scholarly journals Numerical Analysis of the Combustion Dynamics of Passively Controlled Jets Issuing from Polygonal Nozzles

Energies ◽  
2021 ◽  
Vol 14 (3) ◽  
pp. 554
Author(s):  
Łukasz Kuban ◽  
Jakub Stempka ◽  
Artur Tyliszczak

In the present work, the combustion of vitiated hydrogen jets issuing from differently shaped nozzles is modelled using the LES method. We investigate the impact of nozzle cross-sectional geometries (circular, square, triangular, hexagonal and hexagram) and the jet Reynolds numbers (Re= 18,000, 20,000 and 23,600) on the flame lift-off height, its structure, the locations of the temperature maxima and species distributions. The triangular nozzle yields the highest mixing rate and therefore the fastest decay of axial velocity and the fastest growth of the average temperature along the flame axis. It was found that for the largest Re, the zone of intense mixing and the reaction zone occur in distinct regions, while for the lower Re, these regions combine into an indistinguishable zone. Finally, it is shown that the lift-off height of the flames and the mean temperature field are non-linearly correlated with Re and strongly dependent on the nozzle shape.

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Clare Shakespeare ◽  
Handsome Dube ◽  
Sikhangezile Moyo ◽  
Solwayo Ngwenya

Abstract Background On the 27th of March 2020 the Zimbabwean government declared the Covid-19 pandemic a ‘national disaster’. Travel restrictions and emergency regulations have had significant impacts on maternity services, including resource stock-outs, and closure of antenatal clinics during the lockdown period. Estimates of the indirect impact of Covid-19 on maternal and perinatal mortality was expected it to be considerable, but little data was yet available. This study aimed to examine the impact of Covid-19 and lockdown control measures on non-Covid outcomes in a government tertiary level maternity unit in Bulawayo, Zimbabwe, by comparing maternal and perinatal morbidity and mortality before, and after the lockdown was implemented. Methods This was a retrospective, observational study, using a cross-sectional design to compare routine monthly maternal and perinatal statistics three months before and after Covid-19 emergency measures were implemented at Mpilo Central Hospital. Results Between January-March and April-June 2020, the mean monthly deliveries reduced from 747.3 (SD ± 61.3) in the first quarter of 2020 to 681.0 (SD ± 17.6) during lockdown, but this was not statistically significant, p = 0.20. The Caesarean section rates fell from a mean of 29.8% (SD ± 1.7) versus 28.0% (SD ± 1.7), which was also not statistically significant, p = 0.18. During lockdown, the percentage of women delivering at Mpilo Central Hospital who were booked at the hospital fell from a mean of 41.6% (SD ± 1.1) to 35.8% (SD ± 4.3) which was statistically significant, p = 0.03. There was no significant change, however, in maternal mortality or severe maternal morbidity (such as post-partum haemorrhage (PPH), uterine rupture, and severe preeclampsia/eclampsia), stillbirth rate or special care baby unit admission. There was an increase in the mean total number of early neonatal deaths (ENND) (mean 18.7 (SD ± 2.9) versus 24.0 (SD ± 4.6), but this was not statistically significant, p = 0.32. Conclusions Overall, maternity services at Mpilo showed resilience during the lockdown period, with no significant change in maternal and perinatal adverse outcomes, with the same number of man-hours worked before and during the lockdown Maternal and perinatal outcomes should continue to be monitored to assess the impact of Covid-19 and the lockdown measures as the pandemic in Zimbabwe unfolds. Further studies would be beneficial to explore women’s experiences and understand how bookings and deliveries at local clinics changed during this time.


2020 ◽  
pp. 019459982096963
Author(s):  
Vanessa F. Torrecillas ◽  
Kaden Neuberger ◽  
Alexander Ramirez ◽  
Paul Krakovitz ◽  
Jeremy D. Meier

Objective Third-party payers advocate for prior authorization (PA) to reduce overutilization of health care resources. The impact of PA in elective surgery is understudied, especially in cases where evidence-based clinical practice guidelines define operative candidacy. The objective of this study is to investigate the impact of PA on the incidence of pediatric tonsillectomy. Study Design Cross-sectional study. Setting Health claims database from a third-party payer. Methods Any pediatric patient who had evaluation for tonsillectomy from 2016 to 2019 was eligible for inclusion. A time series analysis was used to evaluate the change in incidence of tonsillectomy before and after PA. Lag time from consultation to surgery before and after PA was compared with segmented regression. Results A total of 10,047 tonsillectomy claims met inclusion and exclusion criteria. Female patients made up 51% of claims, and the mean age was 7.9 years. Just 1.5% of claims were denied after PA implementation. There was no change in the incidence of tonsillectomy for all plan types ( P = .1). Increased lag time from consultation to surgery was noted immediately after PA implementation by 2.38 days (95% CI, 0.23-4.54; P = .030); otherwise, there was no significant change over time ( P = .98). Conclusion A modest number of tonsillectomy claims were denied approval after implementation of PA. The value of PA for pediatric tonsillectomy is questionable, as it did not result in decreased incidence of tonsillectomy in this cohort.


2021 ◽  
pp. 1-6
Author(s):  
Shivani Saini ◽  
◽  
Agarwal Shail ◽  
Jain Manish ◽  
Yadav Devendra ◽  
...  

Background: Dermatophytosis is a common fungal infection affecting 20-25% of the world population. Aims: Our study was aimed to assess its impact on health-related quality of life(QoL), mental health, and various variables. Materials and Methods: A cross-sectional study was done from April 2019 to September 2019 on 174 patients of dermatophytosis of aged more than 16 years with their informed consent. The impact of infection on the quality of life was assessed by using the Dermatology life quality index questionnaire and General health questionnaire-12 was used to assess psychological impact. A visual analogue scale was used to assess the severity of pruritus. Appropriate statistical tests were applied. Results: Males to females ratio was 1.4:1. The age group of 21-30 was having the highest number of patients with the mean age of 27.8±9.97. Most patients had BSA under 10%. The mean value of DLQI and GHQ-12 were found 15.989±7.407 and 2.8563±2.8964, respectively. We found that dermatophytosis had a very large effect on the quality of life as the maximum number of patients(39%) were within this category. The “work and school” part in the questionnaire gained maximum importance(52.8%). The mean VAS score was 6±2.733 with most patients(32.7%) had moderate itching. We found a positive correlation between VAS and DLQI, VAS and GHQ-12, DLQI, and GHQ-12 with the statistical significance. Conclusion: In our study dermatophytosis affected the quality of life as well as the psychological health of patients. Therefore proper treatment of superficial dermatophtytosis is essential to prevent it from further complications


2019 ◽  
Vol 25 (5-6) ◽  
pp. 107-11
Author(s):  
Helena Siregar ◽  
Azwin Lubis ◽  
M. Arif Nasution ◽  
Indra Kesuma Nasution ◽  
Thamrin Tanjung

A cross sectional study about the relationships between family size and marital age and the impact of educatimt, occupation and family planning programme was conducted in the region of South Tapanuli North Sumatera. The study was performed on 246 married couples by simple random sampling of households in the villages Pakantea, Tamiang, Muarasoro and Sumuran, during the period of September 25 up to October 3, 1982. The eariiest age of marriage for women was 14 years, ancl the latest 20 years. Most of the women (68%) married at 15-20 year. The main education of responders were primary school (67%). The occupational status was mostly (90%) farmer. The mean family size under 20 years old was 6.3 and over 20 years, 5.3. Fertility rate under 20 years was still high. Family Planning was not yet widely accepted in this area.


2003 ◽  
Vol 23 (6) ◽  
pp. 550-556 ◽  
Author(s):  
Mark Wright ◽  
Graham Woodrow ◽  
Siobahn O'Brien ◽  
Neil King ◽  
Louise Dye ◽  
...  

Objective Malnutrition is common among peritoneal dialysis (PD) patients. Reduced nutrient intake contributes to this. It has long been assumed that this reflects disturbed appetite. We set out to define the appetite profiles of a group of PD patients using a novel technique. Design Prospective, cross-sectional comparison of PD patients versus controls. Setting Teaching hospital dialysis unit. Patients 39 PD patients and 42 healthy controls. Intervention Visual analog ratings were recorded at hourly intervals to generate daily profiles for hunger and fullness. Summary statistics were generated to compare the groups. Food intake was measured using 3-day dietary records. Main Outcome Measures Hunger and fullness profiles. Derived hunger and fullness scores. Results Controls demonstrated peaks of hunger before mealtimes, with fullness scores peaking after meals. The PD profiles had much reduced premeal hunger peaks. A postmeal reduction in hunger was evident, but the rest of the trace was flat. The PD fullness profile was also flatter than in the controls. Mean scores were similar despite the marked discrepancy in the profiles. The PD group had lower peak hunger and less diurnal variability in their hunger scores. They also demonstrated much less change in fullness rating around mealtimes, while the mean and peak fullness scores were little different. The reported nutrient intake was significantly lower for PD. Conclusion The data suggest that PD patients normalize their mean appetite perception at a lower level of nutrient intake than controls, suggesting that patient-reported appetite may be misleading in clinical practice. There is a loss of the usual daily variation for the PD group, which may contribute to their reduced food intake. The technique described here could be used to assess the impact of interventions upon the abnormal PD appetite profile.


2018 ◽  
Vol 7 ◽  
Author(s):  
Julius T. Kamwesiga ◽  
Lena K. Von Kock ◽  
Gunilla M. Eriksson ◽  
Susanne G.E. Guidetti

Background: Knowledge about perceived impact of stroke on everyday life as well as rehabilitation needs after stroke in Uganda is necessary to identify and develop rehabilitation interventions.Objectives: To explore and describe clinical characteristics and functioning during the acute or subacute phase and chronic phase, as well as the impact of stroke on everyday life during the chronic phase in stroke survivors in central Uganda.Method: A cross-sectional observational study was conducted on a consecutively included acute or subacute (n = 58) sample and a chronic (n = 62) sample. Face-to-face interviews were conducted to collect demographic information and clinical characteristics. The Scandinavian Stroke Scale (SSS) was used to collect clinical characteristics, assess neurological impairment and define stroke severity. The Barthel Index was used to assess the level of dependence in activities of daily living. In addition, the Stroke Impact Scale (SIS) 3.0 Uganda version was used to assess the impact of stroke in everyday life as perceived by the individuals in the chronic sample receiving rehabilitation.Results: The mean age of the acute/subacute sample was 49 years and 81% had moderate or severe stroke. The mean age of the chronic rehabilitation group was 53 years and 58% had mild stroke. Time since onset in the acute sample was between 2 days and 3 weeks, and time since onset for the chronic sample varied between 3 months and 3 years. Strength, hand function and participation were the most impacted SIS domains in the chronic sample.Conclusion: People with severe and moderate stroke were more likely to be admitted to Mulago Hospital. The mean age in the study sample was lower than that in high-income countries. Further knowledge is needed regarding the impact of stroke to develop guidelines for stroke rehabilitation interventions feasible in the Ugandan healthcare context in both rural and urban areas.


2010 ◽  
Vol 13 (11) ◽  
pp. 1818-1825 ◽  
Author(s):  
Tove Nystad ◽  
Marita Melhus ◽  
Magritt Brustad ◽  
Eiliv Lund

AbstractObjectiveTo assess coffee consumption in the Sami and Norwegian populations and to investigate the impact of unfiltered boiled coffee consumption on serum cholesterol concentrations.DesignA cross-sectional study. Information was collected by self-administrated questionnaires and total serum cholesterol was analysed. Participants were divided into three ethnic groups: Sami I (Sami used as home language in the last three generations), Sami II (at least one Sami identity marker) and Norwegian.SettingIn an area with Sami, Kven/Finnish and Norwegian populations, the SAMINOR study, 2003–2004.SubjectsA total of 5647 men and 6347 women aged 36–79 years.ResultsMore than 90 % of the study populations were coffee drinkers. Only 22 % were unfiltered coffee consumers. Sami I had the highest proportion of participants who consumed nine or more cups of unfiltered coffee per day, although the number of participants was limited. Total coffee consumption was associated with increased total cholesterol for men (P < 0·01) and women (P < 0·0001). For those who drank only unfiltered coffee, a significant association was found only in Norwegian men, adjusted for physical activity in leisure time, BMI and smoking habits (P < 0·001). From the lowest (less than five cups) to the highest (nine or more cups) unfiltered coffee consumption category, the mean total cholesterol levels increased by 0·29 mmol/l in Norwegian men.ConclusionsUnfiltered coffee consumption was lower in the present study compared to previous reports. In general, total coffee consumption was positively associated with total cholesterol levels. However, for unfiltered coffee consumption, an association was found only in Norwegian men.


2017 ◽  
Vol 7 (3) ◽  
pp. 318-327 ◽  
Author(s):  
Håkon Ihle-Hansen ◽  
Thea Vigen ◽  
Trygve Berge ◽  
Gunnar Einvik ◽  
Dag Aarsland ◽  
...  

Aims: To investigate Montreal Cognitive Assessment (MoCA) test scores in a cohort aged 63–65 years from a general population in relation to the proposed cut-off score of 26 for mild cognitive impairment (MCI) and to explore the impact of education. Methods: MoCA scores were assessed in the Akershus Cardiac Examination 1950 Study, a cross-sectional cohort study of all men and women born in 1950 living in Akershus County, Norway. The participants were aged 63–65 at the time of data collection. Results: MoCA scores were available in 3,413 participants, of which 47% had higher education (>12 years). The mean MoCA score was 25.3 (95% confidence interval [CI] 25.2–25.4), and 49% had a score below the suggested cut-off of 26 points. Those with higher education had significantly higher scores (mean 26.2, 95% CI 26.1–26.3 vs. 24.4, 95% CI 24.3–24.6, p < 0.001). Conclusions: Approximately 50% scored below the cut-off score of 26 points, suggesting that the cut-off score may have been set too high to distinguish normal cognitive function from MCI. Educational level had a significant impact on MoCA scores.


2020 ◽  
Vol 1 (1) ◽  
Author(s):  
Ali Almawashee ◽  
Qaswer Yousif ◽  
Karrar Ali Idan

Abstract Background:  Social media are tools that supports electronic conversation. suggested , social media are “a group of internet-based applications that build on the ideological and technological foundations of Web 2.0, that allow the creation and exchange of User Generated Content. Aim of the study: Is to identify the pattern of usage of social media among a sample of Iraqi medical students including the devices used, the time consumed, and   the purpose of usage. Materials &Methods: The study, which is a retrospective cross-sectional, was conducted among medical students at college of Medicine\Baghdad University at 2019 as an online survey for duration of 3 months Data was entered and analyzed using spss version 24.Informed consent was obtained from the participants and the study was approved by the research committee in the college. Results The mean age of the participants in this study was 20.8 with sd 1.78. Results had shown no significant association between the usefulness of social media for educational values and type of social media, device used, and the time spent on these media. Results had shown that those who use social media more frequently were not significantly worried about the potential of social media abuse. Conclusions A study exploring more objectively the relationship between students’ use of social media with their academic achievements and what sort of social media interventions associated with better learning are probably needed. Such knowledge may be useful to guide medical educators to better utilize social media in their instructional strategies.


Blood ◽  
2018 ◽  
Vol 132 (Supplement 1) ◽  
pp. 4860-4860 ◽  
Author(s):  
Pushpendra Goswami ◽  
Esther Natalie Oliva ◽  
Tatyana Ionova ◽  
Sam Salek

Abstract Introduction: Patient-reported outcome (PRO) measures not only have been widely used in clinical research but also increasingly employed in daily clinical practice to understand the health outcomes of medical interventions. A novel hematological malignancy (HM) specific PRO tool, HM-PRO, has been recently developed for use in daily clinical practice. The HM-PRO is a composite measure consisting of two scales: Part A - measuring the 'impact on patients' quality of life (QoL); and Part B-measuring the effect of 'signs and symptoms' experienced by the patients. Both scales have linear scoring system ranging from 0 to 100, with higher scores representing greater impact on QoL and symptom burden. The assessment of the "meaningfulness" of HM-PRO scores is essential if clinicians are to be able to use the instrument to understand patient health outcomes to aid their clinical decision-making and encourage better patient engagement. One way of enhancing the clinical utility of scores on multi-item questionnaires is by investigating the importance (to patients and clinicians) of cross-sectional differences by anchoring those differences and changes to clinically familiar events that are related to patient well-being. The aims of the present study were to determine the relationship between the HM-PRO scores and a Global Question (GQ) measuring the impact on a patient's life from patients' perspective and to identify bands of HM-PRO scores equivalent to each GQ descriptor, reflecting patients' global rating of PROs. Methods: In this multicenter cross-sectional study, 905 patients: male 486; mean age 64.3 (±12.4, years; mean time since diagnosis 4.6 (±5.2) years; with different HM's ( acute lymphoblastic leukemia n=29, acute myeloid leukemia n=67, aggressive non Hodgkin lymphoma n=54, chronic lymphocytic leukemia n=64, chronic myeloid leukemia n=45, Hodgkin lymphoma n=37, indolent non Hodgkin lymphoma n=41, myelodysplastic syndrome n=158, multiple myeloma n=296, and myeloproliferative neoplasm n=114); in different disease states (stable-399, remission-277, and progressing - 229) were recruited from seven secondary hospitals and five patient organizations in the UK. All patients were asked to complete the HM-PRO and answer the global question as an anchor. Anchor-based differences were determined cross-sectionally (differences between clinically-defined groups at one time point) to determine clinically important differences in scores. The data analysis was carried out using IBM SPSS 23, a statistical software. Results: The mean HM-PRO score for Part A was 31.7 (±21.6) with median of 28.3 (IQR 13.6-46.6), for Part B was 20.9 (±14.2) with median of 17.6 (IQR 8.8 - 29.4), and the mean GQ score was 3.2 (±1.19) with range 1-5. The mean, mode, and median of the GQ scores for each HM-PRO score for both scales of HM-PRO were used to devise the bands (Figure 1) and intra-class correlation coefficient (ICC) was calculated for level of agreement. The set of scores proposed for adoption included: for Part A HM-PRO scores 0-7 = 'no impact' on patients' QoL (GQ=1, n=64), scores 8-25 = 'a small impact' on patients' QoL (GQ=2, n=133), scores 26-41 = 'moderate impact' on patients' QoL (GQ=3, n=97), scores 42-74 = 'very large impact' on patients' QoL (GQ=4, n=111), and scores 75-100 = 'extremely large impact' on patients' QoL (GQ=5, n=18), with ICC =0.80 (95% CI-0.77 - 0.83); for Part B HM-PRO scores 0-3 = 'no effect' of signs and symptoms on patient's life (GQ=1, n=56), scores 4-16 = 'a small effect' of signs and symptoms on patient's life (GQ=2, n=133), scores 17-29 = 'a moderate effect' of signs and symptoms on patient's life (GQ=3, n=122), scores 30-65 = 'very large effect' of signs and symptoms on patient's life (GQ=4, n=104), and scores 66-100 = 'extremely large effect' of signs and symptoms on patient's life (GQ=5, n=3), with ICC =0.75 (95% CI- 0.71-0.78), respectively (Table 1). Conclusion: This study employed the anchor-based approach for devising a set of score banding for both Part A and Part B of HM-PRO. The proposed bands (Part A=0-7, 8-25, 26-41, 42-74, 75-100; Part B=0-3, 4-16, 17-29, 30-65, 66-100) had the highest agreement and number of patients in the individual bands. The proposed bands could be applied independent of gender and different age groups. The findings of this study will help the clinician and the care team to interpret the HM-PRO scores to aid their clinical decision-making process in daily routine practice. Disclosures Oliva: Sanofi: Consultancy, Speakers Bureau; Celgene: Consultancy, Other: Royalties, Speakers Bureau; La Jolla: Consultancy; Amgen: Consultancy, Speakers Bureau; Novartis: Consultancy, Speakers Bureau; Janssen: Consultancy, Speakers Bureau. Ionova:Takeda: Research Funding; BMS: Research Funding.


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