Modes of self-organization of diluted bubbly liquids in acoustic fields: One-dimensional theory.

The paper is dedicated to mathematical modeling of self-organization of bubbly liquids in acoustic fields. A continuum model describing the two-way interaction of diluted polydisperse bubbly liquids and acoustic fields in weakly-nonlinear approximation is studied analytically and numerically in the one-dimensional case. It is shown that the regimes of self-organization of monodisperse bubbly liquids can be controlled by only a few dimensionless parameters. Two basic modes, clustering and propagating shock waves of void fraction (acoustically induced transparency), are identified and criteria for their realization in the space of parameters are proposed. A numerical method for solving of one-dimensional self-organization problems is developed. Computational results for mono- and polydisperse systems are discussed.

Negative Temperature Coefficient of Resistance in Aligned CNT Networks: Influence of the Underlying Phenomena.

Temperature dependence of electrical conductivity/resistivity of CNT networks (dry or impregnated), which is characterised by a temperature coefficient of resistance (TCR), is experimentally observed to be negative, especially for the case of aligned CNT (A-CNT). The paper investigates the role of three phenomena defining the TCR, temperature dependence of the intrinsic conductivity of CNTs, of the tunnelling resistance of their contacts, and thermal expansion of the network, in the temperature range 300-400 K. A-CNT films, created by rolling down A-CNT forests of different length and described in Lee et al., Appl Phys Lett, 2015, 106: 053110, are investigated as an example. The modelling of the electrical conductivity is performed by the nodal analysis of resistance networks, coupled with the finite-element thermomechanical modelling of network thermal expansion. The calculated TCR for the film is about -0.002 1/K and is close to the experimentally observed values. Comparative analysis of the influence of the TCR defining phenomena is performed on the case of dry and impregnated films. The analysis shows that in both cases, for an A-CNT film at the studied temperature interval, the main factor affecting a network's TCR is the TCR of the CNTs themselves. The TCR of the tunnelling contacts plays the secondary role; influence of the film thermal expansion is marginal. The prevailing impact of the intrinsic conductivity TCR on the TCR of the film is explained by long inter-contact segments of CNTs in an A-CNT network, which define the homogenised film conductivity.

Postoperative Pulmonary Complications in Patients Undergoing Elective Thoracotomy Versus Thoracoscopic Surgeries.

Background Postoperative pulmonary complications correlate highly with thoracic surgery compared to other surgeries. Video-assisted thoracoscopic surgery (VATS) is a minimally invasive surgical approach that provides considerable advantages over major open thoracotomy. Methodology This is a retrospective cohort study. All patients aged 18 years and above of both genders were included in the study. Cases following up outside King Abdulaziz University Hospital (KAUH), Jeddah, Saudi Arabia, were excluded from our study. Complications were measured per the records on follow-up day 1, day 7, and day 30. Mortality was measured within 30 days after the surgery. Results A total of 151 patients were included in the study. Age ranged from 18 to 85 years, with males representing 62.3% of the sample, while Saudis represented 59.6%. VATS was performed in 71.5%, while thoracotomy was performed in 28.5%. Of the total, 19.4% had postoperative complications within 30 days in the VATS group, while 23.3% were in the thoracotomy group. No significant differences were found between the rates of complications between the two groups. Additionally, the admission rate to ICU was significantly twice as common in the thoracotomy group (65.1%) compared to the VATS group (33.3%). Besides, the average duration of the chest tube's stay was three to seven days in both groups (62.1% in the VATS group and 70.7% in the thoracotomy group). Lastly, regarding the requirements of opioids, VATS showed more need for opioids (44.4%) compared to thoracotomy (32.6%). Conclusion The rates of postoperative complications were low in both groups, and no significant differences were found between the two procedures. In addition, the VATS group showed significantly higher use of opioids compared to the thoracotomy group. We recommend conducting further studies with larger sample sizes to increase the statistical power of detection.

Acute Kidney Injury After Open Heart Surgery.

INTRODUCTION:  Acute kidney injury (AKI) is a term used to describe when the kidney loses its function rapidly. And it's associated with an increase in the level of serum creatinine by 0.5 to 1mg/dL. It can be diagnosed by a plethora of criteria such as the Kidney Disease Improving Global Outcomes (KDIGO) and the Risk, Injury, Failure, Loss, End-stage (RIFLE) criteria. Cardiac surgery-associated AKI (CSA-AKI) is the most prevalent complication in patients following cardiac surgery and is also linked to increased mortality and morbidity rates. In addition, exogenous and endogenous toxins, ischemia and reperfusion, inflammation, oxidative stress, metabolic factors, and neurohormonal activation may all play a role in the development of CSA-AKI. All these factors may be active at varying time intervals and with different degrees of intensity, or may function simultaneously.  Methods: In late 2019, a retrospective study was conducted by reviewing the health data of patients who underwent coronary artery bypass graft (CABG), valvular repairs, and other open cardiac surgeries at the King Abdulaziz University Hospital (KAUH), Jeddah, Saudi Arabia, between November 2014 and June 2019. Information was obtained from the Hospital information system, Jeddah, Saudi Arabia. Of the 159 patients who underwent open-heart surgery at KAUH, 126 (79.2%) were male and 33 (20.8%) were female. Patients below 15 years of age and those with poor renal function prior to open cardiac surgery were excluded. The KDIGO criteria were used to diagnose AKI for our patients. RESULTS:  In this study, 34% of the patients experienced AKI after open cardiac surgery, and the most frequent risk factor encountered was diabetes mellitus (DM), which was present in 97 (61%) patients, followed by angina pectoris in 93 (58.5%) patients. Hypertension was identified in 85 (53.5%) and acute myocardial infarction in 82 (51.6%) patients. There were only two (1.3%) patients with known cases of chronic obstructive lung disease (COPD). Of the surgeries, 131 (82.4%) were classified as elective and 28 (17.6%) were urgent. CONCLUSION:  The most common risk factor associated with AKI following open-heart surgery is DM, followed by angina pectoris. However, further studies are required to investigate all the cardiac procedures.

Modification of Mechanical Properties in Directed Energy Deposition by a Static Magnetic Field: Experimental and Theoretical Analysis.

The superimposed magnetic field affects the microstructure and mechanical properties of additively manufactured metal parts. In this work, the samples were fabricated from Inconel 718 superalloy by directed energy deposition under a 0.2 T static field. The magnetohydrodynamic 1D model is proposed for the estimation of a fluid flow inside a molten pool. According to the theoretical predictions, the fluid flow is slightly decreased by an applied field. The estimated thermoelectric magnetic convection in the mushy zone is shown to be negligible to change in subgrain size, but enough to reduce the hard-to-dissolve Nb-rich phase, thereby improving the average ultimate elongation from 23% to 27%. The obtained results confirm that an external static magnetic field can modify and enhance the mechanical properties of additively manufactured materials.

Hardening of Additive Manufactured 316L Stainless Steel by Using Bimodal Powder Containing Nanoscale Fraction.

The particle size distribution significantly affects the material properties of the additively manufactured parts. In this work, the influence of bimodal powder containing nano- and micro-scale particles on microstructure and materials properties is studied. Moreover, to study the effect of the protective atmosphere, the test samples were additively manufactured from 316L stainless steel powder in argon and nitrogen. The samples fabricated from the bimodal powder demonstrate a finer subgrain structure, regardless of protective atmospheres and an increase in the Vickers microhardness, which is in accordance with the Hall-Petch relation. The porosity analysis revealed the deterioration in the quality of as-built parts due to the poor powder flowability. The surface roughness of fabricated samples was the same regardless of the powder feedstock materials used and protective atmospheres. The results suggest that the improvement of mechanical properties is achieved by adding a nano-dispersed fraction, which dramatically increases the total surface area, thereby contributing to the nitrogen absorption by the material.

N-Doped Carbon NanoWalls for Power Sources.

Cycling stability and specific capacitance are the most critical features of energy sources. Nitrogen incorporation in crystalline carbon lattice allows to increase the capacitance without increasing the mass of electrodes. Despite the fact that many studies demonstrate the increase in the capacitance of energy sources after nitrogen incorporation, the mechanism capacitance increase is still unclear. Herein, we demonstrate the simple approach of plasma treatment of carbon structures, which leads to incorporation of 3 at.% nitrogen into Carbon NanoWalls. These structures have huge specific surface area and can be used for supercapacitor fabrication. After plasma treatment, the specific capacitance of Carbon NanoWalls increased and reached 600 F g-1. Moreover, we made a novel DFT simulation which explains the mechanism of nitrogen incorporation into the carbon lattice. This work paves the way to develop flexible thin film supercapacitors based on carbon nanowalls.

Clinical experience with orthotic repair of pectus carinatum.

BACKGROUND: Pectus carinatum is a congenital chest wall deformity characterized by protrusion of the sternum and adjacent costal cartilages. Multiple treatment options are available for correction of pectus carinatum. OBJECTIVE: We report our initial experience with first-line treatment using a custom fitted dynamic compression orthosis. DESIGN: Prospective evaluation of all patients seen between November 2013 and December 2014. SETTING: University hospital. PATIENTS AND METHODS: The treatment protocol for patients who had pressure for initial correction.

Risk assessment using single-photon emission computed tomographic technetium-99m sestamibi imaging.

OBJECTIVES: This review summarizes the results of single-photon emission computed tomographic (SPECT) technetium-99m (Tc-99m) tracer imaging in patients with stable symptoms, patients with acute coronary syndromes, patients undergoing major non-cardiac surgery and patients with chest pain in the emergency department. BACKGROUND: Previous studies have examined the prognostic value of stress thallium imaging in several subsets of patients with ischemic heart disease. At present, >50% of myocardial perfusion studies are performed with technetium-labeled tracers in the United States. Furthermore, there is a shift from diagnostic to the prognostic utility of stress testing. There are important differences between technetium-labeled tracers and thallium-201. It is therefore important to review the prognostic value of technetium-labeled tracers. METHODS: We analyzed published reports in English on risk assessment using Tc-99m perfusion tracers. Results. The largest experience is in patients with stable symptoms, comprising >12,000 patients in 14 studies. In these patients, normal stress SPECT sestamibi images were associated with an average annual hard event rate of 0.6% (death or nonfatal myocardial infarction [MI]). In contrast, patients with abnormal images had a 12-fold higher event rate (7.4% annually). Both fixed and reversible defects are prognostically important, and quantitative analysis shows increased risk in relation to the severity of the abnormality. These results are similar to those obtained with thallium-201. CONCLUSIONS: Patients with stable chest pain syndromes and normal stress SPECT sestamibi images have a very low risk of death or nonfatal MI. It is highly unlikely that coronary revascularization can improve survival in such patients. Patients with abnormal images have an intermediate to high risk for future cardiac events, depending on the degree of the abnormality. Further prospective studies comparing aggressive medical therapy with coronary revascularization in these patients are warranted.

Real-time assessment of myocardial perfusion and wall motion during bicycle and treadmill exercise echocardiography: comparison with single photon emission computed tomography.

OBJECTIVES: We sought to determine the feasibility and accuracy of real-time imaging of myocardial contrast echocardiography (MCE) in detecting myocardial perfusion defects during exercise echocardiography compared with radionuclide tomography. BACKGROUND: Ultrasound imaging at a low mechanical index and frame rate (10 to 20 Hz) after intravenous injections of perfluorocarbon containing microbubbles has the potential to evaluate myocardial perfusion and wall motion (WVM) simultaneously and in real time. METHODS: One hundred consecutive patients with intermediate-to-high probability of coronary artery disease underwent treadmill (n = 50) or supine bicycle (n = 50) exercise echocardiography. Segmental perfusion with MCE and WM w ere assessed in real time before and at peak exercise using low mechanical index (0.3) and frame rates of 10 to 20 Hz after 0.3 ml bolus injections of intravenous Optison (Mallinckrodt Inc., San Diego, California). All patients had a dual isotope (rest thallium-201, stress sestamibi) study performed during the same exercise session, and 44 patients had subsequent quantitative coronary angiography. RESULTS: In the 100 patients, agreement between MCE and single photon emission computed tomography (SPECT) was 76%, while it was 88% between MCE and WM assessment. Compared with quantitative angiography, sensitivity of MCE, SPECT and WM was comparable (75%), with a specificity ranging from 81% to 100%. The combination of MCE and WM had the best balance between sensitivity and specificity (86% and 88%,respectively) with the highest accuracy (86%). CONCLUSIONS: The real-time assessment of myocardial perfusion during exercise stress echocardiography can be achieved with imaging at low mechanical index and frame rates. The combination of WM and MCE correlates well with SPECT and is a promising important addition to conventional stress echocardiography.

Effect of modified ultrafiltration on pulmonary function after cardiopulmonary bypass.

BACKGROUND: Pulmonary dysfunction is one of the most common manifestations of inflammatory response after cardiopulmonary bypass (CPB). OBJECTIVE: This prospective randomized study was conducted to evaluate the effect of a modified ultrafiltration (MUF) technique on pulmonary function after CPB in children. METHODS: Forty patients weighing from 5 to 10 kg with congenital heart disease who required CPB for primary biventricular operative repair were prospectively randomized into two groups. The control group received conventional ultrafiltration (CUF) during CPB, and the study group received CUF and MUF. Pulmonary compliance (static and dynamic) and gas exchange capacity of the lung expressed as oxygen index, respiratory index, ventilation index, and alveolar-arterial oxygen pressure difference were measured after intubation (baseline), at the termination of CPB, at the end of MUF, on admission to the ICU, and 6 h postoperatively. RESULTS: There was no significant difference in lung compliance and gas exchange between the two groups before CPB. CPB produced a significant decrease in static and dynamic lung compliance in both groups. In the control group, static and dynamic lung compliance decreased from 1.0 +/- 0.3 to 0.90 +/- 0.3 mL/cm/kg and 0.87 +/- 0.2 to 0.71 +/- 0.1 mL/cm/kg (+/- SE) [p = 0.0002 and p = 0.002, respectively]. In the study group, static and dynamic lung compliance decreased from 1.0 +/- 0.2 to 0.89 +/- 0.03 mL/cm/kg and 0.94 +/- 0.2 to 0.77 +/- 0.1 mL/cm/kg (p = 0.002 and p = 0.002, respectively). There was no significant difference in the decrease in static (p = 0.9) or dynamic lung compliance (p = 0.3) between the two groups. MUF produced a significant immediate improvement in both static lung compliance (0.89 +/- 0.2 to 0.98 +/- 0.2 mL/cm/kg, p = 0.03) and dynamic lung compliance (0.77 +/- 0.1 to 0.93 +/- 0.2 mL/cm/kg, p = 0.007). The same was observed regarding the gas exchange capacity. CPB produced a significant decrease in lung gas exchange capacity, and MUF produced a significant immediate improvement in lung gas exchange capacity. The effect of MUF on lung compliance and gas exchange capacity was not sustained after admission to the ICU nor 6 h later postoperatively. There was no significant difference in the time of extubation between the two groups (12 +/- 3 h and 13 +/- 2 h, p = 0.4), the length of ICU stay, or the total hospital stay postoperatively. CONCLUSIONS: The use of MUF after CPB can produce an immediate improvement in lung compliance and gas exchange capacity, which may effectively minimize pulmonary dysfunction postbiventricular repair of congenital heart disease. However, these improvements are not sustained for the first 6 h postoperatively and do not reduce the duration of postoperative intubation, ICU stay, or total hospital stay.

Prognostic utility of myocardial viability assessment.

Myocardial viability assessment is useful in patients with severe coronary artery disease and severe left ventricular dysfunction. Whereas most studies have focused on recovery of regional function, there are emerging data on patient outcome. Review of these data suggests that patients with chronic ischemia, cardiomyopathy, and viable myocardium who are treated medically have a worse, outcome than those treated with coronary revascularization. However, there are no prospective randomized trials. We present perspectives for future studies.

Concurrent antiglomerular basement membrane antibody and immune complex mediated glomerulonephritis.

A teenage male, with Goodpasture's syndrome and serum antiglomerular basement membrane (anti-GBM) antibodies, had a focal proliferative glomerulonephritis with crescents. Immunofluorescence microscopy of his glomeruli using anti-IgG antibodies demonstrated both intense linear GBM staining, and granular subepithelial staining. Electron microscopy revealed numerous subepithelial electron-dense deposits. Identical IgG subclass restriction (dominance of IgG1 and IgG4) of both types of glomerular deposits in this patient supports, but does not prove, a postulate that the linear staining was due to anti-GBM antibodies bound to intact GBM, and that the granular staining was due to anti-GBM antibodies complexed with freed GBM antigens.

Nestin expression in cortical dysplasia.

OBJECT: It is recognized that cortical dysplasia (CD) is associated with an increased incidence of glioneuronal neoplasms. Among hypothetical considerations, there is the possibility that CD and other neuronal migration abnormalities harbor dysmature cells with the potential to give rise to glioneuronal neoplasms. Such cells, if present, would be reasonably expected to display immature features. The goal of the present study was to characterize the expression of nestin, a neuroepithelial precursor/stem cell antigen, in CD, along with other pathological and clinical features of this entity. METHODS: Clinical and surgical features of 10 recent cases meeting the histological criteria for CD were reviewed. Expressions of nestin, MAP2, neurofilament, and glial fibrillary acidic protein (GFAP) were assessed using immunohistochemical analysis and confocal scanning laser microscopy. Immunoreactivity for both glial and neuronal antigens as well as nestin was found in a select group of cells within regions of CD. Immunohistochemical and confocal microscopic findings demonstrated that these cells with neuronal or ambiguous features are a mixed population, some of which are dysmature neurons (positive for nestin and MAP2), whereas others are astrocytic (positive for nestin and GFAP). CONCLUSIONS: Further insight into the nature of nestin-positive neurons may shed light on the cause and pathogenesis of the associated glioneuronal tumors and the accompanying chronic seizures.

Metallothionein induction in human CNS in vitro: neuroprotection from ionizing radiation.

PURPOSE: There have been extensive studies on the regulation of metallothionein (MT) synthesis, and its biological role in liver and kidney. Although there are few reports on brain MT, there is a growing interest in the role of MT in brain. There have been no publications to date on MT synthesis in the human central nervous system (CNS) following exposure to ionizing radiation. In the present study, primary human CNS cultures were used to examine the effect of ionizing radiation on MT mRNA and protein synthesis. In the same cultures, the neuroprotective effects of zinc (Zn) and cadmium (Cd)-induced MT synthesis from high-dose radiation were also examined. MATERIALS AND METHODS: Primary, serum-free, human CNS cultures were exposed to 30 or 60 Gy gamma-rays. The total MT protein was then measured by a Cd-heme assay, and mRNA for MT-II and MT-III was detected by reverse transcription polymerase chain reaction (RT-PCR). Cytotoxicity was measured by LDH release and apoptotic cell death by DNA fragmentation analysis. Sublethal neuroglial injury was assessed morphologically using specific astrocytic (glial fibrillary acidic protein--GFAP) and neuronal (microtubule-associated protein 2--MAP2) immunohistochemical markers. RESULTS: The total MT protein content was increased 12h after exposure to 30Gy. The increase in MT content in response to 60Gy was not statistically significant. MT-II mRNA levels increased at 3 and 6h after exposure to 30Gy gamma-rays, with a maximum expression at 12-24 h. MT-III mRNA was not significantly affected. Exposure to 60 Gy, but not 30 Gy, caused a marked increase in LDH release. Cells exposed to 30 Gy or less showed some apoptotic cell death by DNA fragmentation analysis, while exposure to 60 Gy resulted in a DNA smear confirmed by LDH assays. Preinduction of MT by 5 microM Cd or 100 microM Zn resulted in a significant reduction in radiation-induced LDH release. Morphological evaluations revealed that Cd or Zn preincubation led to relative preservation of MAP2 staining and GFAP. CONCLUSION: Both MT protein and MT-II mRNA can be induced in human CNS cells by ionizing radiation. Furthermore, induction of MT synthesis with Zn and Cd can protect human CNS cells from radiation-induced cytocidal and sublethal injuries. Both findings have implications in the development of strategies to protect human CNS tissue from damage during radiotherapy.

MAP2 and nestin co-expression in dysembryoplastic neuroepithelial tumors.

BACKGROUND: The ontogeny and maturity of neurons and oligodendroglia-like cells (OLC) found in dysembryoplastic neuroepithelial tumors (DNT) remains controversial. A developmental origin has been proposed based on the close association to cortical dysplasia and the benign microscopic and clinical course. Our goal was to characterize the expression of nestin, a neuroepithelial precursor/stem cell antigen in DNT, along with other pathological and clinical features of this entity. METHODS: The clinical and operative features of 13 surgical specimens meeting the histological criteria for DNT were reviewed. Nestin, microtubule-associated protein 2 (MAP2), neurofilament (NF) and glial fibrillary acidic protein (GFAP) were examined by immunohistochemistry and confocal scanning laser microscopy. RESULTS: Select neuronal cells in all cases demonstrated strong MAP2 immunoreactivity. Nestin-positive cells of neuronal morphology were found in 6 cases. OLC demonstrated frequent selective staining for MAP2, GFAP and nestin. Confocal microscopy demonstrated numerous examples of cells co-expressing nestin and MAP2. CONCLUSIONS: Our study suggests that OLCs represent a united population of immature neuronal (nestin + MAP2) and glial (GFAP) phenotypes. Larger, morphologically recognizable neurons also showed occasional co-expression of nestin and MAP2, suggesting a degree of dysmaturity in common with their OLC counterparts. The apparent mixed lineage of OLCs lends support to theories suggesting that DNTs arise from pluripotent neuroepithelial cells.

The cytology of the pouch of Douglas in polycystic ovarian disease.

Cul-de-sac aspiration was performed for cytologic sampling in 137 cases of polycystic ovaries treated by wedge resection. Fifty patients undergoing abdominal tubal ligations also underwent aspiration of the pouch of Douglas as a control group. The cytodifferential count in polycystic ovarian disease showed 30% to 40% mesothelial cells, 15% to 20% polymorphonuclear leukocytes, 15% to 20% lymphocytes, 10% to 15% squamous cells and 1% to 5% histiocytes. The corresponding count in the control group showed 15% to 20% mesothelial cells, 20% to 25% polymorphonuclear leukocytes, 15% to 20% lymphocytes, 10% to 15% squamous cells and 1% to 3% histiocytes. Cells exfoliated from the fimbrial end of the tube were encountered in most smears. Abnormal cells were diagnosed in seven cases of polycystic ovarian disease due to a coexistent neoplasm, i.e., two dermoid cysts, a carcinoid tumor, a hilus cell tumor, a simple serous cyst, a pseudomucinous cystadenoma and endometriosis of the ovary. All tumors were histologically diagnosed in the resected wedges of the ovaries.