Max Thickness Research Articles

Identification of interfacial influence zone (IIZ) in clay rock-cement mortar binary based on the macro-pore distribution in space: An NMR and CT investigation

The interfacial influence zone (IIZ) is a weak link between cast-in-situ cement materials and bulk geological materials. Identifying IIZ is essential for studying binary structure’s mechanical properties. This paper aims to locate the IIZ of a clay rock-cement mortar (C-C) binary by macro-pore distribution in space using CT and NMR tests. First, the porous properties of clay rock and cement mortar were analyzed by the T2 spectrum of the NMR test. Mortar’s macro-pore volume is larger than clay rock’s. Second, the 3D pore-matrix models of these two materials were reconstructed., with larger porosity in mortar than clay rock, consistent with NMR tests. Therefore, the method of pore location using 3D reconstructed models based on CT images may be reliable. Finally, a pore-matrix model of the C-C binary was reconstructed, and the IIZ was identified by pore distribution. The IIZ shape is an approximately ellipsoidal area with thin ends and thick middle, with a max thickness of 8 mm.

A retrospective study of 3D measurement and analysis applied in the morphological evaluation of achalasia cardia.

Achalasia cardia (AC) is defined as a disorder of esophageal motility whose diagnostic gold standard depends on high-resolution manometry (HRM). The invasiveness of HRM can cause difficulties in diagnosis, treatment, and follow-up for patients with AC. Thus, we aimed to investigate the function of 3D reconstruction and measurement to prove the wide application of this alternative non-invasive approach for AC. A total of 126 patients with AC and 40 healthy subjects in Tianjin Medical University General Hospital from January 2018 to October 2022 were enrolled in this retrospective study. Chest CT images of these subjects were used to reconstruct the 3D models of the esophagus, stomach, spine, left crus, and right crus. Measurements of esophagus length, volume of esophagus, gastroesophageal insertion angle (His angle), max thickness of esophageal wall, esophagus maximum transverse and longitudinal diameter, esophagus-spine angle, and spine-lower esophageal sphincter (LES) angle were applied based on the models. Retrocardiac esophagus length, volume of esophagus, max thickness of esophageal wall, esophagus maximum transverse and longitudinal diameter, thoracic esophagus-spine angle, and spine-LES angle in the AC group were higher than those in the control group (all P values <0.05). Among the three subtypes of AC, thoracic esophagus length, intra-abdominal LES length, volume of esophagus, His angle, esophagus maximum transverse and longitudinal diameter, and thoracic esophagus-spine angle all presented statistical differences (all P values <0.05). Correlation analysis revealed that manometric types were positively associated with His angle [r=0.196; 95% confidence interval (CI): 0.009, 0.372; P=0.028] but negatively associated with volume of esophagus (r=-0.480; 95% CI: -0.639, -0.310; P<0.001), esophagus maximum transverse diameter (r=-0.551; 95% CI: -0.679, -0.400; P<0.001), esophagus maximum longitudinal diameter (r=-0.518; 95% CI: -0.649, -0.366; P<0.001), and thoracic esophagus-spine angle (r=-0.324; 95% CI: -0.479, -0.157; P<0.001). This study successfully presented the differences in esophageal length, volume, thickness, and angles between healthy subjects and different AC subtypes on the basis of 3D reconstruction and measurement. Thus, 3D model and measurement can be regarded as a good support for further research and make a valuable contribution to developing non-invasive approaches for AC management.

P124 A TAKOTSUBO SYNDROME MIMICKING AN APICAL HYPERTROPHIC CARDYOMYOPATHY: A CASE REPORT

Abstract A 70–year–old woman was admitted to our Intensive Care Unit (ICU) with high levels Hs–TnT. Coronaries were normal and ventriculography was suggestive for Takotsubo Syndrome (TS). In the acute phase she developed a cardiogenic shock and transthoracic echocardiography (TTE) showed a dilated left ventricle (LV) with iperkinesia of basal segments and biventricular apex and mid –ventricular akinesia, with a severely reduced left ventricular ejection fraction (LVEF 20%). Seven days after admission to Cardiac Rehabilitation Unit, a TTE showed LV apical hypertrophy (max thickness 18 mm), hypokinesia of hypertrophic segments, hypercontractility of basal segments and LVEF 55%. These features could have been suggestive for a coexisting apical hypertrophic cardiomyopathy (HCM). The EKG showed T wave inversions in precordial and inferior leads, not present at admission, this observation being against the presence of a pre–existing unknown HCM. Cardiac Magnetic Resonance (CMR) showed T1 and T2 mapping imagines for oedema in LV infero–lateral, basal segments and apical region, a subepicardial stria of late gadolinium enhancement in infero–lateral basal segment. These patterns were reported as suggestive for myocarditis rather than TS. Recent infectious or autoimmune diseases were excluded. Further TTE showed reversed LV parameters, normal kinesis of all segments, LVEF 66%, with a persistence of negative T waves at EKG. Discussion Our patient developed a classical TS with LV apical ballooning and hyperkinesia of basal segments with uncommon right ventricular hypokinesia. A peculiar finding was the transient apical LV thickness that was seen through TTE, mimicking an apical hypertrophic cardiomyopathy. Such a finding has already been described in few case reports; however, the nature and the physiopathology of that apical thickness was never proved. Through CMR we noted that, in the same region where TTE detected apical hypertrophy, there was a consistent amount of oedema which could be the reason of pseudo–hypertrophy findings. Our experience confirms the importance of integrating CMR in the diagnostic algorithm as already supported in consensus statements. In our case CMR played a key–role in the exclusion of a coexisting apical hypertrophic cardiomyopathy.

Spontaneous Echo Contrast in the Left Atrium and Aortic-Arch Atheroma, Detected by Transesophageal Echocardiography, Was Negatively Correlated with Cognitive Function.

The relationship between transesophageal echocardiography findings and cognitive function. This study aimed to establish an association between transesophageal echocardiography findings and cognitive function in stroke survivors. A single-center study was conducted between April 1, 2017 and March 31, 2022. All subjects that were included had a past history of ischemic stroke and were admitted after >21 days from onset. The participants underwent cognitive function tests including a Mini-Mental State Examination, Revised Hasegawa Dementia Scale, Frontal Assessment Battery, and transesophageal echocardiography. The results of 126 participants were analyzed. The cognitive function of participants with a spontaneous echo contrast (+) in the left atrium including appendage or of those with an aorta-arch plaque with a maximum thickness ≥4 mm significantly worse while neither the patent foramen ovale nor the branch extending plaque influenced cognitive function (The median cognitive scores of the spontaneous echo contrast (-) versus (+) were 26 versus 22, p < 0.01**, 26 versus 21, p < 0.001***, and 14 versus 11, p < 0.01**. Those of the aortic-arch plaque max thickness (<4 mm) versus (≥4 mm) were 26 versus 25, p < 0.05*, 27 versus 24, p < 0.05*, and 15 versus 13, p < 0.05*). Our findings show that spontaneous echo contrast in the left atrium and aortic-arch atheroma detected by transesophageal echocardiography, were negatively associated with cognitive function.

The application of the nnU-Net-based automatic segmentation model in assisting carotid artery stenosis and carotid atherosclerotic plaque evaluation.

Objective: No new U-net (nnU-Net) is a newly-developed deep learning neural network, whose advantages in medical image segmentation have been noticed recently. This study aimed to investigate the value of the nnU-Net-based model for computed tomography angiography (CTA) imaging in assisting the evaluation of carotid artery stenosis (CAS) and atherosclerotic plaque. Methods: This study retrospectively enrolled 93 CAS-suspected patients who underwent head and neck CTA examination, then randomly divided them into the training set (N = 70) and the validation set (N = 23) in a 3:1 ratio. The radiologist-marked images in the training set were used for the development of the nnU-Net model, which was subsequently tested in the validation set. Results: In the training set, the nnU-Net had already displayed a good performance for CAS diagnosis and atherosclerotic plaque segmentation. Then, its utility was further confirmed in the validation set: the Dice similarity coefficient value of the nnU-Net model in segmenting background, blood vessels, calcification plaques, and dark spots reached 0.975, 0.974 0.795, and 0.498, accordingly. Besides, the nnU-Net model displayed a good consistency with physicians in assessing CAS (Kappa = 0.893), stenosis degree (Kappa = 0.930), the number of calcification plaque (Kappa = 0.922), non-calcification (Kappa = 0.768) and mixed plaque (Kappa = 0.793), as well as the max thickness of calcification plaque (intraclass correlation coefficient = 0.972). Additionally, the evaluation time of the nnU-Net model was shortened compared with the physicians (27.3 ± 4.4s vs. 296.8 ± 81.1s, p < 0.001). Conclusion: The automatic segmentation model based on nnU-Net shows good accuracy, reliability, and efficiency in assisting CTA to evaluate CAS and carotid atherosclerotic plaques.

Abstract 11196: Germline Mutation in Plakophilin 2 and Associated Hypertrophic Cardiomyopathy: Clinical Debate of Nascent Pleomorphism and Pleotropism

Introduction: Arrhythmogenic cardiomyopathy(ACM) is often not seen until adolescence or early childhood. Electric abnormalities usually precede the structural remodeling visible on cardiac imaging. Clinical case: 31-year-old male with asthma and hypertension presented to the ED with palpitations and was in atrial fibrillation with rapid ventricular response. He was treated with diltiazem and converted to sinus rhythm. TTE performed showed basal septal hypertrophy with hypercontractile LV. He was discharged on beta-blocker and anticoagulation. Few days after, he reported lightheadedness and syncopal spells after starting on beta-blocker therapy, and orthostatic by nature. ECG revealed sinus rhythm, left ventricular hypertrophy and inferolateral deep T wave inversions. Family history was revealing for HCM in father and grandmother, but no genetic conditions or sudden cardiac deaths. Stress TTE with diltiazem use showed no LVOT obstruction at rest or after exercise. Cardiac MRI revealed asymmetric basal septal hypertrophy with max thickness of 1.5 cm. Dynamic LVOT obstruction was seen with anomalous insertion of papillary muscle into mid-anterior portion of anterior mitral leaflet. LV was hypercontractile with EF 85%, and no evidence of fibrosis. RV was normal in size/function without abnormal wall motion. Holter monitoring was unremarkable. Cardiomyopathy/arrhythmia multigene panel testing surprisingly showed a heterozygous plakophilin-2(PKP2) pathogenic germline mutation c.1689-1G&gt;C, pathogenic for ARVC. Conclusion: Based on current guidelines, he would not have ACM and begs the question of management in patients with positive ACM genetics, but no ACM-related disease expression. The underlining question would be the clinical significance and evolution of such detected mutations, and given the current paucity in evidence, we share your enthusiasm in learning more about this patient’s future clinical trajectory.

Late Pleistocene glacial advances, equilibrium-line altitude changes and paleoclimate in the Jakupica Mts (North Macedonia)

In the Jakupica Mts a plateau glacier was reconstructed (max. area ∼45 km2, max thickness: ∼260 m). The study area comprises six formerly glaciated valleys, five of which were fed by the plateau glacier and one had an independent cirque when local glaciation reached its maximum ice extent (MIE). The equilibrium line altitude (ELA) of the most extended glacial phase was at 2075+37/-25 m asl. The 10Be cosmic ray exposure (CRE) age of this phase was estimated at 19.3+1.7/-1.3 ka, conformable with the Last Glacial Maximum (LGM). CRE ages from the next moraine generation placed the first phase of deglaciation to 18.2+1.0/-3.0 ka. The samples from the moraine of the penultimate deglaciation phase provided CRE ages with large scatter and biased towards old ages, which is probably the result of inherited cosmogenic nuclide concentrations within the rock.Glacio-climatological modelling was performed for the MIE, which has a well-established LGM age. The degree-day model was used to calculate the amount of accumulation required to sustain the glaciological equilibrium assuming a certain temperature drop at the ELA. The degree-day model constrained by the pollen-based July paleo-temperature reconstructions yielded an annual total melt at the LGM ELA comparable to or slightly higher than the current mean annual precipitation at the same elevation. These wetter LGM conditions inferred from the paleo-glaciological evidence in Jakupica Mts suggest an enhanced moisture advection in the region.

Value of endorectal ultrasonography in the assessment of invasion staging of low rectal cancer with local progression after neoadjuvant radiochemotherapy.

Although stages T3 and T4 rectal cancer can be reduced to T1 or T2 after neoadjuvant radiochemotherapy, the accuracy of the en-dorectal ultrasonography (ERUS) for the post-radiochemotherapy evalua-tion of low rectal cancer has seldom been reported. We aimed to investigate the value of ERUS in the assessment of invasion staging in low rectal cancer with local progression, and the factors affecting its accuracy, after neoad-juvant radiochemotherapy. A total of 114 patients administered with neo-adjuvant radiochemotherapy for stages II and III low rectal cancer (local stage T3/T4) from February 2018 to December 2020 were enrolled in the study. The changes in local lesions were evaluated using ERUS before and after radiochemotherapy, and compared with the pathological T staging. The accuracy of post-neoadjuvant radiochemotherapy re-staging examined with ERUS was evaluated, and univariate analysis was used to identify the factors affecting the accuracy. After neoadjuvant radiochemotherapy, the blood flow distribution within the lesion significantly declined (P&lt;0.05), the max length and max thickness of the longitudinal axis of the lesion were reduced (P&lt;0.05), and the uT staging was decreased (P&lt;0.05), when compared with lesions before the treatment. Compared with postoperative pathological T staging, the accuracies of ERUS in T1, T2, T3 and T4 stages were 11.11%, 28.57%, 27.27% and 100%, respectively. Univariate analysis indicated that review time of ERUS, post-operative T staging and Wheeler rectal regression stage were factors affecting the accuracy of ERUS re-stag-ing. ERUS is more accurate for T4 re-staging, follow-up reviewed six weeks after neoadjuvant radiochemotherapy and low regression tumors, with a high application value for the assessment of the efficacy of neoadjuvant radiochemotherapy for low rectal cancer.

EFFECT OF VARIABLE CANT ANGLE ON SWEEPBACK WING

Winglets are commonly used drag-reduction and fuel-saving technologies in today’s aviation. The primary purpose of the winglets is to reduce the lift-induced drag, therefore improving fuel efficiency and aircraft performance. Traditional winglets are designed as fixed devices attached at the tips of the wings. However, because they are fixed surfaces, they give their best lift-induced drag reduction at a single design point. In this work, we propose the use of variable cant angle winglets which could potentially allow aircraft to get the best all-around performance (in terms of lift-induced drag reduction), at different angle-of-attack values.This paper describes a XFLR 3-dimensional winglets analysis that was performed on a wing of NACA2412 cross sectional airfoil. The wing has span 2.40 m, root chord 0.180 m, tip chord 0.110 m, sweep angle 5 degree and taper ratio 0.556 and for a winglet NACA 0024 cross-sectional airfoil was considered of max thickness 24 percent at 30 percent chord, max camber 0 percent at 0 percent chord. The present study shows effects of wing without winglet, wing with winglet at cant angle 30, 60, 90.The results obtained from the analysis demonstrate that by carefully adjusting the cant angle, the aerodynamic performance can be improved.

Reusability of P3 Facial Filter in a Pandemic Emergency: A 3D Analysis of Filter Microstructure with X-ray Microtomography Images after Dry Heat and UV Sterilization Procedures.

Objective: Our goal is to evaluate the effects of heat and ultraviolet (UV) irradiation on P3 facial respirator microstructure. Intervention: P3 facial filters were exposed to dry heat and UV sterilization procedures. Methods: P3 facial filter samples underwent a standardized sterilization process based on dry heat and UV irradiation techniques. We analyzed critical parameters of internal microstructure, such as fiber thickness and porosity, before and after sterilization, using 3D data obtained with synchrotron radiation-based X-ray computed microtomography (micro-CT). The analyzed filter has two inner layers called the “finer” and “coarser” layers. The “finer” layer consists of a dense fiber network, while the “coarser” layer has a less compact fiber network. Results: Analysis of 3D images showed no statistically significant differences between the P3 filter of the controls and the dry heat/UV sterilized samples. In particular, averages fiber thickness in the finer layer of the control and the 60° dry heated and UV-irradiated sample groups was almost identical. Average fiber thickness for the coarser layer of the control and the 60° dry heated and UV-irradiated sample groups was very similar, measuring 19.33 µm (±0.47), 18.33 µm (±0.47), and 18.66 µm (±0.47), respectively. There was no substantial difference in maximum fiber thickness in the finer layers and coarser layers. For the control group samples, maximum thickness was on average 11.43 µm (±1.24) in the finer layer and 59.33 µm (±6.79) in the coarser layer. Similarly, the 60° dry heated group samples were thickened 12.2 µm (±0.21) in the finer layer and 57.33 µm (±1.24) in the coarser layer, while for the UV-irradiated group, the mean max thickness was 12.23 µm (±0.90) in the finer layer and 58.00 µm (±6.68) in the coarser layer. Theoretical porosity analysis resulted in 74% and 88% for the finer and coarser layers. The finer layers’ theoretical porosity tended to decrease in dry heat and UV-irradiated samples compared with the respective control samples. Conclusions: Dry heat and UV sterilization processes do not substantially alter the morphometry of the P3 filter samples’ internal microstructure, as studied with micro-CT. The current study suggests that safe P3 filter facepiece reusability is theoretically feasible and should be further investigated.

Comparative Analysis of Strength and Modal Characteristics of a Full Tubular Pump and an Axial Flow Pump Impellers Based on Fluid-Structure Interaction

Fluid-structure interaction (FSI) was used to determine the structural mechanical characteristics of full tubular and axial-flow pumps. The results showed that as the flow rate increases, the total deformation and equivalent stress are significantly reduced. The max total deformation (MTD) and the max equivalent stress (MES) of the full tubular pump impeller occur on the outer edge of the blade. There are two stress concentrations in the full tubular pump impeller, one of which is located in the outlet area of the rim, and the other is located in the outlet area of the hub. However, the MES of the axial-flow pump appears in the center of the blade hub. The performance difference between the full tubular pump and the axial-flow pump is mainly caused by the clearance backflow. The natural frequency of the full tubular pump is lower than that of the axial-flow pump on the basis of the modal results. The MES of the full tubular pump is mainly concentrated at the junction of the blade and the motor rotor, and the max thickness of the rim is 6mm, which can be more prone to cracks and seriously affect the safety and stability of the pump.

Evaluation of a no-reference image quality metric for projection X-ray imaging using a 3D printed patient-specific phantom.

Feasability of a no-reference image quality metric was assessed on patient-like images using a patient-specific phantom simulating a frame of a coronary angiogram. One background and one contrast-filled frame of a coronary angiogram, acquired using a clinical imaging protocol, were selected from a Philips Integris Allura FD (Philips Healthcare, Best, The Netherlands). The background frame's pixels were extruded to a thickness proportional to their grey value. One phantom was 3D printed using composite 80% bronze filament (max. thickness of 5.1mm), the other was a custom PMMA cast (max thickness of 8.5cm). A vessel mold was created from the contrast-filled frame and injected with a solution of 320mg I/ml contrast fluid (75%), water and gelatin. Still X-ray frames of the vessel mold+background phantom+16cm PMMA were acquired at manually selected different exposure settings using a Philips Azurion (Philips Healthcare, Best, The Netherlands) in User Quality Control Mode and were exported as RAW images. The signal-difference-to-noise-ratio-squared (SDNR2) and a spatial-domain-equivalent of the noise equivalent quanta (NEQSDE) were calculated. The Spearman's correlation of the latter parameters with a no-reference perceptual image quality metric (NIQE) was investigated. The bronze phantom showed better resemblance to the original patient frame selected from a coronary angiogram of an actual patient, with better contrast and less blur than the PMMA phantom. Both phantoms were imaged using a comparable imaging protocol to the one used to acquire the original frame. The bronze phantom was hence used together with the vessel mold for image quality measurements on the 165 still phantom frames. A strong correlation was noted between NEQSDE and NIQE (SROCC=-0.99, p<0.0005) and between SDNR2 and NIQE (SROCC=-0.97, p<0.0005). Using a cost-effective and easy to realize patient-specific phantom we were able to generate patient-like X-ray frames. NIQE as a no-reference image quality model has the potential to predict physical image quality from patient images.

An Auto-segmentation and Measurement of Visceral Adipose Tissue On Ultrasound Image

In order to effectively segment the visceral adipose tissue and help the doctors to rapidly diagnose the potential risks of metabolic syndrome, here we developed a deep learning-based method which is based on the U-net architecture for segmenting and measuring the visceral adipose tissue(VAT). And even no matter which orientation that the operator takes, the model can segment the visceral fat area and then use the appropriate outputs to compute the max thickness of VAT. One hundred and fourteen healthy volunteers were enrolled in this study. Ultrasound(US) was performed, and then the visceral adipose tissue was segmented and measured by the model that we use. We regard the distance behind the linea alba in the xiphoid process as the thickest visceral adipose tissue(VAT max). The dice score and accuracy are 3.46%, 96.44% respectively. In addition, compared with the manually outlined segmentation, the pearson correlation coefficient and the mean relative error (MRE) are R=0.9231 (P<0.001) and 10.12% in the measurement of the VAT max between original and output images. The auto-segmentation and measurement of visceral adipose tissue on ultrasound method demonstrate the accuracy of deep learning in segmentation and measurement of visceral adipose tissue.

Three-Dimensional Analysis of Preoperative and Postoperative Rib Cage Parameters by Simultaneous Biplanar Radiographic Scanning Technique in Adolescent Idiopathic Scoliosis: Minimum 2-Year Follow-Up.

Prospective study. This study aimed to investigate the changes in rib cage deformity in adolescent idiopathic scoliosis (AIS) by comparing the preoperative and postoperative three-dimensional (3D) reconstruction images using simultaneous biplanar radiographic scanning technique (EOS) (EOS Imaging, Paris, France). EOS data are limited for the analyses of preoperative and postoperative rib cage deformity. A total of 67 Lenke type 1 or 2 AIS patients who underwent surgery (59 females and 8 males) were enrolled in this study. The mean patient age was 14.4 years (range: 11-17 yr). In all patients, posterior corrective fusion was performed with a rod rotation maneuver based on segmental pedicle fixation. Spinal parameters (scoliosis and kyphosis) and rib cage parameters (max thickness, thoracic index (TI), rib hump (RH), surface spinal penetration index (sSPI), end thoracic hump ratio, vertebra-sternum angle, rib vertebral angle difference at the apex, and vertebral lateral decentering), were measured. 3D images were assessed preoperatively and postoperatively at 2-year follow-up. Both main thoracic (MT) and proximal thoracic scoliosis were significantly corrected (51° to 15°, 30° to 17°, P < 0.0001). The rotation of MT apical vertebrae was also significantly corrected (12° to 5°, P < 0.0001). Thoracic kyphosis (T4-T12) significantly increased (13° to 18°, P < 0.0001). Besides, max thickness, TI, and RH demonstrated significant differences between preoperative and postoperative images (P < 0.01). T8-10 sSPI and end thoracic hump ratio decreased significantly postoperatively (P < 0.05). Although surgery significantly decreased vertebra-sternum angle (P < 0.0001), no significant difference was observed between the preoperative and postoperative rib vertebral angle difference (P = 0.32). Following the surgery, vertebral lateral decentering and rib cage volume were significantly increased (P < 0.0001). 3D reconstruction of the rib cage using biplanar standing stereoradiography is useful to evaluate preoperative and postoperative rib cage deformity in patients with AIS.Level of Evidence: 2.

182-LB: Cardiovascular Response to Exercise in T2D

Type 2 diabetes (T2D) confers a greater likelihood of heart failure (HF) and hospitalization due to HF. Our group has reported sub-clinical cardiac dysfunction and aortic stiffness in youth and adults with uncomplicated T2D. As aortic stiffening is reported to precede HF and is common in people with uncomplicated T2D, we tested the hypothesis that aerobic exercise training will improve cardiac function and central arterial stiffness in people with T2D compared to participants of similar BMI without T2D. Sedentary adults with (n = 18, age 48±7, 45% female) and without (n = 20, age 45±7, 46% female) T2D, underwent MRI for cardiac function and aortic compliance (aortic relative area change [RAC] and pulse wave velocity [PWV]) before and after 15 weeks of aerobic exercise training. At baseline, both cohorts exhibit subclinical diastolic dysfunction, however, those with T2D had lower end-diastolic volume (EDVN,47.2±9.9 vs. 52.3±9.1 mL/m2) and end-systolic volume (ESVN,21.1±5.4 vs. 23.6±5.2 mL/m2), than controls. The T2D group had higher max thickness of the left ventricular (LV) septal wall (LVMTs, 10.5±1.8 vs. 9.3±1.6 mm) and LV lateral wall (LVMTl, 8.4±1.6 vs. 7.6±1.3 mm) than controls. Those with T2D also had lower RAC (12.7±1.6 vs. 20.2±1.6%) and higher PWV (7.4±1.3 vs. 3.9±0.6 m/s) than controls. Preliminary data in a subset post exercise intervention (n=7 with and n=8 without T2D), revealed increased EDVN(42.8±7.9 to 51.5±11.3 mL/m2) and ESVN(19.7±4.0 to 24.3±6.5 mL/m2) and decreased LVMTs(11.35±1.5 to 9.96±1.3 mm) and LVMTl(8.42±0.81 to 7.74±0.89 mm) in the T2D group, but cardiac endpoints were unchanged in controls. Post-intervention in both groups, ascending aorta RAC increased (control: 16.2±4 % to 18.5±1.7 and T2D: 10.6±1.7 % to 19.6±2.2 %) and PWV decreased (control: 6.3±2.0 to 3.4±0.3 and T2D: 8.0±1.4 to 2.9±0.7). Data from this study in progress suggest that adults with T2D have a greater degree of cardiac dysfunction and arterial stiffness than controls of similar BMI, which improve to a greater degree with exercise than in controls. Disclosure D. Enge: None. J.E. Reusch: None. J.G. Regensteiner: None. M. Schäfer: None. K.S. Hunter: None. A.J. Barker: None. K.J. Nadeau: None. R.L. Scalzo: None. I.E. Schauer: None. L. Abushamat: None. M.O. Whipple: None. D. Rafferty: None. Funding U.S. Department of Veterans Affairs (CX001532)

S1-09 PREVALENCE OF ELEVATED INTRACRANIAL PRESSURE BY SUTURE TYPE DETECTED BY OPTICAL COHERENCE TOMOGRAPHY IN CHILDREN WITH CRANIOSYNOSTOSIS

Introduction: Detecting elevated intracranial pressure (ICP) in craniosynostosis patients may enable timely intervention to prevent neurocognitive impairment, but is challenging with conventional methods. This study employed optical Coherence tomography (OCT) to non-invasively quantify retinal laminae, and sought to determine patterns of elevated ICP by craniosynostosis type. Methods: Elevated ICP (≥15 mmHg) was prospectively assessed using peri-operative bilateral OCT. ICP was considered elevated if retinal nerve fiber layer (RNFL) max thickness >208microns, or max retinal inner projection > 159 microns in either eye, thresholds established by a previous study correlating OCT findings with directly measured ICP with high sensitivity and specificity. Univariate and multivariate analysis of OCT findings and patient and surgical characteristics was performed. Results: 129 subjects aged 0.1–17.1 years were enrolled at time of initial surgical cranial vault expansion, 100 (78%) of which had single-suture craniosynostosis. Patients with single-suture synostosis were less likely nto have OCT-findings suggestive of elevated ICP (39, 39%) than those with multi-suture involvement (18, 62%; p=0.031). Patients with syndromic diagnoses were similarly likely to have elevated ICP (17, 59%; p=0.033.) Among patients with single-suture synostosis, those with metopic suture involvement trended toward less likelihood of elevated ICP (6, 23%) compared to those with unicoronal (4, 36%), sagittal (13, 36%), or lambdoid (3, 60%) suture involvement (p=0.062.) In a multivariate logistic regression, multi-suture craniosynostosis was significantly associated with OCT-detected elevated ICP (OR = 2.789, 95% CI = [1.245, 5.991], p=0.013). There was substantial inter-eye reliability (k=0.616, 95% CI = [0.462, 0.770], p<0.001). Conclusion: Elevated ICP should be suspected in patients with syndromic or multi-suture craniosynostosis. OCT shows promise as a non-invasive diagnostic modality.

Anterior Segment Features in Nanophthalmos With Secondary Chronic Angle Closure Glaucoma: An Ultrasound Biomicroscopy Study.

We compare anterior segment parameters and the risk of malignant glaucoma between nanophthalmos with secondary chronic angle closure glaucoma (NSCACG) and chronic primary angle-closure glaucoma (CPACG). This retrospective case-control study included 32 NSCACG (32 eyes) and 36 CPACG (36 eyes) patients. Anterior segment parameters, including anterior chamber depth (ACD) and width (ACW), pupil diameter (PD), lens vault (LV), ciliary process-ciliary process distance (CCD), angle opening distance500 (AOD500), trabecular-iris angle (TIA), trabecular-ciliary processes distance (TCPD), ciliary body max thickness (CBMT), iris convexity (IC), peripheral iris thickness (PIT), iris-zonule distance (IZD), trabecular ciliary process angle (TCPA), and anterior vault (AV), were measured by ultrasound biomicroscopy. A-scan ultrasonography measurements, including lens thickness (LT) and axial length (AL), also were reviewed. ACD, ACW, CCD, TCPD, and AL were smaller, whereas the LV, LT/AL, LV/LT, LV/ACD, LT/ACD, LV/AV, and AV/AL were larger in NSCACG compared to CPACG eyes (all Bonferroni-corrected P < 0.05). Eyes with NSCACG had a higher risk of malignant glaucoma postoperatively than eyes with CPACG (P = 0.018). Characterized by narrower anterior segment, forward movement of larger lens, more anteriorly rotated ciliary bodies, and smaller CCD, NSCACG eyes have a higher risk of malignant glaucoma than CPACG eyes.

Results of a two-phased clinical study evaluating a new multiband mucosectomy device for early Barrett\u2019s neoplasia: a randomized pre-esophagectomy trial and a pilot therapeutic pilot study

BackgroundMultiband mucosectomy (MBM) is the preferred technique for piecemeal resection of early neoplastic lesions in Barrett’s esophagus (BE). The currently most widely used device for MBM is the Duette device. Recently, the Captivator EMR device has come available which might have practical advantages over the Duette device.MethodsPhase I was a randomized pre-esophagectomy trial with a non-inferiority design aiming to compare EMR specimens obtained with the Captivator and the Duette device. Primary outcome: max diameter of the EMR specimens, secondary outcomes: min diameter, max thickness of the EMR specimens and resected submucosal stroma. Phase II were clinical pilot cases aiming to evaluate the feasibility of EMR using the Captivator device. Primary outcome was the successful EMR rate and secondary outcomes included procedure time and adverse events.ResultsPhase I: 24 EMR specimens (12 pairs) were obtained from six patients. The median max diameter of EMR specimens obtained with the Captivator device was 16 mm [IQR 12–21] versus 18 mm [IQR 13–23] for the Duette device. Non-inferiority of the max diameter of the Captivator specimens could not be demonstrated (median difference 1 mm, 95% CI − 3.26 to + 5.26). However, when using paired analysis, no significant difference was found (p 0.573). In addition, no statistically significant differences were found in the min diameter, max thickness of EMR specimens, and max thickness of resected submucosal stroma. Phase II: 5 BE patients with early neoplastic lesions were included. Successful EMR was achieved in 100%. Median procedure time was 33 min (IQR 25–39). One patient developed transient dysphagia, without signs of stenosis on endoscopy.ConclusionsEMR of early Barrett’s neoplasia using the Captivator device is comparable to Duette EMR when looking at size of resected specimens. In the first patients, EMR using the Captivator was feasible, resulting in successful resection without acute adverse events.

Computational Investigation of Aerodynamic Characteristics for Elliptic UAVs’ Wing

Unmanned Aerial Vehicles, UAVs, gained an important role in modern military and civilian applications. Developments in UAVs technology improve its performance and maneuverability with acceptable cost. Elliptic airfoil had been widely used in the development of Rotor/Wing subsonic aircraft. The present work aims to investigate the effect of various elliptic airfoil parameters, such as Reynolds number, angle of attack and airfoil thickness, on aerodynamic behavior using two-dimensional computational study. The computational results were validated by experimental results. Angles of attack was evaluated from 0° to 18° in order to analyze aerodynamic characteristics up to stall condition, while Reynolds number was evaluated at values of 1×10⁵, 3×105, 2×106, and 8×106, to cover the range of rotary and fixed wing flight conditions. Thickness ratio was ranged from 5% to 25% to include the UAVs airfoil thicknesses so that choice best thickness gets max lift to drag ratio. In addition, the thicknesses location was evaluated for a range of 30% to 70% to get suitable location gets max left to drag ratio. The ANSYS-Fluent software was used with Spalart-Allmaras turbulence model, and found that the maximum lift to drag ratio which improve the UAV capability in this study is at Re=2×106, angle of attack at 8°, max thickness ratio of (0.1chord) located at (0.3chord).

Splitting of glass and SiC ceramic sheets using controlled fracture technique with elliptic microwave spot

This paper presents an alternative splitting method of both thick glass (transparent material) and Sic ceramic (non-transparent) sheets without causing removal of material based on controlled fracture technique with elliptic microwave spot. This method is called as MISM (Microwave Induced Split Method) for short. First, the fact of that 2.45GHz microwave could volumetrically heat 10-mm thickness NaCa glass and Sic ceramic sheets is theoretically proved. Then MISM physical model and corresponding apparatus is developed. Simulating of distribution of power loss density of microwave spot in the physical model is performed. Simulating results shows that an elliptic volumetrically heating microwave spot is obtained, which is testified by measured temperature distribution on the input and output surface of sheet. NaCa glass sheets with max thickness of 4mm and Sic sheets with max thickness of 3mm are both split without causing removal of material. The split line is straight. The split procedure is as same as the procedure of controlled fracture technique with laser spot. The sub-processes of split were related with the movement of three parts of elliptic microwave spot.