Impact of Land Use on Water Quality in River Njoro Watershed, Kenya

Water resources within the River Njoro watershed have become degraded due to high population growth rate and change in land use upsetting environmental stability. Land cover classification using Landsat images (Baldyga et al., 2004) shows loss of about 20% of forested areas between 1986 and 2003 in the watershed. The forested and large-scale farm areas have been converted mainly into small-scale mixed agriculture and human settlements. These changes have impacted negatively on the ecological integrity and hydrologic processes in the watershed (Shivoga, 2001) but little is known about the influence of specific land uses on water quality of the river

Transition phenomena in unstably stratified turbulent flows

We study experimentally and theoretically transition phenomena caused by the external forcing from Rayleigh-Benard convection with the large-scale circulation (LSC) to the limiting regime of unstably stratified turbulent flow without LSC whereby the temperature field behaves like a passive scalar. In the experiments we use the Rayleigh-B\'enard apparatus with an additional source of turbulence produced by two oscillating grids located nearby the side walls of the chamber. When the frequency of the grid oscillations is larger than 2 Hz, the large-scale circulation (LSC) in turbulent convection is destroyed, and the destruction of the LSC is accompanied by a strong change of the mean temperature distribution. However, in all regimes of the unstably stratified turbulent flow the ratio $\big[(\ell_x \nabla_x T)^2 + (\ell_y \nabla_y T)^2 + (\ell_z \nabla_z T)^2\big] /$ varies slightly (even in the range of parameters whereby the behaviour of the temperature field is different from that of the passive scalar). Here $\ell_i$ are the integral scales of turbulence along x, y, z directions, T and \theta are the mean and fluctuating parts of the fluid temperature. At all frequencies of the grid oscillations we have detected the long-term nonlinear oscillations of the mean temperature. The theoretical predictions based on the budget equations for turbulent kinetic energy, turbulent temperature fluctuations and turbulent heat flux, are in agreement with the experimental results.Comment: 14 pages, 14 figures, REVTEX4-1, revised versio

coreNASH: Multi-stakeholder Consensus on Core Outcomes for Decision Making About Nonalcoholic Steatohepatitis Treatment

The increasing prevalence and burden of nonalcoholic steatohepatitis (NASH) has spurred the development of new treatments and a need to consider outcomes used for NASH treatment decision making. Development of a NASH core outcome set (COS) can help prioritize outcomes of highest importance by incorporating the perspectives from a variety of decision makers. coreNASH was an initiative to develop a COS for NASH using a modified Delphi consensus process with a multi-stakeholder voting panel. A candidate outcome list was created based on a literature review and key informant interviews. The candidate outcome list was then condensed and prioritized through three rounds of online voting and through discussion at an in-person meeting. Outcomes were retained or eliminated based on predetermined consensus criteria, which included special weighting of patients’ opinions in the first two voting rounds. The coreNASH Delphi panel included 53 participants (7 patients, 10 clinicians and researchers, 7 health technology assessors, 22 industry representatives, 2 regulators, and 5 payers) who considered outcomes for two NASH-related COS: one for NASH without cirrhosis (F2-F3) and one for NASH with cirrhosis (F4). The initial candidate outcome list for both disease stages included 86 outcomes. The panel agreed on including two core outcomes for NASH without cirrhosis and nine core outcomes for NASH with cirrhosis in the COS. Conclusion: A consensus-based COS has been developed that can be used across the life cycle of NASH treatments. Outcomes included can contribute to decision making for regulatory, market access, and on-market decision making. Including the coreNASH COS in clinical development programs will facilitate improved comparisons and help decision makers assess the value of new products

Analytical method to predict two-phase flow pattern in horizontal micro-capillaries

An a priori prediction of multiphase flow pattern in micro-capillaries or microstructured reactors (MSR) is required for their rational design. The state-of-the-art numerical models require huge computational efforts. In the present work, an analytical model based on flow stability analysis has been applied to study the flow patterns in MSR. In order to simplify the task, a coaxial capillary geometry was chosen as a model of MSR and the two-phase flow was characterized in terms of the rate of perturbation in relation to the axial velocity. Liquid-liquid flow experiments were carried out in glass micro-capillary equipped with high-speed camera under various operating conditions such as flow velocity, flow ratios and viscosity ratios. The volume of fluid (VOF) model by ANSYS Fluent software was applied to predict the flow pattern details numerically. The results obtained were consistent with the experimental observations. Finally, the experimental and simulation results were rationalized in terms of dimensionless numbers allowing simple a priori prediction of the flow pattern in MSR. (C) 2012 Elsevier Ltd. All rights reserved

Lung and heart-lung transplantation: the state of the art

Lung and heart-lung transplantation is one of the most rapidly evolving transplantation fields. Survival has been improving with better patient selection, better graft preservation, and better immunosuppression. This paper outlines criteria for patient selection, reviews the surgical options involving lung transplantation, and discusses factors influencing morbidity and survival in these patients. The Cleveland Clinic Foundation experience with these procedures is presented. Lung and heart-lung transplantation has emerged from the experimental realm to the therapeutic, and can now be offered as an effective treatment option to many patients with previously fatal heart and lung disorders