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.

Aerodynamic instabilities modeling under asymmetric boundary in a centrifugal compressor for turbocharger

The increasing demand for compression systems with high pressure ratio and wide safety margin has set new prerequisites for designers to meet the industrial needs without increasing the manufacturing costs excessively. In this work, the turbulent stability of the vaneless diffuser of the centrifugal compressor was analyzed. Unsteady Reynolds-averaged numerical simulations of the isolated diffuser and full annular diffuser with or without circumferential asymmetric boundary conditions downstream were performed. And a continuous adjoint approach was adopted, which is rarely applied in the stability analysis of compressor flow. Then, the origin of instability under different inflow and outflow conditions was sought with a sensitivity analysis. The prediction of the growth rate reveals that the flow near the shroud dominates the global stability of the diffuser. When connected with an impeller in the upstream direction, the most unstable region is localized at the backflow regions near the outlet. The wave number, however, is altered under the impact of the jet-wake flow. When connected to a circumferential asymmetric condition, the structural sensitivity of the vaneless diffuser with a radius ratio of 1.53 indicates that the interaction between the inlet reverse flow and outlet backflow is responsible for the occurrence of stall. The most unstable regions are localized at the region 90°–135° away from the volute tongue. The present work mainly contributes to the instabilities identification with novel sensitivity methods under asymmetric boundary conditions.

Simulation and Flow Analysis of the Hole Diaphragm Labyrinth Seal at Several Whirl Frequencies

The seal is designed to reduce leakage and improve the efficiency of gas turbine machines, and is an important technology that needs to be studied in gas turbine design. A series of seals were proposed to try to achieve this goal. However, due to the complex fluid dynamic performance of the seal-rotor system, the seal structure can obtain both the best leakage performance and best rotordynamic performance. This paper presents a detailed flow analysis of the hole diaphragm labyrinth seal (HDLS) at several whirl frequencies and several rotation speeds. The pressure drop, velocity, turbulence kinetic energy and leakage performance of the HDLS were discussed by simulations. An interesting exponential–type relationship between rotation speeds and leakage flow at different whirl frequencies was observed by curve fitting technology. A reverse flow rate was proposed to describe such an unusual phenomenon. Such a relationship can be used to further establish the leakage model of the HDLS and other similar seals.

Propeller Flap: Surgical Option after Resection of Lower Limb Melanoma

Objective: To describe a series of cases of lower limb reconstruction using an axial reverse flow flap (propeller flap) after melanoma excision. Patients and methods: From August 2014 to December 2016, at the Plastic Surgery Service at UNIFESP, five patients with defects in the lower limbs after melanoma resection were reconstructed using propeller flap. In all cases, the perforating vessels were previously mapped using Doppler ultrasound. Results: The size of the defect ranged from 4 cm × 3 cm to 8 cm × 4.5 cm. One case had a 180º rotation. In all the others, a 90° rotation was sufficient. All patients had good aesthetic results. Conclusion: The propeller flap is a simple and low cost technique. It is indicated for reconstruction of the distal third of small and/or medium-sized lower limb. The aesthetic result is satisfactory with the thickness and color of the flap very similar to the excised area.

Spectral, Entropy and Bifurcation Analysis of the Dynamics of a Catalyst Chemical Reverse-Flow Tubular Reactor

Oscillations, including chaotic ones, can spontaneously appear in chemical reactors or lean premixed combustors. Such behavior of the system is undesirable and should be identified at the stage of its modeling. This article analyzes the behavior of reverse-flow tubular chemical reactor with longitudinal dispersion in terms of chaotic oscillations. The purpose of using reverse flow is to increase the conversion degree. For the analysis of the reactor, among others, spectral analysis, entropy, and bifurcation analysis were used. The obtained results show the chaotic behavior of the reactor in a wide range of changes in the parameter’s values.

Precursors of backflow events and their relationship with the near-wall self-sustaining process

This study examines the precursors and consequences of rare backflow events at the wall using direct numerical simulation of turbulent pipe flow with a high spatiotemporal resolution. The results obtained from conditionally averaged fields reveal that the precursor of a backflow event is the asymmetric collision between a high- and a low-speed streak (LSS) associated with the sinuous mode of the streaks. As the collision occurs, a lifted shear layer with high local azimuthal enstrophy is formed at the trailing end of the LSS. Subsequently, a spanwise or an oblique vortex spontaneously arises. The dominant nonlinear mechanism by which this vortex is engendered is enstrophy intensification due to direct stretching of the lifted vorticity lines in the azimuthal direction. As time progresses, this vortex tilts and orientates towards the streamwise direction and, as its enstrophy increases, it induces the breakdown of the LSS located below it. Subsequently, this vortical structure advects as a quasi-streamwise vortex, as it tilts and stretches with time. As a result, it is shown that reverse flow events at the wall are the signature of the nonlinear mechanism of the self-sustaining process occurring at the near-wall region. Additionally, each backflow event has been tracked in space and time, showing that approximately 50 % of these events are followed by at least one additional vortex generation that gives rise to new backflow events. It is also found that up to a maximum of seven regenerations occur after a backflow event has appeared for the first time.

The Role of Transport in Reverse Distribution Chains

Reverse distribution operations have become significant to the manufacturers in supporting the firms to achieve the circularity of products in the reverse flow chains. There are four main components of the reverse distribution chains; inbound and outbound transportation, collection of returns, centralised returns centres, and recovery process. Transport is essential by reducing the lead time and transportation cost of the used and the recovered products. Therefore, it is pertinent that the manufacturers continue endeavouring for the sustainable transportation process in each of the components to ensure the success of the reverse distribution chains.