Search

Background: This study aimed to introduce and evaluate a new treatment method for rectus sheath hematoma: ultrasound-guided suction using negative pressure, curettage, and percutaneous drainage. Methods: This retrospective study involved five patients with rectus sheath hematoma rectus sheath hematoma who had cesarean sections. For all patients, ultrasound revealed that the maximum diameter of their hematoma exceeded 70 mm. We summarized and analyzed the therapeutic effects of five patients and introduced the procedure, technical points, precautions, advantages, and indications of the procedure. Results: In all five patients, hematoma area was significantly reduced as confirmed by ultrasound at follow-up, and all patients’ abdominal pain were significantly relieved. No complications, including bleeding or infection, were detected at both the 2-h postoperative and 3-day follow-up assessments. The hematoma volume reduction rates were 90 %, 67 %, 81 %, 68 %, and 70 % at three days re-examinations, and 99 %, 96 %, 98 %, 98 %, and 90 % at the 30-day follow-up. Conclusion: The removal of rectus sheath hematoma by suction using negative pressure can prevent patients from undergoing abdominal wall exploration, offering a less invasive alternative while potentially achieving comparable therapeutic effect to surgical hematoma removal in certain cases. This treatment method shows potential for clinical application, particularly in relatively young and healthy postpartum women, and is expected to be popularized and applied in clinical practice.

The study provides novel and valuable insights into the behavior of fluid flow and heat transfer in a generated plume under the influence of an aligned magnetic field, which is a complex and less-explored area in fluid dynamics. Incorporating variable viscosity and suction effects adds to the realism and applicability of the model, as it accounts for more realistic conditions where fluid properties change with temperature and external forces influence the flow. A mathematical model is formulated as a system of coupled partial differential equations to analyze the flow dynamics. Subsequently, a numerical solution is derived with stream function formulation for the system of coupled partial differential equations, which transmuted it into ordinary differential equations. To achieve this, the numerical properties of the problem are established through the utilization of a Shooting method in tandem with the MATLAB tool bvp4c. The graphical representations of both missing and specified boundary conditions, analyzes the influences of the viscosity parameter ε, suction parameter ξ, magnetic force parameter S, Prandtl number Pr and magnetic Prandtl number γ. The impact of these parameters on the heat transfer and fluid flow is given in detail. Inclusion of suction velocity counteracted the effects of temperature-dependent viscosity. The velocity f′, current density ϕ″, temperature θ, skin friction f″ and magnetic flux ϕ′ depicted an enhanced behavior while heat transfer rate θ′ dropped with an increment in viscosity parameter ε. However, for an increasing suction parameter ξ, the reverse trend of these properties is observed as compared to the viscosity parameter ε. The inclusion of suction counteracted to the effects of variable viscosity. Understanding how heat plumes behave under magnetic fields the study aims to provide insights that can be applied to real-world scenarios, such as improving cooling systems in industrial applications, enhancing environmental safety measures, and optimizing biomedical engineering processes.

Summary: Background: Retrograde intrarenal surgery (RIRS) is the main treatments for upper urinary tract stones. The Ureteral Access Sheath (UAS) serves as a supplementary tool, facilitating direct kidney access during RIRS. High quality of evidence comparing tip bendable suction ureteral access sheath (S-UAS) with traditional UAS in RIRS for the treatment of renal and ureteral stones is lacking. The purpose of the study is to compare the efficacy and safety of S-UAS with traditional UAS in RIRS for the treatment of renal or ureteral stones ≤30 mm. Methods: An international, multicenter, and superiority randomized controlled trial included 320 intention-to-treat patients across 8 medical centers in China, the Philippines, Malaysia and Turkey from August 2023 to February 2024. The inclusion criteria were patients ≥18 years old with renal or ureteral stones ≤30 mm. RIRS was performed using either S-UAS or traditional UAS. The primary outcome was the immediately stone-free rate (SFR). Secondary outcomes included SFR 3 months after operation, operating time, hospital stay, auxiliary procedures, complications (using the Clavien–Dindo grading system), and improvement in the Quality of Life (QoL) score. Differences between proportions [risk difference (RD)]/means [mean difference (MD)] and 95% confidence intervals (CI) were presented. This study is registered at ClinicalTrials.gov: NCT05952635. Findings: The S-UAS group demonstrated a significantly higher immediately SFR (81.3% versus 49.4%; RD 31.9%; 95% CI 22.5%–41.7%; p = 0.004) compared to the traditional UAS group, as determined by the one-side superiority test. Additionally, the S-UAS group exhibited a higher SFR at 3 months post-operation (87.5% versus 70.0%; RD 17.5%; 95% CI 8.7%–26.3%; p

Aim: This study aimed to assess oral suction devices in declining microbial airborne contamination level and particulate matter. Materials and methods: This open-label randomized clinical trial was conducted in an educational hospital with 50 participants above 18 years of age, who had scheduled an appointment at a dental hygienist clinic for scaling procedure. Particulate matter and microbial airborne contamination levels were taken at the beginning for 15 min and during of scaling procedure. Participants were randomized to five groups: low suction, high & low suction, intraoral suction (IOS), extra-oral suction (EOS) & low suction, and IOS & EOS. Repeated measured ANOVA analysis was carried out using STATA version 13. Results: Participants had aged 34.4 ± 8.1 years and the average simplified oral hygiene index was 3.5 ± 1.2. Microbial airborne contamination level for each intervention group was different to baseline; low suction, intraoral suction, high & low suction, EOS & low suction, and EOS and intraoral suction were 1089 ± 610, 296.3 ± 321.2, 43.8 ± 52.1, 17.3 ± 7.3 and 14.3 ± 3.9, respectively [P value 0.05]. Conclusion: Low or intraoral suction was not enough to reduce microbial airborne contamination for better infection control, practitioners highly recommended to use combination of suction devices. Clinical relevance: Using extra-oral with intra-oral suction, or extra-oral suction with low section, or high & low suction are potentially better in microbial airborne contamination reduction compared with low or intraoral suction only. Trial registration: Clinicaltrials.gov (NCT05848245) on April 14, 2023.

In order to evaluate the performance of deep geological disposal of radioactive waste, an underground research laboratory (URL) was constructed by Andra in the Callovo-Oxfordian (COx) claystone formation at the Meuse/Haute-Marne (MHM). The construction of URL induced the excavation damage of host formations, and the ventilation in the galleries desaturated the host formation close to the gallery wall. Moreover, it is expected that the mechanical behaviour of COx claystone is time-dependent. This study presents a constitutive model developed to describe the viscoplastic behaviour of unsaturated and damaged COx claystone. In this model, the unsaturation effect is considered by adopting the Bishop effective stress and the van Genuchten (VG) water retention model. In terms of the viscoplastic behaviour, the nonstationary flow surface (NSFS) theory for unsaturated soils is used with consideration of the coupled effects of strain rate and suction on the yield stress. A progressive hardening law is adopted. Meanwhile, a non-associated flow rule is used, which is similar to that in Barcelona basic model (BBM). In addition, to describe the damage effect induced by suction change and viscoplastic loading, a damage function is defined based on the crack volume proportion. This damage function contains two variables: unsaturated effective stress and viscoplastic volumetric strain, with the related parameters determined based on the mercury intrusion porosimetry (MIP) tests. For the model validation, different tests on COx claystone under different loading paths are simulated. Comparisons between experimental and simulated results indicated that the present model is able to well describe the viscoplastic behaviour of damaged COx claystone, including swelling/shrinkage, triaxial extension and compression, and triaxial creep.

The research studies the numerical analysis of an incompressible Casson hybrid nanofluid, composed of Fe3O4–Cu nanoparticles blended with engine oil, flowing over an exponentially stretched curved surface. It explores the effects of an aligned magnetic field, a uniform heat source, activation energy, and suction while maintaining a low Prandtl number. By employing appropriate similarity transformations, the original partial differential equations are converted into ordinary ones and solved using bvp4c in MATLAB. Graphs and tables depict the influence of dimensionless factors on skin friction coefficient, velocity, thermal, and concentration profiles, as well as Nusselt and Sherwood numbers. The computational findings reveal that magnetic field alignment significantly modifies velocity, decreasing it while uniformly enhancing temperature and concentration profiles. Casson fluid behavior in engine oil amplifies temperature and concentration profiles, thereby enhancing heat and mass transfer rates. Moreover, an increased heat source elevates temperature but reduces overall heat transfer. The chemical reaction parameter diminishes concentration, whereas activation energy enhances it, albeit impacting the mass transfer rate conversely. Additionally, suction increases flow resistance, while the stretching parameter exhibits an inverse effect, both positively influencing heat and mass transfer rates at higher values. Practically, these findings offer insights crucial for optimizing heat exchangers, biomedical devices, and cooling systems, enhancing their efficiency and performance. Additionally, they inform the design of industrial processes involving fluid flow, aiding in the development of more effective and sustainable solutions.

This paper aims to provide the details for making affordable single and multichannel liquid aspirators for wet labs. A liquid aspirator is a basic laboratory device that can cost several hundred Euros. We present a < €25 3D print solution that performs equally well in daily lab routines and is compatible with various vacuum sources, including an aquarium pump or household vacuum cleaner. Presently, commercial aspirators cost more than a decent entry-level 3D printer capable of producing all the parts listed in this manuscript. The models were designed with Tinkercad, with easy printing and minimal support in mind. The versatility and the ultra-low-cost solution we presented could ease the daily workflow of researchers in various research fields. Furthermore, it is valuable to high school or undergraduate student labs and community wet labs for science enthusiasts, where funding is generally limited.

In light of the exciting potential of nanofluids, this work presents a new mathematical model for enhancing heat transfer using tri-hybrid nanofluids. In this study, the influence of heat production/abstraction and mass suction on MHD stagnation point flow in a nonlinearly stretching/shrinking sheet of a tri-hybrid nanofluid based on water is investigated. Boundary conditions based on the Maxwell velocity slip and the Smoluchowski temperature are also considered. We shall model the flow-control equations based on our assumptions. An ordinary differential equation system may be constructed from nonlinear partial differential equations for which a similarity transformation does not provide an exact solution. In MATHEMATICA 10, the shooting with Runge-Kutta (RK-IV) technique will be used to solve the reduced equations analytically. There were charts and figures showing how different variables affected the speeds of motion, temperature, skin friction coefficient, and local heat transmission. The characteristics of volume fraction, mass suction, magnetic field, and stretching all contribute to the acceleration of nanoparticles. When the nanoparticle volume fraction and heat production parameters increase, the temperature profile improves, but the mass suction, magnetic, and stretching parameters decrease. Compared to ordinary fluid, the Nusselt number reveals an improvement of around 9.8% for nanofluid, 19.85% for hybrid nanofluid, and 44.04% for tri-hybrid nanofluid when the strength of S is raised from 2.0 to 2.4. The heat transfer rate of the tri-hybrid nanofluid is also superior to that of the hybrid nanofluid and the traditional nanofluid. Results from this study were compared to those already in the literature, and they were determined to be quite consistent. Many other fields might benefit from this study, including those dealing with extreme heat or cold, aerospace technology, medicine, metal coatings, and biosensors.

Refrigeration systems are becoming more efficient as a result of nanofluids. Cooling and heating process improvements can lead to enhanced industrial efficiency, reduced processing times, energy conservation, and improved heating and cooling processes. A study is being conducted on the effects of magnetohydrodynamics (MHD) in nanofluids by adding double slip and thermal radiation to the governing model. It is numerically simulated using bvp4c code in MATLAB. Analyzing temperature, concentration, and velocity requires the evaluation of multiple parameters. A more uniform distribution of temperatures can be achieved by increasing the Biot number, thermal radiation, and thermophoretic motion parameters. The use of suction is an effective method of controlling the rate of temperature reduction in various manufacturing processes. A product's mechanical properties and overall quality can be enhanced if one is able to control how quickly it cools during the process of melting and condensing raw materials. As a consequence of the emergence of quadratic and linear slip factors, the flow velocity decreases. A distinguishing feature of this research is the use of boundary conditions that are tailored to the geometry that is being investigated.

Constant suction phenomenon has been executed in free convective Oldroyd-B material in an oscillatory flow mode over infinite vertical porous plate. For heat transfer, this study includes the influence of heat dissipation. The resulting governing equations are transferred into a set of dimensionless form of coupled-ordinary differential equations with appropriate non-dimensional variables. MAPLE code is developed for the regular perturbation method and executed to solve the set of non-dimensional couple-ordinary derivative equations. The impact of different embedded parameters on the mean, fluctuating, transient velocities and temperatures on the Oldroyd-B fluid have been discussed and depicted in graphical forms. The influence of some physical terms on the plate mean friction and plate heat mean gradient are computed and demonstrated in a tabular form. The attained results show that as an increase in relaxation time, greater amplitude of temperature fluctuations is observed. Remarkable enhancement is observed in all the parameters (Grashof, Prandtl and Eckert numbers) for transient temperature profiles.

Objective: The purpose of the study was to assess the clinical efficacy and safety of a combined perfusion suction platform with pressure feedback control function and an ureteroscopic suction sheath that can measure the ureteropelvic pressure in implementing lithotripsies. Methods: Fifty-two patients who underwent lithotripsy under intelligent monitoring of ureteral intraluminal pressure from June 2016 to January 2018 were retrospectively recruited. The inclusion standard was stone diameter >1.5 cm but

Variability in moisture content is a common condition in natural soils. It influences soil properties significantly. A comprehensive understanding of the evolution of soil microstructure in wetting/drying process is of great significance for interpretation of soil macro hydro-mechanical behavior. In this review paper, methods that are commonly used to study soil microstructure are summarized. Among them are scanning electron microscope (SEM), environmental SEM (ESEM), mercury intrusion porosimetry (MIP) and computed tomography (CT) technology. Moreover, progress in research on the soil microstructure evolution during drying, wetting and wetting/drying cycles is summarized based on reviews of a large body of research papers published in the past several decades. Soils compacted on the wet side of optimum water content generally have a matrix-type structure with a monomodal pore size distribution (PSD), whereas soils compacted on the dry side of optimum water content display an aggregate structure that exhibits bimodal PSD. During drying, decrease in soil volume is mainly caused by the shrinkage of inter-aggregate pores. During wetting, both the intra- and inter-aggregate pores increase gradually in number and sizes. Changes in the characteristics of the soil pore structure significantly depend on stress state as the soil is subjected to wetting. During wetting/drying cycles, soil structural change is not completely reversible, and the generated cumulative swelling/shrinkage deformation mainly derives from macro-pores. Furthermore, based on this analysis and identified research needs, some important areas of research focus are proposed for future work. These areas include innovative methods of sample preparation, new observation techniques, fast quantitative analysis of soil structure, integration of microstructural parameters into macro-mechanical models, and soil microstructure evolution characteristics under multi-field coupled conditions.

Bentonite buffer materials are important components of engineered barrier systems for the disposal of high-level radioactive waste produced during nuclear power generation. The design temperature of the buffer material is

Control of moisture is critical for retention of sealants, which can reduce the incidence of caries in high-risk groups. Objectives: We investigated the safety and efficacy of the novel SS-suction device in the laboratory and a small clinical trial in children aged 6 to 8-years-old. Methods: First, a laboratory test of 52 SS-suction devices was conducted to determine the pressure generated by the chin plate to maintain suction at different intervals and to determine the pressure resistance of the spring to maintain suction in a child's mouth. Second, 12 healthy children with sound lower molars participated in a clinical trial of the use of SS-suction during sealant application. Results: The laboratory test showed that when pressed to the maximum distance of 25 mm, the chin plate produced a pressure of 247.5 ± 116.6 mmHg. At this pressure, the SS-suction could be used safely for up to 120 min without damaging the soft tissues. In the clinical study, the dentists inserted and removed the SS-suction in 7.80 ± 2.48 s. The range by which the chin plate was pressed down varied between 0 and 13 mm. The highest pressure on the skin was 120 mmHg (at 13 mm) and the device effectively maintained suction and effectively removed water and saliva. The time required to apply sealant was 7.01 ± 2.26 min. Conclusions: The SS-suction is a safe, effective device for two-handed application of sealants in children, with no negative side effects. Clinical significance: We demonstrate the unique SS-suction device can quickly drain water and saliva to help dentists treat young patients using a two-handed approach; this device provides good control of moisture during sealant application. The device prevents the tongue and cheeks from interfering with the operation area, reduces tension, and does not require a dental assistant.

Significance of study: Nanofluids with aggregation effects mediated by nanoparticles, like geothermal panels and crossflow heat exchangers, ignite new industrial interests. Polymer and conversion processes have transport phenomena in the stagnation zone that must be continuously improved to raise the process quality standard. Aim of study: Hence, the current computational study examines a TiO2−C2H6O2 nanofluid's unsteady stagnation-point flow performance via a shrinking horizontal cylinder. In addition, the effects of a magnetic field, joule-heating viscous dissipation, nanoparticles aggregation and mass suction on the boundary layer flow are reflected. Method: ology: The RK-IV with shooting method is applied to resolve the simplified mathematical model numerically in computing software MATHEMATICA. In certain circumstances, comparing the current and prior findings indicates good agreement with a relative error of around 0%. Findings: The implementation of a heat transfer operation may be improved by increasing suction settings. Unsteadiness, nanoparticle volume fraction, magnetic, curvature, and Eckert number (implies the operating Joule heating and viscous dissipation) all influence heat transfer rate. The velocity and temperature profiles both increase as the unsteadiness, magnetic field, and nanoparticle volume fraction parameters increase, whereas the curvature and suction parameters show the opposite behavior. When the values of the suction parameters were changed from 2.0 to 2.5 with φ = 0.01, the heat transfer rates rose by 4.751%. A comparison shows that the model with aggregation has a better velocity profile, while the model without aggregation has a better temperature profile.

To aid in the prevention of reaction explosions, chemical engineers and scientists must analyze the Arrhenius kinetics and activation energies of chemical reactions involving binary chemical mixtures. Nanofluids with an Arrhenius kinetic are crucial for a broad variety of uses in the industrial sector, involving the manufacture of chemicals, thermoelectric sciences, biomedical devices, polymer extrusion, and the enhancement of thermal systems via technology. The goal of this study is to determine how the presence of thermal radiation influences heat and mass transfer during free convective unsteady stagnation point flow across extending/shrinking vertical Riga plate in the presence of a binary chemical reaction where the activation energy of the reaction is known in advance. For the purpose of obtaining numerical solutions to the mathematical model of the present issue the Runge-Kutta (RK-IV) with shooting technique in Mathematica was used. Heat and mass transfer processes, as well as interrupted flow phenomena, are characterized and explained by diagrams in the suggested suction variables along boundary surface in the stagnation point flow approaching a permeable stretching/shrinking Riga Plate. Graphs illustrated the effects of many other factors on temperature, velocity, concentration, Sherwood and Nusselt number as well as skin friction in detail. Velocity profile increased with Z,λ and S and decreased with ε. Increasing values of ε,λ and S decline the temperature profile. The concentration profile boosts up with Z,α and slow down with ε,Sc,β,δ and n1 parameters. Skin friction profile increased with Z and S and decreased with ε. Nusselt number profile increased with S,Z, ε and radiation. Sherwood number profile shows upsurges with ε,Z,α,Sc,β,S and n1 whereas slow down with δ. So that the verdicts could be confirmed, a study was done to compare the most recent research with the results that had already been published for a certain case. The outcomes demonstrated strong concordance between the two sets of results.

ABSTRACT: Aims: The objective of the present study was to investigate the presence of SARS-CoV-2 in aerosol and COVID-19 contamination distance asssociated with ultrasonic scaling and tooth preparation. Methods: Twenty-four patients with COVID-19 were included in this study. Removal of supragingival plaque with ultrasonic instruments for 10 minutes and high-speed air-turbine using for the simulation of cutting the maxillary right canine tooth with a round diamond bur for 5 minutes were performed. Patients were randomly assigned to 2 groups: In group A, medium-volume suction was used during treatment. In group B, high-volume suction with an aerosol cannula was added to medium-volume suction. Prior to treatment, 5 glass petri dishes containing viral transport medium were placed in the operating room. After treatment, petri dishes were immediately delivered to a microbiology laboratory for real-time polymerase chain reaction (RT-PCR) analysis. Results: RT-PCR test results were negative for all specimens in group B. However, 5 positive test results for COVID-19 were detected in group A specimens. Conclusions: Suction with an aerosol cannula is very important to prevent COVID-19 viral contamination via aerosol. In addition, a high-volume suction capacity (air volume) of 150 mm Hg or 325 L/min is sufficient for elimination of viral contamination. Thus, high-volume suction should be used during dental treatments in COVID-19 patients.

Since unsaturated soil conditions are normally experienced above the groundwater table, most treated or stabilised soils for roadworks, earth dams’ embankments, landfill sites, hydraulic barriers etc. could be regarded as existing in this region. The soil–water characteristic (or retention) curve (SWCC) is a useful conceptual tool by which an evaluation of unsaturated soil's property functions and corresponding macro-scale behaviour (strength, volume change, hydraulic conductivity, fluid flow, diffusivity, etc.) can be carried out. Hence, an examination of some of the various factors that could affect the hydraulic or water retention property of the stabilised soil is very vital both for laboratory studies and field practice. However, a thorough assessment of the water retention behaviour of stabilised soils can be understandably limited sometimes. This could be partly due to some of the perculiar conditions associated with soil preparation methods, soil type, soil-stabiliser mix proportion used, curing conditions, method of compaction, durability assessment modalities and other logistical issues surrounding either laboratory instrumentation or in-situ application. This article presents a critical and comprehensive review of these factors on the stabilised soil’s water retention behaviour and also provides a systematic understanding of the mechanisms of stabilisation occurring at the micro- and macro-mechanical levels. Recommendations are also made to stimulate further discussions on the synthesis of SWCC of stabilised soils vis-à-vis factors influencing them with possible interpreted engineering behaviours such as shear strength and soil consolidation.

Sebkha soils are known as saline formations that was rencontred generally in arid and semi-arid regions. With the alternation of drying-wetting cycles (D-W) these soils present variable morphological and geotechnical properties. These cycles D-W have an important effect on the mechanical behavior of sebkha soils which poses enormous problems for the construction of structures in general. In this study, compacted sebkha soil samples from Ain M'Lila, Algeria were subjected to three D-W cycles based on the natural drying process to reach the targeted water contents of 13, 11.4, 7 and 4%, in a laboratory environment. For each of these water contents, laboratory tests were conducted to study the effect of the D-W cycles on the collapse potential Cp, suction, and shear strength of the soil. The results obtained showed that the three components of suction, i.e., total, matric, and osmotic suctions decreased when the number of D-W cycles increased. Moreover, the collapse potential Cp increased with an increase in the number of D-W cycles. Moreover, the results obtained illustrated that the shear strength parameters were affected by the number of D-W cycles a significant decrease in cohesion and an increase in the internal friction angle were observed when the number of D-W cycles was increased. Finally, a correlation was found between the soil salinity and the three factors studied these were affected by the decrease in salinity under the effect of D-W cycles.

A novel approach is proposed to capture the hysteresis of the suction - degree of saturation (ψ-S) relationship of three–phase fluids in porous media. Effective suction ψ′ is defined such that it incorporates the delay in the variation in the degrees of saturation due to the hysteresis, with its movement in a closed domain of suction space. This effective suction space domain represents the possible range in effective suction in which matric suction ψ is always located at the center of the locus. The incremental change in matric suction determines the movement of the effective suction in the suction space. This effective suction is incorporated into the unique (ψ-S) relationship previously defined by van Genuchten (1980) to obtain the delayed variation in the degrees of saturation caused by the hysteresis along the wetting and drying scanning paths. By incorporating the effective suction into the conventional ψ-S relationship, the hysteretic characteristics of the saturation of air, NAPL, and water are described for both 2–phase and 3–phase systems. Realistic soil behavior is further captured through a simulation of the vertical soil profiles in the presence of hysteresis by incorporating the proposed concept into a 3–phase system.

The micro-pipette aspiration technique is a classical experiment used to characterize the physical properties of inert fluids and biological soft materials such as cellular aggregates. The physical parameters of the fluid, as viscosity and interfacial tension, are obtained by studying how the fluid enters the pipette when the suction pressure is increased and how it relaxes when the suction pressure is put to zero. A mathematical model representative of the experiment is needed to extrapolate the physical parameters of the fluid-like matter; however, for biological materials as cells or cell aggregates mathematical models are always based on strong starting hypotheses that impact the significance of the identified parameters. In this article, starting from the bi-constituent nature of the cell aggregate, we derive a general mathematical model based of a Cahn-Hilliard-Navier-Stokes set of equations. The model is applied to describe quantitatively the aspiration-retraction dynamics of a cell-aggregate into and out of a pipette. We demonstrate the predictive capability of the model and highlight the impact of the assumptions made on the identified parameters by studying two cases: one with a non-wetting condition between the cells and the wall of the pipette (classical assumption in the literature) and the second one, which is more realistic, with a partial wetting condition (contact angle θ s = 150°). Furthermore, our results provide a purely physical explanation to the asymmetry between the aspiration and retraction responses which is alternative to the proposed hypothesis of an mechano-responsive alteration of the surface tension of the cell aggregate. STATEMENT OF SIGNIFICANCE: Our study introduces a general mathematical model, based on the Cahn-Hilliard-Navier-Stokes equations, tailored to model micro-pipette aspiration of cell aggregates. The model accounts for the multi-component structure of the cell aggregate and its intrinsic viscoelastic rheology. By challenging prevailing assumptions, particularly regarding perfect non-wetting conditions and the mechano-responsive alteration of cell surface tension, we demonstrate the reliability of the mathematical model and elucidate the mechanisms at play, offering a purely physical explanation for observed asymmetries between the aspiration and retraction stages of the experiment., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 The Author(s). Published by Elsevier Ltd.. All rights reserved.)

This article reviews the major devices, individuals, and other historical landmarks in the development of suction in the field of neurosurgery, where the operating fields are characteristically deep and narrow. Our review spans the 159 years since the first use of aspiration in surgery to modern applications. This report exemplifies a comprehensive history of suction, the minute iteration of devices, and the massive impact this technological development has had on medicine and neurosurgery., (Copyright © 2024 Elsevier Inc. All rights reserved.)

Background: This study was performed to summarize our experience in treating acute superior mesenteric artery embolism (SMAE) by percutaneous mechanical thrombectomy (PMT)., Methods: Between January 2023 and October 2023, 18 patients presenting with acute mesenteric ischemia were admitted to our center, including 11 cases of SMAE, 3 cases of superior mesenteric artery thrombosis, and 4 cases of superior mesenteric vein thrombosis. We retrospectively reviewed 8 patients (4 males and 4 females; range, 51-79 years; mean, 62.50 ± 9.67 years) who underwent treatment of acute SMAE using the AcoStream system. The patients had no obvious evidence of intestinal necrosis as shown by peritoneal puncture or computed tomography. Thrombectomy was performed on the superior mesenteric artery (SMA) using an 8F AcoStream thrombus aspiration system (Acotec, China). The demographics, risk factors, therapeutic effect, complications, mortality, and follow-up of the study population were assessed., Results: The technical success rate was 100%. After 1-3 passes (2.38 ± 0.92) and aspiration thrombectomy, complete thrombus removal was achieved in 7 (87.50%) patients. One patient received an adjunctive catheter-directed thrombolysis due to partial thrombus removal. Thrombolysis was conducted for 2 days, resulting in complete resolution of the thrombus. The other 7 patients did not receive adjunctive endovascular intervention due to complete thrombus removal and no residual stenosis. No distal embolization or device-related complications were noted during the procedure. After the procedure, sufficient clinical improvement was seen in 6 patients within 1-2 days. Two patients showed no significant improvement of their symptoms. Laparotomy was performed on day 1 and day 2 after thrombectomy in patients 3 and 7, respectively. Intestinal necrosis was diagnosed operatively and intestinal resection was performed. All patients were discharged 6-15 days (9.50 ± 3.07) after admission without perioperative complication or death. The mean follow-up period was 5.00 ± 3.30 months (range, 1-10 months), and the follow-up rate was 100%. During the follow-up, all patients remained symptom-free. Computed tomography angiography images showed good flow in the trunk and branches of the SMA in all patients., Conclusions: PMT using the AcoStream system is a minimally invasive, safe, and effective technique for acute SMAE. Early application of PMT can achieve immediate revascularization of the SMA and have the potential advantage of avoiding laparotomy or reducing the extension of enterectomy, as it could theoretically restore intestinal perfusion in less time than open revascularization. If the symptoms do not improve after PMT, exploratory laparotomy should be scheduled as soon as possible. Further studies are necessary on this field to confirm these findings., (Copyright © 2024 Elsevier Inc. All rights reserved.)

Compacted layers of expansive soils are used in different engineering projects, such as subgrades, engineered clay barriers, and buffers for radioactive waste disposal. These layers are exposed to a variety of stresses and wetting conditions during field serviceability. Coupling between hydraulic and mechanical repeated loading provides insight understanding to the induced progressive deformation of expansive clay. This study was conducted to investigate the hydromechanical behavior of unsaturated compacted expansive clay under repeated loading–unloading (RLU) conditions. Two series of one-dimensional (1D) oedometer tests were conducted under controlled matric suction up to 1500 kPa using the axis translation technique (Fredlund soil-water characteristic curve device, SWC-150). The first test series was carried out at different levels of controlled matric suction for non-repeated loading–unloading (NRLU) cycles. RLU cycles were applied in the second test series at different repetitive-stress levels and under different levels of matric suction. The results indicated increasing axial wetting strain εa(s), axial swell pressure σs(s), compression index Cc(s), and swell index Cs(s) with suction reduction. The estimated load–collapse (LC) curves obtained from NRLU series (LCN) and RLU series (LCR) indicated increasing yield stress σy(s) with increasing suction. This is attributed to the developed apparent cohesion between soil particles, which in turn rigidifies the material response. Applying repetitive loading induced a notable reduction of compression index Cc(s) at the same level of suction, whereas swell index Cs(s) seems to be independent of repetitive loading. Finally, repetitive loading exceeding initial yield stresses results in plastic hardening and, hence, enlargement of yield stress locus (i.e. LCR curve).

This research examines the radiative characteristics of electromagnetohydrodynamic (EMHD) boundary layer flow with combined thermal transport properties on a reactive stretching surface using Casson nanofluid. The momentum, temperature, and diffusion equations' governing flow equations are reduced to dimensionless forms through variable transformations. The remedies to the resulting equations are numerically generated using the MATLAB bvp4c. Validation against prior research is carried out. The impact of emerging factors on velocity, temperature, concentration patterns, drag force coefficient, Sherwood number, and Nusselt number are graphically represented and in tables. It indicates that when Prandtl number, lower variables of Suction, and Casson parameters increases with a decline in velocity distribution, the contrasting trend enhancement is perceived for modified Hartmann number. In addition, an increment in the modified Hartmann number increases the rate of energy, mass flux, and friction. Conclusively, As Lewis number, Brownian motion, and chemical reaction rise, the thickness of the concentration boundary layer decreases on the stretching Riga surface.

To better understand the salinity effect on the compaction behaviour of soil, standard Proctor compaction test was conducted on soil samples with different salinities. Matric suction and small-strain shear modulus, Gmax, were determined and pore size distribution was also investigated on samples statically compacted at different water contents. Results showed that with the decrease of soil salinity from initial value of 2.1‰ (g of salt/kg of dry soil) to zero, the maximum dry density increased and the optimum water content decreased, whereas there was no significant change with the increase of soil salinity from 2.1‰ to 6.76‰. Interestingly, it was observed that Gmax also decreased when the soil salinity decreased from initial value of 2.1‰ to zero and kept almost constant when the soil salinity increased from 2.1‰ to 6.76‰, for dry samples with similar matric suction and also for samples compacted at optimum state and on wet side whose matric suctions were slightly different due to the difference in remoulded water content. Furthermore, the effect of salinity on compaction behaviour and Gmax decreased for samples compacted from dry side to wet side. The pore size distribution exhibited bi-modal characteristics with two populations of micro- and macro-pores not only for samples compacted on dry side and at optimum state, but also for those compacted on wet side. Further examination showed that the modal size of micro-pores shifted to lower values and that of macro-pores shifted to higher values for saline soil compared to the soil without salt.

Pile foundations are widely designed extending principles of saturated soil mechanics assuming drained conditions (i.e. effective stress) even in expansive soil deposits despite the fact the soil around the pile is in a state of unsaturated condition. The mechanical behavior of in-situ pile foundations are significantly influenced by suction changes associated with water infiltration. In this paper, a single model pile mechanical behavior variations associated with suction changes in an unsaturated expansive soil under a service load were investigated. Experimental results suggest pile settlement increases due to water infiltration. Such a phenomenon can be attributed to pile shaft friction reduction in the active zone associated with suction reduction due to water infiltration and volume expansion of the soil. Experimental results were also simulated and interpreted using a computation program, PEI (i.e. Pile behavior in Expansive soil upon Infiltration), which was proposed based on principles of unsaturated soil mechanics. A theoretical model was proposed for the estimation of threshold pile head load which distinguishes whether the pile would experience upward or downward movement upon water infiltration. The theoretical model and the numerical modeling approach presented in this are valuable for practicing engineers in the rational design of piles taking account of the mechanical behavior of expansive soils.

Understanding mechanical interactions at the root-soil interface is essential to predict the erosion of vegetated slopes. Recently, the shear strength of vegetatedil under changing hydraulic conditions has been measured and modeled; however, root-soil interfaces have not been investigated under changing hydraulic conditions. This paper proposes (1) a novel pullout apparatus to measure the shear strength at the root-soil interface under changing suction, (2) a Mohr-Coulomb-Vilar (MCV) shear strength model of root-soil interfaces, and (3) a numerical simulation using Node-To-Segment (NTS) approach along with Finite Element Method (FEM). The pullout tests were verified using the numerical simulation, and the results showed that the combination of the MCV model and NTS/FEM approach can accurately predict the shear behavior of root-soil interfaces under changing suction. In addition, we experimentally evaluated the pullout problem of roots and showed that the present method provides reasonably predicts root-pullout problems even when the suction is changed during the pullout process. The current method, therefore, can be used for predicting root-soil interface dynamics under varying suction and soil pressure by only adding two additional parameters of the Vilar model.

This contribution devotedly analyzes the behaviour of momentum and heat transfer of dust particles micropolar fluid flow due to a vertical permeable cone with suction and variable wall temperature. Homogeneously suspended dust nano-particles is suggested. Non-similar solutions for governing equations are noticed to be exist when the surface temperature varies as a power law with the length measured from the leading edge. Via suitable coordinate transformation the flow governing equations transformed into non-similar boundary layer flow equations. The subsequent nonlinearly system of micropolar liquid and the dust particle phases are solved numerically via an efficient, tridiagonal, iterative, implicit finite difference technique using FORTRAN software. Aspects of distinct emerging variables on the computations (carrier and dust-particle phases of velocity and temperature) are illustrated through tables and drawn graphical, also Nusselt number and shear and couple stresses factor are given as functions of suction variables. Results point out that an increment in the suction variable or the relative density parameter tends to enhance the local Nusselt number. The present computations are validated by favorable comparisons with earlier published data.

The objectives of the present study are (i) to observe the duality of solutions, and (ii) to investigate the flow and heat transfer of the hybrid nanofluid past a shrinking cylinder in the appearance of Joule heating. The single phase nanofluid model with modified thermophysical properties are used for the mathematical model. The similarity transformation simplifies the model (PDEs) into similarity (ordinary) differential equations. bvp4c solver is used to compute the reduced equations. For the validation part, the analytical solution is developed using an exact analytical method and compared with the numerical values for several cases. First and second solutions are observable for the shrinking cylinder case only if suction parameter is applied. Meanwhile, only the first solution is found to be stable from the stability analysis. The application of high suction strength make the reduced heat transfer rate is lower for hybrid nanofluid (Cu-Al2O3/water) than alumina-water nanofluid but, opposite result is found for the skin friction coefficient. The addition of curvature parameter (flat plate to cylinder) can quicken the separation process of boundary layer. This results are conclusive to the pair of alumina and copper only.

In this new era of technology in fluid field, hybrid nanofluid has become a fruitful interest topic among researchers due to it thermal properties and potential which gives better result compared to nanofluid in enhancing the heat transfer rate. The intention here is to present the significant effects of suction and magnetic field over a moving plate containing hybrid nanofluid with base fluid is water, Alumina Oxide (Al2O3) and Copper (Cu) as the nanoparticles. A mathematical modelling consists of partial differential equation for the fluid flow are constructed and transformed to a set of ordinary differential equations hence solved numerically using bvp4c in MATLAB. Effects of magnetohydrodynamics (MHD), M, suction, S and relevant thermophysical properties on velocity, temperature, skin friction,Cf and local Nusselt,Nux number are thoroughly examined and presented graphically. It is noted that duality exists in certain range when λc-1. The range on duality of solution are widen as the values of M and S increase. Due to that, a stability analysis is implied to determine which duality of solution is stable and realizable. As M and ϕ2increase, the skin friction increases. For rate of heat transfer, as M increase, the heat transfer rate increase while for arising of ϕ2, the heat transfer decrease. Furthermore, it is noted that the hybrid nanofluid possess better result compared to nanofluid.

The heat transfer technology is growing significantly for desired solutions as the need for efficient heating and cooling systems in the aerospace, automotive, and chemical sectors. Bearing this in mind the need for effective cooling/heating systems, the steady, two-dimensional Glauert wall jet flow with thermophoretic particle deposition is investigated in the presence of Al2O3 nanoliquid. The Glauert transformations are used to transform the system of partial differential equations (PDEs) that reflect conservation, continuity, temperature, and concentration, as well as boundary conditions. The fourth fifth order Runge-Kutta-Fehlberg (RKF-45) method along with the shooting approach is used to solve the reduced system of ordinary differential equations (ODEs). The role of physical quantities for the parameters in concern are visually depicted and described in depth. Results reveal that, rise in values of velocity slip parameter upsurges the velocity profile away from the wall and declines near the surface. The increase in radiation parameter inclines the heat transfer. The growing values of both radiation parameter and volume fraction advances the heat transfer rate. The growing values of thermophoretic parameter improves the mass transfer rate.

Background: Prior studies have found no differences in procedural chest discomfort for patients undergoing manual syringe aspiration or drainage with gravity after thoracentesis. However, whether gravity drainage could protect against chest pain due to the larger negative-pressure gradient generated by wall suction has not been investigated., Research Question: Does wall suction drainage result in more chest discomfort compared with gravity drainage in patients undergoing large-volume thoracentesis?, Study Design and Methods: In this multicenter, single-blinded, randomized controlled trial, patients with large free-flowing effusions of ≥ 500 mL were assigned at a 1:1 ratio to wall suction or gravity drainage. Wall suction was performed with a suction system attached to the suction tubing and with vacuum pressure adjusted to full vacuum. Gravity drainage was performed with a drainage bag placed 100 cm below the catheter insertion site and connected via straight tubing. Patients rated chest discomfort on a 100-mm visual analog scale before, during, and after drainage. The primary outcome was postprocedural chest discomfort at 5 minutes. Secondary outcomes included measures of postprocedure chest discomfort, breathlessness, procedure time, volume of fluid drained, and complication rates., Results: Of the 228 patients initially randomized, 221 were included in the final analysis. The primary outcome of procedural chest discomfort did not differ significantly between the groups (P = .08), nor did the secondary outcomes of postprocedural discomfort and dyspnea. Similar volumes were drained in both groups, but the procedure duration was longer in the gravity arm by approximately 3 minutes. No differences in rate of pneumothorax or reexpansion pulmonary edema were noted between the two groups., Interpretation: Thoracentesis via wall suction and gravity drainage results in similar levels of procedural discomfort and dyspnea improvement., Clinical Trial Registry: ClinicalTrials.gov; No.: NCT05131945; URL: www., Clinicaltrials: gov., Competing Interests: Financial/Nonfinancial Disclosures The authors have reported to CHEST the following: F. M. reports conflicts of interest with Pleural Dynamics, Medtronic, and Rocket Medical. K. K. reports conflicts of interest with Astra Zeneca. L. D. reports conflicts of interest with Intuitive Surgical and Elucent Medical. None declared (S. S., J. Pannu, L. Y., A. F., C. MacR, R. B., L. D., Z. S. DeP., S. A. F., C. A. J., S. K. A., E. V., A. DeM., L. B., T. F., R. A., G. A. E., D. E. O., S. B., A. K., V. S., A. S., R. F. C., S. E. E., K. P., N. C., D. D. B., V. P., R. L., C. P., L. R., J. M., J. Z., J. L., L. V., E. O., G. Y., J. A., C. B., R.-R. A., M. S., J. Pettee, L. Z. M., M. H. A., H. B. G.)., (Copyright © 2024 American College of Chest Physicians. Published by Elsevier Inc. All rights reserved.)

Background: Endotracheal aspirates (ETAs) are widely used for microbiologic studies of the respiratory tract in intubated patients. However, they involve sampling through an established endotracheal tube using suction catheters, both of which can acquire biofilms that may confound results., Research Question: Does standard clinical ETA in intubated patients accurately reflect the authentic lower airway bacterial microbiome?, Study Design and Methods: Comprehensive quantitative bacterial profiling using 16S rRNA V1-V2 gene sequencing was applied to compare bacterial populations captured by standard clinical ETA vs contemporaneous gold standard samples acquired directly from the lower airways through a freshly placed sterile tracheostomy tube. The study included 13 patients undergoing percutaneous tracheostomy following prolonged (median, 15 days) intubation. Metrics of bacterial composition, diversity, and relative quantification were applied to samples., Results: Pre-tracheostomy ETAs closely resembled the gold standard immediate post-tracheostomy airway microbiomes in bacterial composition and community features of diversity and quantification. Endotracheal tube and suction catheter biofilms also resembled cognate ETA and fresh tracheostomy communities., Interpretation: Unbiased molecular profiling shows that standard clinical ETA sampling has good concordance with the authentic lower airway microbiome in intubated patients., Competing Interests: Financial/Nonfinancial Disclosures None declared., (Copyright © 2024 American College of Chest Physicians. Published by Elsevier Inc. All rights reserved.)

The present study investigates the rate of heat and mass transfer in MHD Williamson nanofluid flow over an exponentially porous stretching surface subject to the heat generation/absorption and mass suction. The analysis has been carried out for the two different conditions of heat transfer stated as prescribed exponential order surface temperature (PEST) and prescribed exponential order heat flux (PEHF). Moreover, an exterior magnetic field is applied with an inclined angle along the stretched surface. Mathematically, the existing flow problem has been configured in accordance with the fundamental laws of motion and heat transfer. The similarity transformations have been used to transform the governing equations into the nonlinear ordinary differential equations (ODEs). The numerical solution to the resulting nonlinear ODEs with the associated boundary conditions have been obtained with the utilization of bvp4c package in MATLAB. The behavior of the resulting equations of the problem is checked graphically under the influence of various flow parameters which ensures that the rate of heat transfer decreases with the increase of Brownian motion parameter as well as it increases with the increase of thermophoresis parameter. Moreover, the Sherwood number increases with the rising values of the Prandtl number and Lewis number.

The existing article explores the attributes of convection and Joule heating across a magnetohydrodynamics two-dimensional stagnation point flow of a nano liquid depending on the permeable curved stretching/shrinking surface and mass suction. Applying the non-dimensional variables, the basic model of partial differential equations (PDEs) is converted to the dimensionless ordinary differential equations (ODEs), which are solved through the bvp4c method (bult-in function in MATLAB). Multiple graphical results have been examined to observe the effect of diverse flow parameters against temperature, friction drag, velocity and heat transfer. From these results, it has been determined that the temperature profile escalates with the escalation of Hartmann, Eckert and Biot number, nanoparticles concentration and curvature parameter, although the velocity of fluid reduces with escalating values of nanoparticle concentration parameter, curvature parameter, and Hartmann number. It is equally important to indicate that the friction drag reduces with large curvature and rises with greater suction however the rate of heat transfer declines with least value of Eckert number and improves with strong suction, Hartmann, and Biot number.

The present work is an extension of a previous work published in Journal of Theoretical and Applied Mechanics (Chandrasekar and Kasiviswanathan, 2015). New results and analytical and asymptotic solutions are presented not found in the previous paper.

This paper assesses the changing guidelines regarding Aerosol Generating Procedures and fallow time in Oral and Maxillofacial Surgery Departments in the UK. Many departments have variable local policies and protocols and this could be a contributing factor in increased waiting lists for patients during a time when patients have less access to primary and secondary care.

The steady laminar boundary layer flow over a stationary plate (Blasius flow) or in a moving plate (Sakiadis flow) with suction and in the presence of non-linear Rosseland radiation is investigated in this paper. When the suction varies in a special way the problem is similar whereas when the suction is constant the problem is non-similar. The results are obtained with the direct numerical solution of the governing equations. The problem is governed by Prandtl number, temperature parameter, radiation parameter and suction parameter and the influence of these parameters on the results are presented in tables and figures. It was found that two asymptotic states exist both in the similar and non-similar problem. The asymptotic temperature field in the similar problem has been calculated numerically whereas for the asymptotic temperature field in the non-similar problem analytical solutions have been found.

To understand the shear strength properties for unsaturated soil with different matric suction values, a modified triaxial test device was used. The matric suction is considered an important contributor to unsaturated shear strength properties. In this research, the modified triaxial testing machine is used to control the matric suction and to avoid the turbulence and bubbles during test, which keep the matric suction in positive value. The range of the matric suction used is from (0–100) kPa and the it was applied by increments of (10) kPa in each time. It was concluded that the relationship between the shear strength and the matric suction is divided into two parts, the first part is linear and the second is non-linear. The point between the two parts represents a point of reversal stress the two parts which is also considered as the peak stress point. The matric suction increases the soil elasticity, and all the stress variables also increase the angle of the internal friction between the soil particles. The maximum shear stress occurs at a larger matric suction with increase of confining pressure.

Purpose: Comparing the midterm clinical outcome of surgical treatment versus ultrasound guided needle aspiration of the calcific deposits (NACD) treatment for conservative therapy resistant calcifying tendinitis (CT) of the shoulder. The hypothesis is that both surgical treatment and NACD treatment led to a comparable good clinical outcome., Methods: A comparative cohort study was performed (n = 76). The allocation to surgical group (n = 35) or NACD group (n = 41) was the result of a shared decision-making strategy. Primary outcome was decrease in VAS for pain (pVAS). Secondary outcomes were EQ-5D index, DASH score, ASES, VAS for satisfaction, recommendation of treatment, adverse events, cross-over between groups, additional treatments, and symptomatology after care as usual., Results: At midterm follow-up (5.5 years, SD 0.5 years) decrease in pVAS did not differ (p = 0.20) between two groups (60.6 mm, SD 23.3 mm vs 53.4 mm, SD 24.2 mm). Secondary clinical outcomes were also comparable. In 68.3% surgical treatment was avoided. At final follow-up none of the outcome scores differed significantly between the crossed-over patients (n = 13, 31.7%) and the initial surgical group., Discussion: At midterm follow-up surgical and NACD treatment result in comparable clinical outcomes. In 68.3% a surgical treatment could be avoided. In 31.7% the patient eventually needed a surgical treatment after failed NACD treatment. After midterm follow-up these patients showed comparable good clinical outcomes. In our opinion, both NACD and surgical treatment could be considered as a next step treatment option for conservative therapy resistant CT of the shoulder. Though, one should be aware that after a midterm follow-up a high number of patients cross-over to surgical treatment after a NACD treatment., (Copyright © 2023 The Japanese Orthopaedic Association. Published by Elsevier B.V. All rights reserved.)

An analysis has carried out to study effect of Soret number on MHD free convection flow of heat and mass transfer of an electrically conducting non-Newtonian fluid through a vertical moving porous plate. Set of governing non linear coupled differential equations are converted to a non dimensional set of partial differential equations by introducing the suitable variables. Galerkin finite element technique is applied on non dimensional velocity, temperature and concentration profiles to get numerical solutions. The effect of physical quantities chemical reaction, dufour, other flow parameters on profiles of velocity, temperature and concentration are illustrated through graphs.

In this article, the influence of chemical reaction and heat transfer analysis of Maxwell saturated Ferro-fluid flow over a stretching sheet under the influence of magnetic dipole with Soret and suction effects are investigated. The sheet is assumed to be permeable in a semi-infinite domain. Firstly, partial differential equations of mass, momentum and concentration for the governing flow problem are modelled and converted into a system of differential equations by utilizing similarity approach. Then the solution of resulting non-linear differential equations is solved by efficient Runge-Kutta technique based on shooting algorithm with the help of MATLAB. Effect of all appropriate parameters like ferromagnetic interaction parameter, chemical reaction parameter, Maxwell parameter, Soret number, suction parameter, Maxwell parameter, Schmidt number, and suction parameter on velocity, temperature and concentration field are confirmed through graphs and table. From the present conclusions, it is examined that by increasing the Maxwell parameter there is a decrease in the fluid velocity and boundary layer thickness. On the other hand, the uprising behaviour is prominent for both temperature and concentration profiles. Also predicted that there is an enhancement in skin friction coefficient and rate of heat transfer by enlarging suction parameter, but opposite trend is noted for Sherwood number. Also noted that the values of Prandtl are taken ranges from 0.72 to 10. The Nusselt number increases from 1.09 to 4.80.

Purpose: The HeartMate 3 (HM3) left ventricular assist device (LVAD) has demonstrated excellent clinical outcomes; however, pump speed optimization is challenging with the available HM3 monitoring. Therefore, this study reports on clinical HM3 parameters collected with a noninvasive HM3 monitoring system (HM3 Snoopy) during echocardiographic speed ramp tests and Valsalva maneuvers., Methods: In this prospective, single-center study, the HM3 data communication between the controller and pump was recorded with a novel data acquisition system. Twelve pump parameters sampled every second (1 Hz) and clinical assessments (echocardiography, electrocardiogram (ECG), and blood pressure measurement) during speed ramp tests were analyzed using Pearson's correlation (r, median [IQR]). The cause for the occurrence of pulsatility index (PI)-events during ramp speed tests and valsalva maneuvers was investigated., Results: In 24 patients (age: 58.9 ± 8.8 years, body mass index: 28.1 ± 5.1 kg/m 2 , female: 20.8%), 35 speed ramp tests were performed with speed changes in the range of ±1000 rpm from a baseline speed of 5443 ± 244 rpm. Eight HM3 pump parameters from estimated flow, motor current, and LVAD speed together with blood pressure showed positive collinearities (r = 0.9 [0.1]). Negative collinearities were observed for pump flow pulsatility, pulsatility index, rotor noise, and left ventricular diameters (r = -0.8 [0.1]), whereas rotor displacement and heartrate showed absence of collinearities (r = -0.1 [0.08])., Conclusions: In this study, the HM3 Snoopy was successfully used to acquire more parameters from the HM3 at a higher sampling rate. Analysis of HM3 per-second data provide additional clinical diagnostic information on heart-pump interactions and cause of PI-events., (Copyright © 2023 The Authors. Published by Elsevier Inc. All rights reserved.)

Background: Airway management is a defining skill that demands mastery by emergency physicians. Airway emergencies pose considerable morbidity and mortality risks. Familiarity with, and mastery of, a variety of airway management approaches and equipment can prove invaluable for management of anatomically and physiologically difficult airways., Case Report: A 67-year-old woman presented to a level II trauma after a motor vehicle collision. Emergency medical services reported left-sided injuries, including diminished breath sounds. She arrived in extremis with dyspnea and hypoxia refractory to supplemental oxygen. A portable chest x-ray study showed a considerable traumatic diaphragmatic hernia. Initial attempts at intubation via video laryngoscopy were unsuccessful. Difficulties were attributed to anatomic variation, possibly due to the traumatic diaphragmatic hernia, and hematemesis. The airway was repositioned after removal of a cervical collar and suction-assisted laryngoscopy airway decontamination was performed under video guidance. During airway decontamination, the tip of a DuCanto suction catheter (SSCOR) became located at the level of the vocal cords, prompting the decision to control the airway via utilization of the DuCanto suction catheter and a bougie. The suction tubing was disconnected, a bougie was inserted through the catheter, and the DuCanto was subsequently removed and replaced with a cuffed endotracheal tube. WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE OF THIS?: Airway emergencies are imminent life threats. Familiarity with a variety of tools and techniques allows for definitive airway management via primary, back-up, and contingency plans to secure anatomically or physiologically difficult airway., Competing Interests: Declaration of competing interest None., (Copyright © 2023 Elsevier Inc. All rights reserved.)