Hemodynamic Assessment in Bicuspid Aortic Valve Disease and Aortic Dilation: New Insights From Voxel-By-Voxel Analysis of Reverse Flow, Stasis, and Energetics

Objectives: Clinical management decisions surrounding ascending aorta (AAo) dilation in bicuspid aortic valve (BAV) disease benefit from personalized predictive tools. 4D-flow MRI may provide patient-specific markers reflective of BAV-associated aortopathy. This study aims to explore novel 4D-flow MRI parametric voxel-by-voxel forward flow, reverse flow, kinetic energy and stasis in BAV disease. We hypothesize that novel parametric voxel-by-voxel markers will be associated with aortic dilation and referral for surgery and can enhance our understanding of BAV hemodynamics beyond standard metrics.Methods: A total of 96 subjects (73 BAV patients, 23 healthy controls) underwent MRI scan. Healthy controls had no known cardiovascular disease. Patients were clinically referred for AAo dilation assessment. Indexed diameters were obtained by dividing the aortic diameter by the patient’s body surface area. Patients were followed for the occurrence of aortic surgery. 4D-flow analysis was performed by a single observer in five regions: left ventricular outflow tract (LVOT), AAo, arch, proximal descending aorta (PDAo), and distal descending aorta (DDAo). In each region peak velocity, kinetic energy (KE), forward flow (FF), reverse flow (RF), and stasis were measured on a voxel-by-voxel basis. T-tests (or non-parametric equivalent) compared flow parameters between cohorts. Univariate and multivariate analyses explored associations between diameter and parametric voxel-by-voxel parameters.Results: Compared to controls, BAV patients showed reduced stasis (p < 0.01) and increased RF and FF (p < 0.01) throughout the aorta, and KE remained similar. In the AAo, indexed diameter correlated with age (R = 0.326, p = 0.01), FF (R = −0.648, p < 0.001), RF (R = −0.441, p < 0.001), and stasis (R = −0.288, p < 0.05). In multivariate analysis, FF showed a significant inverse association with AAo indexed diameter, independent of age. During a median 179 ± 180 days of follow-up, 23 patients (32%) required aortic surgery. Compared to patients not requiring surgery, they showed increased KE and peak velocity in the proximal aorta (p < 0.01), accompanied by increased RF and reduced stasis throughout the entire aorta (p < 0.01).Conclusion: Novel voxel-by-voxel reverse flow and stasis were altered in BAV patients and are associated with aortic dilation and surgical treatment.

Emotional salience modulates the forward flow of memory

Conditional response probability (CRP) analyses applied to free recall data indicate that recall occurs for contiguous items with forward-directionality, thought to reflect the shared encoding context of nearby items. We hypothesized that a context disruption, produced by presenting infrequent oddballs, would modulate CRP curves, increasing the forward-flow of recall due to strong binding of items presented after these oddballs to the new encoding context. Seventy young, healthy male and female participants encoded word lists containing either emotional or perceptual oddballs at varying stimulus onset asynchronies (SOA) followed by free recall. Serial recall transitions from emotional, but not perceptual, oddballs were enhanced in the forward direction except at the shortest SOA (1s). The present results provide empirical evidence of CRP modulation selectively by emotional salience and suggest that recall patterns after presenting emotional and perceptual oddballs are mediated by different mechanisms.

A Method of Stall and Surge Prediction in Axial Compressors Based On Three-Dimensional Body-Force Model

The occurrence of stall and surge in axial compressors has a great impact on the performance and reliability of aero-engines. Accurate and efficient prediction of the key features during these events has long been the focus of engine design processes. In this paper, a new body-force model that can capture the three-dimensional and unsteady features of stall and surge in compressors at a fraction of time required for URANS computations is proposed. To predict the rotating stall characteristics, the deviation of local airflow angle from the blade surface is calculated locally during the simulation. According to this local deviation, the computational domain is divided into stalled and forward flow regions, and the body-force field is updated accordingly; to predict the surge characteristics, the local airflow direction is used to divide the computational domain into reverse flow regions and forward flow regions. A single-stage axial compressor and a three-stage axial compressor are used to verify the proposed model. The results show that the method is capable of capturing stall and surge characteristics correctly. Compared to the traditional fully three-dimensional URANS method (fRANS), the simulation time for multi-stage axial compressors is reduced by 1 to 2 orders of magnitude.

An echocardiographic finding mimicking tricuspid atresia in a neonate with dilated cardiomyopathy

We report a neonate with dilated cardiomyopathy and have echocardiographic findings consistent with “functional” tricuspid atresia. There was an echo-bright, plate-like tissue at the tricuspid valve position with no forward flow across it. This report underscores the role of right ventricle intracavitary haemodynamic influence on the tricuspid valve leaflet excursion and demonstrates a phenomenon of “pseudo or functional tricuspid atresia” mimicking tricuspid atresia in a patient with acute presentation of cardiomyopathy.

Research on Multiphysics Coupling Fields in Electrochemical Trepanning of Lateral Flow

Electrochemical trepanning (ECTr) is an effective method for machining the ruled surface parts. Generally, the forward flow mode is used in ECTr. Under the forward flow, the streamlines at the outlet are divergent, resulting in the obvious flow patterns at the outlet and the instability of the machining process. In ECTr of a diffuser with a special structure, the lateral flow mode is adopted to improve the uniformity of the flow field, thereby improving the surface quality at the hub. ECTr is a complicated multiphysics coupling process. To investigate the distributions of electric field, two-phase flow field and thermal field in ECTr with lateral flow, a multiphysics coupling field model was established. In this model, a coupling relationship was formed between the various physical fields through the change of the electrolyte conductivity. Through the multiphysics coupling simulation, the changes of the gas bubbles volume fraction, the electrolyte temperature, the electrolyte conductivity and the current density were obtained along the flow path. Compared with the inlet of the electrolyte, the gas bubbles volume fraction and the temperature at the outlet increased by 38.8% and 6.3 K, respectively. Under the combined influence, the conductivity decreased by 7.227 S/m at the outlet, resulting in a decrease of 57.81 A/cm2 in the current density. Then, the corresponding experiment of lateral flow ECTr was performed to verify the simulation results. Along the flow path, the thickness of the machined blade gradually increased, varying from 2.09 mm to 2.76 mm. The surface quality gradually deteriorated along the flow path and the surface roughness varied from Ra 0.72 μm to Ra 1.05 μm. Combining the simulation and the experiment, the correctness and the effectiveness of the multiphysics coupling model and simulation were confirmed. The results can be applied to other ECM processes.