1
|
Ramella A, Lissoni V, Bridio S, Rodriguez Matas JF, Trimarchi S, Grossi B, Stefanini GG, Migliavacca F, Luraghi G. On the necessity to include arterial pre-stress in patient-specific simulations of minimally invasive procedures. Biomech Model Mechanobiol 2024; 23:525-537. [PMID: 38063955 DOI: 10.1007/s10237-023-01789-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Accepted: 10/27/2023] [Indexed: 03/26/2024]
Abstract
Transcatheter aortic valve implantation (TAVI) and thoracic endovascular aortic repair (TEVAR) are minimally invasive procedures for treating aortic valves and diseases. Finite element simulations have proven to be valuable tools in predicting device-related complications. In the literature, the inclusion of aortic pre-stress has not been widely investigated. It plays a crucial role in determining the biomechanical response of the vessel and the device-tissue interaction. This study aims at demonstrating how and when to include the aortic pre-stress in patient-specific TAVI and TEVAR simulations. A percutaneous aortic valve and a stent-graft were implanted in aortic models reconstructed from patient-specific CT scans. Two scenarios for each patient were compared, i.e., including and neglecting the wall pre-stress. The neglection of pre-stress underestimates the contact pressure of 48% and 55%, the aorta stresses of 162% and 157%, the aorta strains of 77% and 21% for TAVI and TEVAR models, respectively. The stent stresses are higher than 48% with the pre-stressed aorta in TAVI simulations; while, similar results are obtained in TEVAR cases. The distance between the device and the aorta is similar with and without pre-stress. The inclusion of the aortic wall pre-stress has the capability to give a better representation of the biomechanical behavior of the arterial tissues and the implanted device. It is suggested to include this effect in patient-specific simulations replicating the procedures.
Collapse
Affiliation(s)
- Anna Ramella
- Computational Biomechanics Laboratory - LaBS, Department of Chemistry, Materials and Chemical Engineering 'Giulio Natta', Politecnico di Milano, Piazza L. da Vinci 32, 20133, Milan, Italy
| | - Vittorio Lissoni
- Computational Biomechanics Laboratory - LaBS, Department of Chemistry, Materials and Chemical Engineering 'Giulio Natta', Politecnico di Milano, Piazza L. da Vinci 32, 20133, Milan, Italy
| | - Sara Bridio
- Computational Biomechanics Laboratory - LaBS, Department of Chemistry, Materials and Chemical Engineering 'Giulio Natta', Politecnico di Milano, Piazza L. da Vinci 32, 20133, Milan, Italy
| | - Jose Felix Rodriguez Matas
- Computational Biomechanics Laboratory - LaBS, Department of Chemistry, Materials and Chemical Engineering 'Giulio Natta', Politecnico di Milano, Piazza L. da Vinci 32, 20133, Milan, Italy
| | - Santi Trimarchi
- Section of Vascular Surgery, Cardio Thoracic Vascular Department, Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, Via Francesco Sforza 35, Milan, Italy
- Department of Clinical Sciences and Community Health, University of Milan, Via Della Commenda 19, 20122, Milan, Italy
| | - Benedetta Grossi
- Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, 20072, Pieve Emanuele, Milan, Italy
| | - Giulio G Stefanini
- Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, 20072, Pieve Emanuele, Milan, Italy
- IRCCS Humanitas Research Hospital, Via Alessandro Manzoni 56, 20089, Rozzano, Milan, Italy
| | - Francesco Migliavacca
- Computational Biomechanics Laboratory - LaBS, Department of Chemistry, Materials and Chemical Engineering 'Giulio Natta', Politecnico di Milano, Piazza L. da Vinci 32, 20133, Milan, Italy
| | - Giulia Luraghi
- Computational Biomechanics Laboratory - LaBS, Department of Chemistry, Materials and Chemical Engineering 'Giulio Natta', Politecnico di Milano, Piazza L. da Vinci 32, 20133, Milan, Italy.
| |
Collapse
|
2
|
Ashktorab H, Oskrochi G, Challa SR, Chirumamilla LG, Saroya S, Dusmatova S, Shayegh N, Nair V, Senthilvelan K, Byer D, Morrison N, Grossi B, Barclay A, Smith T, Watson K, Rashid M, Rashid R, Deverapalli M, Latella G, Carethers JM, Youssef A, Brim H. Age, Gender, and Liver Enzyme Impact Hospital Stay in COVID-19 Minority Patient with Cancer in the USA: Does Race Matters in the Pandemic? Ann Clin Med Case Rep 2024; 13:7. [PMID: 38633403 PMCID: PMC11022387] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Subscribe] [Scholar Register] [Indexed: 04/19/2024]
Abstract
Patients with cancer are known to have a poor prognosis when infected with SARS-CoV-2 infection. We aimed in this study to assess health outcomes in COVID-19 patients with different cancers in comparison to non-cancer COVID-19 patients from different centers in the United States (US). We evaluated medical records of 1,943 COVID-19 Cancer patients from 3 hospitals admitted between December 2019 to October 2021 and compared them with non-cancer COVID-19 patients. Among 1,943 hospitalized COVID-19 patients, 18.7% (n=364) have an active or previous history of cancer. Among these 364 cancer patients, 222 were African Americans (61.7%) and 121 were Caucasians (33.2%). Cancer patients had significantly longer hospitalization compared to controls (8.24 vs 6.7 days). Overall, Lung cancer is associated with high mortality. Patients with a previous history of cancer were more prone to death (p=0.04) than active cancer patients. In univariate and multivariate analyses, predictors of death among cancer patients were male sex, older age, presence of dyspnea, elevated troponin, elevated AST (0.001) and ALT (0.05), low albumin (p=0.04) and mechanical ventilation (p=0.001). Patients with a previous history of cancer were more prone to death when compared to active cancer COVID-19 patients. Early recognition of cancer COVID-19 patients' death-associated risk factors can help determine appropriate treatment and management plans for better prognosis and outcome.
Collapse
Affiliation(s)
- H Ashktorab
- Department of Medicine, GI Division, Cancer Center, Howard University Hospital, Washington DC, USA
| | - G Oskrochi
- College of Engineering and Technology, American University of the Middle East, Kuwait
| | - S R Challa
- Department of Medicine, GI Division, Cancer Center, Howard University Hospital, Washington DC, USA
| | - L G Chirumamilla
- Department of Medicine, GI Division, Cancer Center, Howard University Hospital, Washington DC, USA
| | - S Saroya
- Department of Medicine, GI Division, Cancer Center, Howard University Hospital, Washington DC, USA
| | - S Dusmatova
- Department of Medicine, GI Division, Cancer Center, Howard University Hospital, Washington DC, USA
| | - N Shayegh
- Department of Medicine, GI Division, Cancer Center, Howard University Hospital, Washington DC, USA
| | - V Nair
- Department of Medicine, GI Division, Cancer Center, Howard University Hospital, Washington DC, USA
| | - K Senthilvelan
- Department of Medicine, GI Division, Cancer Center, Howard University Hospital, Washington DC, USA
| | - D Byer
- Department of Medicine, GI Division, Cancer Center, Howard University Hospital, Washington DC, USA
| | - N Morrison
- Department of Medicine, GI Division, Cancer Center, Howard University Hospital, Washington DC, USA
| | - B Grossi
- Department of Medicine, GI Division, Cancer Center, Howard University Hospital, Washington DC, USA
| | - A Barclay
- Department of Medicine, GI Division, Cancer Center, Howard University Hospital, Washington DC, USA
| | - T Smith
- Department of Medicine, GI Division, Cancer Center, Howard University Hospital, Washington DC, USA
| | - K Watson
- Department of Medicine, GI Division, Cancer Center, Howard University Hospital, Washington DC, USA
| | - M Rashid
- Department of Medicine, GI Division, Cancer Center, Howard University Hospital, Washington DC, USA
| | - R Rashid
- Department of Medicine, GI Division, Cancer Center, Howard University Hospital, Washington DC, USA
| | - M Deverapalli
- Department of Medicine, GI Division, Cancer Center, Howard University Hospital, Washington DC, USA
| | - G Latella
- Gastroenterology Unit, Division of Gastroenterology, Hepatology, and Nutrition, Department of Life, Health and Environmental Sciences, University of L'Aquila, L'Aquila, Italy
| | - J M Carethers
- Division of Gastroenterology & Hepatology, Department of Medicine and Moores Cancer Center, UC San Diego, USA
| | - A Youssef
- Division of Gastroenterology and Hepatology, Department of Internal Medicine; Department of Human Genetics and Rogel Cancer Center, University of Michigan, Ann Arbor, MI, USA
| | - H Brim
- Department of Pathology and Cancer Center, Department of Biochemistry & Molecular Biology, Howard University College of Medicine, Washington DC, USA
| |
Collapse
|
4
|
Abstract
The extreme sexual size dimorphism in spiders has motivated studies for many years. In many species the male can be very small relative to the female. There are several hypotheses trying to explain this fact, most of them emphasizing the role of energy in determining spider size. The aim of this paper is to review the role of energy in sexual size dimorphism of spiders, even for those spiders that do not necessarily live in high foliage, using physical and allometric principles. Here we propose that the cost of transport or equivalently energy expenditure and the speed are traits under selection pressure in male spiders, favoring those of smaller size to reduce travel costs. The morphology of the spiders responds to these selective forces depending upon the lifestyle of the spiders. Climbing and bridging spiders must overcome the force of gravity. If bridging allows faster dispersal, small males would have a selective advantage by enjoying more mating opportunities. In wandering spiders with low population density and as a consequence few male-male interactions, high speed and low energy expenditure or cost of transport should be favored by natural selection. Pendulum mechanics show the advantages of long legs in spiders and their relationship with high speed, even in climbing and bridging spiders. Thus small size, compensated by long legs should be the expected morphology for a fast and mobile male spider.
Collapse
Affiliation(s)
- B Grossi
- Departamento de Ciencias Ecológicas, Facultad de Ciencias, Universidad de Chile, Santiago, Chile
| | | |
Collapse
|