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Abstract Background Thrombolysis is a dynamic and time-dependent process influenced by the haemodynamic conditions. Currently there is no model that allows for time-continuous, non-contact measurements under physiological flow conditions. The aim of this work was to introduce such a model. Methods The model is based on a computer-controlled pump providing variable constant or pulsatile flows in a tube system filled with blood substitute. Clots can be fixed in a custom-built clot carrier within the tube system. The pressure decline at the clot carrier is measured as a novel way to measure lysis of the clot. With different experiments the hydrodynamic properties and reliability of the model were analyzed. Finally, the lysis rate of clots generated from human platelet rich plasma (PRP) was measured during a one hour combined application of diagnostic ultrasound (2 MHz, 0.179 W/cm2) and a thrombolytic agent (rt-PA) as it is commonly used for clinical sonothrombolysis treatments. Results All hydrodynamic parameters can be adjusted and measured with high accuracy. First experiments with sonothrombolysis demonstrated the feasibility of the model despite low lysis rates. Conclusions The model allows to adjust accurately all hydrodynamic parameters affecting thrombolysis under physiological flow conditions and for non-contact, time-continuous measurements. Low lysis rates of first sonothrombolysis experiments are primarily attributable to the high stability of the used PRP-clots.

Competing Interests: Interessenkonflikt M. Ohlrich, M. Carstens, J.P. Goltz und J. Schaumberg geben an, dass kein Interessenkonflikt besteht.

Background: Thrombus histology has become a potential diagnostic tool for the etiology assessment of patients with ischemic stroke caused by embolic proximal vessel occlusion. We validated a classification rule that differentiates between cardiac and arteriosclerotic emboli in individual stroke patients. We aim to describe in detail the development of this classification rule and disclose its reliability., Methods: The classification rule is based on the hypothesis that cardiac emboli arise out of separation thrombi and arteriosclerotic emboli result from agglutinative thrombi. 125 emboli recovered by thrombectomy from stroke patients and 11 thrombi serving as references for cardiac (n = 5) and arteriosclerotic emboli (n = 6) were Hematoxylin and eosin, Elastica-van Gieson and CD61 stained and rated independently by two histopathologists blinded to the presumed etiology by several pre-defined criteria. Intra- and interobserver reliabilities of all criteria were determined. Out of the different criteria, three criteria with the most satisfactory reliability values were selected to compose the classification rule that was finally adjusted to the reference thrombi. Reliabilities of the classification rule were calculated by using the emboli of stroke patients., Results: The classification rule reached intraobserver reliabilities for the two raters of 92.9% and 68.2%, respectively. Interobserver reliability was 69.9%., Conclusions: A new classification rule for emboli obtained from thrombectomy was established. Within the limitations of histological investigations, it is reliable and able to distinguish between cardioembolic and arteriosclerotic emboli., (© 2021. The Author(s).)

Endovascular treatment of strokes caused by large vessel occlusion enables the histopathological investigation of the retrieved embolus, possibly providing a novel opportunity to contribute to the diagnostic workup of etiology and to define secondary prevention measures in strokes with uncertain genesis. We aimed to develop a classification rule based on pathophysiological considerations and adjustment to reference thrombi for distinction between cardiac and arteriosclerotic emboli and to validate this classification rule on a patient cohort. From 125 patients with stroke due to large vessel occlusion and thrombectomy, 82 patients with known etiology (55 cardioembolic and 27 arterioembolic strokes) were included. The corresponding emboli were histologically evaluated by two raters blinded to the etiology of stroke by means of a novel classification rule. Presumed etiology and classification results were compared. Agreement concerning cardiac emboli was 72.2% (95% CI: 58.4-83.5) for rater I and 78.2% (95% CI: 65.0-88.2) for rater II. Agreement concerning arteriosclerotic emboli was 70.4% (95% CI: 49.8-86.3) for rater I and 74.1% (95% CI: 53.7-88.9) for rater II. Overall agreement reached 71.6% (95% CI: 60.5-81.1) for rater I and 76.8% (95% CI: 66.2-85.4) for rater II. Within the limits of generally restricted accuracy of histological evaluations, the classification rule differentiates between cardiac and arteriosclerotic emboli of acute ischemic stroke patients. Further improvement is needed to provide valuable complementary data for stroke etiology workup.

Spin crossover materials are bi-stable systems with potential applications as molecular scale electronic switches, actuators, thermometers, barometers, and displays. However, calculating the enthalpy difference, ΔH, between the high spin and low spin states has been plagued with difficulties. For example, many common density functional theory (DFT) methods fail to even predict the correct sign of ΔH, which determines the low temperature state. Here, we study a collection of Fe(II) and Fe(III) materials, where ΔH has been measured, which has previously been used to benchmark density functionals. The best performing hybrid functional, TPSSh, achieves a mean absolute error compared to experiment of 11 kJ mol -1 for this set of materials. However, hybrid functionals scale badly in the solid state; therefore, local functionals are preferable for studying crystalline materials, where the most interesting spin crossover phenomena occur. We show that both the Liechtenstein and Dudarev DFT+U methods are a little more accurate than TPSSh. The Dudarev method yields a mean absolute error of 8 kJ mol -1 for U eff = 1.6 eV. However, the mean absolute error for both TPSSh and DFT+U is dominated by a single material, for which the two theoretical methods predict similar enthalpy differences-if this is excluded from the set, then DFT+U achieves chemical accuracy. Thus, DFT+U is an attractive option for calculating the properties of spin crossover crystals, as its accuracy is comparable to that of meta-hybrid functionals, but at a much lower computational cost.

The aim of the study described here was to evaluate the thrombolytic efficacy of combined treatment with the fibrin-selective plasminogen activator desmoteplase (DSPA) and therapeutic ultrasound (sonothrombolysis [STL]) compared with conventional rt-PA (recombinant tissue plasminogen activator) treatment in vitro. Lysis rates were determined by the weight loss of platelet-rich plasma (PRP) clots treated with rt-PA (60 kU/mL) or DSPA (2 μg/mL) combined with pulsed wave ultrasound (2 MHz, 0.179 W/cm(2)). To reveal the individual effects of medication and ultrasound, lysis rates were also determined for DSPA monotherapy and for combined treatment with rt-PA and ultrasound. Clots solely placed in plasma served as the control group. Lysis increased significantly with rt-PA (26.5 ± 7.8%) and DSPA (30.5 ± 6%) compared with the control group (18.2 ± 5.9%) (each p < 0.001). DSPA lysis was more effective than rt-PA lysis (without STL: p = 0.015, with STL: p = 0.01). Combined treatment with DSPA and 2-MHz STL significantly exceeded rt-PA lysis (32.8% vs. 26.5%, p < 0.001)., (Copyright © 2015 World Federation for Ultrasound in Medicine & Biology. Published by Elsevier Inc. All rights reserved.)

Background: Agreement about the most suitable clot formation protocol for sonothrombolysis investigations is lacking. Lysis rates vary strongly owing to different test conditions and, thus, cannot be compared. We aim to establish a simple but physiologically grounded protocol for in vitro coagulation to enable standardized sonothrombolysis investigations., Method: Clots were generated from platelet-rich plasma (PRP) obtained by centrifugation (10 min, 180 × g) of human venous blood (VB). PRP was mixed with the boundary layer formed between the supernatant and the erythrocyte layer. To achieve clots with different platelet counts, PRP was gradually substituted with platelet-free plasma (PFP), harvested from the supernatant of VB after centrifugation (10 min, 2570 × g). Clot types were examined for histological appearance, hydrodynamic resistance under physiological flows, and lysis rate measured by weight loss after a 2-h treatment with recombinant tissue plasminogen activator (rt-PA) (60 kU/ml). Lysis rates of the most suitable clot were measured after a 1-h treatment with rt-PA (60 kU/ml), and combined treatment with rt-PA and 2-MHz transcranial color-coded sonography (TCCS) (0.179 W/cm(2)) or 2-MHz transcranial Doppler (TCD) (0.457 W/cm(2))., Results: With increased platelet count, the hydrodynamic resistance of the artificial clots increased, their histological appearance became more physiological, and lysis rates decreased. The most suitable clots consisted of 1.5-ml PRP, 2.0-ml PFP, and 0.5-ml boundary layer. Their lysis rates were 36.7 ± 7.8% (rt-PA), 40.8 ± 8.6% (rt-PA+TCCS), and 40.4 ± 8.3% (rt-PA+TCD)., Comparison With Existing Methods: These systemic investigations were conducted for the first time., Conclusion: This protocol should be used for standardized sonothrombolysis investigations., (Copyright © 2014 Elsevier B.V. All rights reserved.)

Plates reinforced by ribs or joists are common elements in lightweight building structures, as well as in other engineering structures such as vehicles, ships, and aircraft. These structures, however, are often not well suited for simple structural acoustic prediction models such as statistical energy analysis. One reason is that the modal density is not uniformly distributed due to the spatial periodicity introduced by the ribs. This phenomenon is investigated in the present paper, using a modal model of a ribbed plate. The modal model uses the Fourier sine modes, and the coupling between the plate and ribs is incorporated using Hamilton's principle. This model is then used to investigate the modal density of the considered spatially periodic structure, and a grouping of the modes in different dominating directions is proposed. Suggestions are also given regarding how to proceed towards a simplified prediction model for ribbed plates.

No agreement exists about which protocol for in-vitro clot formation is suitable for sonothrombolysis investigations. Lysis rates vary considerably because of different clotting processes and cannot be compared. We aim to establish a new protocol for in-vitro coagulation to permit standardized sonothrombolysis investigations. The proposed procedure is based upon clots prepared from platelet-rich plasma (PRP). This clot material (group A) was compared with the two most commonly used procedures, namely, recalcification of citrate-anticoagulated whole venous blood (group B) and spontaneous clotting of nonanticoagulated venous blood (group C). Histological examinations were performed and clot stability was tested under physiological flow conditions in vitro for all groups (each n = 10). Lysis rates measured by mass loss were compared using buffered plasma and recombinant tissue plasminogen activator (60 kU/ml), or buffered plasma alone. PRP clots displayed a high degree of similarity to emboli specimens in histological examinations and remained stable under pulsatile flow conditions. B and C clots were mechanically unstable and did not resist physiological flow and pressure. Measuring the lysis rate by weighing seems to be inaccurate, with lowest variability in PRP clots. PRP clots appeared more resistant to lysis. PRP clots should be used for standardized sonothrombolysis investigations.

Background: Thrombolysis is a dynamic and time-dependent process influenced by the haemodynamic conditions. Currently there is no model that allows for time-continuous, non-contact measurements under physiological flow conditions. The aim of this work was to introduce such a model., Methods: The model is based on a computer-controlled pump providing variable constant or pulsatile flows in a tube system filled with blood substitute. Clots can be fixed in a custom-built clot carrier within the tube system. The pressure decline at the clot carrier is measured as a novel way to measure lysis of the clot. With different experiments the hydrodynamic properties and reliability of the model were analyzed. Finally, the lysis rate of clots generated from human platelet rich plasma (PRP) was measured during a one hour combined application of diagnostic ultrasound (2 MHz, 0.179 W/cm2) and a thrombolytic agent (rt-PA) as it is commonly used for clinical sonothrombolysis treatments., Results: All hydrodynamic parameters can be adjusted and measured with high accuracy. First experiments with sonothrombolysis demonstrated the feasibility of the model despite low lysis rates., Conclusions: The model allows to adjust accurately all hydrodynamic parameters affecting thrombolysis under physiological flow conditions and for non-contact, time-continuous measurements. Low lysis rates of first sonothrombolysis experiments are primarily attributable to the high stability of the used PRP-clots.

Plates stiffened with ribs can be modeled as equivalent homogeneous isotropic or orthotropic plates. Modeling such an equivalent smeared plate numerically, say, with the finite element method requires far less computer resources than modeling the complete stiffened plate. This may be important when a number of stiffened plates are combined in a complicated assembly composed of many plate panels. However, whereas the equivalent smeared plate technique is well established and recently improved for flat panels, there is no similar established technique for doubly curved stiffened shells. In this paper the improved smeared plate technique is combined with the equation of motion for a doubly curved thin rectangular shell, and a solution is offered for using the smearing technique for stiffened shell structures. The developed prediction technique is validated by comparing natural frequencies and mode shapes as well as forced responses from simulations based on the smeared theory with results from experiments with a doubly curved cross-stiffened shell. Moreover, natural frequencies of cross-stiffened panels determined by finite element simulations that include the exact cross-sectional geometries of panels with cross-stiffeners are compared with predictions based on the smeared theory for a range of different panel curvatures. Good agreement is found.

Many complicated systems of practical interest consist basically of a well-defined outer shell-like master structure and a complicated internal structure with uncertain dynamic properties. Using the "fuzzy structure theory" for predicting audible frequency vibration, the internal structure is considered as one or more fuzzy substructures that are known in some statistical sense only. Experiments have shown that such fuzzy substructures often introduce a damping in the master which is much higher than the structural losses account for. A special method for modeling fuzzy substructures with a one-dimensional continuous boundary was examined in a companion paper [L. Friis and M. Ohlrich, "Vibration modeling of structural fuzzy with continuous boundary," J. Acoust. Soc. Am. 123, 718-728 (2008)]. In the present paper, this method is extended, such that it allows modeling of fuzzy substructures with a two-dimensional continuous boundary. Additionally, a simple method for determining the so-called equivalent coupling factor is presented. The validity of this method is demonstrated by numerical simulations of the vibration response of a master plate structure with fuzzy attachments. It is revealed that the method performs very well above a nondimensional frequency of 500 of the master, and it is shown that errors below this frequency are caused mainly by simplifying assumptions concerning the shape of the master vibration displacement.

From experiments it is well known that the vibration response of a main structure with many attached substructures often shows more damping than structural losses in the components can account for. In practice, these substructures, which are not attached in an entirely rigid manner, behave like a multitude of different sprung masses each strongly resisting any motion of the main structure (master) at their base antiresonance. The "theory of structural fuzzy" is intended for modeling such high damping. In the present article the theory of fuzzy structures is briefly outlined and a method of modeling fuzzy substructures examined. This is done by new derivations and physical interpretations are provided. Further, the method is extended and simplified by introducing a simple deterministic approach to determine the boundary impedance of the structural fuzzy. By using this new approach, the damping effect of the fuzzy with spatial memory is demonstrated by numerical simulations of a main beam structure with fuzzy attachments. It is shown that the introduction of spatial memory reduces the damping effect of the fuzzy and in certain cases the damping effect may even be eliminated completely.