Three-dimensional flow characteristics in ventricular assist devices: Impact of valve design and operating conditions

ObjectiveThe use of paracorporeal ventricular assist devices has become a well-established procedure for patients with cardiogenic shock. However, implantation of ventricular assist devices is often associated with severe complications, such as thrombosis inside the ventricular assist device and subsequent embolic events. It was the purpose of this study to use flow-sensitive 4-dimensional magnetic resonance imaging for a detailed analysis of the 3-dimensional (3D) flow dynamics inside a clinical routine ventricular assist device and to study the effect of different system adjustments and a new valve design on flow patterns.MethodsA routinely used clinical paracorporeal ventricular assist device was integrated into a magnetic resonance-compatible mock loop. Flow-sensitive 3D magnetic resonance imaging was performed to measure time-resolved 3-directional flow velocities (spatial resolution ∼ 1.2 mm, temporal resolution = 42.4 ms) in the entire device under ideal conditions (full fill, full empty, ejection fraction = 88%), insufficient filling (ejection fraction = 81%), and insufficient emptying (ejection fraction = 67%) of the pump chamber. In addition, a new valve design was evaluated. Flexible control and monitoring of pressures at inlet and outlet were used to generate realistic boundary conditions.ResultsFlow pattern changes for different operating conditions were clearly identified and included reduced velocities during systolic outflow for impaired filling (78% reduction in pump flow compared with optimal operating conditions) and impaired clearing of the pump chamber for insufficient emptying (52% reduction). For all operating conditions, 3D visualization revealed vortex flow inside the ventricular assist device at typical locations of thrombus formation near the valve systems. Most noticeably, the new valve design provided similar global ventricular assist device function (pump flow 3.6 L/min), but vortex formation was eliminated.ConclusionsThe results of this study provide insight into the mechanisms underlying possible thrombus formation inside a ventricular assist device and the effect of different system adjustments. The presented methods may permit the optimization of future ventricular assist device systems with respect to optimal flow conditions

Mobile Data Collection of Cognitive-Behavioral Tasks in Substance Use Disorders: Where Are We Now?

INTRODUCTION: Over the last decades, our understanding of the cognitive, motivational, and neural processes involved in addictive behavior has increased enormously. A plethora of laboratory-based and cross-sectional studies has linked cognitive-behavioral measures to between-subject differences in drinking behavior. However, such laboratory-based studies inevitably suffer from small sample sizes and the inability to link temporal fluctuations in task measures to fluctuations in real-life substance use. To overcome these problems, several existing behavioral tasks have been transferred to smartphones to allow studying cognition in the field. METHOD: In this narrative review, we first summarize studies that used existing behavioral tasks in the laboratory and self-reports of substance use with ecological momentary assessment (EMA) in the field. Next, we review studies on psychometric properties of smartphone-based behavioral tasks. Finally, we review studies that used both smartphone-based tasks and self-reports with EMA in the field. RESULTS: Overall, studies were scarce and heterogenous both in tasks and in study outcomes. Nevertheless, existing findings are promising and point toward several methodological recommendations: concerning psychometrics, studies show that - although more systematic studies are necessary - task validity and reliability can be improved, for example, by analyzing several measurement sessions at once rather than analyzing sessions separately. Studies that use tasks in the field, moreover, show that power can be improved by choosing sampling schemes that combine time-based with event-based sampling, rather than relying on time-based sampling alone. Increasing sampling frequency can further increase power. However, as this also increases the burden to participants, more research is necessary to determine the ideal sampling frequency for each task. CONCLUSION: Although more research is necessary to systematically study both the psychometrics of smartphone-based tasks and the frequency at which task measures fluctuate, existing studies are promising and reveal important methodological recommendations useful for researchers interested in implementing behavioral tasks in EMA studies

Mobile Data Collection of Cognitive-Behavioral Tasks in Substance Use Disorders: Where Are We Now?

Introduction: Over the last decades, our understanding of the cognitive, motivational, and neural processes involved in addictive behavior has increased enormously. A plethora of laboratory-based and cross-sectional studies has linked cognitive-behavioral measures to between-subject differences in drinking behavior. However, such laboratory-based studies inevitably suffer from small sample sizes and the inability to link temporal fluctuations in task measures to fluctuations in real-life substance use. To overcome these problems, several existing behavioral tasks have been transferred to smartphones to allow studying cognition in the field. Method: In this narrative review, we first summarize studies that used existing behavioral tasks in the laboratory and self-reports of substance use with ecological momentary assessment (EMA) in the field. Next, we review studies on psychometric properties of smartphone-based behavioral tasks. Finally, we review studies that used both smartphone-based tasks and self-reports with EMA in the field. Results: Overall, studies were scarce and heterogenous both in tasks and in study outcomes. Nevertheless, existing findings are promising and point toward several methodological recommendations: concerning psychometrics, studies show that – although more systematic studies are necessary – task validity and reliability can be improved, for example, by analyzing several measurement sessions at once rather than analyzing sessions separately. Studies that use tasks in the field, moreover, show that power can be improved by choosing sampling schemes that combine time-based with event-based sampling, rather than relying on time-based sampling alone. Increasing sampling frequency can further increase power. However, as this also increases the burden to participants, more research is necessary to determine the ideal sampling frequency for each task. Conclusion: Although more research is necessary to systematically study both the psychometrics of smartphone-based tasks and the frequency at which task measures fluctuate, existing studies are promising and reveal important methodological recommendations useful for researchers interested in implementing behavioral tasks in EMA studies

Density growth in Kantowski-Sachs cosmologies with cosmological constant

In this work the growth of density perturbations in Kantowski-Sachs cosmologies with a positive cosmological constant is studied, using the 1+3 and 1+1+2 covariant formalisms. For each wave number we obtain a closed system for scalars formed from quantities that are zero on the background and hence are gauge-invariant. The solutions to this system are then analyzed both analytically and numerically. In particular the effects of anisotropy and the behaviour close to a bounce in the cosmic scale factor are considered. We find that typically the density gradient in the bouncing directions experiences a local maximum at or slightly after the bounce.Comment: 33 pages, 17 picture

Patch area and current coffee management determine woody plant diversity in patches of semi-forest coffee embedded in an agricultural matrix

AbstractEffective conservation of biodiversity in patches of (semi-) natural vegetation is dependent on an understanding of the influence of management as well as spatial and temporal factors. In southwestern Ethiopia coffee generally grown under a rather dense layer of indigenous trees (so called semi-forest coffee - SFC) often in patches embedded in an open agricultural landscape. The aim of the study was to disentangle what governs the variation in species richness of woody species among such patches. We collected data on species and possible explanatory factors in 40~×~40 m plots centered in 40 SFC patches, measured the patch area for 1987 and 2013, and the amount of surrounding SFC-area for each patch. We recorded the number of coffee stems and the level of disturbance caused by slashing of the understory vegetation. Species richness of large coffee shade trees (>20 cm in diameter) was higher in larger patches with even slightly better fit of the statistical models when the historical area was taken into account. However, most species of large trees also occurred as seedlings showing that there is still a potential to conserve these species in the patches. Coffee management negatively affected the richness and density of woody species, especially in the intermediate size class (1.6–20~cm diameter). Disturbances accompanying coffee management such as slashing of the ground vegetation also negatively affected tree seedling density as well as species richness. There was no effect of connectivity on species richness. Based on the combination of these results we conclude that small patches of semi-forest coffee had fewer species of large trees, not because of a lack of tree seedlings, but probably because of differentiated local extinctions, perhaps during the time when the species were intermediate sized. To maintain the species richness of large trees in semi-forest coffee patches, the sites need to be actively managed