123 research outputs found

    Transient Thermal Diffusion in Conical Bodies

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    A numerical solution has been obtained for transient thermal diffusion in a cone in which chemical, electrical or nuclear energy at a constant rate. An implicit method is used to set up the finite difference equations and detailed analysis is carried out to trace the time history of the temperature distribution from the initial stages to the steady state. The effect of the rate of heat generation on the time required to reach steady state thermal distribution has also been depicted

    Transient Heat Transfer in Composite Solids with Non-Linear Boundary Condition

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    Transient heat transfer in composite media with non-linear radiation boundary condition has been studied by implicit finite difference scheme. It is observed that as the diffusivity ratio decreases there is more transfer of heat from radiating surface towards the non-radiating surface

    Transient Heat Transfer in Cylinpers.

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    A numerical solution has been obtained for transient heat transfer in cylinders by appropriate choice of body ,conforming grid points. The physical domain is transformed to computational domain using elliptic partial differential equation technique, wherein the grid spacing becomes uniform. The advantage of this method is that the discretisation of transformed equations. and accompanying boundary conditipns becdme very simple. The applicability of this method is very broad, as it can beused for carryinI giout study of any comple'x domain in contrast to finite difference methods, which have limited applicability. Detailedcalculations have been carried out to trace the evolution of temperaturedistribution frpm the initiial stages to the steadystate for circular cylinder, elliptical cylinder and square block with circular hole. This paper is aimed for general-shaped bodies and it has been applied to studytransient heat transfer in combustion-driven shock tube

    GAINS ASIA: Scenarios for cost-effective control of air pollution and greenhouse gases in India

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    There is growing recognition that a comprehensive and combined analysis of air pollution and climate change could reveal important synergies of emission control measures. Insight into the multiple benefits of measures could make emission controls economically more viable, both in industrialized and developing countries. However, while scientific understanding on many individual aspects of air pollution and climate change has considerably increased in the last years, little attention has been paid to a holistic analysis of the interactions between both problems. The Greenhouse gas - Air pollution Interactions and Synergies (GAINS) model has been developed as a tool to identify emission control strategies that maximize synergies between the control of local air quality and the mitigation of greenhouse emissions. GAINS investigates how specific mitigation measures simultaneously influence different pollutants that threaten human health via the exposure of fine particles and ground-level ozone, damage natural vegetation and crops, contribute to climate change. In recent years the GAINS model has been implemented for India in collaboration between the International Institute for Applied Systems Analysis (IIASA) and The Energy and Resources Institute (TERI). This report presents a first analysis conducted with the GAINS model that highlights how strategies to control local air quality could be designed in such a way that co-benefits on greenhouse gas mitigation could be maximized

    Defining the role of cellular immune signatures in diagnostic evaluation of suspected tuberculosis

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    BACKGROUND: Diagnosis of paucibacillary tuberculosis (TB) including extrapulmonary TB is a significant challenge, particularly in high-income, low-incidence settings. Measurement of Mycobacterium tuberculosis (Mtb)-specific cellular immune signatures by flow cytometry discriminates active TB from latent TB infection (LTBI) in case-control studies; however, their diagnostic accuracy and clinical utility in routine clinical practice is unknown. METHODS: Using a nested case-control study design within a prospective multicenter cohort of patients presenting with suspected TB in England, we assessed diagnostic accuracy of signatures in 134 patients who tested interferon-gamma release assay (IGRA)-positive and had final diagnoses of TB or non-TB diseases with coincident LTBI. Cellular signatures were measured using flow cytometry. RESULTS: All signatures performed less well than previously reported. Only signatures incorporating measurement of phenotypic markers on functional Mtb-specific CD4 T cells discriminated active TB from non-TB diseases with LTBI. The signatures measuring HLA-DR+IFNγ + CD4 T cells and CD45RA-CCR7-CD127- IFNγ -IL-2-TNFα + CD4 T cells performed best with 95% positive predictive value (95% confidence interval, 90-97) in the clinically challenging subpopulation of IGRA-positive but acid-fast bacillus (AFB) smear-negative TB suspects. CONCLUSIONS: Two cellular immune signatures could improve and accelerate diagnosis in the challenging group of patients who are IGRA-positive, AFB smear-negative, and have paucibacillary TB

    Operator training requirements and diagnostic accuracy of Fibroscan in routine clinical practice

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    BACKGROUND: Fibroscan is a quick, non-invasive technique used to measure liver stiffness (kPa), which correlates with fibrosis. To achieve a valid liver stiffness evaluation (LSE) the operator must obtain all the following three criteria: (1) ≥10 successful liver stiffness measurements; (2) IQR/median ratio <0.30 and (3) ≥60% measurement success rate. OBJECTIVES: To assess the operator training requirements and the importance of adhering to the LSE validity criteria in routine clinical practice. METHODS: We retrospectively analysed the LSE validity rates of 2311 Fibroscans performed (1 August 2008 to 31 July 2011) in our tertiary liver outpatients department at the University Hospital Birmingham, UK. The diagnostic accuracy of Fibroscan was assessed in 153 patients, by comparing LSE (valid and invalid) with the modified Ishak fibrosis stage on liver biopsy. RESULTS: Learning curve analysis highlighted that the greatest improvement in validity of LSE rates occurs in the operator’s first 10 Fibroscans, reaching 64.7% validity by the 50th Fibroscan. The correlation between LSE and the fibrosis stage on liver biopsy was superior in patients with a valid LSE (n=97) compared with those with an invalid LSE (n=56) (r(s) 0.577 vs 0.259; p=0.022). Area under receiving operating characteristics for significant fibrosis was greater when LSE was valid (0.83 vs 0.66; p=0.048). Using an LSE cut-off of 8 kPa, the negative predictive value of valid LSE was superior to invalid LSE for the detection of significant (84% vs 71%) and advanced fibrosis (100% vs 93%). CONCLUSIONS: Fibroscan requires minimal operator training (≥10 observed on patients), and when a valid LSE is obtained, it is an accurate tool for excluding advanced liver fibrosis. To ensure the diagnostic accuracy of Fibroscan it is essential that the recommended LSE validity criteria are adhered to in routine clinical practice

    Conventional liquid-based techniques versus Cytyc Thinprep(® )processing of urinary samples: a qualitative approach

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    BACKGROUND: The aim of our study was to objectively compare Cytyc Thinprep(® )and other methods of obtaining thin layer cytologic preparations (cytocentrifugation, direct smearing and Millipore(® )filtration) in urine cytopathology. METHODS: Thinprep slides were compared to direct smears in 79 cases. Cytocentrifugation carried out with the Thermo Shandon Cytospin(® )4 was compared to Thinprep in 106 cases, and comparison with Millipore filtration followed by blotting was obtained in 22 cases. Quality was assessed by scoring cellularity, fixation, red blood cells, leukocytes and nuclear abnormalities. RESULTS: The data show that 1) smearing allows good overall results to be obtained, 2) Cytocentrifugation with reusable TPX(® )chambers should be avoided, 3) Cytocentrifugation using disposable chambers (Cytofunnels(® )or Megafunnel(® )chambers) gives excellent results equalling or surpassing Thinprep and 4) Millipore filtration should be avoided, owing to its poor global quality. Despite differences in quality, the techniques studied have no impact on the diagnostic accuracy as evaluated by the rate of abnormalities. CONCLUSION: We conclude that conventional methods such as cytocentrifugation remain the most appropriate ones for current treatment of urinary samples. Cytyc Thinprep processing, owing to its cost, could be used essentially for cytology-based molecular studies

    A proposal for a CT driven classification of left colon acute diverticulitis

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    Computed tomography (CT) imaging is the most appropriate diagnostic tool to confirm suspected left colonic diverticulitis. However, the utility of CT imaging goes beyond accurate diagnosis of diverticulitis; the grade of severity on CT imaging may drive treatment planning of patients presenting with acute diverticulitis. The appropriate management of left colon acute diverticulitis remains still debated because of the vast spectrum of clinical presentations and different approaches to treatment proposed. The authors present a new simple classification system based on both CT scan results driving decisions making management of acute diverticulitis that may be universally accepted for day to day practice

    Complicated intra-abdominal infections worldwide: the definitive data of the CIAOW Study.

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    The CIAOW study (Complicated intra-abdominal infections worldwide observational study) is a multicenter observational study underwent in 68 medical institutions worldwide during a six-month study period (October 2012-March 2013). The study included patients older than 18 years undergoing surgery or interventional drainage to address complicated intra-abdominal infections (IAIs).1898 patients with a mean age of 51.6 years (range 18-99) were enrolled in the study. 777 patients (41%) were women and 1,121 (59%) were men. Among these patients, 1,645 (86.7%) were affected by community-acquired IAIs while the remaining 253 (13.3%) suffered from healthcare-associated infections. Intraperitoneal specimens were collected from 1,190 (62.7%) of the enrolled patients.827 patients (43.6%) were affected by generalized peritonitis while 1071 (56.4%) suffered from localized peritonitis or abscesses.The overall mortality rate was 10.5% (199/1898).According to stepwise multivariate analysis (PR = 0.005 and PE = 0.001), several criteria were found to be independent variables predictive of mortality, including patient age (OR = 1.1; 95%CI = 1.0-1.1; p &lt; 0.0001), the presence of small bowel perforation (OR = 2.8; 95%CI = 1.5-5.3; p &lt; 0.0001), a delayed initial intervention (a delay exceeding 24 hours) (OR = 1.8; 95%CI = 1.5-3.7; p &lt; 0.0001), ICU admission (OR = 5.9; 95%CI = 3.6-9.5; p &lt; 0.0001) and patient immunosuppression (OR = 3.8; 95%CI = 2.1-6.7; p &lt; 0.0001). © 2014 Sartelli et al.; licensee BioMed Central Ltd
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