Reduction In Flow Research Articles

Continuous Flow Process for Carbonyl and α,β-Unsaturated Carbonyl Compounds Reduction Using NaBH4 Solutions: Toward Implementation of Luche Reduction in Flow

Continuous Flow Process for Carbonyl and α,β-Unsaturated Carbonyl Compounds Reduction Using NaBH₄ Solutions: Toward Implementation of Luche Reduction in Flow

Case report of a Pulmonary embolism in a patient with Inferior vena cava compression by a 11x28 cm abdominal benign tumor

ABSTRACT Background: Pulmonary embolism is a life-threatening condition causing abrupt reduction in blood flow in the pulmonary vasculature due to a migrating thrombus. The most cases are related to thromboembolism events originating in the lower limbs. However alternate etiologies should be suspected in certain clinical cases mainly in young patients with no risk factors. Case: We present a case of young patient with proximal pulmonary embolism caused by compression on the inferior vena cava by an abdominal benign tumour measuring 11x28cm. The patient was treated surgically and started on therapeutic dose of Anticoagulation. The etiology of pulmonary embolism in this case was attributed to large vein compression promoting blood stasis and leading to thrombus formation Conclusion: In short, acute pulmonary embolism in young female patients, is unusual and should raise the suspicion for miscellaneous causes including vascular compression by tumors.

Preoperative recovery sleep ameliorates postoperative cognitive dysfunction aggravated by sleep fragmentation in aged mice by enhancing EEG delta-wave activity and LFP theta oscillation in hippocampal CA1

Sleep fragmentation (SF) is a common sleep problem experienced during the perioperative period by older adults, and is associated with postoperative cognitive dysfunction (POCD). Increasing evidence indicates that delta-wave activity during non-rapid eye movement (NREM) sleep is involved in sleep-dependent memory consolidation and that hippocampal theta oscillations are related to spatial exploratory memory. Recovery sleep (RS), a self-regulated state of sleep homeostasis, enhances delta-wave power and memory performance in sleep-deprived older mice. However, it remains unclear whether RS therapy has a positive effect on cognitive changes following SF in older mouse models. Therefore, this study aimed to explore whether preoperative RS can alleviate cognitive deficits in aged mice with SF. A model of preoperative 24-h SF combined with exploratory laparotomy-induced POCD was established in 18-month-old mice. Aged mice were treated with preoperative 6-h RS following SF and postoperative 6-h RS following surgery, respectively. The changes in hippocampus-dependent cognitive function were investigated using behavioral tests, electroencephalography (EEG), local field potential (LFP), magnetic resonance imaging, and neuromorphology. Mice that underwent 24-h SF combined with surgery exhibited severe spatial memory impairment; impaired cognitive performance could be alleviated by preoperative RS treatment. In addition, preoperative RS increased NREM sleep; enhanced EEG delta-wave activity and LFP theta oscillation in the hippocampal CA1; and improved hippocampal perfusion, microstructural integrity, and neuronal damage. Taken together, these results provide evidence that preoperative RS may ameliorate the severity of POCD aggravated by SF by enhancing delta slow-wave activity and hippocampal theta oscillation, and by ameliorating the reduction in regional cerebral blood flow and white matter microstructure integrity in the hippocampus.

Treatment for middle cerebral artery bifurcation aneurysms: in silico comparison of the novel Contour device and conventional flow-diverters

Endovascular treatment has become the standard therapy for cerebral aneurysms, while the effective treatment for middle cerebral artery (MCA) bifurcation aneurysms remains a challenge. Current flow-diverting techniques with endovascular coils cover the aneurysm orifice as well as adjacent vessel branches, which may lead to branch occlusion. Novel endovascular flow disruptors, such as the Contour device (Cerus Endovascular), are of great potential to eliminate the risk of branch occlusion. However, there is a lack of valid comparison between novel flow disruptors and conventional (intraluminal) flow-diverters. In this study, two in silico MCA bifurcation aneurysm models were treated by specific Contour devices and flow-diverters using fast-deployment algorithms. Computational fluid dynamic simulations were used to examine the performance and efficiency of deployed devices. Hemodynamic parameters, including aneurysm inflow and wall shear stress, were compared among each Contour device, conventional flow-diverter, and untreated condition. Our results show that the placement of devices can effectively reduce the risk of aneurysm rupture, while the deployment of a Contour device causes more flow reduction than using flow-diverters (e.g. Silk Vista Baby). Besides, the Contour device presents the flow diversion capability of targeting the aneurysm neck without occluding the daughter vessel. In summary, the in silico aneurysm models presented in this study can serve as a powerful pre-planning tool for testing new treatment techniques, optimising device deployment, and predicting the performance in patient-specific aneurysm cases. Contour device is proved to be an effective treatment of MCA bifurcation aneurysms with less daughter vessel occlusion.

Predicting Quantum-Mechanical Partial Charges in Arbitrarily Long Boron Nitride Nanotubes to Accurately Simulate Nanoscale Water Transport.

Single-walled boron nitride nanotubes (BNNTs) have been explored for various applications, ranging from water desalination to osmotic power harvesting. However, no simulation work so far has modeled the changes in the partial charge distribution when a flat sheet is rolled into a tube, hindering the ability to perform accurate molecular dynamics (MD) simulations of water flow through BNNTs. To address this knowledge gap, we employ electronic density functional theory (DFT) calculations to precisely estimate quantum-mechanically derived partial charges on boron (B) and nitrogen (N) atoms in BNNTs of varying lengths and diameters. We observe a spatially varying charge distribution inside both armchair and zigzag nanotubes of finite lengths. Performing DFT calculations for longer BNNTs is computationally intractable, even with state-of-the-art computing resources. To solve this issue, we devise a charge assignment scheme to predict partial charges for longer BNNTs using DFT data for shorter nanotubes, thus overcoming the need to perform more expensive DFT calculations. We show that these charges reproduce the electrostatic potential predicted from first-principles simulations. Subsequently, we carried out MD simulations to predict the effect of the charge distribution inside BNNTs on water flow enhancement via them. We find that using uniform charges leads to an underprediction in flow enhancement, as compared to using quantum-mechanical charges for both armchair and zigzag BNNTs. We also incorporate atomic vibrations into our simulations and show that these vibrations lead to a reduction in the water flow through aperiodic BNNTs. Our work demonstrates the requirement of a quantum-mechanical charge assignment scheme for BNNTs and evolves a framework to assign charges to nanotubes of arbitrary length, thus allowing realistic MD simulations of long BNNTs using accurate partial charges.

Detecting High-Dose Methotrexate-Induced Brain Changes in Pediatric and Young Adult Cancer Survivors Using [18F]FDG PET/MRI: A Pilot Study.

Significant improvements in treatments for children with cancer have resulted in a growing population of childhood cancer survivors who may face long-term adverse outcomes. Here, we aimed to diagnose high-dose methotrexate-induced brain injury on [18F]FDG PET/MRI and correlate the results with cognitive impairment identified by neurocognitive testing in pediatric cancer survivors. Methods: In this prospective, single-center pilot study, 10 children and young adults with sarcoma (n = 5), lymphoma (n = 4), or leukemia (n = 1) underwent dedicated brain [18F]FDG PET/MRI and a 2-h expert neuropsychologic evaluation on the same day, including the Wechsler Abbreviated Scale of Intelligence, second edition, for intellectual functioning; Delis-Kaplan Executive Function System (DKEFS) for executive functioning; and Wide Range Assessment of Memory and Learning, second edition (WRAML), for verbal and visual memory. Using PMOD software, we measured the SUVmean, cortical thickness, mean cerebral blood flow (CBFmean), and mean apparent diffusion coefficient of 3 different cortical regions (prefrontal cortex, cingulate gyrus, and hippocampus) that are routinely involved during the above-specified neurocognitive testing. Standardized scores of different measures were converted to z scores. Pairs of multivariable regression models (one for z scores < 0 and one for z scores > 0) were fitted for each brain region, imaging measure, and test score. Heteroscedasticity regression models were used to account for heterogeneity in variances between brain regions and to adjust for clustering within patients. Results: The regression analysis showed a significant correlation between the SUVmean of the prefrontal cortex and cingulum and DKEFS-sequential tracking (DKEFS-TM4) z scores (P = 0.003 and P = 0.012, respectively). The SUVmean of the hippocampus did not correlate with DKEFS-TM4 z scores (P = 0.111). The SUVmean for any evaluated brain regions did not correlate significantly with WRAML-visual memory (WRAML-VIS) z scores. CBFmean showed a positive correlation with SUVmean (r = 0.56, P = 0.01). The CBFmean of the cingulum, hippocampus, and prefrontal cortex correlated significantly with DKEFS-TM4 (all P < 0.001). In addition, the hippocampal CBFmean correlated significantly with negative WRAML-VIS z scores (P = 0.003). Conclusion: High-dose methotrexate-induced brain injury can manifest as a reduction in glucose metabolism and blood flow in specific brain areas, which can be detected with [18F]FDG PET/MRI. The SUVmean and CBFmean of the prefrontal cortex and cingulum can serve as quantitative measures for detecting executive functioning problems. Hippocampal CBFmean could also be useful for monitoring memory problems.

Fishes move to transient local refuges, not persistent landscape refuges during river drying experiment

Abstract Anthropogenically driven flow intermittency is increasing in freshwater streams, with important implications for the management and conservation of aquatic ecosystems. Because most freshwater fishes are mobile, they are expected to emigrate from intermittent reaches, but this may not be true in streams transitioning from perennial to intermittent. Here, we attempt to determine if riverine fishes vacate drying reaches before intermittency or remain in local refuges. We implemented a controlled, in situ experimental flow reduction resulting in intermittency, reducing flows from ~1.0 to 0 m3/s over a 3‐week period. We monitored fish and fish‐habitat changes over a 5‐week period before, during and after flow reductions. During flow reductions, total wetted habitat was ultimately reduced by 91%. Habitat loss over time was not equal among habitat types: pool habitat increased slightly as run habit was lost, and backwater and isolated pool habitats were not strongly related to discharge. Likewise, water depth in run habitats decreased faster than other habitats. Only the river carpsucker Carpiodes carpio appeared to move upstream during flow recession; seven other species remained within drying sites. Habitat loss negatively affected fish populations, but at a lower rate than that at which habitat was lost, until sites dried completely. Overall, two species, red shiner Cyprinella lutrensis and western mosquitofish Gambusia affinis, had increased population growth during the study, whereas the remaining species had population declines. Fishes were able to find transient local refuges during flow reductions but did not vacate sites before intermittent conditions. Accounting for lack of emigration from anthropogenic flow‐intermittent reaches will be important for designing conservation actions for fishes threatened by increasing flow intermittency. Creation of refuge habitats may not be effective for widely dispersed species that do not actively seek refuge habitats, unless those habitats support enough individuals to maintain resilience following the intermittent conditions.

Drag reduction in a minimal channel flow with scientific multi-agent reinforcement learning

We study drag reduction in a minimal turbulent channel flow using scientific multi-agent reinforcement learning (SMARL). The flow is controlled by blowing and suction at the wall of an open channel, with observable states derived from flow velocities sensed at adjustable heights. We explore the actions, state, and reward space of SMARL using the off-policy algorithm V-RACER. We compare single- and multi-agent setups, and compare the identified control policies against the well-known mechanism of opposition-control. Our findings demonstrate that off-policy SMARL reduces drag in various experimental setups, surpassing classical opposition-control by up to 20 percentage points.

Evaluation of the effect of phacoemulsification surgery on retinal and choroidal microvasculature in diabetic patients using optical coherence tomography angiography

Aim To evaluate the effect of phacoemulsification surgery on retinal and choroidal microvasculature in diabetic patients using optical coherence tomography angiography (OCTA). Settings and design A prospective comparative case-control study was performed at the Ophthalmology Department of Ain Shams University hospital, between November 2020 and November 2022. Patients and material A total 50 eyes of 35 cataractous patients were included in this prospective study and divided into two groups: the control group (25 eyes of 19 patients) and the diabetic group (25 eyes of 16 patients with mild nonproliferative diabetic retinopathy). All patients underwent routine ophthalmic examination, OCT and OCTA scans of the macula before phacoemulsification surgery and 1 week, 1, 3, and 6 months after the surgery. Results The best corrected visual acuity significantly improved in both groups by ∼ 0.26 logMAR units in control and diabetic groups (P &lt;0.001 for both). The mean change in central subfoveal thickness was 23.44±43.7 versus 13.6±22 um (P=0.3) in the control group and the diabetic group, respectively but statistically insignificant. There was insignificant change in each group in all vascular parameters during the follow-up period. In addition, there was insignificant difference between the two groups at each visit in most vascular parameters of superficial vessel density, deep vessel density (DVD), and choriocapillaris vessel density (CC VD). On the other hand, the diabetic groups have significantly lower superficial vessel density of whole image and perifovea at 1 week than controls (42.92±4.54% vs. 46.16±3.98%, P=0.01 in the whole image, respectively) (44.29±4.87% vs. 47.32±3.85%, P=0.018 in perifovea, respectively). The diabetic group also showed significantly higher parafoveal deep vessel density than the control group at 1 month postoperatively: 52.67±4.00 versus 47.24±9.85% (P=0.014) that leveled up on month 3 and 6 (P=0.397, 0.538, respectively). The diabetic group showed lower CC VD of the whole image than the control group at 1 week postoperatively: 70.60±2.87 versus 72.22±1.98%, respectively (P=0.025), and also significantly lower CC VD of perifovea than the control group at 1 week: 71.19±2.82 versus 72.72±2.20% (P=0.038), 1 month: 71.08±2.87 versus 72.78±2.61% (P=0.033) and 3 months: 71.35±2.63 versus 72.83±2.52% (P=0.048). Those values leveled up at the last postoperative visit at month 6 (P=0.152). Conclusion Phacoemulsification surgery may lead to the transient and mild reduction of choroidal blood flow in diabetic eyes rather than retinal blood flow. Most of choroidal and retinal vascular changes happened in the perifoveal area within 1 week to 1 month postoperatively and rarely extended to 3 months.

An Improvised Modulation and Control Approach for Dual Active Bridge DC–DC Converter System

Aimed at the control and modulation of dual active bridge bi-directional dc (DAB-BIDC) converter, an unconventional approach is applied to explore its effect in symmetrical wave-based isolated dc-dc converters. The existing control schemes of DAB-BIDC converter with unified or optimal phase shift (UPS/OPS) modulation have the constraints like complex control schemes, light load efficiency, current stress, and reactive power. Since a 50 Hz, grid-connected conventional converter system uses the sinusoidal pulse width modulation method to minimize the requirement for passive filters. Similarly, this work investigates the same analogy for the high-frequency (HF) symmetrical wave converters to get effective modulation and control scheme for the DAB-BIDC converter. Furthermore, the proposed sinusoidal pulse width-phase shift (SPW-PS) modulation scheme has been implemented by the optimally derived control parameters using Lagrange's Multiplier Method (LMM) to minimize the reactive power flow and current stress reduction at the HF link. Therefore, the DAB-BIDC converter with the proposed modulation and control approach can be used for EV charging and solid-state transformers applications. Finally, the proposed work is validated using MATLAB simulation and experimental setup having turn ratio 36/12 V, fundamental frequency 5-kHz, and switching frequency 100-kHz for the experimental validation using OPAL-RT.

Global analysis of groundwater pumping from increased river capture

In many regions globally, groundwater overuse exceeds natural replenishment, leading to immediate consequences such as reduced river flows and devastating impacts on freshwater ecosystems. In alluvial aquifers in particular, groundwater pumping contributes to river flow reduction in two significant ways: first, by intercepting water that would naturally discharge into the river, and second, by lowering groundwater levels below the riverbed, causing river water to infiltrate. Despite these critical interactions, large-scale water resources assessments often overlook the relationship between groundwater and surface water, hindering a comprehensive understanding of the consequences of groundwater pumping on both the groundwater and surface water systems. Our study, utilizing a coupled global-scale groundwater–surface water model, reveals that approximately 20% of globally pumped groundwater stems from diminished streamflow, while 16% results from reduced storage. Projections for the end of the century, accounting for climate change, suggest potential increases to 30% from reduced streamflow and a decrease to 12% from reduced storage. Notably, our results highlight that the impact on streamflow is more widespread and linked to smaller pumping rates, contrasting with impacts on storage associated with higher pumping rates. This study shows the crucial need to include groundwater–surface water interactions in large-scale water resources assessments, not only for accurate estimates of freshwater availability but also for a comprehensive understanding of the far-reaching impacts of groundwater overuse related to increasing water demands and climate change.

Prevalence and Impact of Modifiable Risk Factors on Acute Coronary Syndrome: A Case Control Study

Highlights: 1. Smoking duration, dyslipidemia, hypertension, diabetes mellitus, obesity, and hyperuricemia, are significantly associated with ACS. 2. Obesity and hypertension are identified as risk factors for inpatient ACS. - Background: Acute coronary syndrome (ACS) is defined by the abrupt reduction or total obstruction of blood flow to the myocardium. Recognized risk factors for ACS include conditions such as hypertension, dyslipidemia, smoking, obesity, diabetes mellitus, hyperuricemia, as well as variables like age, gender, and family history of the ailment. The objective of this research was to examine the prevalence and importance of modifiable risk factors associated with ACS. Material and Methods: The study is structured as a prospective case-control study. The research sample comprises 100 ACS patients, categorized into three groups: STEMI, NSTEMI, and UAP. The Chi-Square test and logistic regression were used to examine the samples. The threshold for statistical significance was set at p&lt;0.05. Results: ACS occurred more frequently in male patients (54%) and those aged ≥ 40 years (85%). Several factors demonstrated significant associations with ACS, including smoking habits, dyslipidemia, hypertension, diabetes mellitus, obesity, and hyperuricemia. Among these, inpatient ACS was notably linked with obesity (OR: 7.42; 95% CI: 1.48-37.11; p=0.015) and hypertension (OR: 0.13; 95% CI: 0.03-0.53; p=0.005). The presence of ACS was also correlated with a notable increase in inpatient care, with obesity and hypertension emerging as risk factors for inpatient ACS. Conclusion: ACS was more common in males and individuals aged 40 or older, with significant associations identified between ACS and various factors, including smoking, dyslipidemia, diabetes, obesity, hyperuricemia, and hypertension, with obesity and hypertension specifically linked to inpatient ACS.

Simulations of low impact development designs using the storm water management model

This study assessed the U.S. Environmental Protection Agency's Storm Water Management Model (SWMM) for urban water management challenges. This study conducted a sensitivity analysis to identify the most influential factors in the SWMM. Moreover, the performance of SWMM was evaluated with the HYDRUS-1D module in simulating infiltration rates. The sensitivity results showed field capacity as the most significant factor, highlighting the need for advanced modeling techniques to consider factors like field capacity. The SWMM was evaluated by the HYDRUS-1D that SWMM consistently underestimated peak infiltration rates and commenced infiltration calculations only when soil moisture exceeded field capacity. It reveals its limitations in handling unsaturated soil conditions and highlights the consideration of the matric head of the soil during the infiltration calculation in soil media. Moreover, the evaluation of bioretention areas showed larger areas resulting in more substantial flow reductions but with significant variability under different rainfall conditions. Accordingly, this result emphasizes the importance of careful consideration for environmental factors in bioretention design. This study contributes by enhancing understanding of SWMM's limitations in simulating urban water management challenges. Thus, this research will offer technical assistance to stakeholders focused on challenges such as runoff, hydrologic cycle, and urban flooding in urban areas.

생분해성 PLA-나노바이오실리카 복합재 사출성형 최적화

Plant-based biodegradable polylactic acid (PLA) polymers have limited applications, such as in the production of disposable products using the extrusion method. This restricted usability is due to their low glass transition temperature and poor low-temperature molding properties. In the present study, we investigated the changes in PLA polymer properties induced by bioadditives and optimized the conditions of extrusion molding to commercialize biodegradable polymers using an injection molding process. Compared to pure PLA, the constructed PLA composite with nanosilica showed a 15% reduction in melt flow; however, the tensile strength increased by 13%, flexural strength increased by 15.9%, impact strength improved by 18.2%, and hardness increased by 40%, enabling injection molding even at temperatures of 180-190 °C. The mold flow of the nanocomposite and optimization analysis of product injection molding were conducted using a runner and fingate.

Endothelial-Specific Reduction in Arf6 Impairs Insulin-Stimulated Vasodilation and Skeletal Muscle Blood Flow Resulting in Systemic Insulin Resistance in Mice.

Much of what we know about insulin resistance is based on studies from metabolically active tissues such as the liver, adipose tissue, and skeletal muscle. Emerging evidence suggests that the vascular endothelium plays a crucial role in systemic insulin resistance; however, the underlying mechanisms remain incompletely understood. Arf6 (ADP ribosylation factor 6) is a small GTPase that plays a critical role in endothelial cell function. Here, we tested the hypothesis that the deletion of endothelial Arf6 will result in systemic insulin resistance. We used mouse models of constitutive endothelial cell-specific Arf6 deletion (Arf6f/- Tie2Cre+) and tamoxifen-inducible Arf6 knockout (Arf6f/f Cdh5CreER+). Endothelium-dependent vasodilation was assessed using pressure myography. Metabolic function was assessed using a battery of metabolic assessments including glucose and insulin tolerance tests and hyperinsulinemic-euglycemic clamps. We used a fluorescence microsphere-based technique to measure tissue blood flow. Skeletal muscle capillary density was assessed using intravital microscopy. Endothelial Arf6 deletion impaired insulin-stimulated vasodilation in white adipose tissue and skeletal muscle feed arteries. The impairment in vasodilation was primarily due to attenuated insulin-stimulated nitric oxide bioavailability but independent of altered acetylcholine-mediated or sodium nitroprusside-mediated vasodilation. Endothelial cell-specific deletion of Arf6 also resulted in systematic insulin resistance in normal chow-fed mice and glucose intolerance in high-fat diet-fed obese mice. The underlying mechanisms of glucose intolerance were reductions in insulin-stimulated blood flow and glucose uptake in the skeletal muscle and were independent of changes in capillary density or vascular permeability. Results from this study support the conclusion that endothelial Arf6 signaling is essential for maintaining insulin sensitivity. Reduced expression of endothelial Arf6 impairs insulin-mediated vasodilation and results in systemic insulin resistance. These results have therapeutic implications for diseases that are associated with endothelial cell dysfunction and insulin resistance such as diabetes.

Evaluation of surface water supply impacts from permit exemptions: A comparison with climate change and demand growth

AbstractMany states in the Eastern U.S. have limited water withdrawal regulations, posing significant risks to water supply management during periods of low flows. While these states require water withdrawal permits, exemptions for grandfathered withdrawals that allow unregulated access to surface water are common. Such permit exemptions present a challenge to water supply management, as full utilization of allowable withdrawals by permit‐exempt users could pose risks to maintaining adequate water supplies for current and projected demand. This study used reported permit exemption data in Virginia to understand the extent, volume, and potential impact of permit‐exempt withdrawals on 30‐ and 90‐day low flows. The permit‐exempt withdrawal values used in this study were obtained from Virginia Department of Environmental Quality. Maximum permit‐exempt withdrawal volumes were significantly higher than projected future demands in permitted users. The impacts of these withdrawals on drought flows were compared with the impacts presented by climate change and demand growth. Widespread reduction in flows was observed with the “dry” future climate change scenario, while impacts were more localized in the exempt users and the demand growth scenarios. The impacts of exempt users exceeded the impact of climate change and demand growth scenarios in many regions during low‐flow periods. Therefore, more comprehensive water planning, policy and research is needed to address the impact of permit exemptions.

Extended period of ventilation before delayed cord clamping augments left-to-right shunting and decreases systemic perfusion at birth in preterm lambs.

Previous studies have suggested that an extended period of ventilation before delayed cord clamping (DCC) augments birth-related rises in pulmonary arterial (PA) blood flow. However, it is unknown whether this greater rise in PA flow is accompanied by increases in left ventricular (LV) output and systemic arterial perfusion or whether it reflects enhanced left-to-right shunting across the ductus arteriosus and/or foramen ovale (FO), with decreased systemic arterial perfusion. Using an established preterm lamb birth transition model, this study compared the effect of a short (∼40s, n=11), moderate (∼2min, n=11) or extended (∼5min, n=12) period of initial mechanical lung ventilation before DCC on flow probe-derived perinatal changes in PA flow, LV output, total systemic arterial blood flow, ductal shunting and FO shunting. The LV output was relatively stable during initial ventilation but increased after DCC, with similar responses in all groups. Systemic arterial flow patterns displayed only minor differences during brief and moderate periods of initial ventilation and were similar after DCC. However, an increase in PA flow was augmented with an extended initial ventilation (P < 0.001), owing to an earlier onset of left-to-right ductal and FO shunting (P < 0.001), and was accompanied by a pronounced reduction in total systemic arterial flow (P=0.005) that persisted for 4min after DCC (P ≤ 0.039). These findings suggest that, owing to increased left-to-right shunting and a greater reduction in systemic arterial perfusion, an extended period of ventilation before DCC does not result in greater perinatal circulatory benefits than shorter periods of initial ventilation in the birth transition. KEY POINTS: Previous studies suggest that an extended period of initial ventilation before delayed cord clamping (DCC) augments birth-related rises in pulmonary arterial (PA) blood flow. It is unknown whether this greater rise in PA flow is accompanied by an increased left ventricular output and systemic arterial perfusion or whether it reflects enhanced left-to-right shunting across the ductus arteriosus and/or foramen ovale, with decreased systemic arterial perfusion. Anaesthetized preterm fetal lambs instrumented with central arterial flow probes underwent a brief (∼40s), moderate (∼2min) or extended (∼5min) period of ventilation before DCC. Perinatal changes in left ventricular output were similar in all groups, but extended initial ventilation augmented both perinatal increases in PA flow, owing to earlier onset and greater left-to-right ductal and foramen ovale shunting, and perinatal reductions in total systemic arterial perfusion. Extended ventilation before DCC does not confer a greater perinatal circulatory benefit than shorter periods of initial ventilation.

SEDIMENTATION ANALYSIS ON SEYHAN DAM RESERVOIR USING LONG TERM BATHYMETRY DATA

In this study, sedimentation in the Seyhan Dam reservoir was investigated by analyzing a long-term bathymetric survey dataset. The focus was on understanding how reservoir capacity changes impact reservoir operation rules. The findings revealed that sedimentation from the main branch of the Seyhan River has largely stopped since the construction of the Çatalan Dam, but sedimentation from the Çakıt branch continues. Furthermore, the study observed changes in the upper basin between 1990 and 2018 based on the CORINE Land Cover (CLC) dataset. The forest area increased from 23.71% to 24.36%, and water bodies expanded from 0.3% to 0.9%. This increase in forest and water bodies contributed to a reduction in sediment flow into the Seyhan Dam reservoir. The researchers used regression analysis and found a high correlation (R2=0.96) between water storage capacity changes and time (in years) at a 67.5-meter water level in the Seyhan Dam Reservoir. Overall, the study's results suggest that the decrease in sediment entering from the main branch of the Seyhan River has significantly improved the sedimentation issue.

A patient-specific circle of Willis blood flow model in predicting outcomes of balloon test occlusion.

Balloon test occlusion (BTO) evaluates cerebral ischemic tolerance before internal carotid artery (ICA) sacrifice but carries risks like dissection and thrombosis. This study introduces a new approach using a patient-specific circle of Willis (COW) blood flow model, based on non-invasive quantitative MR angiography (qMRA) measurements, to predict the outcomes of BTO. We developed individualized COW blood flow models for 43 patients undergoing BTO. These models simulated blood flow and pressure under normal conditions and with the ICA occlusion. We then compared the model's predictions of blood flow changes due to the simulated ICA occlusion to actual qMRA measurements before the BTO. For all 31 BTO failures, the ipsilateral hemisphere showed an average flow decrease of 15 ± 10% (mean ± standard deviation), compared to 3 ± 2% in the contralateral hemisphere. In all 12 BTO passes, these figures were 6 ± 3% and 1 ± 0.8%, respectively. Notably, all BTO passes had less than a 10% reduction in the ipsilateral hemisphere. In contrast, 65% of BTO failures and 67% single-photon emission computed tomography (SPECT) failures exhibited a decrease of 10% or more in the same region. Blood flow reduction exceeding 10% in the ipsilateral hemisphere during BTO is a strong predictor of failure in both BTO and SPECT. Our patient-specific COW blood flow models, incorporating detailed flow and arterial geometry data, offered valuable insights for predicting BTO outcomes. These models are especially beneficial for situations where conducting BTO or SPECT is clinically impractical.

Impact of Cerebral Revascularization on Pial Collateral Flow in Patients With Unilateral Moyamoya Disease Using Quantitative Magnetic Resonance Angiography.

Moyamoya disease (MMD) is a chronic steno-occlusive disease of the intracranial circulation that depends on neoangiogenesis of collateral vessels to maintain cerebral perfusion and is primarily managed with cerebral revascularization surgery. A quantitative assessment of preoperative and postoperative collateral flow using quantitative magnetic resonance angiography with noninvasive optimal vessel analysis (NOVA) was used to illustrate the impact of revascularization on cerebral flow distribution. A retrospective review of patients with unilateral MMD who underwent direct, indirect, or combined direct/indirect cerebral revascularization surgery was conducted between 2011 and 2020. Using NOVA, flow was measured at the anterior cerebral artery (ACA), ACA distal to the anterior communicating artery (A2), middle cerebral artery (MCA), posterior cerebral artery (PCA), and PCA distal to the posterior communicating artery (P2). Pial flow (A2 + P2) and collateral flow (ipsilateral [A2 + P2])-(contralateral [A2 + P2]) were measured and compared before and after revascularization surgery. Total hemispheric flow (MCA + A2 + P2) with the addition of the bypass graft flow postoperatively was likewise measured. Thirty-four patients with unilateral MMD underwent cerebral revascularization. Median collateral flow significantly decreased from 68 to 39.5 mL/min ( P = .007) after bypass. Hemispheres with maintained measurable bypass signal on postoperative NOVA demonstrated significant reduction in median collateral flow after bypass ( P = .002). Median total hemispheric flow significantly increased from 227 mL/min to 247 mL/min ( P = .007) after bypass. Only one patient suffered an ipsilateral ischemic stroke, and no patients suffered a hemorrhage during follow-up. NOVA measurements demonstrate a reduction in pial collateral flow and an increase in total hemispheric flow after bypass for MMD, likely representing a decrease in leptomeningeal collateral stress on the distal ACA and PCA territories. Further studies with these measures in larger cohorts may elucidate a role for NOVA in predicting the risk of ischemic and hemorrhagic events in MMD.