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Pyloric interventions are surgical procedures employed to increase the gastric emptying rate in gastroparesis patients. In this study, we use anin silicomodel to investigate the consequences of pyloric intervention on gastric flow and emptying for two phenotypes of gastroparesis: antral hypomotility and decreased gastric tone. The transpyloric pressure gradient predicted by thein silicomodel, based on viscous fluid flow equations, is compared againstin vivomeasurements. Both phenotypes exhibit a similar pre-procedural emptying rate reduction, but after pyloric surgery, antral hypomotility case with preserved gastric tone shows significant improvements in emptying rates, up to 131%, accompanied by bile reflux from the duodenum into the stomach. Conversely, severely reduced gastric tone cases exhibited a post-procedural reduction in the net emptying rate due to the relatively larger bile reflux. In cases with a combination of antral hypomotility and reduced gastric tone, post-procedural improvements were observed only when both conditions were mild. Our findings highlight the pivotal role of the relative increase in pyloric orifice diameter in determining post-operative emptying rates. The study suggests a possible explanation for the selective response of patients toward these procedures and underscores the potential ofin silicomodelling to generate valuable insights to inform gastric surgery.

 

This article presents the evolutionary history of immersed boundary methods (IBMs), tracing their origins to the very beginning of computational fluid dynamics in the late 1950s all the way to the present day. The article highlights the advancements in this simulation methodology over the last 50 years and explores the interplay between IBMs and body-conformal grid methods during this time. Drawing upon the authors’ combined experience of more than 40 years in this arena, the perspective offered is personal and subjective. By employing a critical and comparative approach through the chronological lens, we hope that this article empowers the reader to understand both the capabilities and limitations of these methods, and to pursue advancements that fill the key gaps and break new ground. 

A reduced-order model of face mask aerodynamics and aerosol filtration is introduced. This model incorporates existing empirical data on filtration efficiency for different types of face masks, as well as the size distribution of exhaled aerosol particles. By considering realistic peripheral gap profiles, our model estimates both the extent of peripheral leakage and the fitted filtration efficiency of face masks in terms of outward protection. Simulations employing realistic peripheral gap profiles reveal that, for surgical masks, 80% or more of the total exhaled airflow could leak through the mask periphery, even when the average peripheral gap measures only 0.65 mm. However, the majority of exhaled aerosol particles do not follow the flow path through the peripheral gaps but, instead, impact directly on the mask fabric. As a result, these face masks can filter out approximately 70% of the exhaled particles despite the significant peripheral leakage. To validate our model, we compare its predictions with experimental data, and we find a reasonable agreement in estimating the outward protection provided by surgical masks. This validation underscores the reliability of our model in assessing the efficacy of surgical masks. Moreover, leveraging the insights gained from our model, we explore the impact of mask usage on the transmission of respiratory viruses within communities. By considering various scenarios, we can assess the potential reduction in viral spread achieved through widespread mask adoption.

 

Although face masks have been used for over a century to provide protection against airborne pathogens and pollutants, close scrutiny of their effectiveness has peaked in the past two years in response to the COVID-19 pandemic. The simplicity of face masks belies the complexity of the physical phenomena that determine their effectiveness as a defense against airborne infections. This complexity is rooted in the fact that the effectiveness of face masks depends on the combined effects of respiratory aerodynamics, filtration flow physics, droplet dynamics and their interactions with porous materials, structural dynamics, physiology, and even human behavior. At its core, however, the face mask is a flow-handling device, and in the current review, we take a flow physics–centric view of face masks and the key phenomena that underlie their function. We summarize the state of the art in experimental measurements, as well as the growing body of computational studies that have contributed to our understanding of the factors that determine the effectiveness of face masks. The review also lays out some of the important open questions and technical challenges associated with the effectiveness of face masks.

 

Although face masks have been used for over a century to provide protection against airborne pathogens and pollutants, close scrutiny of their effectiveness has peaked in the past two years in response to the COVID-19 pandemic. The simplicity of face masks belies the complexity of the physical phenomena that determine their effectiveness as a defense against airborne infections. This complexity is rooted in the fact that the effectiveness of face masks depends on the combined effects of respiratory aerodynamics, filtration flow physics, droplet dynamics and their interactions with porous materials, structural dynamics, physiology, and even human behavior. At its core, however, the face mask is a flow-handling device, and in the current review, we take a flow physics–centric view of face masks and the key phenomena that underlie their function. We summarize the state of the art in experimental measurements, as well as the growing body of computational studies that have contributed to our understanding of the factors that determine the effectiveness of face masks. The review also lays out some of the important open questions and technical challenges associated with the effectiveness of face masks. 

The peristaltic motion of stomach walls combines with the secretion of digestive enzymes to initiate the process that breaks down food. In this study, the mixing, breakdown, and emptying of a liquid meal containing protein is simulated in a model of a human stomach. In this model, pepsin, the gastric enzyme responsible for protein hydrolysis, is secreted from the proximal region of the stomach walls and allowed to react with the contents of the stomach. The velocities of the retropulsive jet induced by the peristaltic motion, the emptying rate, and the extent of hydrolysis are quantified for a control case as well as for three other cases with reduced motility of the stomach, which may result from conditions such as diabetes mellitus. This study quantifies the effect of stomach motility on the rate of food breakdown and its emptying into the duodenum and we correlate these observations with the mixing in the stomach induced by the wall motion. 

A computational model of drug dissolution in the human stomach is developed to investigate the interaction between gastric flow and orally administrated drug in the form of a solid tablet. The stomach model is derived from the anatomical imaging data and the motion and dissolution of the drug in the stomach are modeled via fluid-structure interaction combined with mass transport simulations. The effects of gastric motility and the associated fluid dynamics on the dissolution characteristics are investigated. Two different pill densities are considered to study the effects of the gastric flow as well as the gravitational force on the motion of the pill. The average mass transfer coefficient and the spatial distributions of the dissolved drug concentration are analyzed in detail. The results show that the retropulsive jet and recirculating flow in the antrum generated by the antral contraction wave play an important role in the motion of the pill as well as the transport and mixing of the dissolved drug concentration. It is also found that the gastric flow can increase the dissolution mass flux, especially when there is substantial relative motion between the gastric flow and the pill.