Polynomial adaptivity in LES: Application to compressibility effects investigation on bluff bodies

The use of a Discontinuous Galerkin framework to perform a compressible Large Eddy Simulation is an effective and accurate way to simulate complex turbulent flows. However, since the turbulent scales size is not known a priori, assumptions during the grid generation must be made. With the aim of reducing the influence of such assumptions, lowering the computational effort required to perform the LES and moving towards the adaptive LES postulated by Pope, New J Phys, 6(1):35, 2004, [5], we introduced a polynomial adaptive framework in Tugnoli, J Comput Phys, 349:33–58, 2017, [7]. In the present work we employ the aforementioned procedure to assess the effects of a varying Mach number in a flow around a square section cylinder, a configuration of interest for example for flame holders in combustors. Since most of the reference data on this kind of flows is obtained by incompressible computations (e.g. Rodi et al, J Fluids Eng, 119(2):248–262, 1997, [6]) and experiments (e.g. Lyn et al, J Fluid Mech, 304:285–319, 1995, [4]) the aim is to assess what are the effects of slightly higher Mach numbers in such flows, and what is the error involved into comparing compressible simulations results with incompressible reference data

Adverse drug events resulting from use of drugs with sulphonamide-containing anti-malarials and artemisinin-based ingredients: findings on incidence and household costs from three districts with routine demographic surveillance systems in rural Tanzania.

BACKGROUND: Anti-malarial regimens containing sulphonamide or artemisinin ingredients are widely used in malaria-endemic countries. However, evidence of the incidence of adverse drug reactions (ADR) to these drugs is limited, especially in Africa, and there is a complete absence of information on the economic burden such ADR place on patients. This study aimed to document ADR incidence and associated household costs in three high malaria transmission districts in rural Tanzania covered by demographic surveillance systems. METHODS: Active and passive surveillance methods were used to identify ADR from sulphadoxine-pyrimethamine (SP) and artemisinin (AS) use. ADR were identified by trained clinicians at health facilities (passive surveillance) and through cross-sectional household surveys (active surveillance). Potential cases were followed up at home, where a complete history and physical examination was undertaken, and household cost data collected. Patients were classified as having 'possible' or 'probable' ADR by a physician. RESULTS: A total of 95 suspected ADR were identified during a two-year period, of which 79 were traced, and 67 reported use of SP and/or AS prior to ADR onset. Thirty-four cases were classified as 'probable' and 33 as 'possible' ADRs. Most (53) cases were associated with SP monotherapy, 13 with the AS/SP combination (available in one of the two areas only), and one with AS monotherapy. Annual ADR incidence per 100,000 exposures was estimated based on 'probable' ADR only at 5.6 for AS/SP in combination, and 25.0 and 11.6 for SP monotherapy. Median ADR treatment costs per episode ranged from US$2.23 for those making a single provider visit to US$146.93 for patients with four visits. Seventy-three per cent of patients used out-of-pocket funds or sold part of their farm harvests to pay for treatment, and 19% borrowed money. CONCLUSION: Both passive and active surveillance methods proved feasible methods for anti-malarial ADR surveillance, with active surveillance being an important complement to facility-based surveillance, given the widespread practice of self-medication. Household costs associated with ADR treatment were high and potentially catastrophic. Efforts should be made to both improve pharmacovigilance across Africa and to identify strategies to reduce the economic burden endured by households suffering from ADR