Defect interactions in a two-dimensional sheared lamellar mesophase

The interaction between two edge dislocations in a sheared lyotropic lamellar liquid-crystalline medium is examined. The model is a mesoscale hydrodynamic model based on a free-energy functional that is minimised for a sinusoidal concentration modulation coupled with concentration and momentum equations. The defect dynamics are analysed as a function of the system size and the Ericksen number, the ratio of the shear stress and the characteristic free-energy density for deformation. Three different regimes are observed as the Ericksen number is increased when the edge dislocations are sheared towards each other, such that there is compression of layers between the defects: (a) defect motion that reduces the cross-stream separation till there is a steady spacing with plug flow between the defects, (b) defect attraction and cancellation resulting in a well-aligned state, and (c) defect creation due to a compressional instability between the defects resulting in an increase in the disorder. When the edge dislocations are sheared away from each other, such that there is extension of the layers between the defects, two distinct regimes are observed as the Ericksen number is increased: (a) bending of layers and a plug flow between the defects at their initial separation, and (b) buckling of the layers leading to creation of more defects and a dynamical steady state between defect creation and cancellation. These regimes are found to be robust for different values of the system size, from 32 to 128 layers, and for different values of the dimensionless groups that characterise the ratio of mass/momentum convection and diffusion.

The relationship between structure and rheology in a three-dimensional sheared lamellar mesophase

The evolution of a lamellar mesophase from an initially disordered state under shear is examined using simulations of a mesoscale model based on a concentration field ψ that distinguishes the hydrophilic and hydrophobic components. The Landau-Ginzburg free-energy functional is augmented by a term that is minimised for sinusoidal modulations in the concentration field with wavelength λ = (2π/k), and the dynamical equations are the model H equations. The structure and rheology are determined by the relative magnitudes of the diffusion time for coarsening, (λ²/D) and the inverse of the strain rate ^-1, and the Ericksen number, which is the ratio of the shear stress and the layer stiffness. When the diffusion time is small compared with the inverse of the strain rate, there is a local formation of misaligned layers, which are deformed by the imposed flow. There is near-perfect ordering with isolated defects at low values of the Ericksen number, but the defects result in a significant increase in viscosity due to the high layer stiffness. At high values of the Ericksen number, the concentration field is deformed by the mean shear before layers form via diffusion. Cylindrical structures aligned along the flow direction form after about 8-10 strain units, and these evolve into layers with disorder through diffusion perpendicular to the flow. The layers are not perfectly ordered, even after hundreds of strain units, due to the creation and destruction of defects via shear. The excess viscosity is low because the layer stiffness is small compared with the applied shear at a high Ericksen number. This study provides guidance on how the material parameters and imposed flow can be tailored to achieve the desired rheological behaviour.

A new approach for accurate determination of particle sizes in microfluidic impedance cytometry

In microfluidic impedance cytometry, the change in impedance is recorded as an individual cell passes through a channel between electrodes deposited on its walls, and the particle size is inferred from the amplitude of the impedance signal using calibration. However, because the current density is nonuniform between electrodes of finite width, there could be an error in the particle size measurement because of uncertainty about the location of the particle in the channel cross section. Here, a correlation is developed relating the particle size to the signal amplitude and the velocity of the particle through the channel. The latter is inferred from the time interval between the two extrema in the impedance curve as the particle passes through a channel with cross-sectional dimensions of 50 μm (width) × 30 μm (height) with two pairs of parallel facing electrodes. The change in impedance is predicted using 3D COMSOL finite-element simulations, and a theoretical correlation that is independent of particle size is formulated to correct the particle diameter for variations in the cross-sectional location. With this correlation, the standard deviation in the experimental data is reduced by a factor of two to close to the standard deviation reported in the manufacturer specifications.

Moving efficiently through a crowd: A nature-inspired traffic rule

In this article, we propose a traffic rule inspired from nature that instructs how a crowd made up of inert agents should respond to an elite agent to facilitate its motion through the crowd. When an object swims in a fluid medium or an intruder is forced through granular matter, characteristic flow fields are created around them. We show that if inert agents made small movements based on a traffic rule derived from these characteristic flow fields, then they efficiently reorganize and transport enough space for the elite to pass through. The traffic rule used in the article is a dipole field which satisfactorily captures the features of the flow fields around a moving intruder. We study the effectiveness of this dipole traffic rule using numerical simulations in a two-dimensional periodic domain, where one self-propelled elite agent tries to move through a crowd of inert agents that prefer to stay in a state of rest. Simulations are carried out for a wide range of strengths of the traffic rule and packing densities of the crowd. We characterize and analyze four regions in the parameter space-free-flow, motion due to cooperation and frozen and collective drift regions-and discuss the consequence of the traffic rule in light of the collective behavior observed. We believe that the proposed method can be of use in a swarm of robots working in constrained environments.

A cartridge based Point-of-Care device for complete blood count

We demonstrate a proprietary lab-on-chip/μ TAS technology platform for a regulatory grade portable instrument for complete blood count (CBC) hematology tests including 3 part differential WBCs, RBCs, platelet and hemoglobin for rapid diagnostics at the point of care in resource-poor settings. Presently, diagnostics based on blood tests are confined to centralized laboratory settings, dependent on large footprint and expensive cytometers or on a microscope, requiring trained laboratory technicians. Consequently, such facilities are not present in rural and semi-urban settings, where there are opportunities and challenges in delivering efficient healthcare infrastructure at an affordable cost in resource-challenged environments. Our proposed design leverages advances in microfluidics and lab-on-chip fabrication techniques to miniaturize the conventional cytometer and bring down the cost significantly. The device can be operated autonomously, without skilled manpower, by primary healthcare professionals in the field and by patients (like glucose self-test devices). The instrument consists of a single-use chip, the size of a credit card, pre-loaded with reagents, in which the sample is loaded, and which is fluidically insulated from the environment. The controller, the size of a toaster, performs the necessary fluid handling and the impedance measurements to deliver the results in minutes.

Effect of magnetic dipolar interactions and size dispersity on the origin of steady state magnetomechanical response in bidisperse Mn–Zn ferrite spherical particle based magnetorheological fluids

A mechanism for the excellent magneto-mechanical behaviour of bi-disperse spherical soft-ferrimagnetic Mn_0.7Zn_0.3Fe₂O₄ particle based magnetorheological fluids.

Magnetorheological fluids containing rod-shaped lithium-zinc ferrite particles: the steady-state shear response

We report the magnetic field and particle-concentration dependent steady-state shear-responses of rod shaped Li-Zn ferrite particle based magnetorheological fluids (MRFs). Rod-shaped soft ferrimagnetic Li-Zn ferrite (Li0.4Zn0.2Fe2.4O4) particles were synthesized using the combustion synthesis method. MRFs of three different particle-concentrations (φ = 0.1, 0.2 and 0.4, in weight fraction) were prepared using silicone oil. Their yield strength and dynamic viscosity were studied at different applied magnetic fields (B). With an increase in B and φ, the yield strength (τY) of the MRFs increases. This behaviour is assigned to the formation of stronger columnar structures of the magnetically interacting particles which resist the flow (shear) of the MRF. For the MRF with φ = 0.4 and B = 1.2 T, we observed a maximum τY value of ∼1.25 kPa. Furthermore, we observed that, based on the on-state to off-state viscosity ratio (ηon/ηoff) at a particular operating B value, the optimum particle concentration required for energy- and cost-efficient operation of the MRFs can be chosen. The absence of a stabilizing-agent or de-agglomerating-coating, the low density, and the excellent oxidation- and corrosion-resistance of the soft ferrimagnetic rod-shaped Li-Zn ferrite particles make this MRF-system highly versatile and economical for many magneto-mechanical applications.

Effect of particle stiffness on contact dynamics and rheology in a dense granular flow

Dense granular flows have been well described by the Bagnold rheology, even when the particles are in the multibody contact regime and the coordination number is greater than 1. This is surprising, because the Bagnold law should be applicable only in the instantaneous collision regime, where the time between collisions is much larger than the period of a collision. Here, the effect of particle stiffness on rheology is examined. It is found that there is a rheological threshold between a particle stiffness of 10^{4}-10^{5} for the linear contact model and 10^{5}-10^{6} for the Hertzian contact model above which Bagnold rheology (stress proportional to square of the strain rate) is valid and below which there is a power-law rheology, where all components of the stress and the granular temperature are proportional to a power of the strain rate that is less then 2. The system is in the multibody contact regime at the rheological threshold. However, the contact energy per particle is less than the kinetic energy per particle above the rheological threshold, and it becomes larger than the kinetic energy per particle below the rheological threshold. The distribution functions for the interparticle forces and contact energies are also analyzed. The distribution functions are invariant with height, but they do depend on the contact model. The contact energy distribution functions are well fitted by Gamma distributions. There is a transition in the shape of the distribution function as the particle stiffness is decreased from 10^{7} to 10^{6} for the linear model and 10^{8} to 10^{7} for the Hertzian model, when the contact number exceeds 1. Thus, the transition in the distribution function correlates to the contact regime threshold from the binary to multibody contact regime, and is clearly different from the rheological threshold. An order-disorder transition has recently been reported in dense granular flows. The Bagnold rheology applies for both the ordered and disordered states, even though the rheological constants differ by orders of magnitude. The effect of particle stiffness on the order-disorder transition is examined here. It is found that when the particle stiffness is above the rheological threshold, there is an order-disorder transition as the base roughness is increased. The order-disorder transition disappears after the crossover to the soft-particle regime when the particle stiffness is decreased below the rheological threshold, indicating that the transition is a hard-particle phenomenon.

Magnetic field dependent steady-state shear response of Fe3O4 micro-octahedron based magnetorheological fluids

The magneto-rheological behaviour of fluids containing soft-ferrimagnetic Fe₃O₄ micro-octahedrons (M = magnetization, τ_Y = dynamic yield-stress and H = applied-magnetic-field).

On The Origin of Shear Stress Induced Myogenesis Using PMMA Based Lab-on-Chip

One of the central themes in cell and tissue engineering is to develop an understanding as to how biophysical cues can influence cell functionality changes. The flow induced shear stress is regarded as one such biophysical cue to influence physiological changes in shear-sensitive tissues, in vivo. The origin of such phenomena is, however, poorly understood. While addressing such an issue, the present work demonstrates the intriguing synergistic effect of shear stress and spatial constraints in inducing aligned growth and differentiation of myoblast cells to myotubes. In a planned set of in vitro experiments, the regulation of laminar flow regime within a narrow window was obtained in a PMMA-based Lab-on-Chip (LOC) device, wherein the murine muscle cells (C2C12), chosen for their phenotypical differentiation stages, were cultured under graded shear conditions. The two factors of shear stress and spatial allowance were decoupled by another two sets of experiments. This aspect has been conclusively established using a PMMA device having a fixed width microchannel with varying shear and an identical amount of shear with different width of channels. On the basis of the extensive analysis of biochemical assays (WST-1, picogreen) together with gene expression using qRT-PCR and cell morphological changes (fluorescence/confocal microscopy), extensive differentiation of the myoblasts into myotubes is found to be dependent on both shear stress and spatial allocation with a maximum at an optimal shear of ca. 16 mPa. Quantitatively, the mRNA expression of myogenic biomarkers, i.e., myogenin, MyoD, and neogenin, exhibited 10- to 50-fold changes at ca. 16 mPa shear flow, compared to that under static conditions. Also, myotube aspect ratio and myotube density are modulated with shear stress and are in commensurate with gene expression changes. The flow cytometry analysis further confirmed that the cell cycle arrest at the G1/G0 phase triggers the onset of myogenesis. Taken together, the present study unambiguously establishes qualitative and quantitative biophysical basis for the origin of myogenesis toward the critical shear stress of murine myoblasts in a microfludic device, in vitro.

System size dependence of the structure and rheology in a sheared lamellar liquid crystalline medium

The structural and rheological evolution of an initially disordered lamellar phase system under a shear flow is examined using a mesoscale model based on a free energy functional for the concentration field, which is the scaled difference in the concentration between the hydrophilic and hydrophobic components. The dimensionless numbers which affect the shear evolution are the Reynolds number (γ˙¯L²/ν), the Schmidt number (ν/D), a dimensionless parameter Σ=(Aλ²/ρν²), a parameter μ_r which represents the viscosity contrast between the hydrophilic and hydrophobic components, and (L/λ), the ratio of system size and layer spacing. Here, ρ, ν, and D are the density, kinematic viscosity (ratio of viscosity and density), and the mass diffusivity, and A is the energy density in the free energy functional which is proportional to the compression modulus. Two distinct modes of structural evolution are observed for moderate values of the parameter Σ depending only on the combination ScΣ and independent of system size. For ScΣ less than about 10, the layers tend to form before they are deformed by the mean shear, and layered but misaligned domains are initially formed, and these are deformed and rotated by the flow. In this case, the excess viscosity (difference between the viscosity and that for an aligned state) does not decrease to zero even after 1000 strain units, but appears to plateau to a steady state value. For ScΣ greater than about 10, layers are deformed by the mean shear before they are fully formed, and a well aligned lamellar phase with edge dislocation orders completely due to the cancellation of dislocations. The excess viscosity scales as t^-1 in the long time limit. The maximum macroscopic viscosity (ratio of total stress and average strain rate over the entire sample) during the alignment process increases with the system size proportional to (L/λ)^3/2. For large values of Σ, there is localisation of shear at the walls, and the bulk of the sample moves as a block. The thickness of the shearing region appears to be invariant with the system size, leading to an increase of viscosity proportional to L. The time for structural evolution is found to be the inverse of the strain rate γ˙^-1. In the case of a significant viscosity contrast between the hydrophilic and hydrophobic parts, the average viscosity increases by 1-2 orders of magnitude due to the defect pinning mechanism, where the regions between defects move as a block, and shear localisation at the wall.

Fabrication of electrodes with ultralow platinum loading by RF plasma processing of self-assembled arrays of Au@Pt nanoparticles

Conductive, carbon-free, electrocatalytically active, nanostructured electrodes with ultra-low platinum loading were fabricated using self-assembly of octadecanethiol-coated Au@Pt nanoparticles followed by RF plasma treatment. Bilayer arrays of Au@Pt nanoparticles with platinum loadings of 0.50, 1.04, 1.44, and 1.75 μg cm(-2) (corresponding to 0.5, 1, 1.5 and 2 atomic layer coverage of platinum on nominally 5 nm gold core) were subjected to RF argon plasma treatment for various durations and their electrical conductivity, morphological evolution, and electrocatalytic activity characterized. Samples with monolayer and above platinum coverages exhibit maximum electrochemically active surface areas values of ∼100 m(2)/gpt and specific activities that are ∼4× to 6× of a reference platinum nanoparticle bilayer array. The underlying gold core influences the structural evolution of the samples upon RF plasma treatment and leads to the formation of highly active Pt(110) facets on the surface at an optimal plasma treatment duration, which also corresponds to the onset of a sharp decline in lateral sheet resistance. The sample having a two atom thick platinum coating has the highest total mass activity of 48 ± 3 m(2)/g(pt+au), corresponding to 44% Pt atom utilization, while also exhibiting enhanced CO tolerance as well as high methanol oxidation reaction and oxygen reduction reaction activity.

Structure-rheology relationship in a sheared lamellar fluid

The structure-rheology relationship in the shear alignment of a lamellar fluid is studied using a mesoscale model which provides access to the lamellar configurations and the rheology. Based on the equations and free energy functional, the complete set of dimensionless groups that characterize the system are the Reynolds number (ργL(2)/μ), the Schmidt number (μ/ρD), the Ericksen number (μγ/B), the interface sharpness parameter r, the ratio of the viscosities of the hydrophilic and hydrophobic parts μ(r), and the ratio of the system size and layer spacing (L/λ). Here, ρ and μ are the fluid density and average viscosity, γ is the applied strain rate, D is the coefficient of diffusion, B is the compression modulus, μ(r) is the maximum difference in the viscosity of the hydrophilic and hydrophobic parts divided by the average viscosity, and L is the system size in the cross-stream direction. The lattice Boltzmann method is used to solve the concentration and momentum equations for a two dimensional system of moderate size (L/λ=32) and for a low Reynolds number, and the other parameters are systematically varied to examine the qualitative features of the structure and viscosity evolution in different regimes. At low Schmidt numbers where mass diffusion is faster than momentum diffusion, there is fast local formation of randomly aligned domains with "grain boundaries," which are rotated by the shear flow to align along the extensional axis as time increases. This configuration offers a high resistance to flow, and the layers do not align in the flow direction even after 1000 strain units, resulting in a viscosity higher than that for an aligned lamellar phase. At high Schmidt numbers where momentum diffusion is fast, the shear flow disrupts layers before they are fully formed by diffusion, and alignment takes place by the breakage and reformation of layers by shear, resulting in defects (edge dislocations) embedded in a background of nearly aligned layers. At high Ericksen number where the viscous forces are large compared to the restoring forces due to layer compression and bending, shear tends to homogenize the concentration field, and the viscosity decreases significantly. At very high Ericksen number, shear even disrupts the layering of the lamellar phase. At low Ericksen number, shear results in the formation of well aligned layers with edge dislocations. However, these edge dislocations take a long time to anneal; the relatively small misalignment due to the defects results in a large increase in viscosity due to high layer stiffness and due to shear localization, because the layers between defects get pinned and move as a plug with no shear. An increase in the viscosity contrast between the hydrophilic and hydrophobic parts does not alter the structural characteristics during alignment. However, there is a significant increase in the viscosity, due to pinning of the layers between defects, which results in a plug flow between defects and a localization of the shear to a part of the domain.

Endoscopic management of post-liver transplant billiary complications: A prospective study from tertiary centre in India

BACKGROUND

Liver transplantation has become common in India over the last decade and biliary strictures after the procedure cause a significant morbidity. Endoscopic retrograde cholangiopancreatography (ERCP) is a safe and effective treatment modality for post-transplant biliary strictures so we decided to evaluate prospectively the outcomes of endoscopic treatment in post-living donor liver transplantation (LDLT) biliary strictures.

METHODS

We studied ten consecutive patients who had developed biliary strictures (out of 312 who had undergone liver transplantation between June 2009 and June 2013) and had been referred to the Department of Gastroenterology for management. All patients underwent liver function tests, ultrasound of the abdomen, magnetic resonance cholangiography and liver biopsy, if this was indicated.

RESULTS

Of these 312 patients who underwent liver transplantation, 305 had living donors (LDLT) and 7 deceased donors (DDLT). Ten patients in the LDLT group (3.3%) developed biliary strictures. There were seven males and three females who had median age of 52 years (range 4-60 years). The biliary anastomosis was duct-to-duct in all patients with one patient having an additional duct-to-jejunum anastomosis. The mode of presentation was cholangitis in four patients (40%), asymptomatic elevation of liver enzymes in four (40%) and jaundice in two patients (20%). The median time from transplantation to the detection of the stricture was 12 months (2-42.5 months). ERCP was attempted as initial therapy in all patients: seven were managed entirely by endoscopic therapy, and three required a combined percutaneous and endoscopic approach. Cholangiography demonstrated anastomotic stricture in all patients. A total of 32 sessions of ERCP were done with mean of 3.2 (2-5) endoscopic sessions and 3.4 (1-6) stents required to resolve the stricture. The median time from the first intervention to stricture resolution was 4 months (range 2-12 months). In four patients, the stents were removed after one session and in two patients each after two, three and four sessions. In six patients more than one stent was placed and all of them required dilatation of stricture. Seven patients completed treatment and are off stents at a median follow up period of 9.5 months (7-11 months). Two patients developed recurrence of their stricture after 7.5 months. Both had long strictures and required a combined endoscopic and percutaneous approach. There was one mortality due to sepsis secondary to cholangitis.

CONCLUSIONS

Post-LDLT biliary strictures can be successfully treated with ERCP, and most patients remain well on follow up (median 9.5 months). A combined endoscopic and percutaneous approach is useful when ERCP alone fails.

Digital model as an alternative to plaster model in assessment of space analysis

Introduction:

Digital three-dimensional models are widely used for orthodontic diagnosis. The purpose of this study was to appraise the accuracy of digital models obtained from computer-aided design/computer-aided manufacturing (CAD/CAM) and cone-beam computed tomography (CBCT) for tooth-width measurements and the Bolton analysis.

Materials and Methods:

Digital models (CAD/CAM, CBCT) and plaster model were made for each of 50 subjects. Tooth-width measurements on the digital models (CAD/CAM, CBCT) were compared with those on the corresponding plaster models. The anterior and overall Bolton ratios were calculated for each participant and for each method. The paired t-test was applied to determine the validity.

Results:

Tooth-width measurements, anterior, and overall Bolton ratio of digital models of CAD/CAM and CBCT did not differ significantly from those on the plaster models.

Conclusion:

Hence, both CBCT and CAD/CAM are trustable and promising technique that can replace plaster models due to its overwhelming advantages.

Stability of the flow in a soft tube deformed due to an applied pressure gradient

A linear stability analysis is carried out for the flow through a tube with a soft wall in order to resolve the discrepancy of a factor of 10 for the transition Reynolds number between theoretical predictions in a cylindrical tube and the experiments of Verma and Kumaran [J. Fluid Mech. 705, 322 (2012)]. Here the effect of tube deformation (due to the applied pressure difference) on the mean velocity profile and pressure gradient is incorporated in the stability analysis. The tube geometry and dimensions are reconstructed from experimental images, where it is found that there is an expansion and then a contraction of the tube in the streamwise direction. The mean velocity profiles at different downstream locations and the pressure gradient, determined using computational fluid dynamics, are found to be substantially modified by the tube deformation. The velocity profiles are then used in a linear stability analysis, where the growth rates of perturbations are calculated for the flow through a tube with the wall modeled as a neo-Hookean elastic solid. The linear stability analysis is carried out for the mean velocity profiles at different downstream locations using the parallel flow approximation. The analysis indicates that the flow first becomes unstable in the downstream converging section of the tube where the flow profile is more pluglike when compared to the parabolic flow in a cylindrical tube. The flow is stable in the upstream diverging section where the deformation is maximum. The prediction for the transition Reynolds number is in good agreement with experiments, indicating that the downstream tube convergence and the consequent modification in the mean velocity profile and pressure gradient could reduce the transition Reynolds number by an order of magnitude.

Wall-mode instability in plane shear flow of viscoelastic fluid over a deformable solid

The linear stability analysis of a plane Couette flow of an Oldroyd-B viscoelastic fluid past a flexible solid medium is carried out to investigate the role of polymer addition in the stability behavior. The system consists of a viscoelastic fluid layer of thickness R, density ρ, viscosity η, relaxation time λ, and retardation time βλ flowing past a linear elastic solid medium of thickness HR, density ρ, and shear modulus G. The emphasis is on the high-Reynolds-number wall-mode instability, which has recently been shown in experiments to destabilize the laminar flow of Newtonian fluids in soft-walled tubes and channels at a significantly lower Reynolds number than that for flows in rigid conduits. For Newtonian fluids, the linear stability studies have shown that the wall modes become unstable when flow Reynolds number exceeds a certain critical value Re(c) which scales as Σ(3/4), where Reynolds number Re=ρVR/η,V is the top-plate velocity, and dimensionless parameter Σ=ρGR(2)/η(2) characterizes the fluid-solid system. For high-Reynolds-number flow, the addition of polymer tends to decrease the critical Reynolds number in comparison to that for the Newtonian fluid, indicating a destabilizing role for fluid viscoelasticity. Numerical calculations show that the critical Reynolds number could be decreased by up to a factor of 10 by the addition of small amount of polymer. The critical Reynolds number follows the same scaling Re(c)∼Σ(3/4) as the wall modes for a Newtonian fluid for very high Reynolds number. However, for moderate Reynolds number, there exists a narrow region in β-H parametric space, corresponding to very dilute polymer solution (0.9≲β<1) and thin solids (H≲1.1), in which the addition of polymer tends to increase the critical Reynolds number in comparison to the Newtonian fluid. Thus, Reynolds number and polymer properties can be tailored to either increase or decrease the critical Reynolds number for unstable modes, thus providing an additional degree of control over the laminar-turbulent transition.

Laterally structured ripple and square phases with one and two dimensional thickness modulations in a model bilayer system

Molecular dynamics simulations of bilayers in a surfactant/co-surfactant/water system with explicit solvent molecules show formation of topologically distinct gel phases depending upon the bilayer composition. At low temperatures, the bilayers transform from the tilted gel phase, Lβ', to the one dimensional (1D) rippled, Pβ' phase as the surfactant concentration is increased. More interestingly, we observe a two dimensional (2D) square phase at higher surfactant concentration which, upon heating, transforms to the gel Lβ' phase. The thickness modulations in the 1D rippled and square phases are asymmetric in two surfactant leaflets and the bilayer thickness varies by a factor of ∼2 between maximum and minimum. The 1D ripple consists of a thinner interdigitated region of smaller extent alternating with a thicker non-interdigitated region. The 2D ripple phase is made up of two superimposed square lattices of maximum and minimum thicknesses with molecules of high tilt forming a square lattice translated from the lattice formed with the thickness minima. Using Voronoi diagrams we analyze the intricate interplay between the area-per-head-group, height modulations and chain tilt for the different ripple symmetries. Our simulations indicate that composition plays an important role in controlling the formation of low temperature gel phase symmetries and rippling accommodates the increased area-per-head-group of the surfactant molecules.

Risk of developing adulthood obesity among females born with low birth weight: Results from a non-concurrent study from rural Southern India

OBJECTIVE

To determine the relationship between birth weight and the evolution of obesity in adult life in women from a rural developmental block in southern India.

DESIGN

Non-concurrent cohort.

SETTING

General community- a rural developmental block in southern India.

PARTICIPANTS

Two hundred and seventy one young healthy females were recruited from a birth cohort. The study subjects were 98 women in the age group of 19-23 years who had been born with low birth weight (LBW) and 173 women in the same age group who had been born with normal birth weight (NBW).

MATERIALS AND METHODS

Data collection involved interview using a structured questionnaire and anthropometric measurements.

ANALYSIS

Chi-square test to assess significance of association, independent sample t test to assess the difference between means, odds ratios for measuring magnitude of association, stratified analysis to identify various interactions and confounders, and multiple logistic regression models to identify the relationship between birth weight and young adult obesity (BMI > 25).

RESULTS

A crude odds ratio of 0.564 (95% CI 0.262 - 1.214) was obtained for the association between LBW and development of obesity later in life. In the final logistic regression model, it was found that a young adult female with low birth weight who belonged to a higher socio-economic group had a higher risk of developing obesity (Adjusted odds for the interaction term between LBW and high SES 6.251; 95% CI 1.236 - 31.611).

CONCLUSION

The study could not find any significant association between LBW and development of obesity later in life, but it found a higher probability of developing obesity later in life among low birth weight female children born in high socio-economic status families.

Medical students' views on the migration of doctors: self-interest vs altruism

The migration of doctors from developing to developed countries is an ongoing phenomenon. There is scant information on the attitudes of medical students to the ethical aspects of this trend. This paper reports on a study of 50 first-year medical students and 52 interns in a college in Vellore city, Tamil Nadu. Only 13 of 102 respondents thought that migrant doctors contributed significantly to the health system in India. 17% thought that doctor migration was not an ethical issue, and 40% thought that individual altruism had no role in solving public problems. The responses to case scenarios suggest that first-year medical students are more likely to have an altruistic and communitarian attitude whereas interns tended to emphasise individual liberty and autonomy.

Dynamics of edge dislocations in a sheared lamellar mesophase

The dynamics and interactions of edge dislocations in a nearly aligned sheared lamellar mesophase is analysed to provide insights into the relationship between disorder and rheology. First, the mesoscale permeation and momentum equations for the displacement field in the presence of external forces are derived from the model H equations for the concentration and momentum field. The secondary flow generated due to the mean shear around an isolated defect is calculated, and the excess viscosity due to the presence of the defect is determined from the excess energy dissipation due to the secondary flow. The excess viscosity for an isolated defect is found to increase with system size in the cross-stream direction as L(3/2) for an isolated defect, though this divergence is cut-off due to interactions in a defect suspension. As the defects are sheared past each other due to the mean flow, the Peach-Koehler force due to elastic interaction between pairs of defects is found to cause no net displacement relative to each other as they approach from large separation to the distance of closest approach. The equivalent force due to viscous interactions is found to increase the separation for defects of opposite sign, and decrease the separation for defects of same sign. During defect interactions, we find that there is no buckling instability due to dilation of layers for systems of realistic size. However, there is another mechanism, which is the velocity difference generated across a slightly deformed bilayer due to the mean shear, which could result in the creation of new defects.

Diabetes self-care activities: a community-based survey in urban southern India

BACKGROUND

Diabetes is a lifestyle disease and can be successfully managed by good self-care activities such as diet, exercise, monitoring and drug adherence. Adequate baseline information about the prevalence of good self-care activities is not available from India. We aimed to estimate the existing self-care behaviours and factors influencing these behaviours among adult patients with type 2 diabetes in urban southern India.

METHODS

A cross-sectional survey was conducted using a cluster design in an urban community in southern India. The Summary Diabetes Self-Care Activities questionnaire was used to collect information on diet, exercise, monitoring of blood sugars and adherence to drugs. Risk factors such as marital status, socioeconomic status, depression, benefit-finding and duration of illness, which are likely to influence self-care behaviour, were assessed.

RESULTS

Good dietary behaviour was present in 29% (95% CI 20.8%-37.2%), good exercise behaviour in 19.5% (95% CI 17.4%-21.6%), regular blood sugar monitoring in 70% (95% CI 62.2%-77.8%) and drug adherence in 79.8% (95% CI 75.1%-84.5%). Being male (OR 3.38; 95% CI 1.541-7.407) and married (OR 5.60; 95% CI 1.242-25.212) significantly favoured good exercise behaviour. Being married (OR 2.322; 95% CI 1.104-4.883) and belonging to the higher socioeconomic status (OR 2.713; 95% CI 1.419-5.190) were significantly associated with monitoring of blood sugars.

CONCLUSIONS

Self-care activities with respect to diet and exercise are poor in the population studied. The self-care activities relating to blood sugar monitoring and drug adherence are good. Improving self-care behaviour among patients with diabetes in India should start with adequate targeted health education.

Route to neo-inguinal canal: Our experience

AIM

The objective of this study was to stress the importance and value of this route to neo-inguinal canal creation for undescended testis management laparoscopically.

MATERIALS AND METHODS

Data from the Department of Paediatric Surgery, Coimbatore Medical College, was taken. Retrospective study was undertaken for the period 2004 to 2008. Here the surgical technique and outcome of the treatment are recorded for children aged 1 year to 12 years.

RESULTS

A total of 126 children underwent laparoscopic stage II surgery by this route (medial to the medial umbilical ligament). Right-sided undescended testis (UDT) was present in 76 (60%) patients. Left-sided UDT was present in 45 (35%) patients. Bilateral UDT was present in 5 (5%) patients. There were 90 (71%) patients aged less than 2 years and 36 (29%) patients aged more than 2 years. The eldest patient was 12 years of age. The overall hospital stay was 1 day. There were no complications seen in the follow-up. In all cases, the testis could not be brought down in a single stage.

CONCLUSION

Creation of neo-inguinal canal medial to the medial umbilical ligament and just lateral to the bladder has the advantage of gaining more length on the vessels and vas to bring the testis to scrotum. The laparoscopic management of undescended testis in stage II by this innovative new route is simple, less complicated and well tolerated.

Laparoscopic assisted anorectal pull through: Reformed techniques

AIM

To assess the modifications in the technique of laparoscopic assisted anorectal pull through (LAARP) practiced at our institute and analyze the post operative outcome and associated complications.

MATERIALS AND METHODS

A retrospective study from January 2001 to May 2009 analyzing LAARP for high anorectal malformations.

RESULTS

A total of 40 patients - 34 males and six females, in the age group of two months to six years were studied. Staged procedure was done in 39 patients; one child with recto vestibular fistula underwent single stage procedure. All the patients withstood surgery well. One patient required conversion due to problems in gaining enough length for the distal rectum in a patient with rectovesical fistula so colostomy was closed and re-located at a proximal splenic flexure. The complications were mucosal prolapse (six cases), anal stenosis (three), adhesive obstruction (two), distal rectal necrosis (one), and urethral diverticulum (one). The patients were followed up with clinical evaluation and continence scoring. The progress has been satisfactory and weight-gain is adequate.

CONCLUSIONS

THE ADVANTAGES OF THE REFORMED TECHNIQUES ARE AS FOLLOWS: Transcutaneous bladder stitch provides excellent visualization; traction over the fistula helps in dissection of the puborectalis, dividing the fistula without ligation is safe, railroading of Hegar's dilators over the suction canula creates adequate pull through channel, saves time and makes procedure simpler with reproducible comparable reports.

Fluctuation-dissipation relation for nonlinear Langevin equations

It is shown that the fluctuation-dissipation theorem is satisfied by the solutions of a general set of nonlinear Langevin equations with a quadratic free-energy functional (constant susceptibility) and field-dependent kinetic coefficients, provided the kinetic coefficients satisfy the Onsager reciprocal relations for the irreversible terms and the antisymmetry relations for the reversible terms. The analysis employs a perturbation expansion of the nonlinear terms, and a functional integral calculation of the correlation and response functions, and it is shown that the fluctuation-dissipation relation is satisfied at each order in the expansion.

Shear alignment of a disordered lamellar mesophase

The shear alignment of an initially disordered lamellar phase is examined using lattice Boltzmann simulations of a mesoscopic model based on a free-energy functional for the concentration modulation. For a small shear cell of width 8λ, the qualitative features of the alignment process are strongly dependent on the Schmidt number Sc=ν/D (ratio of kinematic viscosity and mass diffusion coefficient). Here, λ is the wavelength of the concentration modulation. At low Schmidt number, it is found that there is a significant initial increase in the viscosity, coinciding with the alignment of layers along the extensional axis, followed by a decrease at long times due to the alignment along the flow direction. At high Schmidt number, alignment takes place due to the breakage and reformation of layers because diffusion is slow compared to shear deformation; this results in faster alignment. The system size has a strong effect on the alignment process; perfect alignment takes place for a small systems of width 8λ and 16λ, while a larger system of width 32λ does not align completely even at long times. In the larger system, there appears to be a dynamical steady state in which the layers are not perfectly aligned--where there is a balance between the annealing of defects due to shear and the creation due to an instability of the aligned lamellar phase under shear. We observe two types of defect creation mechanisms: the buckling instability under dilation, which was reported earlier, as well as a second mechanism due to layer compression.

Orientational ordering in sheared inelastic dumbbells

Using even driven simulations, we show that homogeneously sheared inelastic dumbbells in two dimensions are randomly orientated in the limit of low density. As the packing fraction is increased, particles first tend to orient along the extensional axis, and then as the packing fraction is further increased, the alignment shifts closer to the flow axis. The orientational order parameter displays a continuous increase with packing fraction and does not appear to exhibit a universal scaling with elongation. Except at the highest packing fractions, the orientational distribution function can be reconstructed with only the first coefficient of the Fourier expansion.

Structure and dynamics of two-dimensional sheared granular flows

The structure and dynamics of the two-dimensional linear shear flow of inelastic disks at high area fractions are analyzed. The event-driven simulation technique is used in the hard-particle limit, where the particles interact through instantaneous collisions. The structure (relative arrangement of particles) is analyzed using the bond-orientational order parameter. It is found that the shear flow reduces the order in the system, and the order parameter in a shear flow is lower than that in a collection of elastic hard disks at equilibrium. The distribution of relative velocities between colliding particles is analyzed. The relative velocity distribution undergoes a transition from a Gaussian distribution for nearly elastic particles, to an exponential distribution at low coefficients of restitution. However, the single-particle distribution function is close to a Gaussian in the dense limit, indicating that correlations between colliding particles have a strong influence on the relative velocity distribution. This results in a much lower dissipation rate than that predicted using the molecular chaos assumption, where the velocities of colliding particles are considered to be uncorrelated.

Mesoscale description of an asymmetric lamellar phase

The relationship between the parameters in a description based on a mesoscale free energy functional for the concentration field and the macroscopic properties, such as the bending and compression moduli and the permeation constant, are examined for an asymmetric lamellar phase where the mass fractions of the hydrophobic and hydrophilic parts are not equal. The difference in the mass fractions is incorporated using a cubic term in the free energy functional, in addition to the usual quadratic and quartic terms in the Landau-Ginsburg formulation. The relationship between the coefficient of the cubic term and the difference in the mass fractions of the hydrophilic and hydrophobic parts is obtained. For a lamellar phase, it is important to ensure that the surface tension is zero due to symmetry considerations. The relationship between the parameters in the free energy functional for zero surface tension is derived. When the interface between the hydrophilic and hydrophobic parts is diffuse, it is found that the bending and compression moduli, scaled by the parameters in the free energy functional, do increase as the asymmetry in the bilayer increases. When the interface between the hydrophilic and hydrophobic parts is sharp, the scaled bending and compression moduli show no dependence on the asymmetry in the bilayer. The ratio of the permeation constant in between the water and bilayer in a molecular description and the Onsager coefficient in the mesoscale description is O(1) for both sharp and diffuse interfaces and it increases as the difference in the mass fractions is increased.

Multiscale modeling of lamellar mesophases

The mesoscale simulation of a lamellar mesophase based on a free energy functional is examined with the objective of determining the relationship between the parameters in the model and molecular parameters. Attention is restricted to a symmetric lamellar phase with equal volumes of hydrophilic and hydrophobic components. Apart from the lamellar spacing, there are two parameters in the free energy functional. One of the parameters, r, determines the sharpness of the interface, and it is shown how this parameter can be obtained from the interface profile in a molecular simulation. The other parameter, A, provides an energy scale. Analytical expressions are derived to relate these parameters to r and A to the bending and compression moduli and the permeation constant in the macroscopic equation to the Onsager coefficient in the concentration diffusion equation. The linear hydrodynamic response predicted by the theory is verified by carrying out a mesoscale simulation using the lattice-Boltzmann technique and verifying that the analytical predictions are in agreement with simulation results. A macroscale model based on the layer thickness field and the layer normal field is proposed, and the relationship between the parameters in the macroscale model from the parameters in the mesoscale free energy functional is obtained.

Dynamics of a dilute sheared inelastic fluid. I. Hydrodynamic modes and velocity correlation functions

The hydrodynamic modes and the velocity autocorrelation functions for a dilute sheared inelastic fluid are analyzed using an expansion in the parameter =(1-e);{12} , where e is the coefficient of restitution. It is shown that the hydrodynamic modes for a sheared inelastic fluid are very different from those for an elastic fluid in the long-wave limit, since energy is not a conserved variable when the wavelength of perturbations is larger than the "conduction length." In an inelastic fluid under shear, there are three coupled modes, the mass and the momenta in the plane of shear, which have a decay rate proportional to k;{23} in the limit k-->0 , if the wave vector has a component along the flow direction. When the wave vector is aligned along the gradient-vorticity plane, we find that the scaling of the growth rate is similar to that for an elastic fluid. The Fourier transforms of the velocity autocorrelation functions are calculated for a steady shear flow correct to leading order in an expansion in . The time dependence of the autocorrelation function in the long-time limit is obtained by estimating the integral of the Fourier transform over wave number space. It is found that the autocorrelation functions for the velocity in the flow and gradient directions decay proportional to t;{-52} in two dimensions and t;{-154} in three dimensions. In the vorticity direction, the decay of the autocorrelation function is proportional to t;{-3} in two dimensions and t;{-72} in three dimensions.

Dynamics of a dilute sheared inelastic fluid. II. The effect of correlations

The effect of correlations on the viscosity of a dilute sheared inelastic fluid is analyzed using the ring-kinetic equation for the two-particle correlation function. The leading-order contribution to the stress in an expansion in =(1-e);{12} is calculated, and it is shown that the leading-order viscosity is identical to that obtained from the Green-Kubo formula, provided the stress autocorrelation function in a sheared steady state is used in the Green-Kubo formula. A systemmatic extension of this to higher orders is also formulated, and the higher-order contributions to the stress from the ring-kinetic equation are determined in terms of the terms in the Chapman-Enskog solution for the Boltzmann equation. The series is resummed analytically to obtain a renormalized stress equation. The most dominant contributions to the two-particle correlation function are products of the eigenvectors of the conserved hydrodynamic modes of the two correlated particles. In Part I, it was shown that the long-time tails of the velocity autocorrelation function are not present in a sheared fluid. Using those results, we show that correlations do not cause a divergence in the transport coefficients; the viscosity is not divergent in two dimensions, and the Burnett coefficients are not divergent in three dimensions. The equations for three-particle and higher correlations are analyzed diagrammatically. It is found that the contributions due to the three-particle and higher correlation functions to the renormalized viscosity are smaller than those due to the two-particle distribution function in the limit -->0 . This implies that the most dominant correlation effects are due to the two-particle correlations.

Minimally invasive pediatric surgery: Our experience

Aim:

Departmental survey of the pediatric laparoscopic and thoracoscopic procedures.

Materials and Methods:

It is a retrospective study from January 1999 to December 2007. The various types of surgeries, number of patients, complications and conversions of laparoscopic and thoracoscopic procedures were analyzed.

Results:

The number of minimally invasive procedures that had been performed over the past 9 years is 734, out of which thoracoscopic procedures alone were 48. The majority of the surgeries were appendicectomy (31%), orchiopexy (19%) and diagnostic laparoscopy (16%). The other advanced procedures include laparoscopic-assisted anorectoplasty, surgery for Hirschprung’s disease, thoracosocpic decortication, congenital diaphragmatic hernia repair, nephrectomy, fundoplication, etc. Our complications are postoperative fever, bleeding, bile leak following choledochal cyst excision and pneumothorax following bronchogenic cyst excision. A case of empyema thorax following thoracoscopic decortication succumbed due to disseminated tuberculosis. Our conversion rate was around 5% in the years 1999 to 2001, which has come down to 3% over the past few years. Conversions were for sliding hiatus hernia, nephrectomy, perforated adherent appendicitis, Meckel’s diverticulum, thoracoscopic decortication and ileal perforation.

Conclusion:

The minimally invasive pediatric surgical technique is increasingly accepted world wide and the need for laparoscopic training has become essential in every teaching hospital. It has a lot of advantages, such as less pain, early return to school and scarlessness. Our conversion rate has come down from 5% to 3% with experience and now we do more advanced procedures with a lower complication rate.

Weakly nonlinear analysis of viscous instability in flow past a neo-Hookean surface

We analyze the stability of the plane Couette flow of a Newtonian fluid past an incompressible deformable solid in the creeping flow limit where the viscous stresses in the fluid (of the order eta_{f}VR ) are comparable with the elastic stresses in the solid (of the order G ). Here, eta_{f} is the fluid viscosity, V is the top-plate velocity, R is the channel width, and G is the shear modulus of the elastic solid. For (eta_{f}VGR)=O(1) , the flexible solid undergoes finite deformations and is, therefore, appropriately modeled as a neo-Hookean solid of finite thickness which is grafted to a rigid plate at the bottom. Both linear as well as weakly nonlinear stability analyses are carried out to investigate the viscous instability and the effect of nonlinear rheology of solid on the instability. Previous linear stability studies have predicted an instability as the dimensionless shear rate Gamma=(eta_{f}VGR) is increased beyond the critical value Gamma_{c} . The role of viscous dissipation in the solid medium on the stability behavior is examined. The effect of solid-to-fluid viscosity ratio eta_{r} on the critical shear rate Gamma_{c} for the neo-Hookean model is very different from that for the linear viscoelastic model. Whereas the linear elastic model predicts that there is no instability for H<sqrt[eta_{r}] , the neo-Hookean model predicts an instability for all values of eta_{r} and H . The value of Gamma_{c} increases upon increasing eta_{r} from zero up to sqrt[eta_{r}]H approximately 1 , at which point the value of Gamma_{c} attains a peak and any further increase in eta_{r} results in a decrease in Gamma_{c} . The weakly nonlinear analysis indicated that the bifurcation is subcritical for most values of H when eta_{r}=0 . However, upon increasing eta_{r} , there is a crossover from subcritical to supercritical bifurcation for sqrt[eta_{r}]H approximately 1 . Another crossover is observed as the bifurcation again becomes subcritical at large values of eta_{r} . A plot in H versus sqrt[eta_{r}]H space is constructed to mark the regions where the bifurcation is subcritical and supercritical. The equilibrium amplitude and some physical quantities of interest, such as the total strain energy of the disturbance in the solid, have been calculated, and the effect of parameters H , eta_{r} , and interfacial tension on these quantities are analyzed.

Applicability of constitutive relations from kinetic theory for dense granular flows

The applicability of constitutive models based on kinetic theory for dense granular flows is examined. First, we calculate the average coordination number of a particle in a dense flow down an inclined plane using discrete element simulations that employ a linear spring-dashpot model for particle interactions. It is found that the average coordination number decreases as the spring constant increases at constant coefficient of restitution, and is less than 1 for the values of spring constant corresponding to materials such as sand and glass beads. The Bagnold coefficients, which are the ratios of the different components of the stress and the square of the strain rate, are calculated using both discrete element (DE) simulations and event driven (ED) simulations; collisions are considered to be instantaneous in the latter simulations. It is found that the theoretical predictions of the Bagnold coefficients are in quantitative agreement with both DE and ED simulations provided the pair distribution function obtained from the simulations is inserted into the theory. However, it is found that the pair distribution function in a sheared granular flow is significantly larger than that in an equilibrium fluid of elastic particles.

Does patent ductus arteriosus affect feed tolerance in preterm neonates?

Patent ductus arteriosus (PDA), especially PDA with sepsis, has been reported as a risk factor for feed intolerance in preterm neonates. In this study, the start to full feeds interval was found to be longest in preterm neonates (<or=28 weeks' gestation) with sepsis, followed by that in preterm neonates with sepsis and PDA, and in those with PDA alone.