Three-dimensional CFD analysis of liquid slug acceleration and impact in a voided pipeline with end orifice

This research describes the dynamic behavior of an isolated slug driven by pressurized air in a voided line with an end orifice. A three-dimensional (3D) computational-fluid-dynamics (CFD) model is used to simulate the rapid propulsion and impact at the orifice for given slug length and driving air pressure, and is validated against experimental data. New mechanisms are observed: (i) the driving air pressure at the slug tail decreases with the slug motion; (ii) when the slug arrives at the orifice, the air fraction is almost one hundred percent in the most upstream part of the pipe, then it attenuates rapidly until an invariant eighty percent is achieved with a constant mass shedding rate; (iii) the velocity distribution in the radial direction of the cross-section at the midpoint of the slug length evolves from uniform to trapezoidal and then to logarithmic during slug movement; (iv) the initial vertical slug front changes its shape due to air intrusion at the top of the slug front; (v) the slug’s acceleration decreases first and then increases under the combined effects of its decreasing mass, nonlinear attenuation of the driving pressure, and increasing skin friction; (vi) the slug length has a constant rate of decrease

Thigh-length compression stockings and DVT after stroke

Controversy exists as to whether neoadjuvant chemotherapy improves survival in patients with invasive bladder cancer, despite randomised controlled trials of more than 3000 patients. We undertook a systematic review and meta-analysis to assess the effect of such treatment on survival in patients with this disease

Diversification by Urbanization: Tracing the Property-Finance Nexus in Dubai and the Gulf

This article explores the role of liberalized real estate markets in shaping financial-sector development in the Arab Gulf region. Since 2001, record oil revenues and the inflow of repatriated wealth into the region have generated immense demand for new, productive destinations for surplus capital. Gulf Cooperation Council states have subsequently undergone rapid growth that is intimately tied to the regulatory transformation of urban real estate markets and the circulation of surplus capital from oil rents to the ‘secondary circuit’ of the built environment. With an emphasis on the city of Dubai, we employ the notion of diversification by urbanization to trace the re-regulation of real estate markets and highlight how these strategies have subsequently shaped Gulf financial markets. Through an examination of the impacts of real estate mega-project development on local banking credit, equities and Islamic financial markets, we reframe recent urbanization in the region as a process of financial re-engineering, and identify the emergence of capital groups whose accumulation activities are tightly connected to both the real estate and financial circuit

Azithromycin in patients admitted to hospital with COVID-19 (RECOVERY): a randomised, controlled, open-label, platform trial

Background Azithromycin has been proposed as a treatment for COVID-19 on the basis of its immunomodulatory actions. We aimed to evaluate the safety and efficacy of azithromycin in patients admitted to hospital with COVID-19. Methods In this randomised, controlled, open-label, adaptive platform trial (Randomised Evaluation of COVID-19 Therapy [RECOVERY]), several possible treatments were compared with usual care in patients admitted to hospital with COVID-19 in the UK. The trial is underway at 176 hospitals in the UK. Eligible and consenting patients were randomly allocated to either usual standard of care alone or usual standard of care plus azithromycin 500 mg once per day by mouth or intravenously for 10 days or until discharge (or allocation to one of the other RECOVERY treatment groups). Patients were assigned via web-based simple (unstratified) randomisation with allocation concealment and were twice as likely to be randomly assigned to usual care than to any of the active treatment groups. Participants and local study staff were not masked to the allocated treatment, but all others involved in the trial were masked to the outcome data during the trial. The primary outcome was 28-day all-cause mortality, assessed in the intention-to-treat population. The trial is registered with ISRCTN, 50189673, and ClinicalTrials.gov, NCT04381936. Findings Between April 7 and Nov 27, 2020, of 16 442 patients enrolled in the RECOVERY trial, 9433 (57%) were eligible and 7763 were included in the assessment of azithromycin. The mean age of these study participants was 65·3 years (SD 15·7) and approximately a third were women (2944 [38%] of 7763). 2582 patients were randomly allocated to receive azithromycin and 5181 patients were randomly allocated to usual care alone. Overall, 561 (22%) patients allocated to azithromycin and 1162 (22%) patients allocated to usual care died within 28 days (rate ratio 0·97, 95% CI 0·87–1·07; p=0·50). No significant difference was seen in duration of hospital stay (median 10 days [IQR 5 to >28] vs 11 days [5 to >28]) or the proportion of patients discharged from hospital alive within 28 days (rate ratio 1·04, 95% CI 0·98–1·10; p=0·19). Among those not on invasive mechanical ventilation at baseline, no significant difference was seen in the proportion meeting the composite endpoint of invasive mechanical ventilation or death (risk ratio 0·95, 95% CI 0·87–1·03; p=0·24). Interpretation In patients admitted to hospital with COVID-19, azithromycin did not improve survival or other prespecified clinical outcomes. Azithromycin use in patients admitted to hospital with COVID-19 should be restricted to patients in whom there is a clear antimicrobial indication. Funding UK Research and Innovation (Medical Research Council) and National Institute of Health Research