A Novel Multiscale Methodology forSimulating Tunnel Ventilation Flows duringFire

This paper applies a novel and fast modelling approach to simulate tunnel ventilation flows during fires. The complexity and high cost of full CFD models and the inaccuracies of simplistic zone or analytical models are avoided by efficiently combining mono-dimensional (1D) and CFD (3D) modelling techniques. A simple 1D network approach is used to model tunnel regions where the flow is fully developed (far field), and a detailed CFD representation is used where flow conditions require 3D resolution (near field). This multi-scale method has previously been applied to simulate tunnel ventilation systems including jet fans, vertical shafts and portals (Colella et al., Build Environ 44(12): 2357-2367, 2009) and it is applied here to include the effect of fire. Both direct and indirect coupling strategies are investigated and compared for steady state conditions. The methodology has been applied to a modern tunnel of 7 m diameter and 1.2 km in length. Different fire scenarios ranging from 10 MW to 100 MW are investigated with a variable number of operating jet fans. Comparison of cold flow cases with fire cases provides a quantification of the fire throttling effect, which is seen to be large and to reduce the flow by more than 30% for a 100 MW fire. Emphasis has been given to the discussion of the different coupling procedures and the control of the numerical error. Compared to the full CFD solution, the maximum flow field error can be reduced to less than few percents, but providing a reduction of two orders of magnitude in computational time. The much lower computational cost is of great engineering value, especially for parametric and sensitivity studies required in the design or assessment of ventilation and fire safety system

Trends in Outcomes for Neonates Born Very Preterm and Very Low Birth Weight in 11 High-Income Countries

OBJECTIVE: To evaluate outcome trends of neonates born very preterm in 11 high-income countries participating in the International Network for Evaluating Outcomes of neonates. STUDY DESIGN: In a retrospective cohort study, we included 154 233 neonates admitted to 529 neonatal units between January 1, 2007, and December 31, 2015, at 24(0/7) to 31(6/7) weeks of gestational age and birth weight <1500 g. Composite outcomes were in-hospital mortality or any of severe neurologic injury, treated retinopathy of prematurity, and bronchopulmonary dysplasia (BPD); and same composite outcome excluding BPD. Secondary outcomes were mortality and individual morbidities. For each country, annual outcome trends and adjusted relative risks comparing epoch 2 (2012-2015) to epoch 1 (2007-2011) were analyzed. RESULTS: For composite outcome including BPD, the trend decreased in Canada and Israel but increased in Australia and New Zealand, Japan, Spain, Sweden, and the United Kingdom. For composite outcome excluding BPD, the trend decreased in all countries except Spain, Sweden, Tuscany, and the United Kingdom. The risk of composite outcome was lower in epoch 2 than epoch 1 in Canada (adjusted relative risks 0.78; 95% CI 0.74-0.82) only. The risk of composite outcome excluding BPD was significantly lower in epoch 2 compared with epoch 1 in Australia and New Zealand, Canada, Finland, Japan, and Switzerland. Mortality rates reduced in most countries in epoch 2. BPD rates increased significantly in all countries except Canada, Israel, Finland, and Tuscany. CONCLUSIONS: In most countries, mortality decreased whereas BPD increased for neonates born very preterm

The International Network for Evaluating Outcomes (iNeo) of neonates: evolution, progress and opportunities

Neonates born very preterm (before 32 weeks’ gestational age), are a significant public health concern because of their high-risk of mortality and life-long disability. In addition, caring for very preterm neonates can be expensive, both during their initial hospitalization and their long-term cost of permanent impairments. To address these issues, national and regional neonatal networks around the world collect and analyse data from their constituents to identify trends in outcomes, and conduct benchmarking, audit and research. Improving neonatal outcomes and reducing health care costs is a global problem that can be addressed using collaborative approaches to assess practice variation between countries, conduct research and implement evidence-based practices. The International Network for Evaluating Outcomes (iNeo) of neonates was established in 2013 with the goal of improving outcomes for very preterm neonates through international collaboration and comparisons. To date, 10 national or regional population-based neonatal networks/datasets participate in iNeo collaboration. The initiative now includes data on >200,000 very preterm neonates and has conducted important epidemiological studies evaluating outcomes, variations and trends. The collaboration has also surveyed >320 neonatal units worldwide to learn about variations in practices, healthcare service delivery, and physical, environmental and manpower related factors and support services for parents. The iNeo collaboration serves as a strong international platform for Neonatal-Perinatal health services research that facilitates international data sharing, capacity building, and global efforts to improve very preterm neonate care