The effect of innate compliance on the performance of a counterpulsation device

Cardiovascular disease (CVD) continues to be one of the top causes of mortality in the world. World Heart Organization (WHO) reported that in 2004, CVD contributed to almost 30% of death from estimated worldwide death figures of 58 million[1]. Heart failure treatment varies from lifestyle adjustment to heart transplantation; its aims are to reduce HF symptoms, prolong patient survival and minimize risk [2]. One alternative available in the market for HF treatment is Left Ventricular Assist Device (LVAD). Chronic Intermittent Mechanical Support (CIMS) device is a novel (LVAD) heart failure treatment using counterpulsation similar to Intra Aortic Balloon Pumps (IABP). However, the implantation site of the CIMS balloon is in the ascending aorta just distal to aortic valve contrasted with IABP in the descending aorta. Counterpulsation coupled with implantation close to the aortic valve enables comparable flow augmentation with reduced balloon volume. Two prototypes of the CIMS balloon were constructed using rapid prototyping: the straight-body model is a cylindrical tube with a silicone membrane lining with zero expansive compliance. The compliant-body model had a bulging structure that allowed the membrane to expand under native systolic pressure increasing the device’s static compliance to 1.5 mL/mmHg. This study examined the effect of device compliance and vascular compliance on counterpulsating flow augmentation. Both prototypes were tested on a two-element Windkessel model human mock circulatory loop (MCL). The devices were placed just distal to aortic valve and left coronary artery. The MCL mimicked HF with cardiac output of 3 L/min, left ventricular pressure of 85/15 mmHg, aortic pressure of 70/50 mmHg and left coronary artery flow rate of 66 mL/min. The mean arterial pressure (MAP) was calculated to be 57 mmHg. Arterial compliance was set to be1.25 mL/mmHg and 2.5 mL/mmHg. Inflation of the balloon was triggered at the dicrotic notch while deflation was at minimum aortic pressure prior to systole. Important haemodynamics parameters such as left ventricular pressure (LVP), aortic pressure (AoP), cardiac output (CO), left coronary artery flowrate (QcorMean), and dP (Peak aortic diastolic augmentation pressure – AoPmax ) were simultaneously recorded for both non-assisted mode and assisted mode. ANOVA was used to analyse the effect of both factors (balloon and arterial compliance) to flow augmentation. The results showed that for cardiac output and left coronary artery flowrate, there were significant difference between balloon and arterial compliance at p < 0.001. Cardiac output recorded maximum output at 18% for compliant body and stiff arterial compliance. Left coronary artery flowrate also recorded around 20% increase due to compliant body and stiffer arterial compliance. Resistance to blood ejection recorded highest difference for combination of straight body and stiffer arterial compliance. From these results it is clear that both balloon and arterial compliance are statistically significant factors for flow augmentation on peripheral artery and reduction of resistance. Although the result for resistance reduction was different from flow augmentation, these results serves as an important aspect which will influence the future design of the CIMS balloon and its control strategy. References: 1. Mathers C, Boerma T, Fat DM. The Global Burden of disease:2004 update. Geneva: World Heatlh Organization; 2008. 2. Jessup M, Brozena S. Heart Failure. N Engl J Med 2003;348:2007-18.

The development and investigation of a novel pulsatile heart assist device

Cardiovascular diseases (CVD) contributed to almost 30% of worldwide mortality; with heart failure being one class of CVD. One popular and widely available treatment for heart failure is the intra-aortic balloon pump (IABP). This heart assist device is used in counterpulsation to improve myocardial function by increasing coronary perfusion, and decreasing aortic end-diastolic pressure (i.e. the resistance to blood ejection from the heart). However, this device can only be used acutely, and patients are bedridden. The subject of this research is a novel heart assist treatment called the Chronic Intermittent Mechanical Support (CIMS) which was conceived to offer advantages of the IABP device chronically, whilst overcoming its disadvantages. The CIMS device comprises an implantable balloon pump, a percutaneous drive line, and a wearable driver console. The research here aims to determine the haemodynamic effect of balloon pump activation under in vitro conditions. A human mock circulatory loop (MCL) with systemic and coronary perfusion was constructed, capable of simulating various degrees of heart failure. Two prototypes of the CIMS balloon pump were made with varying stiffness. Several experimental factors (balloon inflation/deflation timing, Helium gas volume, arterial compliance, balloon pump stiffness and heart valve type) form the factorial design experiments. A simple modification to the MCL allowed flow visualisation experiments using video recording. Suitable statistical tests were used to analyse the data obtained from all experiments. Balloon inflation and deflation in the ascending aorta of the MCL yielded favourable results. The sudden balloon deflation caused the heart valve to open earlier, thus causing longer valve opening duration in a cardiac cycle. It was also found that pressure augmentation in diastole was significantly correlated with increased cardiac output and coronary flowrate. With an optimum combination (low arterial compliance and low balloon pump stiffness), systemic and coronary perfusions were increased by 18% and 21% respectively, while the aortic end-diastolic pressure (forward flow resistance) decreased by 17%. Consequently, the ratio of oxygen supply and demand to myocardium (endocardial viability ratio, EVR) increased between 33% and 75%. The increase was mostly attributed to diastolic augmentation rather than systolic unloading.

Bromocriptine:old drug, new formulation and new indication

Bromocriptine is an ergot alkaloid dopamine D receptor agonist that has been used extensively in the past to treat hyperprolactinaemia, galactorrhoea and Parkinsonism. It is known that hypothalamic hypodopaminergic states and disturbed circadian rhythm are associated with the development of insulin resistance, obesity and diabetes in animals and humans. When administered in the early morning at the start of the light phase, a new quick release (QR) formulation of bromocriptine appears to act centrally to reset circadian rhythms of hypothalamic dopamine and serotonin and improve insulin resistance and other metabolic abnormalities. Phase II and III clinical studies show that QR-bromocriptine lowers glycated haemoglobin by 0.6-1.2% (7-13 mmol/mol) either as monotherapy or in combination with other antidiabetes medications. Apart from nausea, the drug is well tolerated. The doses used to treat diabetes (up to 4.8 mg daily) are much lower than those used to treat Parkinson's disease and have not been associated with retroperitoneal fibrosis or heart valve abnormalities. QR-bromocriptine (Cycloset™) has recently been approved in the USA for the treatment of type 2 diabetes mellitus (T2DM). Thus, a QR formulation of bromocriptine timed for peak delivery in the early morning may provide a novel neurally mediated approach to the control of hyperglycaemia in T2DM. © 2010 Blackwell Publishing Ltd.

Using a simulation model for capacity management

A simulation model has been constructed of a valve manufacturing plant with the aim of assessing capacity requirements in response to a forecast increase in demand. The plant provides a weekly cycle of valves of varying types, based on a yearly production plan. Production control is provided by a just-in-time type system to minimise inventory. The simulation model investigates the effect on production lead time of a range of valve sequences into the plant. The study required the collection of information from a variety of sources, and a model that reflected the true capabilities of the production system. The simulation results convinced management that substantial changes were needed in order to meet demand. The case highlights the use of simulation in enabling a manager to quantify operational scenarios and thus provide a rational basis on which to take decisions on meeting performance criteria.

Reliability modelling and verification of manufacturing processes based on process knowledge management

Reliability modelling and verification is indispensable in modern manufacturing, especially for product development risk reduction. Based on the discussion of the deficiencies of traditional reliability modelling methods for process reliability, a novel modelling method is presented herein that draws upon a knowledge network of process scenarios based on the analytic network process (ANP). An integration framework of manufacturing process reliability and product quality is presented together with a product development and reliability verification process. According to the roles of key characteristics (KCs) in manufacturing processes, KCs are organised into four clusters, that is, product KCs, material KCs, operation KCs and equipment KCs, which represent the process knowledge network of manufacturing processes. A mathematical model and algorithm is developed for calculating the reliability requirements of KCs with respect to different manufacturing process scenarios. A case study on valve-sleeve component manufacturing is provided as an application example of the new reliability modelling and verification procedure. This methodology is applied in the valve-sleeve component manufacturing processes to manage and deploy production resources.

Durability assessment of polymer trileaflet heart valves

The durability of a polymer trileaflet valve is dependent on leaflet stress concentrations, so valve designs that reduce stress can, hypothetically, increase durability. Design aspects that are believed to contribute to reduced leaflet stress include stent flexibility, parabolic coaptation curvature, and leaflet anisotropy. With this in mind, the purpose of this investigation was to elucidate what specific combinations of these parameters promote optimal acute and long-term valve function. A combination of four stent designs, seven leaflet reinforcement materials, and three coaptation geometries were evaluated through a combination of experimentation and modeling. Static tensile and Poisson’s ratio tests and dynamic tensile fatigue testing were used to evaluate the individual leaflet components; and hydrodynamic testing and accelerated valve fatigue was used to assess complete valve prototypes. The two most successful designs included a 0.40 mm thick knit-reinforced valve with a fatigue life of 10.35 years, and a 0.20 mm thick knit-reinforced valve with a 28.9 mmHg decrease in pressure drop over the former. A finite element model was incorporated to verify the impact of the above-mentioned parameters on leaflet stress concentrations. Leaflet anisotropy had a large impact on stress concentrations, and matching the circumferential modulus to that of the natural valve showed the greatest benefit. Varying the radial modulus had minimal impact. Varying coaptation geometry had no impact, but stent flexibility did have a marked effect on the stress at the top of the commissure, where a completely rigid stent resulted in a higher peak stress than a flexible stent (E = 385 MPa). In conclusion, stent flexibility and leaflet anisotropy do effect stress concentrations in the SIBS trileaflet valve, but coaptation geometry does not. Regions of high stress concentrations were linked to failure locations in vitro, so a fatigue prediction model was developed from the S/N curves generated during dynamic tensile testing of the 0.20 mm knit-reinforced leaflets. Failure was predicted at approximately 400 million cycles (10 years) at the top of the commissure. In vitro fatigue of this valve showed failure initiation after approximately 167 million cycles (4.18 years), but it was related to a design defect that is subsequently being changed.

Soot measurements in steady and pulsed ethylene/air diffusion flames using Laser-Induced Incandescence

Combustion-generated carbon black nano particles, or soot, have both positive and negative effects depending on the application. From a positive point of view, it is used as a reinforcing agent in tires, black pigment in inks, and surface coatings. From a negative point of view, it affects performance and durability of many combustion systems, it is a major contributor of global warming, and it is linked to respiratory illness and cancer. Laser-Induced Incandescence (LII) was used in this study to measure soot volume fractions in four steady and twenty-eight pulsed ethylene diffusion flames burning at atmospheric pressure. A laminar coflow diffusion burner combined with a very-high-speed solenoid valve and control circuit provided unsteady flows by forcing the fuel flow with frequencies between 10 Hz and 200 Hz. Periodic flame oscillations were captured by two-dimensional phase-locked LII images and broadband luminosity images for eight phases (0° – 360°) covering each period. A comparison between the steady and pulsed flames and the effect of the pulsation frequency on soot volume fraction in the flame region and the post flame region are presented. The most significant effect of pulsing frequency was observed at 10 Hz. At this frequency, the flame with the lowest mean flow rate had 1.77 times enhancement in peak soot volume fraction and 1.2 times enhancement in total soot volume fraction; whereas the flame with the highest mean flow rate had no significant change in the peak soot volume fraction and 1.4 times reduction in the total soot volume fraction. A correlation (fvRe-1 = a + b·Str) for the total soot volume fraction in the flame region for the unsteady laminar ethylene flames was obtained for the pulsation frequency between 10 Hz and 200 Hz, and the Reynolds number between 37 and 55. The soot primary particle size in steady and unsteady flames was measured using the Time-Resolved Laser-Induced Incandescence (TIRE-LII) and the double-exponential fit method. At maximum frequency (200 Hz), the soot particles were smaller in size by 15% compared to the steady case in the flame with the highest mean flow rate.

Melanocytes in the developing and adult atrioventricular valves of the murine heart

The Neural Crest (NC) is a multipotential group of cells that arises from the dorsal aspect of the neural tube early in development. It is well established that a group of NC cells named Cardiac Neural Crest (CNC) migrates to the heart and plays a critical role in the remodeling of the aortic arch arteries and septation of the outflow tract. In this study, using the mouse mutant Pax3sp/sp that has CNC deficits I have identified a putative novel role for the CNC in regulating apoptosis in the atrioventricular (AV) endocardial cushion. The AV endocardial cushion undergoes remodeling to give rise to the cardiac AV valves. Using a transgenic mouse that carries the LacZ reporter gene under the control of the Dopachrome tautomerase promoter (Dct-LacZ), I found that another NC derived population, melanocyte precursors, also contribute to the AV endocardial cushion and developing AV valves. The analysis of Dct-LacZ embryos at different stages showed that NC cells already committed to the melanocytic fate migrate to the heart along the same initial pathway taken by those that will populate the skin. Hypopigmented mice carrying mutations in the Kit and Endothelin receptor b genes, that are critical for the proper development of skin melanocytes, do not have cardiac melanocytes indicating that cardiac and skin melanocyte precursors share the same initial signaling requirements. The analysis of murine adult hearts showed that melanocytes are mostly found in the atrial sides of the tricuspid and mitral valve leaflets. The distribution of melanocytes in the AV valves corresponds exactly to areas of high Versican B expression, a proteoglycan essential for the process of AV valve remodeling. To evaluate a potential role for melanocytes in the AV valves, a nanoindentation analysis of the tricuspid valves of wild type, hypopigmented and hyperpigmented mice was performed. The storage modulus, a measure of stiffness, for the leaflets obtained from hyperpigmented mice was considerably higher (10.5GPa) than that for the leaflets from wild type (7.5GPa) and hypopigmented animals (between 3.5 and 5.5 GPa) suggesting that melanocytes may contribute to the mechanical properties of the AV valves.

Envekadea Metzeltinii Sp. Nov., A New Diatom (Bacillariophyta) Species from the Subtropical Karstic Wetlands of the Florida Everglades, U.S.A.

Envekadea metzeltinii sp. nov. is described from periphyton assemblages in the subtropical karstic wetlands of the Florida Everglades, U.S.A. The morphology of the new diatom species is documented by light and scanning electron micrographs and discussed in detail, including comparisons with related species in the genera Envekadea, Caloneis, andNavicula. The new species is characterized by a linear valve outline, a sigmoid raphe course, broad variability in areola shapes and sizes, and two clearly raised axial costae. Apart from the type locality in Florida, the species was observed from similar wetlands in the Yucatan, Mexico. Notes on its ecology and distribution are added. Based on the morphology of the most similar species, Navicula palestinae, the latter is transferred to the genus Envekadea.

Characterization of the Anti-Quorum Sensing Activity Exhibited by Marine Macro algae of South Florida

Quorum sensing is a communication mechanism employed by many bacteria. The bacteria secrete signal molecules known as acyl homoseriene lactones (AHLs) that cue to population size/density. Bacteria can be alerted of this optimum population by the concentration of these signal molecules. When the concentration of AHLs exceed a threshold valve, they enter the bacterial cell and causes the transcription of genes encoding virulence factors necessary for their colonization and survival. The marine algae Delise a pulchra, found off the coast of Australia is thought to produce compounds that inhibit the activity of the AHLs. The algae employ these compounds, known as furanones, as an anti-fouling agent. We postulated that marine algae of South Florida might contain similar activity; we screened 30 different algal species and found 22 species had the activity. Algal extracts were made from Halimeda incrassata using hexane, chloroform, ethyl acetate and methanol as solvents. The extracts were assayed for anti-quorum sensing activity. The results showed many of the South Florida green algae to possess anti-quorum sensing activity, however extracts of H incrassata did not show quorum sensing inhibition.

Movement Effects on the Flow Physics and Nutrient Delivery in Engineered Valvular Tissues

Mechanical conditioning has been shown to promote tissue formation in a wide variety of tissue engineering efforts. However the underlying mechanisms by which external mechanical stimuli regulate cells and tissues are not known. This is particularly relevant in the area of heart valve tissue engineering (HVTE) owing to the intense hemodynamic environments that surround native valves. Some studies suggest that oscillatory shear stress (OSS) caused by steady flow and scaffold flexure play a critical role in engineered tissue formation derived from bone marrow derived stem cells (BMSCs). In addition, scaffold flexure may enhance nutrient (e.g. oxygen, glucose) transport. In this study, we computationally quantified the i) magnitude of fluid-induced shear stresses; ii) the extent of temporal fluid oscillations in the flow field using the oscillatory shear index (OSI) parameter, and iii) glucose and oxygen mass transport profiles. Noting that sample cyclic flexure induces a high degree of oscillatory shear stress (OSS), we incorporated moving boundary computational fluid dynamic simulations of samples housed within a bioreactor to consider the effects of: 1) no flow, no flexure (control group), 2) steady flow-alone, 3) cyclic flexure-alone and 4) combined steady flow and cyclic flexure environments. We also coupled a diffusion and convention mass transport equation to the simulated system. We found that the coexistence of both OSS and appreciable shear stress magnitudes, described by the newly introduced parameter OSI-t , explained the high levels of engineered collagen previously observed from combining cyclic flexure and steady flow states. On the other hand, each of these metrics on its own showed no association. This finding suggests that cyclic flexure and steady flow synergistically promote engineered heart valve tissue production via OSS, so long as the oscillations are accompanied by a critical magnitude of shear stress. In addition, our simulations showed that mass transport of glucose and oxygen is enhanced by sample movement at low sample porosities, but did not play a role in highly porous scaffolds. Preliminary in-house in vitro experiments showed that cell proliferation and phenotype is enhanced in OSI-t environments.

Durability Assessment of Polymer Trileaflet Heart Valves

The durability of a polymer trileaflet valve is dependent on leaflet stress concentrations, so valve designs that reduce stress can, hypothetically, increase durability. Design aspects that are believed to contribute to reduced leaflet stress include stent flexibility, parabolic coaptation curvature, and leaflet anisotropy. With this in mind, the purpose of this investigation was to elucidate what specific combinations of these parameters promote optimal acute and long-term valve function. A combination of four stent designs, seven leaflet reinforcement materials, and three coaptation geometries were evaluated through a combination of experimentation and modeling. Static tensile and Poisson’s ratio tests and dynamic tensile fatigue testing were used to evaluate the individual leaflet components; and hydrodynamic testing and accelerated valve fatigue was used to assess complete valve prototypes. The two most successful designs included a 0.40 mm thick knit-reinforced valve with a fatigue life of 10.35 years, and a 0.20 mm thick knit-reinforced valve with a 28.9 mmHg decrease in pressure drop over the former. A finite element model was incorporated to verify the impact of the above-mentioned parameters on leaflet stress concentrations. Leaflet anisotropy had a large impact on stress concentrations, and matching the circumferential modulus to that of the natural valve showed the greatest benefit. Varying the radial modulus had minimal impact. Varying coaptation geometry had no impact, but stent flexibility did have a marked effect on the stress at the top of the commissure, where a completely rigid stent resulted in a higher peak stress than a flexible stent (E = 385 MPa). In conclusion, stent flexibility and leaflet anisotropy do effect stress concentrations in the SIBS trileaflet valve, but coaptation geometry does not. Regions of high stress concentrations were linked to failure locations in vitro, so a fatigue prediction model was developed from the S/N curves generated during dynamic tensile testing of the 0.20 mm knit-reinforced leaflets. Failure was predicted at approximately 400 million cycles (10 years) at the top of the commissure. In vitro fatigue of this valve showed failure initiation after approximately 167 million cycles (4.18 years), but it was related to a design defect that is subsequently being changed.

Soot Measurements in Steady and Pulsed Ethylene/Air Diffusion Flames Using Laser-Induced Incandescence

Combustion-generated carbon black nano particles, or soot, have both positive and negative effects depending on the application. From a positive point of view, it is used as a reinforcing agent in tires, black pigment in inks, and surface coatings. From a negative point of view, it affects performance and durability of many combustion systems, it is a major contributor of global warming, and it is linked to respiratory illness and cancer. Laser-Induced Incandescence (LII) was used in this study to measure soot volume fractions in four steady and twenty-eight pulsed ethylene diffusion flames burning at atmospheric pressure. A laminar coflow diffusion burner combined with a very-high-speed solenoid valve and control circuit provided unsteady flows by forcing the fuel flow with frequencies between 10 Hz and 200 Hz. Periodic flame oscillations were captured by two-dimensional phase-locked LII images and broadband luminosity images for eight phases (0°- 360°) covering each period. A comparison between the steady and pulsed flames and the effect of the pulsation frequency on soot volume fraction in the flame region and the post flame region are presented. The most significant effect of pulsing frequency was observed at 10 Hz. At this frequency, the flame with the lowest mean flow rate had 1.77 times enhancement in peak soot volume fraction and 1.2 times enhancement in total soot volume fraction; whereas the flame with the highest mean flow rate had no significant change in the peak soot volume fraction and 1.4 times reduction in the total soot volume fraction. A correlation (ƒv Reˉ1 = a+b· Str) for the total soot volume fraction in the flame region for the unsteady laminar ethylene flames was obtained for the pulsation frequency between 10 Hz and 200 Hz, and the Reynolds number between 37 and 55. The soot primary particle size in steady and unsteady flames was measured using the Time-Resolved Laser-Induced Incandescence (TIRE-LII) and the double-exponential fit method. At maximum frequency (200 Hz), the soot particles were smaller in size by 15% compared to the steady case in the flame with the highest mean flow rate.

Productivity- and ocean circulation changes in the sub-Antarctic Atlantic during the last deglaciation and Marine Isotope Stage 3

Millennial-scale climate changes during the last glacial period and deglaciation were accompanied by rapid changes in atmospheric CO2 that remain unexplained. While the role of the Southern Ocean as a 'control valve' on ocean-atmosphere CO2 exchange has been emphasized, the exact nature of this role, in particular the relative contributions of physical (for example, ocean dynamics and air-sea gas exchange) versus biological processes (for example, export productivity), remains poorly constrained. Here we combine reconstructions of bottom-water [O2], export production and 14C ventilation ages in the sub-Antarctic Atlantic, and show that atmospheric CO2 pulses during the last glacial- and deglacial periods were consistently accompanied by decreases in the biological export of carbon and increases in deep-ocean ventilation via southern-sourced water masses. These findings demonstrate how the Southern Ocean's 'organic carbon pump' has exerted a tight control on atmospheric CO2, and thus global climate, specifically via a synergy of both physical and biological processes.

Detecção e diagnostico de agarramento em válvulas posicionadoras

Valve stiction, or static friction, in control loops is a common problem in modern industrial processes. Recently, many studies have been developed to understand, reproduce and detect such problem, but quantification still remains a challenge. Since the valve position (mv) is normally unknown in an industrial process, the main challenge is to diagnose stiction knowing only the output signals of the process (pv) and the control signal (op). This paper presents an Artificial Neural Network approach in order to detect and quantify the amount of static friction using only the pv and op information. Different methods for preprocessing the training set of the neural network are presented. Those methods are based on the calculation of centroid and Fourier Transform. The proposal is validated using a simulated process and the results show a satisfactory measurement of stiction.