Proximal Area Research Articles

Qualitative Analysis of the Right Plantar Dermatoglyphic Configurations in Himachal Pradesh: A Dimorphic Study

Introduction: Dermatoglyphics is defined as the study of the configurations on the plantar aspect of the feet and the palmar aspect of the hands. It is a well established fact that these epidermal configurations are distinct for each and every individual. Aim: To study and analyse the plantar dermatoglyphic patterns on the right sole of the individuals of Himachal Pradesh and to know its implication in gender determination. Material and Methods: This cross-sectional study was conducted in the Department of Anatomy, Adesh Institute of Medical Sciences, Bathinda, Punjab, India, and the data was collected over a period of one year (May 2021 to May 2022). The sole dermatoglyphic prints of 400 individuals (200 males and 200 females) of the age group 18-45 years without any known medical conditions were analysed for the dermatoglyphic patterns visualised in the Hallucal/Thenar/ First Interdigital Area (Rt Th/H/ID1), Second Interdigital Area (Rt ID2), Third Interdigital Area (Rt ID3), Fouth Interdigital Area (Rt ID4), Hypothenar Distal Area (Rt HTD), Hypothenar Proximal Area (Rt HTP) and the Calcar Area (Rt C) of the right sole. The findings thus obtained were then subjected to Chi-square test using the Statistical Package for the Social Sciences (SPSS) version 21.0 software. Results: The mean age of the subjects included in the study was 29±4 years and 16±7 years for 200 Himachali males and 200 Himachali females, respectively. The study showed that there was indeed an association between the right plantar dermatoglyphic patterns and the sex of the people belonging to Himachal Pradesh, India. The results suggest that the distribution of the dermatoglyphic patterns on Rt Th/H/ID1 of the females was significantly different from the males (p-value <0.05). On the Rt ID2, Rt ID3 and Rt ID4, the differences observed between the females and males were highly significant (p-value <0.001) whereas on the Rt HTD, Rt HTP and the Rt C, all the males and females depicted a lack of pattern. Conclusion: The results of this investigation suggest that there exist some significant differences between the male and female subjects of Himachali population. The plantar dermatoglyphic patterns could therefore be utilised as an important tool to determine the gender of an individual in forensic and medico-legal aspects as well as to determine the relationship of an individual to an ethnic group based in different geographical areas.

Do Arterial and Venous Diameter Predict the Success of Wrist Radiocephalic Arteriovenous Fistula for Haemodialysis?: A Prospective Interventional Study

Introduction: Native or autogenous Arteriovenous Fistula (AVFs) placed for Chronic Kidney Disease (CKD) is the gold standard. Radiocephalic Arteriovenous Fistula (RCAVF) just proximal to the wrist is preferred, as it provides a larger proximal area for cannulation and can be created using End-to-Side (E-S) and Side-to-Side (S-S) techniques with good patency. Diameters of the radial artery and cephalic vein have been shown to produce predictable results in RCAVF. The distance between the radial artery and the cephalic vein at wrist or even more proximal has not been studied previously and may be instrumental in choosing either of the two surgical techniques for RCAVF. Aim: To find the optimum diameters of radial artery and cephalic vein, evaluated by Colour Doppler Ultrasound (CDU) that predicted the success of wrist RCAVF in E-S and S-S RCAVF placement techniques for Haemodialysis (HD). Materials and Methods: This prospective interventional study was carried out in the Departments of Plastic Surgery and Nephrology, Institute of Medical Sciences, Banaras Hindu University, Varanasi, Eastern Uttar Pradesh, India, from January 2019 to June 2021, to study 62 fistula in 52 patients of CKD in whom wrist RCAVF, as vascular access for HD, was constructed. The variables studied were calibre of radial artery and cephalic vein and their bearing on the surgical outcome in E-S and S-S surgical techniques. Further distance between radial artery and cephalic vein (in mm) at the wrist were meticulously studied to find its significance in both E-S and S-S surgical techniques. The outcomes measured were fistula usability (time from AVF placement to fistula maturation and subsequent functional use for HD) and AVF patency three months postoperatively. Significance of comparative variables was studied by two-tailed t-test. Results: In the present study, average age was 46.86±14.85 years and 37 patients were males while 15 were females. Mean diameter of radial artery was 2.14±0.48 mm while it was 2.12±0.49 mm in E-S and 2.16±0.45 mm in S-S technique (p-value=0.309). Mean diameter of cephalic vein was 2.24±0.64 mm, 2.26±0.67 mm in E-S and 2.22±0.61 mm in S-S technique (p-value=0.734). The distance between the both artery and vein was 5.77±4.06 mm. Thirteen RCF failed to mature (25%), 10 of these underwent secondary surgery for AVF. RCAVF became usable for HD after 7.70±1.12 weeks in E-S group and 7.59±1.19 weeks in S-S group (p-value=0.592). Primary AVF patency was 90.9% in E-S and 92.6% in S-S procedures at three months after surgery when the radial artery and cephalic vein were both larger than 2 mm. If the arteriovenous distance is less than 3 mm, the fistula can be treated using the S-S approach, and if it is greater than 3 mm, the E-S technique. Conclusion: This study demonstrated association between cephalic vein and Radial Artery Diameter (RAD) (>2 mm) with good three months RCAVF patency. It was shown that the distance between the radial artery and cephalic vein at the wrist serves as a criterion for using either the S-S or E-S surgical procedures.

A Multi-proxy Provenance Study of Late Carboniferous to Middle Jurassic Sandstones in the Eastern Sverdrup Basin and Its Bearing on Arctic Palaeogeographic Reconstructions

A multi-proxy provenance study of Late Carboniferous to Middle Jurassic sandstones from the eastern Sverdrup Basin was undertaken employing optical petrography and heavy mineral analysis, chemical analysis of apatite, garnet and rutile grains, as well as detrital zircon U–Pb geochronology and Hf isotope analysis. Late Carboniferous to Middle Jurassic strata on the southern basin margin are inferred as being predominantly reworked from Silurian to Devonian strata within the adjacent Franklinian Basin succession. Higher-grade metamorphic detritus appeared during Middle to Late Triassic times and indicates exhumation and erosion of lower (Neoproterozoic to Cambrian) levels within the Franklinian Basin succession and/or a direct detrital input from the Canadian-Greenland Shield. The provenance of northern-derived sediments is more enigmatic owing to the subsequent opening of the Arctic Ocean. Northern-derived Middle Permian to Early Triassic sediments were likely derived from proximal areas of the Chukotkan part of the Arctic Alaska-Chukotka microplate. Late Triassic northern-derived sediments have different detrital zircon U–Pb age spectra from Middle Permian to Early Triassic ones and were likely derived from the Uralian orogenic belt and/or the Arctic Uralides. The loss of this sand input during latest Triassic times is interpreted to reflect drainage reorganisation farther upstream on the Barents Shelf. Middle Jurassic sands in the northern and axial parts of the basin were largely reworked from local northern-derived Late Triassic strata. This may have been facilitated by rift flank uplift of the northern basin margin in response to rifting in the adjacent proto-Amerasia Basin.

843 QUANTIFICATION OF VENTRICULAR FUNCTIONAL MITRAL REGURGITATION USING THE VOLUMETRIC METHOD BY 3D-ECHOCARDIOGRAPHY

Abstract Background ventricular functional mitral regurgitation (v-FMR) is associated with an increased risk of mortality and hospitalization for heart failure. In this setting, the echocardiographic assessment of v-FMR severity using 2D proximal isovelocity surface area (PISA) yields several limitations, potentially leading to an underestimation of v-FMR severity. An alternative approach is to derive the regurgitant volume (RegVol) and the effective regurgitant orifice area (EROA) using the three-dimensional echocardiography (3DE) to estimate left ventricular volumes (volumetric method, VM). However, a direct comparison of these methods has never been tested. Accordingly, the aims of our study are: i; to compare both 2D PISA measurements of EROA and RegVol with those obtained by VM using 3DE, ii; to test their accuracy using the 3D planimetry of vena contracta area (3D-VCA) of MR jet, as reference. Methods we retrospectively analysed 82 (mean age 75±12, 48% men, 79% sinus rhythm, 85% with ischemic cardiomyopathy, 15% with dilated cardiomyopathy) consecutive patients with v-FMR and reduced left ventricular ejection fraction (LVEF <50%), acquired between July 2020 and October 2021. Exclusion criteria were: age < 18 years, primary MR, presence of intra-cardiac shunts, greater than mild aortic regurgitation, and inadequate acoustic window. PISA EROA was calculated using the formula: 6.28 r2×Va/Vp (where: r= PISA radius, Va= aliasing velocity, Vp= MR peak velocity). FMR regurgitant volume (RegVol) by PISA was calculated as EROA×VTIMR, where VTIMR represents the time–velocity integral of the CW Doppler MR jet tracing. FMR RegVol by 3DE volumetric method (VM) was calculated as: total LV stroke volume (LV SV) – forward LV SV (Ao SV). LV SV was obtained by subtracting the respective end-systolic (ESV) from the end-diastolic (EDV) volumes measured by 3DE. Ao SV was calculated by multiplying LV outflow area by LV outflow tract velocity time integral (VTI). EROA by VM was calculated as the MR RegVol divided by VTIMR. In a group of 10 patients, the quantification of 3D-VCA was performed by multiplanar reconstruction using a dedicated software package (EchoPAC 204 GE Vingmed, Horten, Norway). Results average LV end-diastolic and end-systolic volumes, total stroke volume, LVEF and global longitudinal strain were 211±25 mL, 134±17 mL, 73±9 mL, 36±8% and, 9.4±2.7% respectively. Median Ao SV was 50±12 mL. Left atrial volume and left atrial reservoir strain were respectively 99±19 mL and 10±16%. Both EROA and RegVol by VM were larger than EROA (0.17± 0.09 cm2 vs 0.11± 0.01 cm2; p<0.001) and RegVol (25.7±12.1 mL vs 17.2±9.9 mL; p<0.001) by PISA, respectively. Compared to 3D-VCA, EROA by VM resulted more accurate than EROA by PISA (bias= -0.15 cm2, LOA ±0.24 cm2 vs bias= -0.25 cm2, LOA ±0.29 cm2). Finally, VM EROA (r= 0.778) showed a better correlation than PISA EROA (r= 0.681) with the 3D-VCA (p<0.001). Conclusions in patients with v-FMR, the echocardiographic assessment of EROA and RegVol using the 3DE volumetric method showed larger values compared to the conventional PISA method, and a closer correlation with the 3D VCA. Accordingly, the 3DE VM could improve the accuracy of evaluation of v-FMR severity. Larger studies with longer clinical follow-up are needed to define if it translates into improved risk stratification and may address patients’ management.

897 PEAK RIGHT ATRIAL LONGITUDINAL STRAIN: A NEW PARAMETER IN PREDICTING VENOUS CONGESTION

Abstract Background tricuspid regurgitation (TR) of either organic or functional etiology can lead to systemic venous congestion particularly in its more severe forms. Little is known about the role of the right atrium (RA) which acts as an intermediate player between TR and systemic veins. Purpose to assess the influence of right atrial size and function on venous congestion in TR patients. Methods 101 stable patients with at least mild to moderate TR were enrolled at the time of echocardiography (age 74±13 years, 37% male). Systemic congestion was assessed by inferior vena cava (IVC) diameter and right atrial pressure (RAP) estimated according to inferior vena cava diameter and collapsibility. TR severity was quantified by means of proximal isovelocity surface area (PISA) derived effective regurgitant orifice area (EROA) and regurgitant volume (RVol). RA and right ventricular (RV) function were assessed respectively by peak atrial longitudinal strain (PALS) and free wall longitudinal strain (FWLS) while indexed RA volume (RAVi) by Simpson's disk summation method. Results TR was quantified mild or moderate in 52 patients and more than moderate in 49 patients (mean EROA 37±31 mm2; mean RVol 34±23 ml). Mean indexed RA volume was 58±31 ml/m2; mean RA strain was 18±11% and mean RV strain (free wall) was -21 ± 7%. Mean IVC diameter was 20±6 mm; estimated RAP was ≤5 mmHg in 32 patients, 6-10 mmHg in 26, 11-15 mmHg in 26 and greater than 15 mmHg in 17 patients. In univariate analysis both IVC diameter and RAP correlated significantly with EROA, RVol, RAVi and RA strain (p<0.0001 for all); only RAP correlated with RV strain. In linear multivariate analysis only RAVi and RA strain were independent predictors of IVC diameter (p=0.01 and <0.0001, respectively), and only RVol and RA strain were independent predictors of RAP (p=0.001 and 0.002, respectively). We found a RA strain cut-off of -15% to have a sensitivity of 82% and specificity of 70% to identify a RAP greater than 15 mmHg (area under the curve-AUC 0.842). Conclusions RA size and function together with the TR-related volume overload were independent predictors of venous congestion. Among these variables, only RA strain predicted both parameters of venous congestion.

1038 RIGHT VENTRICULAR-PULMONARY ARTERIAL (UN)COUPLING ESTIMATION IN PATIENTS WITH TRICUSPID REGURGITATION

Abstract Background right-ventricular (RV)-pulmonary arterial (PA) uncoupling expressed by Tricuspid Annular Plane Systolic Excursion (TAPSE)/Pulmonary Artery Systolic Pressure (PAPs) ratio is associated with poor outcomes in patients with heart failure (HF). TAPSE/PAPs ratio has been poorly investigated in patients with tricuspid regurgitation (TR) with related volume overload and progressive right chambers remodeling. Purpose to assess the effectiveness of other estimation methods of RV-PA coupling in different TR severity groups compared to the classic TAPSE/PAPs ratio. Material and Methods 116 stable patients with TR were enrolled at the time of echocardiography (43 men, 37%; mean age 74±13 years). TR severity was quantified by means of proximal isovelocity surface area (PISA) derived effective regurgitant orifice area (EROA) and regurgitant volume (RVol). RV function was assessed by RV Free Wall Longitudinal Strain (FWLS). PAPs was obtained using the following formula: 4*(peak tricuspid regurgitation velocity)2 + right atrial pressure (RAP); meanPAP was estimated using TR continuous wave signal mean gradient (PAPmIT) and pulmonary artery regurgitation peak gradient (PAPmIP), adding RAP for both. RV-PA coupling was evaluated by TAPSE/PAPs ratio, TAPSE/PAPmIT and TAPSE/PAPmIP ratios. Result TR was quantified mild in 23 patients, moderate in 49, severe and torrential in 29 and 15 patients respectively. Mean RV-FWLS was -26.4±6.9% in mild, -21.8±7.4% in moderate, -18±7% and -18.3±4.2% in severe and torrential TR respectively (p<0.0001). Mean TAPSE/PAPs ratio was 0.6±0.23 mm/mmHg, 0.44±0.19, 0.38±0.19 and 0.37±0.12 mm/mmHg in mild, moderate, severe and torrential TR respectively, with a statistically significant difference between the 4 groups (p<0.0001). Mean TAPSE/PAPmIP ratio was 1.08±0.5 mm/mmHg in mild TR, 0.68±0.34 in moderate, 0.67±0.5 in severe TR and 0.47±0.13 mm/mmHg in torrential TR with a statistically significant difference between distinct TR grades (p=0.004). Mean TAPSE/PAPmIT in mild TR was 0.92±0.5 mm/mmHg, 0.63±0.29 in moderate, 0.53±0.29 and 0.51±0.16 mm/mmHg in severe and torrential TR respectively with a statistically significant difference between the groups (p<0.0001). Finally, an analysis of covariance with RV-FWLS as potential confounder was performed: only the adjusted means of TAPSE/PAPmIP and TAPSE/PAPmIT ratios preserved a statistically significant difference between distinct TR groups (p=0.01 and p=0.019 respectively). Conclusion TAPSE/PAPmIP and TAPSE/PAPmIT ratios seem to preserve a stronger relation with increasing TR grade and worsening of RV disfunction, suggesting it as a more powerful index in this subset of patients. The progression of TR grade leading to a right chamber remodeling could influence the reliability of RV-PA uncoupling expressed by standard TAPSE/PAPs ratio.

Effects of Cardiac Contractility Modulation Electrodes on Tricuspid Regurgitation in Patients with Heart Failure with Reduced Ejection Fraction: A Pilot Study.

Cardiac contractility modulation (CCM) is an innovative therapy for heart failure with reduced ejection fraction delivered by a cardiac implantable device (Optimizer Smart®). One of the most prominent periprocedural complications common to all cardiac implantable devices (CIDs) is tricuspid regurgitation (TR) due to the placement of the right ventricular endocardial leads. To date, no published studies have assessed the changes in the TR degree in patients with heart failure with reduced ejection fraction (HFrEF) who received an implantable cardioverter-defibrillator (ICD) after the implantation of cardiac contractility modulation therapy devices. This study aimed to evaluate the effect of the implantation of the trans-tricuspid leads required to deliver CCM therapy on the severity of TR in patients with HFrEF who previously underwent ICD implantation. We enrolled 30 HFrEF patients who underwent CCM therapy between November 2020 and October 2021. For all the patients, echocardiographic evaluations of TR were performed according to current guidelines 24 h before and six months after the Optimizer Smart® implant was applied. At the 6-month follow-up, the grade of TR remained unchanged compared to the preimplant grade. The value of the vena contracta (VC) of TR was 0.40 ± 0.19 cm in the preimplant period and 0.45 ± 0.21 cm at the 6-month follow-up (p = 0.33). Similarly, the TR proximal isovelocity surface area (PISA) radius value was unchanged at follow-up (0.54 ± 0.22 cm vs. 0.62 ± 0.20 cm; p = 0.18). No statistically significant difference existed between the preimplant VC and PISA radius values, irrespective of the device type. The implantation of right ventricular electrodes for the delivery of CCM therapy did not worsen tricuspid regurgitation in patients with HFrEF and ICD.

1000 THE EFFECT OF RIGHT VENTRICULAR SIZE AND FUNCTION ON TRICUSPID REGURGITATION SEVERITY

Abstract Background Tricuspid regurgitation (TR) is a relatively common echocardiographic finding and its proportional influence on prognosis and quality of life has been well described. A bidirectional relationship connects TR severity and its volume overload with right ventricular (RV) dilation and dysfunction. Purpose to assess the impact of RV size and function on TR severity. Material and Methods 116 stable patients with TR were enrolled at the time of echocardiography (43 men, 37%; mean age 74±13 years). TR severity was quantified by means of proximal isovelocity surface area (PISA) derived effective regurgitant orifice area (EROA) and regurgitant volume (RVol). RV size was assessed by RV End Diastolic Area (EDA) and RV function by RV Free Wall Longitudinal Strain (FWLS). Results TR was quantified mild in 23 patients, moderate in 53 and severe in 40 patients, with higher predominance of functional rather than organic etiology (101 vs 15 patients); median EROA was 31 mm2 and median RVol was 30 mL. Mean RV-FWLS was -25.9±7%, -21.4±7.4% and -18.4±6.4% respectively in mild, moderate and severe TR with a statistically significant difference between the groups (p=0.001). Mean RV-EDA was 19±7.7 cm2 in mild TR, 21.7±8.5 cm2 and 26.2±7 cm2 in moderate and severe TR respectively (p=0.002). In univariate analysis both RV-FWLS and RV-EDA were predictor of TR grade estimated by TR-EROA (p=0.012 and p<0.0001 respectively). In linear multivariable analysis only RV-EDA was an independent predictor of TR-EROA (p=0.001). A ROC curve analysis confirmed the better ability of RV-EDA to identify severe TR (sTR) compared to RV-FWLS (AUC=0.738 vs AUC=0.669). Conclusions RV remodeling in terms of chamber dilation seems to better predict a higher TR severity compared to RV dysfunction.

SCPM-CR: A Novel Method for Spatial Co-Location Pattern Mining With Coupling Relation Consideration

Spatial co-location pattern mining (SCPM) aims to discover subsets of spatial features frequently located together in proximate areas. Previous studies of SCPM solely concern the inter-features association of a pattern, but neglect the interesting intra-feature behavior. In this paper, we propose the task of spatial co-location pattern mining with coupling relation consideration (SCPM-CR) to capture complex relations embedded in a co-location. Specifically, InterPCI measure is designed to capture the inter-features coupling by considering the comprehensive interaction of objects for the features in a pattern, and luckily it possesses the anti-monotone property. Another measure, IntraCAI, is proposed to capture the congregating behavior of intra-feature objects under the restriction of a co-location. A general framework is designed for SCPM-CR task and experiments show that a large fraction of computation time is devoted to identifying the participating objects of a candidate pattern. To tackle this calculation bottleneck, a novel candidate-and-search algorithm is suggested, CS-HBS, equipped with heuristic backtracking search. Extensive experiments are conducted on real and synthetic datasets to demonstrate the superiority of SCPM-CR compared with traditional SCPM methods, and also to validate the efficiency and scalability of CS-HBS. Experimental results show that CS-HBS outperforms the baselines by several times or even orders of magnitude.

Digital Analysis of the Dimensional Change Of an Irreversible Hydrocolloid Impression Material (Alginate) with Varying Storage Times.

The aim of this study was to digitally measure the dimensional changes in an irreversible hydrocolloid impression material (alginate) resulting from varying storage times under optimal storage conditions. A single type V dental stone control cast was used to make 25 alginate impressions using perforated stock trays. The impressions were randomly assigned into five groups of five samples each (n=5 per group) with varying storage times: Group 1, poured at 15 minutes; Group 2, poured at one hour; Group 3, poured at 24 hours (one day); Group 4, poured at 72 hours (three days); Group 5, poured at 168 hours (seven days). All impressions were stored in sealed Ziploc® plastic bags with a wet paper towel (100% relative humidity) at room temperature and stored according to the assigned group storage times. All impressions were poured in type V dental stone according to the manufacturer's instructions. The casts were scanned with a digital 3D desktop scanner and saved as electronic stereolithography (.stl) files. Each .stl file of the scanned casts were superimposed on the .stl file of the control cast using Geomagic® Control X™ software. Three preselected fixed comparison measuring points (CMP) on each cast were compared to the control cast. Point one (CMP1) was on the midfacial surface of central incisor. Point two (CMP2) and point three (CMP3) were on the mesiobuccal proximal marginal ridge areas of third molars. The discrepancies between the files at each point were analysed with colour maps, and quantified (Table 1). The tolerance was set at ±10μm. CMP scores were analysed using one-way analysis of variance (ANOVA) and Kruskal-Wallis (K-W) non-parametric H tests. Average gap distances across groups ranged from 0.04mm (seven-day group) to 0.06mm (one hour and 24-hour groups). Colour maps indicated increased dimensional change with increased storage time up to one day. After three days, shrinkage up to 139μm was measured. ANOVA results for CMP1 (F[4,20] = 1.65, p = 0.020) and CMP3 (F[4,20] = 0.44, p = -0.78) were not statistically significant. Similarly, K-W results for CMP2 were not significant (χ2= 3.62, p = 0.46). Under optimal storage conditions, there were no significant dimensional changes in casts poured from alginate up to seven days.

Spatial Chaos in the Airport-Proximate Areas - Case Study of Gdansk Lech Walesa Airport

Abstract The airport may be an opportunity for the development of airport-proximate areas, as well as a source of conflicts and nuisances for stakeholders. From the perspective of spatial order and sustainable development, it is necessary to create a coherent vision of the development and operationalize it via spatial management. This article aims to analyze spatial management in areas proximate to Gdansk Airport in the context of spatial chaos. The analyses are based on 232 local spatial development plans for the period 1996-2020, for 11 selected areas in the vicinity of the Gdansk Lech Walesa Airport, documents obtained from the local government, and open-source data. The research concentrates on the analysis of the functions of areas, spatial chaos, and the threat of potential conflicts. The results demonstrate the spatial chaos in proximate areas of Gdansk Airport. This implies that the decisions made by the authorities responsible for spatial management do not respect spatial order and sustainable development and contribute to spatial chaos.

KUALITAS FOTO POLOS PASIEN DENGAN DAN TANPA LAVEMENT

ABSTRACT
 Introduction: Patient preparation aims to minimize the appearance of air and feces which can interfere with doctors assessing anatomy and pathology on radiographs, and in some cases can even cause a delay in IVP examination. The results showed that there was no statistically significant difference between KUB examination patients with and without patient preparation (Abbasi A, Siyal A and Soomro M.I, 2015). Preparation of IVP patients between outpatients and inpatients at Prof. Hospital. Dr. Margono Soekardjo Purwokerto differs in the presence or absence of lavement.
 Method: This type of research is descriptive research. The population of the study was request sheets for photos and plain photo radiographs for BNO IVP examination with indications of hydronephrosis. The exclusion criteria for this study were patients aged ≥ 50 years to avoid the effects of constipation. The assessment uses a questionnaire that refers to The European Commission Guideline For Evaluation Of Radiographic Images and the assessment criteria determined by the researcher.
 Results: up to 6 patients came from the Inpatient Installation and 6 patients came from the Outpatient Installation. Inpatient installation has a higher total score for renal outline. Inpatient installation has a lower total score for visualization of the right psoas line and bone system, but gives the same score for the left psoas line. The Inpatient Installation has a higher total score for visualizing a lot of air and feces than the Outpatient Installation for the proximal colon area, while the distal colon area has the same score. In the distal colonic area, more radiographs from inpatient settings show air and stool features that may interfere with diagnosis than outpatient settings. This can be caused by visits from guests when visiting patients. The tendency of guests to bring food and chat with patients can affect this.
 Conclusion: In general, radiographs from outpatients and inpatients can clearly show the organs which include, the entire urinary tract area from the upper pole of the kidney to the basal bladder, renal outline, psoas line and bone system, but visualization of a lot of air and feces is more higher than the Outpatient Installation for the proximal colon area, while the distal colon area has the same score.

No evidence for expansion of global ocean euxinia during the base Stairsian mass extinction event (Tremadocian, Early Ordovician)

A Tremadocian (Early Ordovician, base Stairsian North American Stage) mass extinction event is recorded globally in rocks from several ancient continents and is accompanied by a globally correlated positive carbon isotope excursion (CIE; the largest during the Early Ordovician). In this study, elemental concentrations and uranium isotope compositions (δ238U) were measured for carbonate samples from three sections (along a proximal-to-distal transect: Ibex area, Shingle Pass, Meiklejohn Peak, respectively) in the Great Basin to test the role of ocean anoxia/euxinia on the base Stairsian mass extinction event. Dysoxic/suboxic to oxic water columns and non-sulfidic porewaters are inferred for these sections based on multiple local redox proxies (e.g., Mo/Al, U/Al, Mo and U concentrations, Mo/U ratios).Carbonate δ238U data exhibit different δ238U trends in the three sections. The proximal Ibex area exhibits a small negative δ238U excursion (a magnitude of 0.2–0.3‰) and the Shingle Pass section has one sample with unusually low δ238U, in both cases within the middle of the CIE. Samples with the lowest δ238U in each section also have the highest Mn/Sr ratios, suggesting diagenetic alteration associated with adsorption of isotopically light U onto Mn oxides, followed by dissolution of Mn oxides by reducing porewaters and capture of the isotopically light U by sediments. The distal Shingle Pass and Meiklejohn Peak sections better preserve global ocean signals and the limited δ238U variations in these sections imply no significant changes in global seawater δ238U and thus no significant changes in the extent of global ocean euxinia. Given the non-sulfidic porewaters inferred for these carbonates, we apply a sediment–seawater δ238U offset of 0–0.27‰ (the 0.27 ± 0.14‰ isotopic offset observed for modern Bahamas carbonates with sulfidic porewaters is used as a maximum constraint) to the average carbonate δ238U from the two distal sections (−0.48 ± 0.09‰) to derive a coeval seawater δ238U of between −0.75 ± 0.09‰ and −0.48 ± 0.09‰. A three-sink U isotope mass balance model suggests 0.2–15.8% global euxinic seafloor area existed during deposition of these Tremadocian carbonates. Our study implies that a small biotic crisis during a small CIE was not associated with an expansion of global ocean euxinia, in contrast to major Phanerozoic mass extinctions that were commonly associated with significant expansion of ocean euxinia during large carbon perturbations (e.g., the Late Devonian). In addition, we propose that the post-SPICE Cambrian and Early Ordovician oceans were characterized by limited changes in ocean euxinia and only a few episodes of expanded ocean suboxia-anoxia during carbon perturbations. The “biomere” events within this period, including the base Stairsian event, were probably related to these episodes of expanded suboxic-anoxic oceans and/or other ecological stresses.

Understanding of groundwater evolution through chemical and age dating information in the Yongding River alluvial fan in Beijing

Groundwater plays important roles in human community development and the urbanization process as the results of global environmental change and rapid population growth. A clear understanding of the vertical and horizontal spatial distribution characteristics of groundwater and sediment is the premise of efficient groundwater resource management and utilization in alluvial plains. To explore the evolution process of groundwater and the distribution of sediment in the Yongding River (YDR) alluvial fan, a typical profile from Mentougou to Fengheying was chosen to conduct an extensive hydrogeological investigation with multiple hydrochemical, isotopic, and age dating analyses, which represents one of the most typical hydrogeological units in the YDR alluvial fan. The analysis results show that (i) along the profile, the water’s chemistry type gradually changes from HCO3-Ca·Mg to HCO3-Na. The contents of coarse grain gradually decrease while fine particles regularly increase. Also, a similar evolution trend is found in the vertical direction. (ii) The annual renewable rate of groundwater is > 10% in the upper fan, 2%–8% nearby Daxing, and < 2% in Fengheying. (iii) In the proximal fan area, the average flow velocity of the single and double layer is about 65 m yr−1 and of approximately 18.9 m yr−1. From the mid fan to distal fan, the value of velocity and hydraulic conductivity decreases from 12.4 m yr−1 to 3.75 m yr−1 and from 8.54 m yr−1 to 0.64 m yr−1, respectively. (iv) The 14C analysis results indicate that the age of shallow and deep groundwater ranges from 5a to 60a and from 4000a to 12000a, respectively. The groundwater age increases with depth in the vertical direction and increases from northwest to southeast along in the alluvial fan in the horizontal direction. Understanding the evolution process of sediment and hydrochemistry in the YDR alluvial fan provides a valuable reference for groundwater resource development, utilization, and pollution prevention in the alluvial fan.

Neogene-Quaternary evolution of the La Baja Guajira basin, Colombia: Burial and thermal history with implications on petroleum systems

The La Baja Guajira Basin is South America's northernmost part that extends from onshore Colombia into the Caribbean Sea and represents an important gas-producing region in Colombia. The dataset used in this study consists of twenty-four (24) regional 2D seismic-reflection lines integrated with information from nine (9) boreholes across the basin. We present seismic interpretations of key stratigraphic and structural features constrained by 1D basin modeling. This allows us to describe the Neogene-Quaternary evolution of the basin, and understand the possible implications for the hydrocarbon potential.We have interpreted eight (8) seismic units within the La Baja Guajira Basin (acoustic basement to U7) affected by three fault groups: 1) NW-SE-striking basement normal faults, 2) inverted normal faults, and 3) strike-slip faults. Considering the evidence, we propose four tectonic phases along the basin's evolution. The basement was affected by normal faulting as the result of extensional tectonics prior to the deposition of the sedimentary infill (Paleogene?). Another extensional interval occurred during the Early Miocene, triggering a moderate accommodation within the proximal area. Subsequently, extension migrated westwards resulting in the formation of the main La Baja Guajira Basin depocenter. In the Middle Miocene (post-extension), sedimentation was controlled by exhumation pulses in adjacent areas to the basin, which resulted in significant sediment input contemporaneous with rapid tectonic subsidence. Yet, local inversion of NW-SE-oriented basement-rooted faults affected today's offshore domain until the Late Miocene. This inversion can be associated with regional compressive deformation linked to the activity of the Oca and Cuiza faults. A second episode of rapid tectonic subsidence happened in the Early Pliocene. In the south of the basin, rocks were subjected to maximum burial and highest temperatures in recent times, conditions that might lead to hydrocarbon generation. The high Neogene to recent sedimentation rates calculated for the La Baja Guajira Basin support microbial gas generation; structural reactivation in this time supported trap formation, particularly in the offshore parts of the basin.

The largest rock avalanche in China at Iymek, Eastern Pamir, and its spectacular emplacement landscape

Catastrophic rock avalanches are widely distributed on Earth and share a series of common diagnostic features that play a vital role in revealing their emplacement mechanisms. Combined with satellite imagery, field investigation, and statistical analysis, a comprehensive investigation is conducted on the gigantic Iymek rock avalanche (IRA) in eastern Pamir, China. The IRA with a volume of ~0.98 km3 detached mass advanced 16.3 km on an unconfined terrain, covered an area of 48.5 km2 with a depth of 10–90 m, and deposited an estimated volume of 1.37 km3 deposits, making it the largest rock avalanche known in China. Its spectacular emplacement landscape provides an excellent laboratory for studying rock avalanches. Morphologically, the IRA deposit exhibits characteristic undulating features, including trimlines, longitudinal ridges, hummocks, transverse ridges, raised distal edge, and raised lateral levees. On the profile, numerous representative landslide-tectonic structures, principally composed of the preserved stratigraphic sequence, pervasive shear bands, spectacular clastic dikes, diapiric intrusion, folds, and normal/thrust faults, are revealed. The sequential assemblage of these morphological landforms and internal structures demonstrates that the propagation of the IRA should behave like a laminar flow with distributed shearing and obey three major stress processes, i.e. extension-dominated process in the proximal area, compression-dominated process in the distal area, and slightly lateral spreading in the central area and the areas adjacent to the margin of the deposit sheet. During its propagation, the strong substrate, mainly composed of gravel-dominated coarse material, should play a decisive role in casting most of the depositional landscapes. Restricted by the strong substrate, prominent lateral levees are well-developed in the accumulation zone with a series of rolling flame structures. This powerfully indicates that the formation of the lateral levees should be attributed to a continuously sideward movement of the frontal mass due to the push from the rear part instead of a particle self-segregation mechanism. Furthermore, the cutting relationship between the clastic dikes and subhorizontal shear bands in local positions indicates that the localized liquefaction of the substrate is not a contributor for the high mobility of the IRA and is only a product of the strong interaction between the sliding mass and the substrate at the final stage. This comprehensive study not only provides important information that contributes to an interpretation of similar features on Earth, but also yields insight into the underlying mechanisms responsible for the emplacement of rock avalanches.

Registration based assessment of femoral torsion for rotational osteotomies based on the contralateral anatomy

BackgroundComputer-assisted techniques for surgical treatment of femoral deformities have become increasingly important. In state-of-the-art 3D deformity assessments, the contralateral side is used as template for correction as it commonly represents normal anatomy. Contributing to this, an iterative closest point (ICP) algorithm is used for registration. However, the anatomical sections of the femur with idiosyncratic features, which allow for a consistent deformity assessment with ICP algorithms being unknown. Furthermore, if there is a side-to-side difference, this is not considered in error quantification.The aim of this study was to analyze the influence and value of the different sections of the femur in 3D assessment of femoral deformities based on the contralateral anatomy.Material and methods3D triangular surface models were created from CT of 100 paired femurs (50 cadavers) without pathological anatomy. The femurs were divided into sections of eponymous anatomy of a predefined percentage of the whole femoral length. A surface registration algorithm was applied to superimpose the ipsilateral on the contralateral side. We evaluated 3D femoral contralateral registration (FCR) errors, defined as difference in 3D rotation of the respective femoral section before and after registration to the contralateral side. To compare this method, we quantified the landmark-based femoral torsion (LB FT). This was defined as the intra-individual difference in overall femoral torsion using with a landmark-based method.ResultsContralateral rotational deviation ranged from 0° to 9.3° of the assessed femoral sections, depending on the section. Among the sections, the FCR error using the proximal diaphyseal area for registration was larger than any other sectional error. A combination of the lesser trochanter and the proximal diaphyseal area showed the smallest error. The LB FT error was significantly larger than any sectional error (p < 0.001).ConclusionWe demonstrated that if the contralateral femur is used as reconstruction template, the built-in errors with the registration-based approach are smaller than the intraindividual difference of the femoral torsion between both sides. The errors are depending on the section and their idiosyncratic features used for registration. For rotational osteotomies a combination of the lesser trochanter and the proximal diaphyseal area sections seems to allow for a reconstruction with a minimal error.

Abstract 10890: A Simplified Method for Correction of Effective Regurgitant Orifice and Flow Underestimation by Pisa in Non-Circular Orifices: An in vitro Study

Introduction: The proximal isovelocity surface area (PISA) method has been validated for quantifying severity of mitral regurgitation (MR) in orifices with circular geometry. However, functional MR often has an elliptical orifice, which alters the proximal isovelocity contour from a hemisphere to a hemi-ellipsoid. Studies have previously shown that PISA underestimates regurgitant flow (RF) and effective regurgitant orifice (ERO) in functional MR. Hypothesis: The application of a simplified hemi-ellipsoid formula based on biplane color Doppler improves accuracy in calculating RF and ERO across elliptical orifices. Methods: An in vitro model for flow quantification was used for all experiments. Multiple size orifices with minor to major ratios ranging from 1:1 to 1:9 were constructed by 3D printing. Flow was adjusted at multiple intervals to generate peak flow velocities ranging from 4.1 to 5.5 m/s and aliasing velocities from 12 to 18 cm/s. Isovelocity contours were evaluated by biplane color Doppler (Figure 1A). RF and ERO were estimated using the traditional hemispheric PISA (HS-PISA) formula and a simplified hemiellipsoid formula (HE-PISA) based on two orthogonal diameter measurements (Figure 1A and 1B). The estimated RF and ERO values were compared and validated against those derived from a magnetic flowmeter (FM). Results: Isovelocity contours changed from hemisphere to hemi-ellipsoid orifices with increasing ellipticity ratios. HS-PISA significantly underestimated RF (116 ± 27 vs FM 155 ± 20 ml/s) and ERO (26 ± 4 vs FM 34 ± 1 mm 2 ). Underestimation was significantly reduced by HE-PISA (135 ± 17 ml/s and 30 ± 2.5 mm 2 , both p&lt;0.001). Conclusions: A simplified hemi-ellipsoid PISA method provides more accurate assessment of RF and ERO in regurgitant orifices with non-circular geometries.

Impact of assuming a circular orifice on flow error through elliptical regurgitant orifices: computational fluid dynamics and in vitro analysis of proximal flow convergence.

Grounded in hydrodynamic theory, proximal isovelocity surface area (PISA) is a simplistic and practical technique widely used to quantify valvular regurgitation flow. PISA provides a relatively reasonable, though slightly underestimated flow rate for circular orifices. However, for elliptical orifices frequently seen in functional mitral regurgitation, PISA underestimates the flow rate. Based on data obtained with computational fluid dynamics (CFD) and in vitro experiments using systematically varied orifice parameters, we hypothesized that flow rate underestimation for elliptical orifices by PISA is predictable and within a clinically acceptable range. We performed 45 CFD simulations with varying orifice areas 0.1, 0.3 and 0.5 cm2, orifice aspect ratios 1:1, 2:1, 3:1, 5:1, and 10:1, and peak velocities (Vmax) 400, 500 and 600cm/s. The ratio of computed effective regurgitant orifice area to true effective area (EROAC/EROA) against the ratio of aliasing velocity to peak velocity (VA/Vmax) was analyzed for orifice shape impact. Validation was conducted with in vitro imaging in round and 3:1 elliptical orifices. Plotting EROAC/EROA against VA/Vmax revealed marginal flow underestimation with 2:1 and 3:1 elliptical axis ratios against a circular orifice (< 10% for 8% VA/Vmax), rising to ≤ 35% for 10:1 ratio. In vitro modeling confirmed CFD findings; there was a 8.3% elliptical EROA underestimation compared to the circular orifice estimate. PISA quantification for regurgitant flow through elliptical orifices produces predictable, but generally small, underestimation deemed clinically acceptable for most regurgitant orifices.

Proximal ear hole injury heals by limited regeneration during the early postnatal phase in mice.

Ear pinna is a particular feature of mammals that shows several repair responses depending on age. Two millimeter hole made in the pinna of middle-aged female mice heals due to partial reconstitution of new tissues (limited regeneration), whereas a hole punched in the ear of young mice forms a scar tissue. In these studies, the injury is made in the center of the ear pinna, but little is known about the type of reparative response along the proximodistal polarity of the ear. This study evaluated the effect of pinna polarity, age, and sex in the ear hole-repairing response in Balb/c mice. Proximal injuries were repaired more efficiently by limited regeneration than wounds made in the middle region. Non-injured ear histological analysis revealed a higher presence of muscle, adipose tissue, cartilage, and larger blood vessels in the proximal ear area, which could influence ear hole closure by limited regeneration. To evaluate the healing response during ear growth, we punched a standard hole in the proximal area of the ear on postnatal day21 and 8-month-old mice (adults). Thirty-five days after the wound, both groups reached the same wound closure, despite the greater proportional size of holes made in the younger mice. Ear growth also improved ear hole closure in male mice. These results suggest that ear growth accelerates hole closure, providing an example of enhanced regenerative abilities in growing structures. Finally, hole closure kinetics in the growing ear indicated an early re-differentiation phase exhibited at 14 days post-wound. In conclusion, ear topography and growth positively influenced the healing response to ear holes, making it a tractable model to study in mammals.