91 research outputs found
Investigating droplet separation efficiency in wire-mesh mist eliminators in bubble column
AbstractEffects of design parameters on performance of wire-mesh mist eliminators were experimentally investigated in 15cm bubble column. The demisters performances were evaluated by droplet collection efficiency as a function of wide ranges of operating and design parameters. These parameters include: droplet size exiting the demister (250–380μm), specific surface area (236–868m2/m3), void fraction (97–98.3%), wire diameter (0.14–0.28mm), packing density (130–240kg/m3), and superficial gas velocity (0.109–0.118m/s. All demisters were 15cm in diameter with 10cm pad thickness, made from 316L stainless steel layered type demister pad wires. Experiments were carried out using air–water system at ambient temperature and atmospheric pressure. The experimental data on the droplet removal efficiency were obtained using Malvern Laser Droplet Sizer. The removal efficiency was found to increase with the increasing the demister specific surface area, packing density, and superficial gas velocity. In contrast, the removal efficiency was found to increase with decreasing the demister void fraction and wire diameter. The separation efficiency is correlated empirically as a function of the design parameters. A good agreement was obtained between the measured values and the correlation predictions with ±5% accuracy
The use of porcine small intestinal submucosa mesh (SURGISIS) as a pelvic sling in a man and a woman with previous pelvic surgery: two case reports
<p>Abstract</p> <p>Introduction</p> <p>Closing the pelvic peritoneum to prevent the small bowel dropping into the pelvis after surgery for locally recurrent rectal cancer is important to prevent adhesions deep in the pelvis or complications of adjuvant radiotherapy. Achieving this could be difficult because sufficient native tissue is unavailable; we report on the use of small intestine submucosa extra-cellular matrix mesh in the obliteration of the pelvic brim.</p> <p>Case presentation</p> <p>We describe two cases in which submucosa extra-cellular matrix mesh was used to obliterate the pelvic brim following resection of a recurrent rectal tumour; the first patient, a 78-year-old Caucasian man, presented with small bowel obstruction caused by adhesions to a recurrent rectal tumour. The second patient, an 84-year-old Caucasian woman, presented with vaginal discharge caused by an entero-vaginal fistula due to a recurrent rectal tumour.</p> <p>Conclusion</p> <p>We report on the use of submucosa extra-cellular matrix mesh as a pelvic sling in cases where primary closure of the pelvic peritoneum is unfeasible. Its use had no infective complications and added minimal morbidity to the postoperative period. This is an original case report that would be of interest to general and colorectal surgeons.</p
Comparison of Three Protocols: Dietary Therapy and Physical Activity, Acupuncture, or Laser Acupuncture in Management of Obese Females
AIM: The aim of this study was to compare efficiency of three types of obesity management protocols: dietary measures and physical activity; acupuncture or laser acupuncture with  healthy diet among obese females.SUBJECTS AND METHODS: Randomized longitudinal prospective study, carried out on 76 adult females. Blood pressure, anthropometric, ultrasonographic and biochemical assessments were done.RESULTS: Females undergo nutritional intervention showed highly significant improvement in the anthropometric measurements, visceral fat at umbilicus by US and diastolic blood pressure (decreased), and insignificant differences in fasting blood sugar and lipid profile. Female undergo acupuncture intervention showed highly significant improvement in visceral fat by US, lipid profile (decreased triglycerides, total cholesterol and LDL, and increased HDL), and decreased fasting blood sugar, and insignificant differences in the anthropometric measurements. Those undergo laser intervention showed highly significant improvement in all anthropometric measurements under study, visceral fat at umbilicus by US, blood pressure and some parameters of lipid profile (decreased total cholesterol and LDL). CONCLUSIONS: Nutritional intervention alone could be used to reduce weight if the lipid profile within normal range, but if it is impaired, acupuncture should be used beside. To strength the reduction in body anthropometry, laser intervention was recommended beside the nutritional intervention
Body Composition Changes after Weight-Loss Interventions among Obese Females: A Comparison of Three Protocols
AIM: To evaluate body composition changes after use of three different types of obesity management protocols: dietary measures and physical activity; acupuncture or laser acupuncture with healthy diet; aiming at achieving stable weight loss among obese Egyptian females.METHODS: A randomized longitudinal prospective study included 76 obese adult females; aged 26 up to 55 years. Anthropometric, body composition, ultrasonographic and biochemical assessments were done.RESULTS: The three types of obesity management protocols showed significant improvement in body composition (decrease in fat% and increases in FFM and TBW) and visceral fat by US. However, nutritional intervention showed highly significant improvement in the skin fold thickness at triceps and biceps sites and peripheral adiposity index. Acupuncture intervention showed highly significant improvement in fasting blood glucose (decreased) and lipid profile (decreased triglycerides, total cholesterol and LDL, and increased HDL). Laser intervention showed highly significant improvement in all the skin fold thickness and some parameters of lipid profile (decreased total cholesterol and LDL). CONCLUSIONS: The three obesity management protocols have significant effect on body composition, but acupuncture has the best effect in improving the lipid profile and fasting blood sugar. In addition, Laser intervention was recommended to improve skin fold thickness and subcutaneous fat
Syndromics: A Bioinformatics Approach for Neurotrauma Research
Substantial scientific progress has been made in the past 50 years in delineating many of the biological mechanisms involved in the primary and secondary injuries following trauma to the spinal cord and brain. These advances have highlighted numerous potential therapeutic approaches that may help restore function after injury. Despite these advances, bench-to-bedside translation has remained elusive. Translational testing of novel therapies requires standardized measures of function for comparison across different laboratories, paradigms, and species. Although numerous functional assessments have been developed in animal models, it remains unclear how to best integrate this information to describe the complete translational “syndrome” produced by neurotrauma. The present paper describes a multivariate statistical framework for integrating diverse neurotrauma data and reviews the few papers to date that have taken an information-intensive approach for basic neurotrauma research. We argue that these papers can be described as the seminal works of a new field that we call “syndromics”, which aim to apply informatics tools to disease models to characterize the full set of mechanistic inter-relationships from multi-scale data. In the future, centralized databases of raw neurotrauma data will enable better syndromic approaches and aid future translational research, leading to more efficient testing regimens and more clinically relevant findings
Impact of opioid-free analgesia on pain severity and patient satisfaction after discharge from surgery: multispecialty, prospective cohort study in 25 countries
Background: Balancing opioid stewardship and the need for adequate analgesia following discharge after surgery is challenging. This study aimed to compare the outcomes for patients discharged with opioid versus opioid-free analgesia after common surgical procedures.Methods: This international, multicentre, prospective cohort study collected data from patients undergoing common acute and elective general surgical, urological, gynaecological, and orthopaedic procedures. The primary outcomes were patient-reported time in severe pain measured on a numerical analogue scale from 0 to 100% and patient-reported satisfaction with pain relief during the first week following discharge. Data were collected by in-hospital chart review and patient telephone interview 1 week after discharge.Results: The study recruited 4273 patients from 144 centres in 25 countries; 1311 patients (30.7%) were prescribed opioid analgesia at discharge. Patients reported being in severe pain for 10 (i.q.r. 1-30)% of the first week after discharge and rated satisfaction with analgesia as 90 (i.q.r. 80-100) of 100. After adjustment for confounders, opioid analgesia on discharge was independently associated with increased pain severity (risk ratio 1.52, 95% c.i. 1.31 to 1.76; P < 0.001) and re-presentation to healthcare providers owing to side-effects of medication (OR 2.38, 95% c.i. 1.36 to 4.17; P = 0.004), but not with satisfaction with analgesia (beta coefficient 0.92, 95% c.i. -1.52 to 3.36; P = 0.468) compared with opioid-free analgesia. Although opioid prescribing varied greatly between high-income and low- and middle-income countries, patient-reported outcomes did not.Conclusion: Opioid analgesia prescription on surgical discharge is associated with a higher risk of re-presentation owing to side-effects of medication and increased patient-reported pain, but not with changes in patient-reported satisfaction. Opioid-free discharge analgesia should be adopted routinely
Evaluation of appendicitis risk prediction models in adults with suspected appendicitis
Background
Appendicitis is the most common general surgical emergency worldwide, but its diagnosis remains challenging. The aim of this study was to determine whether existing risk prediction models can reliably identify patients presenting to hospital in the UK with acute right iliac fossa (RIF) pain who are at low risk of appendicitis.
Methods
A systematic search was completed to identify all existing appendicitis risk prediction models. Models were validated using UK data from an international prospective cohort study that captured consecutive patients aged 16–45 years presenting to hospital with acute RIF in March to June 2017. The main outcome was best achievable model specificity (proportion of patients who did not have appendicitis correctly classified as low risk) whilst maintaining a failure rate below 5 per cent (proportion of patients identified as low risk who actually had appendicitis).
Results
Some 5345 patients across 154 UK hospitals were identified, of which two‐thirds (3613 of 5345, 67·6 per cent) were women. Women were more than twice as likely to undergo surgery with removal of a histologically normal appendix (272 of 964, 28·2 per cent) than men (120 of 993, 12·1 per cent) (relative risk 2·33, 95 per cent c.i. 1·92 to 2·84; P < 0·001). Of 15 validated risk prediction models, the Adult Appendicitis Score performed best (cut‐off score 8 or less, specificity 63·1 per cent, failure rate 3·7 per cent). The Appendicitis Inflammatory Response Score performed best for men (cut‐off score 2 or less, specificity 24·7 per cent, failure rate 2·4 per cent).
Conclusion
Women in the UK had a disproportionate risk of admission without surgical intervention and had high rates of normal appendicectomy. Risk prediction models to support shared decision‐making by identifying adults in the UK at low risk of appendicitis were identified
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