Experimental and theoretical performance evaluation of parabolic trough mirror as solar thermal concentrator to thermoelectric generators

This paper presents the prospects of harnessing radiative heat from the sun with a parabolic trough mirror, as a solar thermal concentrator, in comparison to the mathematical model and experimental quartz-halogen concentrator model for the electrical energy conversion utilizing thermoelectric generators (TEG). The construction and design of TEG-setup along with Parabolic trough mirrors and quartz-halogen lamps are presented. The Parabolic trough mirror used as a focal point at a distance of 19.05 cm. With eight quartz-halogen concentrated heat, the maximum performance achieved at ΔT of 11.8 K, Voc of 292 mV and Isc of 95.8 mA, recorded at the concentrated hot-side surface temperature of 317.8 K. When compared to the natural solar concentrated heat, higher temperature of 473.15 K at the hot-side surface temperature of TG was achieved. It is concluded that the heat concentration of the parabolic mirror increases with an increase in the intensity of heat using natural solar radiations. The Voc of 1.76 V and Isc of 1.1 A at a temperature difference of 110 K were measured, which are in good agreement with validated mathematical results. The parabolic through mirror utilized is smaller in size and thus collected lesser sun rays than the larger dish style mirror, and hence the heat in the focal point was very low, for better results, parabolic trough mirror with higher surface area would be important for future experiments

Modern eminence and concise critique of solar thermal energy and vacuum insulation technologies for sustainable low-carbon infrastructure

A concise critique on harnessing the abundant solar thermal energy and improvement with vacuum insulation for the utilization and conversion is presented. This research implicates that the world is becoming a global solar smart city prompted by increasing daily demand of energy by the global population and land-use. Amongst all the renewable energy resources available, solar thermal energy collectors (STC) are the most copious because it is accessible in both direct and indirect modes with global solar thermal capacity in operation in 2019 was 479 GWth and annual energy yield estimated to be 389 TWh. Hybridization has been found to be the only way of improving the existing performance of (STC) such as hybrid photovoltaic thermal (PVT) with phase-change material (PCM) for energy storage and magneto-thermoelectric generators (MTEGs) and/or vacuum insulated TEG (VTEG) for waste heat energy conversion to electrical power. The concentrating solar power (CSP) technologies were also precisely studied and yet parabolic trough collector, dish sterling and solar tower are amongst the top solar thermal heat energy harvesters and its electrical power generation has also been comprehended. The modern eminence of vacuum insulation technologies on thermal comfort and sound insulation in sustainable low-carbon buildings is presented. The research implicates that there is still a scope of improving the building and construction sector and target to achieve not only zero-energy buildings (ZEB) but generating-energy buildings (GEB). A concise critique on vacuum insulated smart glazed windows is presented and the review implicates that the hybridization with PV and TEG and novelty in the constructional materials of vacuum glazing (VG) and translucent vacuum insulation panel (TVIP) are vital in the realistic move towards the GEB. The future of vacuum insulation is not only limited to GEB but vital applications occur in medical, imaging, mechatronics and manufacturing industries

Utilisation of an operative difficulty grading scale for laparoscopic cholecystectomy

Background A reliable system for grading operative difficulty of laparoscopic cholecystectomy would standardise description of findings and reporting of outcomes. The aim of this study was to validate a difficulty grading system (Nassar scale), testing its applicability and consistency in two large prospective datasets. Methods Patient and disease-related variables and 30-day outcomes were identified in two prospective cholecystectomy databases: the multi-centre prospective cohort of 8820 patients from the recent CholeS Study and the single-surgeon series containing 4089 patients. Operative data and patient outcomes were correlated with Nassar operative difficultly scale, using Kendall’s tau for dichotomous variables, or Jonckheere–Terpstra tests for continuous variables. A ROC curve analysis was performed, to quantify the predictive accuracy of the scale for each outcome, with continuous outcomes dichotomised, prior to analysis. Results A higher operative difficulty grade was consistently associated with worse outcomes for the patients in both the reference and CholeS cohorts. The median length of stay increased from 0 to 4 days, and the 30-day complication rate from 7.6 to 24.4% as the difficulty grade increased from 1 to 4/5 (both p < 0.001). In the CholeS cohort, a higher difficulty grade was found to be most strongly associated with conversion to open and 30-day mortality (AUROC = 0.903, 0.822, respectively). On multivariable analysis, the Nassar operative difficultly scale was found to be a significant independent predictor of operative duration, conversion to open surgery, 30-day complications and 30-day reintervention (all p < 0.001). Conclusion We have shown that an operative difficulty scale can standardise the description of operative findings by multiple grades of surgeons to facilitate audit, training assessment and research. It provides a tool for reporting operative findings, disease severity and technical difficulty and can be utilised in future research to reliably compare outcomes according to case mix and intra-operative difficulty

Limited diversity associated with duplicated class II MHC-DRB genes in the red squirrel population in the United Kingdom compared with continental Europe

The red squirrel (Sciurus vulgaris) population in the United Kingdom has declined over the last century and is now on the UK endangered species list. This is the result of competition from the eastern grey squirrel (S. carolinensis) which was introduced in the 19th century. However, recent evidence suggests that the rate of population decline is enhanced by squirrelpox disease, caused by a viral infection carried asymptomatically by grey squirrels but to which red squirrels are highly susceptible. Population genetic diversity provides some resilience to rapidly evolving or exotic pathogens. There is currently no data on genetic diversity of extant UK squirrel populations with respect to genes involved in disease resistance. Diversity is highest at loci involved in the immune response including genes clustered within the major histocompatibility complex (MHC). Using the class II DRB locus as a marker for diversity across the MHC region we genotyped 110 red squirrels from locations in the UK and continentalEurope. Twenty four Scvu-DRB alleles at two functional loci; Scvu-DRB1 and Scvu- DRB2, were identified. High levels of diversity were identified at both loci in the continental populations. In contrast, no diversity was observed at the Scvu-DRB2 locus in the mainland UK population while a high level of homozygosity was observed at the Scvu-DRB1 locus. The red squirrel population in the UK appears to lack the extensive MHC diversity associated with continental populations, a feature which may have contributed to their rapid decline

Population‐based cohort study of outcomes following cholecystectomy for benign gallbladder diseases

Background The aim was to describe the management of benign gallbladder disease and identify characteristics associated with all‐cause 30‐day readmissions and complications in a prospective population‐based cohort. Methods Data were collected on consecutive patients undergoing cholecystectomy in acute UK and Irish hospitals between 1 March and 1 May 2014. Potential explanatory variables influencing all‐cause 30‐day readmissions and complications were analysed by means of multilevel, multivariable logistic regression modelling using a two‐level hierarchical structure with patients (level 1) nested within hospitals (level 2). Results Data were collected on 8909 patients undergoing cholecystectomy from 167 hospitals. Some 1451 cholecystectomies (16·3 per cent) were performed as an emergency, 4165 (46·8 per cent) as elective operations, and 3293 patients (37·0 per cent) had had at least one previous emergency admission, but had surgery on a delayed basis. The readmission and complication rates at 30 days were 7·1 per cent (633 of 8909) and 10·8 per cent (962 of 8909) respectively. Both readmissions and complications were independently associated with increasing ASA fitness grade, duration of surgery, and increasing numbers of emergency admissions with gallbladder disease before cholecystectomy. No identifiable hospital characteristics were linked to readmissions and complications. Conclusion Readmissions and complications following cholecystectomy are common and associated with patient and disease characteristics

Mortality from gastrointestinal congenital anomalies at 264 hospitals in 74 low-income, middle-income, and high-income countries: a multicentre, international, prospective cohort study

Background: Congenital anomalies are the fifth leading cause of mortality in children younger than 5 years globally. Many gastrointestinal congenital anomalies are fatal without timely access to neonatal surgical care, but few studies have been done on these conditions in low-income and middle-income countries (LMICs). We compared outcomes of the seven most common gastrointestinal congenital anomalies in low-income, middle-income, and high-income countries globally, and identified factors associated with mortality. // Methods: We did a multicentre, international prospective cohort study of patients younger than 16 years, presenting to hospital for the first time with oesophageal atresia, congenital diaphragmatic hernia, intestinal atresia, gastroschisis, exomphalos, anorectal malformation, and Hirschsprung's disease. Recruitment was of consecutive patients for a minimum of 1 month between October, 2018, and April, 2019. We collected data on patient demographics, clinical status, interventions, and outcomes using the REDCap platform. Patients were followed up for 30 days after primary intervention, or 30 days after admission if they did not receive an intervention. The primary outcome was all-cause, in-hospital mortality for all conditions combined and each condition individually, stratified by country income status. We did a complete case analysis. // Findings: We included 3849 patients with 3975 study conditions (560 with oesophageal atresia, 448 with congenital diaphragmatic hernia, 681 with intestinal atresia, 453 with gastroschisis, 325 with exomphalos, 991 with anorectal malformation, and 517 with Hirschsprung's disease) from 264 hospitals (89 in high-income countries, 166 in middle-income countries, and nine in low-income countries) in 74 countries. Of the 3849 patients, 2231 (58·0%) were male. Median gestational age at birth was 38 weeks (IQR 36–39) and median bodyweight at presentation was 2·8 kg (2·3–3·3). Mortality among all patients was 37 (39·8%) of 93 in low-income countries, 583 (20·4%) of 2860 in middle-income countries, and 50 (5·6%) of 896 in high-income countries (p<0·0001 between all country income groups). Gastroschisis had the greatest difference in mortality between country income strata (nine [90·0%] of ten in low-income countries, 97 [31·9%] of 304 in middle-income countries, and two [1·4%] of 139 in high-income countries; p≤0·0001 between all country income groups). Factors significantly associated with higher mortality for all patients combined included country income status (low-income vs high-income countries, risk ratio 2·78 [95% CI 1·88–4·11], p<0·0001; middle-income vs high-income countries, 2·11 [1·59–2·79], p<0·0001), sepsis at presentation (1·20 [1·04–1·40], p=0·016), higher American Society of Anesthesiologists (ASA) score at primary intervention (ASA 4–5 vs ASA 1–2, 1·82 [1·40–2·35], p<0·0001; ASA 3 vs ASA 1–2, 1·58, [1·30–1·92], p<0·0001]), surgical safety checklist not used (1·39 [1·02–1·90], p=0·035), and ventilation or parenteral nutrition unavailable when needed (ventilation 1·96, [1·41–2·71], p=0·0001; parenteral nutrition 1·35, [1·05–1·74], p=0·018). Administration of parenteral nutrition (0·61, [0·47–0·79], p=0·0002) and use of a peripherally inserted central catheter (0·65 [0·50–0·86], p=0·0024) or percutaneous central line (0·69 [0·48–1·00], p=0·049) were associated with lower mortality. // Interpretation: Unacceptable differences in mortality exist for gastrointestinal congenital anomalies between low-income, middle-income, and high-income countries. Improving access to quality neonatal surgical care in LMICs will be vital to achieve Sustainable Development Goal 3.2 of ending preventable deaths in neonates and children younger than 5 years by 2030

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

Femtosecond-assisted intracorneal ring segment complications in keratoconus: from novelty to expertise

Amr Mounir, Gamal Radwan, Mahmoud Mohamed Farouk, Engy Mohamed Mostafa Department of Ophthalmology, Faculty of Medicine, Sohag University, Sohag, Egypt Objectives: To document the difference between complication rate in the early curve of practicing intracorneal stromal rings and after gaining experience. Patients and methods: A retrospective study of 623 eyes of 417 patients with keratoconus who underwent Keraring implantation using femtosecond laser for channel creation. Results: The main outcome measures were reported intraoperative and postoperative complications. The overall complication rate was 12.7% (79 eyes) over the 4 years with 34 eyes in the first year (5.5%) and six eyes in the fourth year (0.96%). Over the 4 years of our practice, intraoperative complications were 7.1% and postoperative complications were 5.6%. Yet, there was a significant difference in intraoperative complications between the first and the fourth year where it was 3.5% and 0.48%, respectively. This also applies to the postoperative complication rate, which decreased from 1.9% to 0.5% in the fourth year. Conclusion: Complications with femtosecond-assisted intracorneal stromal ring procedure can be reduced by experience, making this procedure a safe and effective means of treating keratoconus. Yet, there are some complications that cannot be avoided such as sterile keratitis. Keywords: femtosecond laser, intracorneal rings, Kerarings, keratoconu

Flow boiling in a four-compartment heat sink for high-heat flux cooling: A parametric study

Semiconductor devices and microelectronic devices are widely used in many applications such as central processing units. These devices produce a huge amount of heat that must be dissipated properly because their operation is sensitive to operating temperature. Under high operating temperatures, physical damage is expected because of thermal stresses harming the structure of the components and increasing the failure rate. The thermal management of these devices is mandatory to fulfill the recommended operating conditions. The complexity of applying even the most powerful single-phase liquid cooling arrangement is that the semiconductor component temperature increases linearly with increasing heat dissipation rate. Consequently, the temperature of the device could reach higher than the maximum temperature limit. Unlike the single-phase flow, the two-phase flow boiling–cooling system can provide more robust thermal management, uniform temperature distribution over the surface and high heat dissipation by the latent heat. Hence, the flow boiling in microscale devices is an effective cooling technique for high dense-power electronic components. The current study used ethanol, acetone, and Novec-7000 coolants with high, medium, and low boiling points, respectively to study the flow boiling in a microchannel device. The effects of the volumetric flow rate and heat flux were experimentally investigated. A graphite sheet was used as thermal interface material (TIM) for further enhancing the heat dissipation, and wall temperature uniformity was assessed under boiling conditions. The Novec-7000 coolant showed outstanding cooling capabilities under ultra-high-heat flux conditions. When TIM was used, effective heat flux increased by 0.62% and 1.62% for acetone and Novec-7000, respectively. Moreover, the experimental results showed that the boiling point is a critical parameter in the system performance of flow boiling–cooling