A comprehensive review on the exergy analysis of combined cycle power plants

The arriving optimum improvement of a thermodynamic system of energy conversion such as a combined cycle power plant (CCPP) is complicated due to the existence of different factors. Energy and exergy analysis is utilized as effective methods to determine both the quantity and quality of the energy sources. This paper reviews the latest thermodynamics analysis on each system components of a CCPP independently and determine the exergy destruction of the plant. A few layouts of the CCPP plant from different locations considered as case studies. In fact, the most energy losses occurred in the condenser compared with the plant components. It found that in the combustion chamber (CC) the highest exergy destruction occurred. The ambient temperature causes an evident decrement in the power production by the gas turbine (GT). The result has proved that besides energy, exergy analysis is an efficient way to the assessment of the performance of the CCPP by recommending a more advantageous configuration of the CCPP plant, which would lead to reductions in fuel required and emissions of air pollutants

Exercise as a treatment modality for depression: A narrative review

Depression is a major health burden associated with poor quality of life and impaired functioning. Depression is a leading cause of disability worldwide and is associated with profound economic costs. Depression is usually treated with antidepressant medications and psychological therapy or combination of both. However, there are lot of limitations associated with these therapies and as a result, a number of alternative or adjunctive therapies have been sought for. Exercise is one such option with a lot of substantial supportive research. The objective of the article was to review the beneficial effects of exercise in depression. An electronic search of literature from inception till 06/2017 highlighting the effects of exercise on depression and the possible mechanistic pathways involved was conducted using PubMed/ Medline, Google scholar and Scopus and relevant articles were utilized for this review. The results of this review confirmed the beneficial role of exercise in depression as evidenced by the improvement in the outcomes and the various psychobiological parameters measured. Thus exercise can be considered as a treatment option for the management of depression.Keywords: Depression, Exercise, Physical activity, Mechanistic pathways, BDN

Is Forced Coughing Effective in Reducing Pain During Cervical Biopsy? A systematic review and meta-analysis

Our objective was to compare potential analgesic effect of forced coughing (FC) technique versus local anesthetics (LA) or placebo during cervical biopsy. We systematically searched five electronic databases from inception till March 2021; Scopus, PubMed, Web of Science, Cochrane Library, Google Scholar. The data was extracted from six RCTs and analyzed them using Review Manager Software. During cervical biopsy, the overall effect estimate favored LA over FC group (MD =1.06; 95% CI [0.58 to 1.54]; p < 0.0001). On the other hand, when compared to no pain management pooled data were comparable between the two groups (MD = -1.2; 95% CI [-3.35 to 0.94]; p = 0.27). Procedure duration was significantly longer in LA than FC group (MD = -1.94; 95% CI [-2.47 to - 1.41]; p < 0.00001). FC and LA seemed to useful pain-lowering modalities during the cervical biopsy according to settings and availability. Further studies are recommended. Keywords: Cervical Biopsy; Colposcopy; Forced Coughing; Pain

Intravenous iron for acute and chronic heart failure with reduced ejection fraction (HFrEF) patients with iron deficiency: An updated systematic review and meta-analysis.

Patients with heart failure (HF) and iron deficiency are at increased risk of adverse clinical outcomes. We searched databases for randomised controlled trials that compared IV iron to placebo, in patients with HF with reduced ejection fraction (HFrEF). A total of 7,813 participants, all having HFrEF with 3,998 receiving IV iron therapy, and 3,815 control recipients were included. There was a significant improvement in Kansas City Cardiomyopathy Questionnaire favouring IV iron with MD 7.39, 95% CI [3.55, 11.22], p = 0.0002. Subgroup analysis, based on acute and chronic HF, has displayed a sustained statistical significance. Additionally, a significant increase in the left ventricular ejection fraction % was observed, with MD 3.76, 95% CI [2.32, 5.21], p 2, serum ferritin, and haemoglobin levels. Finally, despite the lack of difference in terms of all-cause hospitalisation and HF-related death, IV iron was associated with a significant reduction in HF-related, any cardiovascular reason hospitalisations, and all-cause death; which supports the need for implementation of IV iron as a standard of care in patients with HF and iron deficiency

Bioactive Lipids and Circulating Progenitor Cells in Patients with Cardiovascular Disease

Bone marrow-derived progenitor cells are mobilized into the peripheral blood after acute myocardial injury and in chronic ischemic heart disease. However, the mechanisms responsible for this mobilization are poorly understood. We examined the relationship between plasma levels of bioactive lipids and number of circulating progenitor cells (CPCs) in patients (N = 437) undergoing elective or emergent cardiac catheterization. Plasma levels of sphingosine-1 phosphate (S1P) and ceramide-1 phosphate (C1P) were quantified using mass spectrometry. CPCs were assessed using flow cytometry. S1P levels correlated with the numbers of CD34+, CD34+/CD133+, and CD34+/CXCR4+ CPCs even after adjustment for potential confounding factors. However, no significant correlation was observed between C1P levels and CPC count. Plasma levels of S1P correlated with the number of CPCs in patients with coronary artery disease, suggesting an important mechanistic role for S1P in stem cell mobilization. The therapeutic effects of adjunctive S1P therapy to mobilize endogenous stem cells need to be investigated

Enhanced reactivity of pyridin-3-o1 towards 4-phenyl-l, 2, 4-triazoline-3, 5- dione: FMO treatment of the cycloaddition process

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Efficacy and Safety of AmBisome in Combination with Sodium Stibogluconate or Miltefosine and Miltefosine Monotherapy for African Visceral Leishmaniasis: Phase II Randomized Trial.

BACKGROUND: SSG&PM over 17 days is recommended as first line treatment for visceral leishmaniasis in eastern Africa, but is painful and requires hospitalization. Combination regimens including AmBisome and miltefosine are safe and effective in India, but there are no published data from trials of combination therapies including these drugs from Africa. METHODS: A phase II open-label, non-comparative randomized trial was conducted in Sudan and Kenya to evaluate the efficacy and safety of three treatment regimens: 10 mg/kg single dose AmBisome plus 10 days of SSG (20 mg/kg/day), 10 mg/kg single dose AmBisome plus 10 days of miltefosine (2.5mg/kg/day) and miltefosine alone (2.5 mg/kg/day for 28 days). The primary endpoint was initial parasitological cure at Day 28, and secondary endpoints included definitive cure at Day 210, and pharmacokinetic (miltefosine) and pharmacodynamic assessments. RESULTS: In sequential analyses with 49-51 patients per arm, initial cure was 85% (95% CI: 73-92) in all arms. At D210, definitive cure was 87% (95% CI: 77-97) for AmBisome + SSG, 77% (95% CI 64-90) for AmBisome + miltefosine and 72% (95% CI 60-85) for miltefosine alone, with lower efficacy in younger patients, who weigh less. Miltefosine pharmacokinetic data indicated under-exposure in children compared to adults. CONCLUSION: No major safety concerns were identified, but point estimates of definitive cure were less than 90% for each regimen so none will be evaluated in Phase III trials in their current form. Allometric dosing of miltefosine in children needs to be evaluated. TRIAL REGISTRATION: The study was registered with ClinicalTrials.gov, number NCT01067443

Surgical site infection after gastrointestinal surgery in high-income, middle-income, and low-income countries: a prospective, international, multicentre cohort study

Background: Surgical site infection (SSI) is one of the most common infections associated with health care, but its importance as a global health priority is not fully understood. We quantified the burden of SSI after gastrointestinal surgery in countries in all parts of the world. Methods: This international, prospective, multicentre cohort study included consecutive patients undergoing elective or emergency gastrointestinal resection within 2-week time periods at any health-care facility in any country. Countries with participating centres were stratified into high-income, middle-income, and low-income groups according to the UN's Human Development Index (HDI). Data variables from the GlobalSurg 1 study and other studies that have been found to affect the likelihood of SSI were entered into risk adjustment models. The primary outcome measure was the 30-day SSI incidence (defined by US Centers for Disease Control and Prevention criteria for superficial and deep incisional SSI). Relationships with explanatory variables were examined using Bayesian multilevel logistic regression models. This trial is registered with ClinicalTrials.gov, number NCT02662231. Findings: Between Jan 4, 2016, and July 31, 2016, 13 265 records were submitted for analysis. 12 539 patients from 343 hospitals in 66 countries were included. 7339 (58·5%) patient were from high-HDI countries (193 hospitals in 30 countries), 3918 (31·2%) patients were from middle-HDI countries (82 hospitals in 18 countries), and 1282 (10·2%) patients were from low-HDI countries (68 hospitals in 18 countries). In total, 1538 (12·3%) patients had SSI within 30 days of surgery. The incidence of SSI varied between countries with high (691 [9·4%] of 7339 patients), middle (549 [14·0%] of 3918 patients), and low (298 [23·2%] of 1282) HDI (p < 0·001). The highest SSI incidence in each HDI group was after dirty surgery (102 [17·8%] of 574 patients in high-HDI countries; 74 [31·4%] of 236 patients in middle-HDI countries; 72 [39·8%] of 181 patients in low-HDI countries). Following risk factor adjustment, patients in low-HDI countries were at greatest risk of SSI (adjusted odds ratio 1·60, 95% credible interval 1·05–2·37; p=0·030). 132 (21·6%) of 610 patients with an SSI and a microbiology culture result had an infection that was resistant to the prophylactic antibiotic used. Resistant infections were detected in 49 (16·6%) of 295 patients in high-HDI countries, in 37 (19·8%) of 187 patients in middle-HDI countries, and in 46 (35·9%) of 128 patients in low-HDI countries (p < 0·001). Interpretation: Countries with a low HDI carry a disproportionately greater burden of SSI than countries with a middle or high HDI and might have higher rates of antibiotic resistance. In view of WHO recommendations on SSI prevention that highlight the absence of high-quality interventional research, urgent, pragmatic, randomised trials based in LMICs are needed to assess measures aiming to reduce this preventable complication