34 research outputs found
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A High Efficiency PSOFC/ATS-Gas Turbine Power System
A study is described in which the conceptual design of a hybrid power system integrating a pressurized Siemens Westinghouse solid oxide fuel cell generator and the Mercury{trademark} 50 gas turbine was developed. The Mercury{trademark} 50 was designed by Solar Turbines as part of the US. Department of Energy Advanced Turbine Systems program. The focus of the study was to develop the hybrid power system concept that principally would exhibit an attractively-low cost of electricity (COE). The inherently-high efficiency of the hybrid cycle contributes directly to achieving this objective, and by employing the efficient, power-intensive Mercury{trademark} 50, with its relatively-low installed cost, the higher-cost SOFC generator can be optimally sized such that the minimum-COE objective is achieved. The system cycle is described, major system components are specified, the system installed cost and COE are estimated, and the physical arrangement of the major system components is discussed. Estimates of system power output, efficiency, and emissions at the system design point are also presented. In addition, two bottoming cycle options are described, and estimates of their effects on overall-system performance, cost, and COE are provided
Risk stratification by pre-operative cardiopulmonary exercise testing improves outcomes following elective abdominal aortic aneurysm surgery : a cohort study
Background:
In 2009, the NHS evidence adoption center and National Institute for Health and Care Excellence (NICE) published a review of the use of endovascular aneurysm repair (EVAR) of abdominal aortic aneurysms (AAAs). They recommended the development of a risk-assessment tool to help identify AAA patients with greater or lesser risk of operative mortality and to contribute to mortality prediction.
A low anaerobic threshold (AT), which is a reliable, objective measure of pre-operative cardiorespiratory fitness, as determined by pre-operative cardiopulmonary exercise testing (CPET) is associated with poor surgical outcomes for major abdominal surgery. We aimed to assess the impact of a CPET-based risk-stratification strategy upon perioperative mortality, length of stay and non-operative costs for elective (open and endovascular) infra-renal AAA patients.
Methods:
A retrospective cohort study was undertaken. Pre-operative CPET-based selection for elective surgical intervention was introduced in 2007. An anonymized cohort of 230 consecutive infra-renal AAA patients (2007 to 2011) was studied. A historical control group of 128 consecutive infra-renal AAA patients (2003 to 2007) was identified for comparison.
Comparative analysis of demographic and outcome data for CPET-pass (AT ≥ 11 ml/kg/min), CPET-fail (AT < 11 ml/kg/min) and CPET-submaximal (no AT generated) subgroups with control subjects was performed. Primary outcomes included 30-day mortality, survival and length of stay (LOS); secondary outcomes were non-operative inpatient costs.
Results:
Of 230 subjects, 188 underwent CPET: CPET-pass n = 131, CPET-fail n = 35 and CPET-submaximal n = 22. When compared to the controls, CPET-pass patients exhibited reduced median total LOS (10 vs 13 days for open surgery, n = 74, P < 0.01 and 4 vs 6 days for EVAR, n = 29, P < 0.05), intensive therapy unit requirement (3 vs 4 days for open repair only, P < 0.001), non-operative costs (£5,387 vs £9,634 for open repair, P < 0.001) and perioperative mortality (2.7% vs 12.6% (odds ratio: 0.19) for open repair only, P < 0.05). CPET-stratified (open/endovascular) patients exhibited a mid-term survival benefit (P < 0.05).
Conclusion:
In this retrospective cohort study, a pre-operative AT > 11 ml/kg/min was associated with reduced perioperative mortality (open cases only), LOS, survival and inpatient costs (open and endovascular repair) for elective infra-renal AAA surgery
Preoperative Behavioural Intervention versus standard care to Reduce Drinking before elective orthopaedic Surgery (PRE-OP BIRDS):Protocol for a multicentre pilot randomised controlled trial
Background
Evidence suggests that increased preoperative alcohol consumption increases the risk of postoperative complications; therefore, a reduction or cessation in alcohol intake before surgery may reduce perioperative risk. Preoperative assessment presents an opportunity to intervene to optimise patients for surgery. This multicentre, two-arm, parallel group, individually randomised controlled trial will investigate whether a definitive trial of a brief behavioural intervention aimed at reducing preoperative alcohol consumption is feasible and acceptable to healthcare professionals responsible for its delivery and the preoperative elective orthopaedic patient population.
Methods
Screening will be conducted by trained healthcare professionals at three hospitals in the North East of England. Eligible patients (those aged 18 or over, listed for elective hip or knee arthroplasty surgery and scoring 5 or more or reporting consumption of six or more units on a single occasion at least weekly on the alcohol screening tool) who enrol in the trial will be randomised on a one-to-one non-blinded basis to either treatment as usual or brief behavioural intervention delivered in the pre-assessment clinic. Patients will be followed up 1–2 days pre-surgery, 1–5 days post-surgery (as an in-patient), 6 weeks post-surgery, and 6 months post intervention. Feasibility will be assessed through rates of screening, eligibility, recruitment, and retention to 6-month follow-up. An embedded qualitative study will explore the acceptability of study methods to patients and staff.
Discussion
This pilot randomised controlled trial will establish the feasibility and acceptability of trial procedures reducing uncertainties ahead of a definitive randomised controlled trial to establish the effectiveness of brief behavioural intervention to reduce alcohol consumption in the preoperative period and the potential impact on perioperative complications
The physiological impact of high?intensity interval training in octogenarians with comorbidities
BackgroundDeclines in cardiorespiratory fitness (CRF) and fat-free mass (FFM) with age are linked to mortality, morbidity and poor quality of life. High-intensity interval training (HIIT) has been shown to improve CRF and FFM in many groups, but its efficacy in the very old, in whom comorbidities are present is undefined. We aimed to assess the efficacy of and physiological/metabolic responses to HIIT, in a cohort of octogenarians with comorbidities (e.g. hypertension and osteoarthritis).MethodsTwenty-eight volunteers (18 men, 10 women, 81.2 ± 0.6 years, 27.1 ± 0.6 kg·m−2) with American Society of Anaesthesiology (ASA) Grade 2–3 status each completed 4 weeks (12 sessions) HIIT after a control period of equal duration. Before and after each 4 week period, subjects underwent body composition assessments and cardiopulmonary exercise testing. Quadriceps muscle biopsies (m. vastus lateralis) were taken to quantify anabolic signalling, mitochondrial oxidative phosphorylation, and cumulative muscle protein synthesis (MPS) over 4-weeks.ResultsIn comorbid octogenarians, HIIT elicited improvements in CRF (anaerobic threshold: +1.2 ± 0.4 ml·kg−1·min−1, P = 0.001). HIIT also augmented total FFM (47.2 ± 1.4 to 47.6 ± 1.3 kg, P = 0.04), while decreasing total fat mass (24.8 ± 1.3 to 24 ± 1.2 kg, P = 0.0002) and body fat percentage (33.1 ± 1.5 to 32.1 ± 1.4%, P = 0.0008). Mechanistically, mitochondrial oxidative phosphorylation capacity increased after HIIT (i.e. citrate synthase activity: 52.4 ± 4 to 67.9 ± 5.1 nmol·min−1·mg−1, P = 0.005; membrane protein complexes (C): C-II, 1.4-fold increase, P = 0.002; C-III, 1.2-fold increase, P = 0.03), as did rates of MPS (1.3 ± 0.1 to 1.5 ± 0.1%·day−1, P = 0.03). The increase in MPS was supported by up-regulated phosphorylation of anabolic signalling proteins (e.g. AKT, p70S6K, and 4E-BP1; all P < 0.05). There were no changes in any of these parameters during the control period. No adverse events were reported throughout the study.ConclusionsThe HIIT enhances skeletal muscle mass and CRF in octogenarians with disease, with up-regulation of MPS and mitochondrial capacity likely underlying these improvements. HIIT can be safely delivered to octogenarians with disease and is an effective, time-efficient intervention to improve muscle mass and physical function in a short time frame
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Intake of ashe juniper and live oak by Angora goats
Angora mutton goats (Capra hircus) were fed diets of either live oak [Quercus virginiana (Small) Sarg. var. fusiformis], alfalfa hay (Medicago sativa L.), Coastal bermudagrass hay (Cynodon dactylon (L.)Pers.) or female ashe juniper (Juniperus ashei Buchholz) plus Coastal bermudagrass hay during the spring and fall of 1991 in a digestion/metabolism study. Nitrogen concentration of Coastal bermudagrass hay was nearly equal to that of alfalfa hay; nitrogen concentration of ashe juniper and live oak were much lower than those of the hays, and were higher in fall than spring. Dry matter intake and dietary nitrogen were highest for alfalfa hay, intermediate for Coastal bermudagrass hay, and lower for ashe juniper and live oak. Goats retained more nitrogen when consuming alfalfa and Coastal bermudagrass hays than juniper or live oak during fall, but differences were smaller (P > 0.10) during spring. Nitrogen balance was negative for goats consuming live oak in the spring. Nitrogen balance was positive for live oak in the fall and positive for ashe juniper for the spring and fall. Animals fed hay diets had higher levels of urine output than those fed juniper or live oak. Dry matter digestibility of juniper and live oak diets was less in fall than in spring. During fall, dry matter intakes of juniper and live oak were significantly lower than those of alfalfa and Coastal bermudagrass hays. We conclude that both ashe juniper and live oak foliage can provide nutrients for goats but only as portions of diets.The Journal of Range Management archives are made available by the Society for Range Management and the University of Arizona Libraries. Contact [email protected] for further information.Migrated from OJS platform August 202
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Volatile oil contents of ashe and redberry juniper and its relationship to preference by Angora and Spanish goats
Angora and Spanish goats (Capra bircus) were exposed to ashe (Juniperus ashei Buchholz) female, ashe male, redberry (Juniperus pinchotti Sudw.) female and redberry male branches in cafeteria style feeding trials. Preferences were consistent across seasons (except winter). Spanish goats generally consumed more juniper than Angoras. Both breeds preferred ashe over redberry juniper and female over male plants. Concentrations of volatile oils varied significantly between species of juniper and among seasons, but not between sexes. Concentrations of total oils were greater in the spring and summer than in the fall and winter. Concentrations of sabinine+beta-pinene were greater in redberry than ashe for all seasons. Concentrations of myrcene were significantly greater for redberry during the spring and summer. Significant correlation of oil concentration with grams of juniper consumed indicated that specific oils were influencing preference for juniper. Correlations were similar for Angora and Spanish goats, indicating no differences between goat breeds in sensitivity to oils.The Journal of Range Management archives are made available by the Society for Range Management and the University of Arizona Libraries. Contact [email protected] for further information.Migrated from OJS platform August 202
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The Impact of Grazing Systems on the Magnitude and Stability of Ranch Income in the Rolling Plains of Texas
Results of a 1961-1974 grazing system study on the Texas Experimental Ranch in the Rolling Plains were used to evaluate annual net income stability characteristics for a cow-calf operation. A linear programming risk analysis model was utilized to select optimal combinations of grazing systems which minimized annual negative net income fluctuations. Greatest annual net incomes, expressed in 1979 dollars, were obtained from heavier stocked, continuously grazed systems which received winter feed. For the 1961-1974 period, annual net income stability was not increased by selecting combination of grazing systems. However, when only the last 5 years were included in the analysis, the stability of annual net income was improved by selecting a combination of grazing systems. Supplemental winter feeding did not have a significant effect on annual net incomes. However, under heavier stocking rates the standard deviation of annual net income was approximately doubled when cows did not receive supplemental winter feed. Annual income and income variability was determined to have increased during the last 5 years of the study, relative to the total study period. It is hypothesized that a portion of this increased variability at the heavier rates of stocking is the result of changes in the composition of vegetation. The general increase in variability across all systems indicates that ranch operators may need to consider alternatives for risk management as well as management for profits.This material was digitized as part of a cooperative project between the Society for Range Management and the University of Arizona Libraries.The Journal of Range Management archives are made available by the Society for Range Management and the University of Arizona Libraries. Contact [email protected] for further information.Migrated from OJS platform August 202