Investigation of Atomization and Cavitation Characteristics in Nozzle

Abstract: The influence of fuel injector nozzle is critical to the performance and emissions of diesel engine. One of the most difficult problems encountered in the development of high-speed compression-ignition engine is to have the proper atomization of the fuel in the combustion chamber during the extremely short time available. Some of the important parameters including nozzle hole size, geometry, cavitations, convergence, velocity of fuel, density of air into which fuel is injected, affects to enhance the fuel atomization. Atomization is primarily occurs due to cavitation and turbulence in the vicinity of nozzle. In this paper discharge coefficient phenomenon is used, which accounts for the different orifice approach for the better atomization such as convergence. Numerical results shows that orifice having smaller outlet diameter gives increase in the coefficient of discharge with intent of increase in cavitations up to certain range causes to increase in atomization

UK primary care survey of venous leg ulceration management and referral - Post-EVRA trial

Objective Determine standards of referral and management of patients with venous leg ulceration in primary care after the release of the EVRA (A Randomized Trial of Early Endovenous Ablation in Venous Ulceration) study results. Methods An online questionnaire was disseminated over four months to professionals working within primary care. Results The survey received 643 responses. Of respondents, 90 (14%) had heard of the EVRA trial and 51 (8%) were familiar with the results. Of those who answered the following questions, 410 (69.1%) stated that referral to a vascular specialist must be made by the General Practitioner and 13 (2.2%) reported that they would always refer patients for secondary care assessment before the publication of EVRA. Considering the EVRA results, 128 (29%) reported that they would change practice regarding referral and would experience no barriers and 198 (45%) reported that they would like to refer earlier but is not their decision. Barriers to changing practice included local referral policies, training and time restrictions, 266 (59%) had heard of the NICE guideline (CG168) and 194 (43%) were aware of the recommendations for referral to a vascular service within two weeks for patients with an open or healed ulcer. Conclusion There is a considerable variation in local referral pathways for venous leg ulceration, and despite clinicians wanting to refer promptly, many primary care professionals are unable to. Unfortunately, the EVRA study alone may not change the overall practice, and work is needed to overcome barriers faced by primary care professionals

Abdominal aortic aneurysm clinical practice guidelines: a methodological assessment using the AGREE II instrument.

OBJECTIVES: Abdominal aortic aneurysm (AAA) clinical practice guidelines (CPGs) provide evidence-based information on patient management; however, methodological differences exist in the development of CPGs. This study examines the methodological quality of AAA CPGs using a validated assessment tool. METHODS: Medline, EMBASE and online CPG databases were searched from 1946 to 31 October 2021. Full-text, English language, evidence-based AAA CPGs were included. Consensus-based CPGs, summaries of CPGs or CPGs which were only available on purchase were excluded. Five reviewers assessed their quality using the Appraisal of Guidelines for Research and Evaluation II instrument. An overall guideline assessment scaled score of ≥80% was considered as the threshold to recommend CPG use in clinical practice. RESULTS: Seven CPGs were identified. Scores showed good inter-reviewer reliability (intraclass correlation coefficient 0.943, 95% CI 0.915 to 0.964). On average, CPGs performed adequately with mean scaled scores of over 50% in all domains. However, between CPGs, significant methodological heterogeneity was observed in all domains. Four CPGs scored ≥80% (European Society of Cardiology, the Society of Vascular Surgery, the European Society of Vascular Surgery and the National Institute of Health and Care Excellence), supporting their use in clinical practice. CONCLUSIONS: Four CPGs were considered of adequate methodological quality to recommend their use in clinical practice; nonetheless, these still showed areas for improvement, potentially through performing economic analysis and trial application of recommendations. A structured approach employing validated CPG creation tools should be used to improve rigour of AAA CPGs. Future work should also evaluate recommendation accuracy using validated appraisal tools

Penggunaan Mindfulness Meditation dalam Manajemen Stres: Sebuah systematic Review

Background. Mindfulnes meditation dan intervensi lain berbasis mindfulnes saat ini sedang populer yang terbukti bermanfaat secara luas terutama pada pasien kanker dan tenaga kesehatan profesional. Objectives. Tujuan dari artikel ini adalah melakukan review secara sistematic pada beberapa hasil penelitian terbaru yang menggunakan randomized controlled trials yang mengkaji efek intervensi mindfulness meditation terhadap berbagai kasus. Methods. Pencarian dilakukan di beberapa database elektronik dalam kurun waktu 10 tahun terakhir yang dipublikasikan dalam Bahasa Inggris. Hasil pencarian menyisakan 8 jurnal yang memenuhi kriteria. Conclusion. Mindfulness meditation menurunkan stres, ansietas, dan fatigue secara signifikan, tidak berpengaruh terhadap faktor metabolik pada pasien obesitas, signifikansi kurang kuat pada nyeri, depresi dan kualitas tidur. Perlu penelitian lebih lanjut penggunaan mindfulness meditation dalam menurunkan nyeri, depresi, dan peningkatan kualitas tidur serta penggunaan pada berbagai kasu

Penggunaan Mindfulness Meditation dalam Manajemen Stres: Sebuah systematic Review

Background. Mindfulnes meditation dan intervensi lain berbasis mindfulnes saat ini sedang populer yang terbukti bermanfaat secara luas terutama pada pasien kanker dan tenaga kesehatan profesional. Objectives. Tujuan dari artikel ini adalah melakukan review secara sistematic pada beberapa hasil penelitian terbaru yang menggunakan randomized controlled trials yang mengkaji efek intervensi mindfulness meditation terhadap berbagai kasus. Methods. Pencarian dilakukan di beberapa database elektronik dalam kurun waktu 10 tahun terakhir yang dipublikasikan dalam Bahasa Inggris. Hasil pencarian menyisakan 8 jurnal yang memenuhi kriteria. Conclusion. Mindfulness meditation menurunkan stres, ansietas, dan fatigue secara signifikan, tidak berpengaruh terhadap faktor metabolik pada pasien obesitas, signifikansi kurang kuat pada nyeri, depresi dan kualitas tidur. Perlu penelitian lebih lanjut penggunaan mindfulness meditation dalam menurunkan nyeri, depresi, dan peningkatan kualitas tidur serta penggunaan pada berbagai kasu

Penggunaan Mindfulness Meditation dalam Manajemen Stres: Sebuah systematic Review

Background. Mindfulnes meditation dan intervensi lain berbasis mindfulnes saat ini sedang populer yang terbukti bermanfaat secara luas terutama pada pasien kanker dan tenaga kesehatan profesional. Objectives. Tujuan dari artikel ini adalah melakukan review secara sistematic pada beberapa hasil penelitian terbaru yang menggunakan randomized controlled trials yang mengkaji efek intervensi mindfulness meditation terhadap berbagai kasus. Methods. Pencarian dilakukan di beberapa database elektronik dalam kurun waktu 10 tahun terakhir yang dipublikasikan dalam Bahasa Inggris. Hasil pencarian menyisakan 8 jurnal yang memenuhi kriteria. Conclusion. Mindfulness meditation menurunkan stres, ansietas, dan fatigue secara signifikan, tidak berpengaruh terhadap faktor metabolik pada pasien obesitas, signifikansi kurang kuat pada nyeri, depresi dan kualitas tidur. Perlu penelitian lebih lanjut penggunaan mindfulness meditation dalam menurunkan nyeri, depresi, dan peningkatan kualitas tidur serta penggunaan pada berbagai kasu

DNA replication stress restricts ribosomal DNA copy number

Ribosomal RNAs (rRNAs) in budding yeast are encoded by ~100–200 repeats of a 9.1kb sequence arranged in tandem on chromosome XII, the ribosomal DNA (rDNA) locus. Copy number of rDNA repeat units in eukaryotic cells is maintained far in excess of the requirement for ribosome biogenesis. Despite the importance of the repeats for both ribosomal and non-ribosomal functions, it is currently not known how “normal” copy number is determined or maintained. To identify essential genes involved in the maintenance of rDNA copy number, we developed a droplet digital PCR based assay to measure rDNA copy number in yeast and used it to screen a yeast conditional temperature-sensitive mutant collection of essential genes. Our screen revealed that low rDNA copy number is associated with compromised DNA replication. Further, subculturing yeast under two separate conditions of DNA replication stress selected for a contraction of the rDNA array independent of the replication fork blocking protein, Fob1. Interestingly, cells with a contracted array grew better than their counterparts with normal copy number under conditions of DNA replication stress. Our data indicate that DNA replication stresses select for a smaller rDNA array. We speculate that this liberates scarce replication factors for use by the rest of the genome, which in turn helps cells complete DNA replication and continue to propagate. Interestingly, tumors from mini chromosome maintenance 2 (MCM2)-deficient mice also show a loss of rDNA repeats. Our data suggest that a reduction in rDNA copy number may indicate a history of DNA replication stress, and that rDNA array size could serve as a diagnostic marker for replication stress. Taken together, these data begin to suggest the selective pressures that combine to yield a “normal” rDNA copy number

Informal support to first-parents after childbirth: a qualitative study in low-income suburbs of Dar es Salaam, Tanzania

<p>Abstract</p> <p>Background</p> <p>In Tanzania, and many sub-Saharan African countries, postpartum health programs have received less attention compared to other maternity care programs and therefore new parents rely on informal support. Knowledge on how informal support is understood by its stakeholders to be able to improve the health in families after childbirth is required. This study aimed to explore discourses on health related informal support to first-time parents after childbirth in low-income suburbs of Dar es Salaam, Tanzania.</p> <p>Methods</p> <p>Thirteen focus group discussions with first-time parents and female and male informal supporters were analysed by discourse analysis.</p> <p>Results</p> <p>The dominant discourse was that after childbirth a first time mother needed and should be provided with support for care of the infant, herself and the household work by the maternal or paternal mother or other close and extended family members. In their absence, neighbours and friends were described as reconstructing informal support. Informal support was provided conditionally, where poor socio-economic status and non-adherence to social norms risked poor support. Support to new fathers was constructed as less prominent, provided mainly by older men and focused on economy and sexual matters. The discourse conveyed stereotypic gender roles with women described as family caretakers and men as final decision-makers and financial providers. The informal supporters regulated the first-time parents' contacts with other sources of support.</p> <p>Conclusions</p> <p>Strong and authoritative informal support networks appear to persist. However, poverty and non-adherence to social norms was understood as resulting in less support. Family health in this context would be improved by capitalising on existing informal support networks while discouraging norms promoting harmful practices and attending to the poorest. Upholding stereotypic notions of femininity and masculinity implies great burden of care for the women and delimited male involvement. Men's involvement in reproductive and child health programmes has the potential for improving family health after childbirth. The discourses conveyed contradicting messages that may be a source of worry and confusion for the new parents. Recognition, respect and raising awareness for different social actors' competencies and limitations can potentially create a health-promoting environment among families after childbirth.</p

Research protocol: general practice organ donation intervention-a feasibility study (GPOD)

BACKGROUND: New interventions are required to increase the number of people donating their organs after death. In the United States of America (USA), general practice has proved to be a successful location to increase organ donor registration. However, a dearth of research exists examining this in the United Kingdom (UK). due to the unique challenges presented by the National Health Service (NHS). This protocol outlines a feasibility study to assess whether UK general practice is a feasible and acceptable location for organ donation intervention targeting NHS Organ Donor Register (NHS ODR) membership. METHODS: The primary intervention element, prompted choice, requires general practice to ask patients in consultations if they wish to join the NHS ODR. Two additional intervention techniques will be used to support prompted choice: staff training and leaflets and posters. The intervention will run for 3 months (April-July 2018) followed by a period of data collection. The following methods will be used to assess feasibility, acceptability and fidelity: registration data, a training evaluation survey, focus groups with staff and online surveys for staff and patients. DISCUSSION: By examining the feasibility, acceptability and fidelity of a prompted choice intervention in UK general practice, important knowledge can be gathered on whether it is a suitable location to conduct this. Additional learning can also be gained generally for implementing interventions in general practice. This could contribute to the knowledge base concerning the feasibility of NHS general practice to host interventions

Functional Recellularization of Acellular Rat Liver Scaffold by Induced Pluripotent Stem Cells: Molecular Evidence for Wnt/B-Catenin Upregulation.

BACKGROUND: Liver transplantation remains the only viable therapy for liver failure but has a severely restricted utility. Here, we aimed to decellularize rat livers to form acellular 3D bio-scaffolds suitable for seeding with induced pluripotent cells (iPSCs) as a tool to investigate the role of Wnt/β-catenin signaling in liver development and generation. METHODS: Dissected rat livers were randomly divided into three groups: I (control); II (decellularized scaffolds) and III (recellularized scaffolds). Liver decellularization was established via an adapted perfusion procedure and assessed through the measurement of extracellular matrix (ECM) proteins and DNA content. Liver recellularization was assessed through histological examination and measurement of transcript levels of Wnt/β-catenin pathway, hepatogenesis, liver-specific microRNAs and growth factors essential for liver development. Adult rat liver decellularization was confirmed by the maintenance of ECM proteins and persistence of growth factors essential for liver regeneration. RESULTS: iPSCs seeded rat decellularized livers displayed upregulated transcript expression of Wnt/β-catenin pathway-related, growth factors, and liver specification genes. Further, recellularized livers displayed restored liver-specific functions including albumin secretion and urea synthesis. CONCLUSION: This establishes proof-of-principle for the generation of three-dimensional liver organ scaffolds as grafts and functional re-establishment