Prediction of the 3D shape of the L1 vertebral body from adjacent vertebrae.

The aim of treatments of vertebral fractures is the anatomical reduction to restore the physiological biomechanics of the spine and the stabilization of the fracture to allow bone healing. However, the three-dimensional shape of the fractured vertebral body before the fracture is unknown in the clinical setting. Information about the pre-fracture vertebral body shape could help surgeons to select the optimal treatment. The goal of this study was to develop and validate a method based on Singular Value Decomposition (SVD) to predict the shape of the vertebral body of L1 from the shapes of T12 and L2. The geometry of the vertebral bodies of T12, L1 and L2 vertebrae of 40 patients were extracted from CT scans available from the VerSe2020 open-access dataset. Surface triangular meshes of each vertebra were morphed onto a template mesh. The set of vectors with the node coordinates of the morphed T12, L1 and L2 were compressed with SVD and used to build a system of linear equations. This system was used to solve a minimization problem and to reconstruct the shape of L1. A leave-one-out cross-validation was performed. Moreover, the approach was tested against an independent dataset with large osteophytes. The results of the study show a good prediction of the shape of the vertebral body of L1 from the shapes of the two adjacent vertebrae (mean error equal to 0.51 ± 0.11 mm on average, Hausdorff distance equal to 2.11 ± 0.56 mm on average), compared to current CT resolution typically used in the operating room. The error was slightly higher for patients presenting large osteophytes or severe bone degeneration (mean error equal to 0.65 ± 0.10 mm, Hausdorff distance equal to 3.54 ± 1.03 mm). The accuracy of the prediction was significantly better than approximating the shape of the vertebral body of L1 by the shape of T12 or L2. This approach could be used in the future to improve the pre-planning of spine surgeries to treat vertebral fractures.

The influence of angioplasty balloon sizing on acute post-procedural outcomes: a Finite Element Analysis.

Atherosclerosis is one of the most common vascular pathologies in the world. Among the most commonly performed endovascular treatments, percutaneous transluminal angioplasty (PTA) has been showing significantly positive clinical outcomes. Due to the complex geometries, material properties and interactions that characterize PTA procedures, finite element analyses of acute angioplasty balloon deployment are limited. In this work, finite element method (FEM) was used to simulate the inflation and deflation of a semi-compliant balloon within the 3D model of a stenosed artery with two different plaque types (lipid and calcified). Self-defined constitutive models for the balloon and the plaque were developed based on experimental and literature data respectively. Balloon deployment was simulated at three different inflation pressures (10, 12 and 14 atm) within the two plaque types. Balloon sizing influence on the arterial elastic recoil obtained immediately after PTA was then investigated. The simulated results show that calcified plaques may lead to higher elastic recoil ratios compared to lipid stenosis, when the same balloon inflation pressures are applied. Also, elastic recoil increases for higher balloon inflation pressure independent of the plaque type. These findings open the way for a data-driven assessment of angioplasty balloon sizing selection and clinical procedures optimization.Clinical Relevance- The FE model developed in this work aims at providing quantitative evaluation of recoil after balloon angioplasty. It may be useful for both manufacturers and clinicians to improve efficiency of angioplasty balloon device design and sizing selection with respect to plaque geometry and constitution, consequently enhancing clinical outcomes.

Simulation of nonlinear transient elastography: finite element model for the propagation of shear waves in homogeneous soft tissues.

In this study, visco-hyperelastic Landau's model, which is widely used in acoustical physic field, is introduced into a finite element formulation. It is designed to model the nonlinear behaviour of finite amplitude shear waves in soft solids, typically, in biological tissues. This law is used in finite element models based on elastography, experiments reported in Jacob et al, the simulations results show a good agreement with the experimental study: It is observed in both that a plane shear wave generates only odd harmonics and a nonplane wave generates both odd and even harmonics in the spectral domain. In the second part, a parametric study is performed to analyse the influence of different factors on the generation of odd harmonics of plane wave. A quantitative relation is fitted between the odd harmonic amplitudes and the non-linear elastic parameter of Landau's model, which provides a practical guideline to identify the non-linearity of homogeneous tissues using elastography experiment.

Patient-Specific Finite-Element Simulation of the Insertion of Guidewire During an EVAR Procedure: Guidewire Position Prediction Validation on 28 Cases.

OBJECTIVE: Validation of a numerical method to compute arterial deformations under the insertion of an "extra-siff" guidewire during Endovascular Repair of Abdominal Aortic Aneurysm. METHODS: We propose the validation of a previously developed simulation method. The model is calibrated using anatomical hypothesis and intraoperative observations. Simulation results are blindly evaluated against 3-D imaging data acquired during the surgical procedure on 28 patients, based on the predicted position of the intraoperative guidewire. RESULTS: Simulation was successfully conducted on the 28 patients. The mean position error given by the Modified Hausdorff Distance for the 28 cases was 3.8 ± 1.9 mm, which demonstrates very good results for most of the cases. CONCLUSION: The work reported here shows that numerical simulation can predict some rather large variations in the vascular geometry due to tools insertion, for a wide variety of aorto-iliac morphologies. This is a new step toward clinically applicable mechanical simulation. SIGNIFICANCE: Validation on 3-D intraoperative data on a large number of cases-robustness on adverse anatomies.

Physiological changes in maternal cortisol do not alter expression of growth-related genes in the ovine placenta.

OBJECTIVES: The aim of this study was to investigate the effect of cortisol on growth-related genes in the ovine placenta. STUDY DESIGN: Ewes carrying singleton pregnancies were operated on between 112 and 116 days of gestation (115 ± 0.4, term = 147 days) and randomly assigned into three groups: six control animals, five ewes that were administered cortisol by continuous intravenous infusion (1 mg/kg/day, high cortisol), and five ewes that were adrenalectomized and replaced with 0.5-0.6 mg cortisol/kg/day and 3 µg aldosterone/kg/day to produce cortisol concentrations equivalent to pre-pregnancy values (low cortisol). At necropsy (130 ± 0.2 days of gestation), placental tissue was frozen and stored at -80 °C for mRNA analysis. MAIN OUTCOME MEASURES: To assess potential molecular mechanisms by which cortisol alters placental structure and function and fetal growth. RESULTS: Cortisol levels did not significantly affect 11ß-hydroxysteroid dehydrogenase 1 and 2 enzymes, glucocorticoid receptor, mineralocorticoid receptor and angiotensin II receptor, type 1 (AT1R) expression levels. Gene expression levels of AT2R were increased in the high cortisol group for type B placentomes. There was little effect of cortisol on the insulin-like growth factor (IGF) axis. There was significantly more IGF-I mRNA in B versus A type and more IGFBP-2 mRNA in B and C type versus A type placentomes regardless of treatment (p < 0.05). CONCLUSIONS: These data suggest that cortisol increases placental AT2R expression at high concentrations whereas it has little effect on the placental IGF axis.

Output characterization of a self-pulsating and aperiodic optical fiber source based on cascaded regeneration.

We investigate the properties of a self-pulsating fiber cavity based on cascaded regeneration. The mechanisms that govern the number of oscillating pulses in the cavity, the pulse peak power, the pulse width, the wavelength tunability as well as the generation of sub-picosecond pulses are identified, analyzed and quantified. We find that the described self-pulsating cavity enables the oscillation of quasi transform-limited pulses with a pulsewidth of 4.8 ps at 1540.0 nm when using 0.4 nm non-Gaussian bandpass filters. Sub-picosecond pulses with an autocorrelation width of 471 fs are generated from the same self-pulsating source with modified bandpass filters and the addition of a chromatic dispersion compensator. The number of eigenpulses that oscillate simultaneously in the cavity can be adjusted from 0 up to 29,500 with proper cavity adjustment. This source has dual-wavelength output and can be tuned throughout the gain band of the amplifiers.

In-band OSNR and chromatic dispersion monitoring using a fibre optical parametric amplifier.

This paper presents an all-optical, in-band optical signal-to-noise ratio (OSNR) and chromatic dispersion monitor. We demonstrate monitoring over the 1 nm bandwidth of our signal, which is a 10 GHz pulse train of 8.8 ps pulses. The monitor output power, as measured on a slow detector, has a 1.9 dB dynamic range when the signal OSNR is varied by 20 dB, and a 1.6 dB dynamic range when +/- 150 ps/nm of chromatic dispersion is applied. Cascaded four-wave mixing occurring in the optical parametric amplifier provides the nonlinear power transfer function responsible for the monitoring. An analysis using the signals' probability density functions show that the nonlinear power transfer function provides preferential gain to clean undispersed pulses when compared to noisy and/or dispersed pulses. Our analysis includes a consideration of the applicability of the device to high duty cycle systems, and simulations on monitoring of a 40 Gb/s pulse train with a 50% duty cycle.

Investigation of self-phase modulation based optical regeneration in single mode As2Se3 chalcogenide glass fiber.

We investigate the feasibility of all-optical regeneration based on self-phase modulation in single mode As2Se3 chalcogenide fiber. By combining the chalcogenide fiber with a bandpass filter, we achieve a near step-like power transfer function with no pulse distortion. The device is shown to operate with 5.8 ps duration pulses, thus demonstrating the feasibility of this device operating with high bit-rate data signals. These results are achieved with pulse peak powers <10 W in a fully passive device, including only 2.8 m of chalcogenide fiber. We obtain an excellent agreement between theory and experiment and show that both the high nonlinearity of the chalcogenide glass along with its high normal dispersion near 1550 nm enables a significant device length reduction in comparison with silica-based devices, without compromise on the performance. We find that even for only a few meters of fiber, the large normal dispersion of the chalcogenide glass inhibits spectral oscillations that would appear with self-phase modulation alone. We measure the two photon absorption attenuation coefficient and find that it advantageously affects the device transfer function.

Osmoregulation of vasopressin secretion via activation of neurohypophysial nerve terminals glycine receptors by glial taurine.

Osmotic regulation of supraoptic nucleus (SON) neuron activity depends in part on activation of neuronal glycine receptors (GlyRs), most probably by taurine released from adjacent astrocytes. In the neurohypophysis in which the axons of SON neurons terminate, taurine is also concentrated in and osmo-dependently released by pituicytes, the specialized glial cells ensheathing nerve terminals. We now show that taurine release from isolated neurohypophyses is enhanced by hypo-osmotic and decreased by hyper-osmotic stimulation. The high osmosensitivity is shown by the significant increase on only 3.3% reduction in osmolarity. Inhibition of taurine release by 5-nitro-2-(3-phenylpropylamino)benzoic acid, niflumic acid, and 4,4'-diisothiocyanatostilbene-2,2'-disulfonic acid suggests the involvement of volume-sensitive anion channels. On purified neurohypophysial nerve endings, activation of strychnine-sensitive GlyRs by taurine or glycine primarily inhibits the high K(+)-induced rise in [Ca(2+)](i) and subsequent release of vasopressin. Expression of GlyRs in vasopressin and oxytocin terminals is confirmed by immunohistochemistry. Their implication in the osmoregulation of neurohormone secretion was assessed on isolated whole neurohypophyses. A 6.6% hypo-osmotic stimulus reduces by half the depolarization-evoked vasopressin secretion, an inhibition totally prevented by strychnine. Most importantly, depletion of taurine by a taurine transport inhibitor also abolishes the osmo-dependent inhibition of vasopressin release. Therefore, in the neurohypophysis, an osmoregulatory system involving pituicytes, taurine, and GlyRs is operating to control Ca(2+) influx in and neurohormone release from nerve terminals. This elucidates the functional role of glial taurine in the neurohypophysis, reveals the expression of GlyRs on axon terminals, and further defines the role of glial cells in the regulation of neuroendocrine function.

Importance of attributable risk in monitoring adverse events after immunization: hepatitis B vaccination in children.

OBJECTIVES: Most vaccine safety data present only the postvaccination incidence of all adverse events rather than an estimate of attributable risk. This study sought to illustrate the difference between the 2 estimates with data from a hepatitis B immunization program. METHODS: The incidence of health problems occurring before and after each dose of hepatitis B vaccine in a cohort of 1130 children were compared. RESULTS: Although 47.5% of all children reported an adverse event during the 4 weeks following each of the 3 doses, adverse events attributable to immunization occurred in only 10.6% of children. CONCLUSIONS: Postimmunization incidence systematically overestimates the risk of adverse events. Estimating actual attributable risk is necessary to avoid false beliefs regarding immunization.

A single dose of an effective whole cell pertussis vaccine does not significantly increase protection in children primed with a less effective vaccine.

We evaluated if a single dose of a protective whole cell pertussis vaccine given before school entry to children primed with a less effective vaccine would increase their protection. A school cohort including 3876 students and a family cohort including 162 children were assessed. Although there was a trend toward increased protection. the better vaccine did not provide a significant improvement. These results suggest that a single dose of an effective vaccine given to children primed with a less effective one does not raise the protection to at level similar to that provided by three doses of the better vaccine.