Search Results (62)

Background: Identifying the cause of recurrent or persisting pain after posterior lumbar interbody fusion (PLIF) is essential for establishing optimal treatment. In this study, we evaluate patients after PLIF surgery by ¹⁸F-fluoride PET/CT scans and patient-reported outcome measures (PROMs). Methods: A total of 36 PLIF patients were included. Sixty minutes after intravenous injection of ¹⁸F-fluoride, PET/CT scanning was performed. Bone graft ingrowth, subsidence, screw loosening and damage of facet joints were scored by quantifying the level of bone metabolism of the vertebral endplates in the disc spaces, around screws and around the facet joints on the PET scans. Results: In contrast to asymptomatic patients, symptomatic patients showed abnormal PET values around pedicle screws and/or facet joints and at the lower endplates of the disc spaces, identifying a possible source of pain. On CT, no significant differences between these two groups were found. Conclusion: The PET/CT findings appeared to correlate better with symptoms on PROMs compared to CT findings alone. When interpreting ¹⁸F-fluoride PET/CT findings after PLIF surgery, one should realize bone metabolism in the disc spaces of the operated segments and around pedicle screws or facet joint changes during follow-up, reflecting natural recovery. Full article

The vertebral cage has been widely used in posterior lumbar interbody fusion. The risk of cage dislodgment is high for patients undergoing lumbar fusion surgery. Therefore, the main objective of this study was to use a lumbar fusion model to investigate the effects of cage dislodgment on different cage arrangements after PLIF. Finite element analysis was used to compare three PEEK cage placements, together with the fibula-type cage, with respect to the four kinds of lumbar movements. The results revealed that a horizontal cage arrangement could provide a better ability to resist cage dislodgment. Overall lumbar flexion movements were confirmed to produce a greater amount of cage slip than the other three lumbar movements. The lower part of the lumbar fusion segment could create a greater amount of cage dislodgment for all of the lumbar movements. Using an autograft with a fibula as a vertebral cage cannot effectively reduce cage dislodgment. Considering the maximum movement type in lumbar flexion, we suggest that a horizontal arrangement of the PEEK cage might be considered when a single PEEK cage is placed in the fusion segment, as doing so can effectively reduce the extent of cage dislodgment. Full article

Clean-burning oxygenated and synthetic fuels derived from renewable power, so-called e-fuels, are a promising pathway to decarbonize compression–ignition engines. Polyoxymethylene dimethyl ethers (PODEs or OMEs) are one candidate of such fuels with good prospects. Their lack of carbon-to-carbon bonds and high concentration of chemically bound oxygen effectively negate the emergence of polycyclic aromatic hydrocarbons (PAHs) and even their precursors like acetylene (C₂H₂), enabling soot-free combustion without the soot-NO_x trade-off common for diesel engines. The differences in the spray combustion process for OMEs and diesel-like reference fuels like n-dodecane and their potential implications on engine applications include discrepancies in the observed ignition delay, the stabilized flame lift-off location, and significant deviations in high-temperature flame morphology. For CFD simulations, the accurate modeling and prediction of these differences between OMEs and n-dodecane proved challenging. This study investigates the spray combustion process of an OME_{3 − 5} mixture and n-dodecane with advanced optical diagnostics, Reynolds-Averaged Navier–Stokes (RANS), and Large-Eddy Simulations (LESs) within a constant-volume vessel. Cool-flame and high-temperature combustion were measured simultaneously via high-speed (50 kHz) imaging with formaldehyde (CH₂O) planar laser-induced fluorescence (PLIF) representing the former and line-of-sight OH* chemiluminescence the latter. Both RANS and LES simulations accurately describe the cool-flame development process with the formation of CH₂O. However, CH₂O consumption and the onset of high-temperature reactions, signaled by the rise of OH* levels, show significant deviations between RANS, LES, and experiments as well as between n-dodecane and OME. A focus is set on the quality of the simulated results compared to the experimentally observed spatial distribution of OH*, especially in OME fuel-rich regions. The influence of the turbulence modeling is investigated for the two distinct ambient temperatures of 900 K and 1200 K within the Engine Combustion Network Spray A setup. The capabilities and limitations of the RANS simulations are demonstrated with the initial cool-flame propagation and periodic oscillations of CH₂O formation/consumption during the quasi-steady combustion period captured by the LES. Full article

The transforaminal lumbar interbody fusion (TLIF) has seen significant evolution since its early inception, reflecting advancements in surgical techniques, patient safety, and outcomes. Originally described as an improvement over the posterior lumbar interbody fusion (PLIF), the TLIF began as an open surgical procedure, that notably reduced the need for the extensive neural retractation that hindered the PLIF. In line with the broader practice of surgery, trending toward minimally invasive access, the TLIF was followed by the development of the minimally invasive TLIF (MIS-TLIF), a technique that further decreased tissue trauma and postoperative complications. Subsequent advancements, including Trans-Kambin’s Triangle TLIF (percLIF) and transfacet LIF, have continued to refine surgical access, minimize surgical footprint, and reduce the risk of injury to the patient. The latest evolution, as we will describe it, the patient-specific TLIF, is a culmination of the aforementioned adaptations and incorporates advanced imaging and segmentation technologies into perioperative planning, allowing surgeons to tailor approaches based on individual patient anatomy and pathology. These developments signify a shift towards more precise methods in spine surgery. The ongoing evolution of the TLIF technique illustrates the dynamic nature of surgery and emphasizes the need for continued adaptation and refinement. Full article

This paper investigates non-invasive techniques for annular two-phase flow analysis, focusing on liquid film characterization to understand the interfacial phenomena that are crucial for heat and mass transfer. Limited methods allow the study of the temporal and spatial evolution of liquid film, such as Planar Laser-Induced Fluorescence (PLIF). However, this method possesses optical challenges, leading to the need for improved techniques to mitigate refraction and reflection, such as Refractive Index Matching (RIM). This study utilizes an experimental annular flow facility to analyze both RIM and non-RIM PLIF over a range of liquid Reynolds numbers from 4200 to 10,400. Three configurations—PLIF RIM90, PLIF RIM40, and PLIF nRIM40—are compared from both qualitative and quantitative perspectives. In the quantitative analysis, key variables of the liquid film are measured, namely mean film thickness, disturbance wave height, and frequency. Variations in the analyzed variables indicate minor deviations, which are not likely to be caused by the technique used. However, all three methodologies exhibited errors that are estimated to be within a maximum of 10%, with a mean value of approximately 8%. Full article

The combustion behavior of various propellant samples, including double-base propellants, pressed nitramine powders, and modified double-base propellants containing nitramine, was examined using OH-PLIF technology. The combustion process took place within a combustion chamber, and images capturing the flame at the moment of stable combustion were selected for further analysis. The distribution and production rate of OH radicals in both the double-base propellant and the nitramine-modified double-base propellant were simulated using Chemkin-17.0 software. The outcomes from both the experimental and simulation studies revealed that the concentration of OH radicals increased with a higher content of NG in the double-base propellant. In the modified double-base propellant containing RDX, the OH radical concentration decreased as the RDX content increased, with these tendencies of change aligning closely with the simulation results. Full article

This study investigated the flame structure and dynamics of a bluff-body flame when numerically close to blow-off conditions. This includes the impact of the hydrogen ratio on lean CH₄/H₂/air flame stabilization and blow-off characteristics. In this study, we assessed the impacts of four different hydrogen ratios: 0%, 30%, 60%, and 90%. Large eddy simulation (LES) was coupled with a thickened flame (TF) model to determine the turbulent combustion using a 30-species skeletal mechanism. The numerical results were progressively validated using OH-PLIF and PIV techniques. The results obtained from the numerical simulations showed minor differences with the experimental data on the velocity field and flame structure for all conditions. The presented results reveal that the flame is stabilized in higher-strain-rate spots more easily in the presence of high hydrogen ratios. Moreover, the flame location moves away from the concentrated vortex area with an increasing hydrogen ratio. The results of our blow-off investigation indicate that the blow-off sequence of a premixed bluff-body flame can be separated into two stages. The entire blow-off process becomes shorter with an increase in the hydrogen ratio. The primary reason for global extinction is a reduction in the heat release rate, and enstrophy analysis implies that blending hydrogen can reduce the enstrophy values of flames at the downstream locations. The dilatation and baroclinic torque terms decrease close to blow-off, but their decline is not significant in high-hydrogen-ratio conditions. Full article

Lumbar interbody fusion procedures have seen a significant evolution over the years, with various approaches being developed to address spinal pathologies and instability, including posterior lumbar interbody fusion (PLIF), transforaminal lumbar interbody fusion (TLIF), anterior lumbar interbody fusion (ALIF), and lateral lumbar interbody fusion (LLIF). LLIF, a pivotal technique in the field, initially emerged as extreme/direct lateral interbody fusion (XLIF/DLIF) before the development of oblique lumbar interbody fusion (OLIF). To ensure comprehensive circumferential stability, LLIF procedures are often combined with posterior stabilization (PS) using pedicle screws. However, achieving this required repositioning of the patient during the surgical procedure. The advent of single-position surgery (SPS) has revolutionized the procedure by eliminating the need for patient repositioning. With SPS, LLIF along with PS can be performed either in the lateral or prone position, resulting in significantly reduced operative time. Ongoing research endeavors are dedicated to further enhancing LLIF procedures making them even safer and easier. Notably, the integration of robotic technology into SPS has emerged as a game-changer, simplifying surgical processes and positioning itself as a vital asset for the future of spinal fusion surgery. This literature review aims to provide a succinct summary of the evolutionary trajectory of lumbar interbody fusion techniques, with a specific emphasis on its recent advancements. Full article

A detailed experimental study of ethanol spray swirling flames was performed in an axial bluff body stabilized burner. The characteristics of the non-reacting and reacting sprays were recorded by particle imaging velocimetry (PIV) and planar laser-induced fluorescence (PLIF) of the OH radical. A few typical flames with different structures (outer-side-flame-lifting, stable, and near-blow-off) were compared and analyzed. The parameters of the spray, including the spray half-angle (α) and droplet number density (n_d), are quantified, and it has been found the flame structure and stability were strongly correlated with the droplet distribution. Several parameters of the flow field, such as velocity magnitude ($\left|U\right|$ vorticity (ω_z), and turbulent kinetic energy (TKE), are quantitively analyzed, and it is observed that the local strain rate rose as the air flow rate increased, which is not conducive to local flame stability. Regarding the flame, quantities such as progress variable (<c>), flame height (L_f), lift–off height (h_lf), and symmetry factor (S_nd and S_<c>) are calculated, and it can be observed that the flame symmetry keeps worsening when approaching blow–off, and the inner flame branch exhibits a worse stabilization than the outer one. Our comprehensive investigations offer a deeper understanding of stable combustion in such two–phase flames. Full article

A hydrogen under-expanded jet released from a high-pressure vessel or equipment into the atmosphere through a 0.53 mm diameter orifice results in a sustained lifted flame for pressures above 4 MPa and flame blow-out at pressures below 3 MPa. Knowledge of whether the leaked hydrogen creates a sustained flame or is extinguished is an important issue for safety engineering. This study aims to clarify, in detail, a mechanism of flame stabilisation and blow-out depending on the spouting pressure. The model of flame stabilisation is derived using measurements and observations at the flame base location by means of high-speed schlieren images, laser diagnostics, and electrostatic probe techniques. The sustained stable flame originating from the 0.53 mm orifice is characterised by the existence of the spherical flame structures with a diameter of about 5 to 7 mm that appear one after another at the flame base and outside the streamlines of the hydrogen jet. As the spouting pressure reduces to 3.5 MPa, the sustained lifted flame becomes quasi-steady with higher fluctuations in amplitude of the flame base (lift-off height). In addition to that, flame structures are moving further from the hydrogen jet outlet, with a further decrease of spouting pressure leading to blow-out. The existence of spherical flame formations plays an important role in flame stabilisation. Based on the measurements of OH radicals using the PLIF method and ion currents, multiple flame surfaces were found to be folded in the flame structures. The hydrogen jet generates the vortex-like flow near its outer edge, creating flamelets upon ignition, ultimately forming the observed in the experiments spherical flame structures. Full article

Background and Objectives: Posterior lumbar interbody fusion (PLIF) plays a crucial role in addressing various spinal disorders. The success of PLIF is contingent upon achieving bone fusion, as failure can lead to adverse clinical outcomes. Demineralized bone matrix (DBM) has emerged as a promising solution for promoting fusion due to its unique combination of osteoinductive and osteoconductive properties. This study aims to compare the effectiveness of three distinct DBMs (Exfuse^®, Bongener^®, and Bonfuse^®) in achieving fusion rates in PLIF surgery. Materials and Methods: A retrospective review was conducted on 236 consecutive patients undergoing PLIF between September 2016 and February 2019. Patients over 50 years old with degenerative lumbar disease, receiving DBM, and following up for more than 12 months after surgery were included. Fusion was evaluated using the Bridwell grading system. Bridwell grades 1 and 2 were defined as ‘fusion’, while grades 3 and 4 were considered ‘non-fusion.’ Clinical outcomes were assessed using visual analog scale (VAS) scores for pain, the Oswestry disability index (ODI), and the European quality of life-5 (EQ-5D). Results: Fusion rates were 88.3% for Exfuse, 94.3% for Bongener, and 87.7% for Bonfuse, with no significant differences. All groups exhibited significant improvement in clinical outcomes at 12 months after surgery, but no significant differences were observed among the three groups. Conclusions: There were no significant differences in fusion rates and clinical outcomes among Exfuse, Bongener, and Bonfuse in PLIF surgery. Full article

This work focused on the experimental characterization of a complex flow structure behind a cross-flow array of cylindrical pins installed on the wall of a supersonic duct. This geometry simulates several common gas dynamic configurations, such as a supersonic mixer, a turbulence-generating grid, or, to some extent, a grid fin. In this work, the instrumentation employed is essentially non-intrusive, including spanwise integrating techniques such as (1) fast schlieren visualization and (2) Shack–Hartmann wavefront sensors; and planar techniques, namely (3) acetone Mie scattering and (4) acetone planar laser-induced fluorescence. An analysis of the data acquired by these complementary methods allowed the reconstruction of a three-dimensional portrait of supersonic flow interactions with a discrete pin array, including the shock wave structure, forefront separation zone, shock-induced separation zone, shear layer, and the mixing zone behind the pins. The main objective of this activity was to use various visualization techniques to acquire essential details of a complex compressible flow in a wide range of temporal–spatial scales. Particularly, a fine structure in the supersonic shear layer generated by the pin tips was captured by a Mie scattering technique. Based on the available publications, such structures have not been previously identified or discussed. Another potential outcome of this work is that the details revealed could be utilized for adequate code validation in numerical simulations. Full article

A flame’s structural feature is a crucial parameter required to comprehensively understand the interaction between turbulence and flames. The generation and evolution processes of the structure feature have rarely been investigated in lean blowout (LBO) flame instability states. Hence, to understand the precursor features of the LBO flame, this work employed high-speed OH-PLIF measurements to acquire time-series LBO flame images and developed a novel feature extraction method based on a deep neural network to quantify the LBO features in real time. Meanwhile, we proposed a deep neural network segmentation method based on a tri-map called the Fire-MatteFormer, and conducted a statistical analysis on flame surface features, primarily holes. The statistical analysis results determined the relationship between the life cycle of holes (from generation to disappearance) and their area, perimeter, and total number. The trained Fire-MatteFormer model was found to represent a viable method for determining flame features in the detection of incipient LBO instability conditions. Overall, the model shows significant promise in ascertaining local flame structure features. Full article

Posterior and transforaminal lumbar interbody fusion (PLIF and TLIF) allow some variation between surgeons, particularly regarding the extent of resection of the posterior interspinous ligamentary complex (PILC) with uncertain implications for outcome. The aim of this study was to assess the importance of preserving the PILC when performing PLIF or TLIF. Systematic review of clinical outcomes (adjacent segment degeneration (ASDG), fusion rate, reoperation rate, and visual analog scale (VAS) scores for back and leg pain) after PLIF/TLIF matched for integrity of PILC, Oswestry Disability Index (ODI) score, and radiological parameters. A total of 191 patients from 2 studies (1 prospective randomized control trial (RCT) and 1 retrospective observational cohort study) were identified. 102 (53.4%) had fusion (PLIF/TLIF) with preserved PILC. All 120 patients in the RCT underwent a L4–L5 single-level fusion, while the 71 patients in the retrospective cohort underwent surgery between T11 and S1. In the retrospective cohort study, significant differences between groups in mean number of fixed levels (4.8 ± 1.0 vs. 4.2 ± 0.5), decompressed levels (2.4 ± 0.7 vs. 3.0 ± 0.7), and interbody fusions (1.2 ± 0.9 vs. 2.0 ± 1.0) were reported. In each of the studies, all groups reported an improved ODI score at 3 months after surgery and at last follow-up. In each of the studies, the incidence of radiographic ASDG was significantly higher for the PILC resection group in both studies (9.0% vs. 43.0%, p < 0.01 and 23.0% vs. 49.0%, p = 0.042). Lumbar lordosis (which decreased after PILC resection in the RCT, p < 0.05) also differed between groups. Taken as a whole, these results suggest that preservation of the PILC during PLIF/TLIF surgery prevents future ASDG and loss of lumbar lordosis as well as the potential clinical consequences of these changes. Further prospective studies are needed. Full article

Type 2 diabetes mellitus and diabetic foot ulcers remain serious worldwide health problems. Caffeic acid is one of the natural products that has been experimentally proven to have diverse pharmacological properties. This study aimed to assess the inhibitory activity of caffeic acid and ethanolic extract of spent coffee grounds targeting DPP-4 and MMP-9 enzymes and evaluate the molecular interactions through 50-ns molecular dynamics simulations. This study also introduced our new version of PyPLIF HIPPOS, PyPLIF HIPPOS 0.2.0, which allowed us to identify protein–ligand interaction fingerprints and interaction hotspots resulting from molecular dynamics simulations. Our findings revealed that caffeic acid inhibited the DPP-4 and MMP-9 activity with an IC₅₀ of 158.19 ± 11.30 µM and 88.99 ± 3.35 µM while ethanolic extract of spent coffee grounds exhibited an IC₅₀ of 227.87 ± 23.80 µg/100 µL and 81.24 ± 6.46 µg/100 µL, respectively. Molecular dynamics simulations showed that caffeic acid interacted in the plausible allosteric sites of DPP-4 and in the active site of MMP-9. PyPLIF HIPPOS 0.2.0 identified amino acid residues interacting more than 10% throughout the simulation, which were Lys463 and Trp62 in the plausible allosteric site of DPP-4 and His226 in the active site of MMP-9. Full article