17 ± 0.08 and 1.11 ± 0.02, respectively), indicating mixing of dust with other particles. Additionally, a retrieval technique representing dust as a mixture of spheres and spheroids was used to derive the mean aerosol microphysical properties (mean and effective radius, number, surface and volume density, and mean refractive index) inside the selected atmospheric layers. Thus, the mean value of the retrieved refractive index was found to be 1.49( ± 0.10) + 0.007( ± 0.007)i, and that of the effective radiuses was 0.30 ± 0.18 μm. The final data set of the aerosol optical and microphysical properties along with the water vapor profiles obtained by Raman lidar were incorporated into the ISORROPIA II model to provide a possible aerosol composition consistent with the retrieved refractive index values. Thus, the inferred chemical properties showed 12–40% of dust content, sulfate composition of 16–60%, and organic carbon content of 15–64%, indicating a possible mixing of dust with haze and smoke. PM<sub>10</sub> concentrations levels, PM<sub>10</sub> composition results and SEM-EDX (Scanning Electron Microscope-Energy Dispersive X-ray) analysis results on sizes and mineralogy of particles from samples during the Saharan dust transport event were used to evaluate the retrieval

Morphological and hemodynamical alterations in brachial artery and cephalic vein. An image‐based study for preoperative assessment for vascular access creation

The current study aims to computationally evaluate the effect of right upper arm position on the geometric and hemodynamic characteristics of the brachial artery (BA) and cephalic vein (CV) and, furthermore, to present in detail the methodology to characterise morphological and hemodynamical healthy vessels. Ten healthy volunteers were analysed in two configurations, the supine (S) and the prone (P) position. Lumen 3D surface models were constructed from images acquired from a non-contrast MRI sequence. Then, the models were used to numerically compute the physiological range of geometric (n = 10) and hemodynamic (n = 3) parameters in the BA and CV. Geometric parameters such as curvature and tortuosity, and hemodynamic parameters based on wall shear stress (WSS) metrics were calculated with the use of computational fluid dynamics. Our results highlight that changes in arm position had a greater impact on WSS metrics of the BA by altering the mean and maximum blood flow rate of the vessel. Whereas, curvature and tortuosity were found not to be significantly different between positions. Inter-variability was associated with antegrade and retrograde flow in BA, and antegrade flow in CV. Shear stress was low and oscillatory shear forces were negligible. This data suggests that deviations from this state may contribute to the risk of accelerated intimal hyperplasia of the vein in arteriovenous fistulas. Therefore, preoperative conditions coupled with post-operative longitudinal data will aid the identification of such relationships

Control of rotorcraft retreating blade stall using air-jet vortex generators

A series of low-speed wind tunnel tests were carried out on an oscillating airfoil fitted with two rows of air-jet vortex generators (AJVGs). The airfoil used had an RAE 9645 section and the two spanwise arrays of AJVGs were located at x/c=0.12 and 0.62. The devices and their distribution were chosen to assess their ability to modify/control dynamic stall; the goal being to enhance the aerodynamic performance of helicopter rotors on the retreating blade side of the disc. The model was pitched about the quarter chord with a reduced frequency (k) of 0.1 in a sinusoidal motion defined by a=15o+10sin_ t. The measured data indicate that, for continuous blowing from the front row of AJVGs with a momentum blowing coefficient (C μ) greater than 0.008, modifications to the stalling process are encouraging. In particular, the pitching moment behavior exhibits delayed stall and there is a marked reduction in the normal force hysteresis

Application of a synergetic lidar and sunphotometer algorithm for the characterization of a dust event over Athens, Greece

We present first retrievals of the Lidar-Radiometer Inversion Code (LIRIC), applied on combined lidar and sunphotometer data during a Saharan dust episode over Athens, Greece, on July 20, 2011. A full lidar dataset in terms of backscatter signals at 355, 532 and 1064 nm, as well as depolarization at 532 nm was acquired from the European Aerosol Research Network (EARLINET) station of Athens and combined with Aerosol Robotic Network (AERONET) data, in order to retrieve the concentration and extinction coefficient profiles of dust. The lidar measurements showed a free tropospheric layer between 1-5 km above Athens, with low Ångström exponent of ~0.5 and high particle depolarization ratio, ~25-30%, both values characteristic of dust particles. The application of LIRIC revealed high concentration profiles of non-spherical coarse particles in the layer, in the range of 0.04-0.07 ppb and a smaller fine particle component with concentrations of ~0.01 ppb. The extinction coefficients at 532 nm ranged between 50 and 90 Mm-1 for coarse non-spherical particles and between 25 and 50Mm-1 for fine particles. The retrievals were compared with modeled dust concentration and extinction coefficient profiles from the Dust Regional Atmospheric Modeling (BSC-DREAM8b), showing good agreement, especially for the coarse modePostprint (published version

An automatic aerosol classification for earlinet: application and results

Aerosol typing is essential for understanding the impact of the different aerosol sources on climate, weather system and air quality. An aerosol classification method for EARLINET (European Aerosol Research Lidar Network) measurements is introduced which makes use the Mahalanobis distance classifier. The performance of the automatic classification is tested against manually classified EARLINET data. Results of the application of the method to an extensive aerosol dataset will be presented. © The Authors, published by EDP Sciences, 2018.Peer ReviewedPostprint (published version