Enhanced Heat Transfer from Arrays of Jets Impinging on Plates

Multiple jets of various shapes, orientation and configuration are used regularly in a wide range of engineering applications to provide heating or cooling with impingement on a plate being one of the most common configurations due to the improved heat transfer rates. Design optimization has largely relied on empirical correlations that are limited by the range over which they were originally generated. Computational Fluid Mechanics is now sufficiently advanced to be used as an alternative method for obtaining optimal designs. This project uses the commercial Fluent package to compute heat transfer from a bank of jets impinging on a plate. Results for a single jet are validated against experimental data. The use of advanced turbulence modeling and appropriate boundary layer formulations are key ingredients for obtaining reliable calculations. The heat transfer resulting form the use of multi-jet configurations will be discussed in the paper

Assessment of Nutrition Information System Using Health Metrics Network Framework

Nutrition Information System (NIS) developed by Heath Ministry's Nutritional Development Directorate since 2011 covers data of toddler assessment in integrated health care, malnutrition case, coverages of Fe tablet among pregnant mothers, iodized salt consumption, vitamin A distribution and exclusive breastfeeding. This study aimed to assess NIS performance in South Tangerang City Health Agency using WHO's Health Metrics Network 2008 framework. NIS is national level information system with gradual reporting mechanism starting from 508 districts/cities to 34 provinces ended at national level. Eight districts/cities over Banten Province have conducted NIS. This study had six informants namely nutrition section, health resources and health information system section, two nutrition duties and two integrated health care workers. Data was collected on January - April 2013 using interview, observation and document analysis guidelines. Data analysis used interpretation analysis. The result showed no any policy and training implemented regarding nutrition surveillance. Monitoring activity was already conducted. Facilities were adequate, but the maintenance was deficient. There are six nutritional development indicators according to MDGs. Data grouping and dictionaries were available. Data reporting was conducted every month. Graphics and maps were used for presenting data. The data served was used for monitoring and making a decision on nutritional development programs at integrated health care, primary health care and health agency levels. Generally, NIS implementation in South Tangerang City. Health agency was already adequate

Using the Reach, Effectiveness, Adoption, Implementation, Maintenance Framework in the Evaluation of Community-Based Adolescent Care Pilot Program

Posyandu Remaja (Posmaja) is a community-based adolescent care service in Indonesia that comprises a group of adolescents working as volunteers and healthcare workers under the guidance and responsibility of the Public Health Centre and City Health Office. The study aims to provide a formative evaluation program of Posmaja using the Reach, Effectiveness, Adoption, Implementation, and Maintenance (RE-AIM) framework. This research used a qualitative approach and took place in South Tangerang City, Indonesia. The data were collected from July until December 2018. Nineteen people participated in the study. The study used in-depth interviews and focus group discussions that adopted the RE-AIM framework for data collection. Content analysis was used to analyze the collected data. The majority of Posmaja’s participants were male adolescents aged around 15 years old. Common themes generated were “adolescent empowerment,” “increasing health knowledge,” and “monitoring health and nutrition” as a result of doing the pilot program. Volunteers and healthcare workers recognized the benefits of Posmaja and thus encouraged the adoption of the program. This awareness, followed by the city Health Office’s willingness to fund and adopt the program, was viewed as highly necessary for the program’s continuation

Glycerol monooleate/solvents systems for progesterone transdermal delivery: In vitro permeation and microscopic studies

A liberação transdérmica de muitos fármacos é dificultada pelas características de barreira do estrato córneo. Promotores químicos de absorção cutânea são capazes de interagir com os constituintes do estrato córneo, induzindo aumento temporário e reversível na permeabilidade da pele. O objetivo deste trabalho foi avaliar a influência de sistemas monoleína (monoleato de glicerol)/solventes na absorção percutânea de um fármaco lipofílico (a progesterona), através do estrato córneo de camundongos sem pelo, bem como o efeito da monoleína nas características estruturais do estrato córneo, por meio de microscopia eletrônica de varredura (SEM) e microscopia de varredura confocal a laser (CLSM). As alterações morfológicas observadas no estrato córneo de camundongos sem pelo sugerem efeito da monoleína na barreira da pele. E, ainda, o aumento no fluxo In vitro da progesterona, bem como na penetração in vivo do marcador fluorescente (fluoresceína), apontam a monoleína como potencial promotor de absorção cutânea. Os resultados obtidos mostraram que os sistemas monoleína/solventes provocaram alterações na estrutura do estrato córneo, que poderiam causar o aumento da permeação da progesterona através da pele de camundongos sem pelo, otimizando, deste modo, a liberação transdérmica deste fármaco.Transdermal delivery of most drugs is precluded by the barrier characteristics of the stratum corneum (SC). Chemical penetration enhancers are capable of interacting with SC constituents, inducing a temporary reversible increase in the skin permeability. The aim of this work was to assess the influence of glycerol monooleate (GMO)/solvents systems on percutaneous absorption across hairless mouse SC of a lipophilic drug, progesterone (PG), as well as its effect on the SC structural characteristics, by scanning electron microscopy (SEM) and confocal laser scanning microscopy (CLSM). The morphological changes observed in the hairless mouse SC suggest a GMO effect on the skin barrier. In addition, the increase in the In vitro PG flux and in vivo penetration of a fluorescent label point towards GMO as a potential absorption enhancer. The results obtained showed that GMO/solvents systems provoked changes in the SC that could be causing increased permeation of PG across hairless mouse skin, optimising in this way the transdermal delivery of this drug

Vulnerability of Brazilian municipalities to hantavirus infections based on multi‑criteria decision analysis

Background: Hantavirus infection is an emerging zoonosis transmitted by wild rodents. In Brazil, high case-fatality rates among humans infected with hantavirus are of serious concern to public health authorities. Appropriate preventive measures partly depend on reliable knowledge about the geographical distribution of this disease. Methods: Incidence of hantavirus infections in Brazil (1993–2013) was analyzed. Epidemiological, socioeconomic, and demographic indicators were also used to classify cities’ vulnerability to disease by means of multi-criteria decision analysis (MCDA). Results: From 1993 to 2013, 1752 cases of hantavirus were registered in 16 Brazilian states. The highest incidence of hantavirus was observed in the states of Mato Grosso (0.57/100,000) and Santa Catarina (0.13/100,000). Based on MCDA analysis, municipalities in the southern, southeastern, and midwestern regions of Brazil can be classified as highly vulnerable. Most municipalities in northern and northeastern Brazil were classified as having low vulnerability to hantavirus cardiopulmonary syndrome. Conclusions: Although most human infections by hantavirus registered in Brazil occurred in the southern region of the country, a greater vulnerability to hantavirus was found in the Brazilian Midwest. This result reflects the need to strengthen surveillance where the disease has thus far gone unreported

Validation of a new test that assesses functional performance of the upper extremity and neck (FIT-HaNSA) in patients with shoulder pathology

<p>Abstract</p> <p>Background</p> <p>There is a lack of standardized tests that assess functional performance for sustained upper extremity activity. This study describes development of a new test for measuring functional performance of the upper extremity and neck and assesses reliability and concurrent validity in patients with shoulder pathology.</p> <p>Methods</p> <p>A series of developmental tests were conducted to develop a protocol for assessing upper extremity tasks that required multi-level movement and sustained elevation. Kinematics of movement were investigated to inform subtask structure. Tasks and test composition were refined to fit clinical applicability criteria and pilot tested on 5 patients awaiting surgery for shoulder impingement and age-sex matched controls. Test-retest reliability was assessed on 10 subjects. Then a cohort of patients with mild to moderate (n = 17) shoulder pathology and 19 controls (17 were age-sex matched to patients) were tested to further validate the Functional Impairment Test-Hand, and Neck/Shoulder/Arm (FIT-HaNSA) by comparing it to self-reported function and measured strength. The FIT-HaNSA, DASH and SPADI were tested on a single occasion. Impairments in isometric strength were measured using hand-held dynamometry. Discriminative validity was determined by comparing scores to those of age-sex matched controls (n = 34), using ANOVA. Pearson correlations between outcome measures (n = 41) were examined to establish criterion and convergent validity.</p> <p>Results</p> <p>A test protocol based on three five-minute subtasks, each either comprised of moving objects to waist-height shelves, eye-level shelves, or sustained manipulation of overhead nuts/bolts, was developed. Test scores for the latter 2 subtasks (or total scores) were different between controls as compared to either surgical-list patients with shoulder impingement or a variety of milder shoulder pathologies (p < 0.01). Test 1 correlated the highest with the DASH (r = -0.83), whereas Test 2 correlated highest with the SPADI (r = -0.76).</p> <p>Conclusion</p> <p>Initial data suggest the FIT-HaNSA provides valid assessment of impaired functional performance in patients with shoulder pathology. It discriminates between patients and controls, is related to self-reported function, and yet provides distinct information. Longitudinal testing is warranted.</p

Elective Cancer Surgery in COVID-19-Free Surgical Pathways During the SARS-CoV-2 Pandemic: An International, Multicenter, Comparative Cohort Study.

PURPOSE: As cancer surgery restarts after the first COVID-19 wave, health care providers urgently require data to determine where elective surgery is best performed. This study aimed to determine whether COVID-19-free surgical pathways were associated with lower postoperative pulmonary complication rates compared with hospitals with no defined pathway. PATIENTS AND METHODS: This international, multicenter cohort study included patients who underwent elective surgery for 10 solid cancer types without preoperative suspicion of SARS-CoV-2. Participating hospitals included patients from local emergence of SARS-CoV-2 until April 19, 2020. At the time of surgery, hospitals were defined as having a COVID-19-free surgical pathway (complete segregation of the operating theater, critical care, and inpatient ward areas) or no defined pathway (incomplete or no segregation, areas shared with patients with COVID-19). The primary outcome was 30-day postoperative pulmonary complications (pneumonia, acute respiratory distress syndrome, unexpected ventilation). RESULTS: Of 9,171 patients from 447 hospitals in 55 countries, 2,481 were operated on in COVID-19-free surgical pathways. Patients who underwent surgery within COVID-19-free surgical pathways were younger with fewer comorbidities than those in hospitals with no defined pathway but with similar proportions of major surgery. After adjustment, pulmonary complication rates were lower with COVID-19-free surgical pathways (2.2% v 4.9%; adjusted odds ratio [aOR], 0.62; 95% CI, 0.44 to 0.86). This was consistent in sensitivity analyses for low-risk patients (American Society of Anesthesiologists grade 1/2), propensity score-matched models, and patients with negative SARS-CoV-2 preoperative tests. The postoperative SARS-CoV-2 infection rate was also lower in COVID-19-free surgical pathways (2.1% v 3.6%; aOR, 0.53; 95% CI, 0.36 to 0.76). CONCLUSION: Within available resources, dedicated COVID-19-free surgical pathways should be established to provide safe elective cancer surgery during current and before future SARS-CoV-2 outbreaks