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Cardiovascular disease often occurs with silent and gradual alterations of cardiac blood flow that can lead to the onset of chronic pathological conditions. Image-based patient-specific Computational Fluid Dynamics (CFD) models allow for an extensive quantification of the flow field beyond the direct capabilities of medical imaging techniques that could support the clinicians in the early diagnosis, follow-up, and treatment planning of patients. Nonetheless, the large and impulsive kinematics of the left ventricle (LV) and the mitral valve (MV) pose relevant modeling challenges. Arbitrary Lagrangian-Eulerian (ALE) based computational fluid dynamics (CFD) methods struggle with the complex 3D mesh handling of rapidly moving valve leaflets within the left ventricle (LV). We, therefore, developed a Chimera-based (overset meshing) method to build a patient-specific 3D CFD model of the beating LV which includes a patient-inspired kinematic model of the mitral valve (LVMV). Simulations were performed with and without torsion. In addition, to evaluate how the intracardiac LV flow is impacted by the MV leaflet kinematics, a third version of the model without the MV was generated (LV with torsion). For all model versions, six cardiac cycles were simulated. All simulations demonstrated cycle-to-cycle variations that persisted after six cycles but were albeit marginal in terms of the magnitude of standard deviation of velocity and vorticity which may be related to the dissipative nature of the numerical scheme used. The MV was found to have a crucial role in the development of the intraventricular flow by enhancing the direct flow, the apical washout, and the propagation of the inlet jet towards the apical region. Consequently, the MV is an essential feature in the patient-specific CFD modeling of the LV. The impact of torsion was marginal on velocity, vorticity, wall shear stress, and energy loss, whereas it resulted to be significant in the evaluation of particle residence times. Therefore, including torsion could be considered in patient-specific CFD models of the LV, particularly when aiming to study stasis and residence time. We conclude that, despite some technical limitations encountered, the Chimera technique is a promising alternative for ALE methods for 3D CFD models of the heart that include the motion of valve leaflets., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (© 2022 Canè, Delcour, Luigi Redaelli, Segers and Degroote.)

Aim: To investigate potential changes in mirror movements after Hand and Arm Bimanual Intensive Therapy Including Lower Extremity (HABIT-ILE) training in children with unilateral cerebral palsy (CP)., Method: Thirty-one children with unilateral CP (mean age 9 years 4 months, SD 4 years 3 months; range 5 years 4 months-17 years 3 months; 14 females, 17 males) were randomized to either a control or treatment group. After allocation, children were assessed three times: before (T1, baseline) and after (T2) a 2-week interval and again at 3 months after T1 (T3) as follow-up. Between T1 and T2, the treatment group received 90 hours of HABIT-ILE training, while the control group continued their customary treatment. Mirror movements were assessed in all children using the Woods and Teuber Scale, as well as the Assisting Hand Assessment, Pediatric Evaluation of Disability Inventory, and Canadian Occupational Performance Measure., Results: Repeated measures analysis of variance indicated a significant decrease in mirror movements in the more-affected (mean difference = 0.97; 95% confidence interval [CI] = 0.51-1.42; p < 0.001) and less-affected (mean difference = 0.71; 95% CI = 0.37-1.0; p < 0.001) hands of children after HABIT-ILE; these improvements were maintained at the 3-month follow-up. Moreover, the mirror movement changes observed at the second assessment (T2) were inversely correlated with changes in the assessment of activities of daily living, especially in the less-affected hand., Interpretation: HABIT-ILE decreased the intensity of mirror movements in a group of children with CP. Furthermore, mirror movement changes were associated with bimanual performance and activities of daily living in these children., What This Paper Adds: The intensity of mirror movements decreased in both hands after 2 weeks of Hand and Arm Bimanual Intensive Therapy Including Lower Extremity (HABIT-ILE) training. Mirror movement changes were maintained at the 3-month follow-up after HABIT-ILE. Mirror movement changes were associated with improvements in bimanual performance and activities of daily living., (© 2022 Mac Keith Press.)

Introduction: Over the last few years, it has been demonstrated that a moist environment enhances the healing process and reduces scar formation of wounds. Such moist conditions can be created and maintained using hydrogels. The aim of this study was to evaluate wound healing, cooling efficacy, local tolerability, and cosmetic appearance of abrasive wounds treated with BepanGel wound care hydrogel., Methods: This study was designed as a within-person, single-center, randomized, investigator-blind clinical investigation comparing a hydrogel-treated test field with an untreated test field in an abrasive wound model. In 33 subjects, two small superficial wounds were induced on the non-dominant forearms. Wounds were treated with BepanGel and covered with a standard semi-occlusive wound plaster or covered with a plaster alone for 11 consecutive days. Wound healing efficacy, cooling effect, and tolerability of the treatment were assessed over 12 investigational days. During follow-up at day 31, the cosmetic appearance of the wounds was evaluated., Results: On day 12, the test field treated with BepanGel was completely healed in nearly all subjects (97.0%) in contrast with the test field treated with a plaster alone (18.2%, AUC days 2-12 p < 0.0001) as assessed by a blinded investigator. Two-thirds of the unblinded subjects indicated an immediate cooling effect of the hydrogel (p = 0.0555). At the end of the investigation, the cosmetic appearance of the BepanGel-treated test fields scored superior to the fields treated with a plaster alone as evaluated by a blinded investigator (p = 0.0005) and the unblinded subjects (p = 0.0078). The hydrogel was generally well tolerated and no signs of infection or adverse events (AEs) related to the treatment were observed., Conclusion: This evaluation shows that treatment of superficial cutaneous wounds with BepanGel results in improved wound healing as demonstrated by faster wound closure and a considerably better cosmetic appearance, while providing immediate cooling., Trial Registration Number: EUDAMED-No.: CIV-19-09-029744.