70 research outputs found
Local pressure loss coefficient during the flow of slurry ice trough sudden pipe expansions
The paper presents the results of experimental studies on ice slurry flow resistance in sudden pipe expansions. In the experimental studies, the mass fraction of solid particles in the slurry ranged from 5 to 30%. The pressure loss coefficients identified as a result of the experimental studies of the turbulent flow of the ice slurry are the same as the coefficients calculated for Newtonian liquids
Matrix-free polynomial preconditioning of saddle point systems using the hyper-power method
This study explores the integration of the hyper-power sequence, a method
commonly employed for approximating the Moore-Penrose inverse, to enhance the
effectiveness of an existing preconditioner. The approach is closely related to
polynomial preconditioning based on Neumann series. We commence with a
state-of-the-art matrix-free preconditioner designed for the saddle point
system derived from isogeometric structure-preserving discretization of the
Stokes equations. Our results demonstrate that incorporating multiple
iterations of the hyper-power method enhances the effectiveness of the
preconditioner, leading to a substantial reduction in both iteration counts and
overall solution time for simulating Stokes flow within a 3D lid-driven cavity.
Through a comprehensive analysis, we assess the stability, accuracy, and
numerical cost associated with the proposed scheme
Flow modelling of slurry ice in a control val
The paper presents the results of simulations of the flow of slurry ice through a control valve. The study focused on a HERZ Strömax-M DN20 control valve. The mass share of ice crystals in the studied slurry ice ranged from 5% to 20%. The results of experimental studies confirmed that the simulations were correct
Assessment of measurement reliability for the IPN test in cardiac patients
Cardiological diagnostics use maximal and submaximal tests with increasing load. Maximal stress tests are currently considered the gold standard. The Institut für Prävention und Nachsorge, Cologne (IPN) test may be an alternative when maximal patient load is not indicated. The universality of the test is well-documented in sport, but the reliability of this test is unknown. The aim of this study was to assess between-trial and between-day reliability for parameters assessed by the IPN stress test in cardiological patients.: In a study of 24 patients aged 39 to 79 years with cardiovascular diseases, the IPN cycle ergometer short test was performed (submaximal performance test). The reliability of heart rate, systolic and diastolic pressure, absolute power at submaximal load, relative performance at submaximal load and target heart rate were assessed. Good (Interclass Correlation Coefficient (ICC) values ranged from 0.832 to 0.894) and excellent (ICC values ranged from 0.904 to 0.969) between-trial reliability was noted. Between-day reliability was good (ICC values from 0.777 to 0.895) and excellent (ICC values from 0.922 to 0.950). The obtained results suggest that the IPN test may be a reliable tool for use in the assessment of cardiological patients, avoiding the implementation of maximal efforts when excessive patient load is not recommended
Towards a Material Oriented Approach in Economics(part1)
The Neo-Classical Economics have regarded objects which have exchange value as goods. In this recognition, it is not necessary to make distinction between material objects and non-material objects or services. However, considering that environmental burdens stem from not enjoyment of services but use of material objects such as energy and matter, I argue that there should be clear distinction between material objects and non-material objects or services in environmental economic theories. In part 1,by reviewing some past masters, I will show there was clear distinction between material and non-material objects in the beginning of this science, describe how the Neo-Classical way of thinking has become dominant, and introduce some works of pioneers those who straggle to make economics stand on material bases, though their efforts had not resulted in success
Measuring universal health coverage based on an index of effective coverage of health services in 204 countries and territories, 1990–2019 : A systematic analysis for the Global Burden of Disease Study 2019
Background
Achieving universal health coverage (UHC) involves all people receiving the health services they need, of high quality, without experiencing financial hardship. Making progress towards UHC is a policy priority for both countries and global institutions, as highlighted by the agenda of the UN Sustainable Development Goals (SDGs) and WHO's Thirteenth General Programme of Work (GPW13). Measuring effective coverage at the health-system level is important for understanding whether health services are aligned with countries' health profiles and are of sufficient quality to produce health gains for populations of all ages.
Methods
Based on the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019, we assessed UHC effective coverage for 204 countries and territories from 1990 to 2019. Drawing from a measurement framework developed through WHO's GPW13 consultation, we mapped 23 effective coverage indicators to a matrix representing health service types (eg, promotion, prevention, and treatment) and five population-age groups spanning from reproductive and newborn to older adults (≥65 years). Effective coverage indicators were based on intervention coverage or outcome-based measures such as mortality-to-incidence ratios to approximate access to quality care; outcome-based measures were transformed to values on a scale of 0–100 based on the 2·5th and 97·5th percentile of location-year values. We constructed the UHC effective coverage index by weighting each effective coverage indicator relative to its associated potential health gains, as measured by disability-adjusted life-years for each location-year and population-age group. For three tests of validity (content, known-groups, and convergent), UHC effective coverage index performance was generally better than that of other UHC service coverage indices from WHO (ie, the current metric for SDG indicator 3.8.1 on UHC service coverage), the World Bank, and GBD 2017. We quantified frontiers of UHC effective coverage performance on the basis of pooled health spending per capita, representing UHC effective coverage index levels achieved in 2019 relative to country-level government health spending, prepaid private expenditures, and development assistance for health. To assess current trajectories towards the GPW13 UHC billion target—1 billion more people benefiting from UHC by 2023—we estimated additional population equivalents with UHC effective coverage from 2018 to 2023.
Findings
Globally, performance on the UHC effective coverage index improved from 45·8 (95% uncertainty interval 44·2–47·5) in 1990 to 60·3 (58·7–61·9) in 2019, yet country-level UHC effective coverage in 2019 still spanned from 95 or higher in Japan and Iceland to lower than 25 in Somalia and the Central African Republic. Since 2010, sub-Saharan Africa showed accelerated gains on the UHC effective coverage index (at an average increase of 2·6% [1·9–3·3] per year up to 2019); by contrast, most other GBD super-regions had slowed rates of progress in 2010–2019 relative to 1990–2010. Many countries showed lagging performance on effective coverage indicators for non-communicable diseases relative to those for communicable diseases and maternal and child health, despite non-communicable diseases accounting for a greater proportion of potential health gains in 2019, suggesting that many health systems are not keeping pace with the rising non-communicable disease burden and associated population health needs. In 2019, the UHC effective coverage index was associated with pooled health spending per capita (r=0·79), although countries across the development spectrum had much lower UHC effective coverage than is potentially achievable relative to their health spending. Under maximum efficiency of translating health spending into UHC effective coverage performance, countries would need to reach adjusted for purchasing power parity) in order to achieve 80 on the UHC effective coverage index. From 2018 to 2023, an estimated 388·9 million (358·6–421·3) more population equivalents would have UHC effective coverage, falling well short of the GPW13 target of 1 billion more people benefiting from UHC during this time. Current projections point to an estimated 3·1 billion (3·0–3·2) population equivalents still lacking UHC effective coverage in 2023, with nearly a third (968·1 million [903·5–1040·3]) residing in south Asia.
Interpretation
The present study demonstrates the utility of measuring effective coverage and its role in supporting improved health outcomes for all people—the ultimate goal of UHC and its achievement. Global ambitions to accelerate progress on UHC service coverage are increasingly unlikely unless concerted action on non-communicable diseases occurs and countries can better translate health spending into improved performance. Focusing on effective coverage and accounting for the world's evolving health needs lays the groundwork for better understanding how close—or how far—all populations are in benefiting from UHC
Measuring universal health coverage based on an index of effective coverage of health services in 204 countries and territories, 1990–2019: a systematic analysis for the Global Burden of Disease Study 2019
Background
Achieving universal health coverage (UHC) involves all people receiving the health services they need, of high quality, without experiencing financial hardship. Making progress towards UHC is a policy priority for both countries and global institutions, as highlighted by the agenda of the UN Sustainable Development Goals (SDGs) and WHO's Thirteenth General Programme of Work (GPW13). Measuring effective coverage at the health-system level is important for understanding whether health services are aligned with countries' health profiles and are of sufficient quality to produce health gains for populations of all ages.
Methods
Based on the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019, we assessed UHC effective coverage for 204 countries and territories from 1990 to 2019. Drawing from a measurement framework developed through WHO's GPW13 consultation, we mapped 23 effective coverage indicators to a matrix representing health service types (eg, promotion, prevention, and treatment) and five population-age groups spanning from reproductive and newborn to older adults (≥65 years). Effective coverage indicators were based on intervention coverage or outcome-based measures such as mortality-to-incidence ratios to approximate access to quality care; outcome-based measures were transformed to values on a scale of 0–100 based on the 2·5th and 97·5th percentile of location-year values. We constructed the UHC effective coverage index by weighting each effective coverage indicator relative to its associated potential health gains, as measured by disability-adjusted life-years for each location-year and population-age group. For three tests of validity (content, known-groups, and convergent), UHC effective coverage index performance was generally better than that of other UHC service coverage indices from WHO (ie, the current metric for SDG indicator 3.8.1 on UHC service coverage), the World Bank, and GBD 2017. We quantified frontiers of UHC effective coverage performance on the basis of pooled health spending per capita, representing UHC effective coverage index levels achieved in 2019 relative to country-level government health spending, prepaid private expenditures, and development assistance for health. To assess current trajectories towards the GPW13 UHC billion target—1 billion more people benefiting from UHC by 2023—we estimated additional population equivalents with UHC effective coverage from 2018 to 2023.
Findings
Globally, performance on the UHC effective coverage index improved from 45·8 (95% uncertainty interval 44·2–47·5) in 1990 to 60·3 (58·7–61·9) in 2019, yet country-level UHC effective coverage in 2019 still spanned from 95 or higher in Japan and Iceland to lower than 25 in Somalia and the Central African Republic. Since 2010, sub-Saharan Africa showed accelerated gains on the UHC effective coverage index (at an average increase of 2·6% [1·9–3·3] per year up to 2019); by contrast, most other GBD super-regions had slowed rates of progress in 2010–2019 relative to 1990–2010. Many countries showed lagging performance on effective coverage indicators for non-communicable diseases relative to those for communicable diseases and maternal and child health, despite non-communicable diseases accounting for a greater proportion of potential health gains in 2019, suggesting that many health systems are not keeping pace with the rising non-communicable disease burden and associated population health needs. In 2019, the UHC effective coverage index was associated with pooled health spending per capita (r=0·79), although countries across the development spectrum had much lower UHC effective coverage than is potentially achievable relative to their health spending. Under maximum efficiency of translating health spending into UHC effective coverage performance, countries would need to reach adjusted for purchasing power parity) in order to achieve 80 on the UHC effective coverage index. From 2018 to 2023, an estimated 388·9 million (358·6–421·3) more population equivalents would have UHC effective coverage, falling well short of the GPW13 target of 1 billion more people benefiting from UHC during this time. Current projections point to an estimated 3·1 billion (3·0–3·2) population equivalents still lacking UHC effective coverage in 2023, with nearly a third (968·1 million [903·5–1040·3]) residing in south Asia.
Interpretation
The present study demonstrates the utility of measuring effective coverage and its role in supporting improved health outcomes for all people—the ultimate goal of UHC and its achievement. Global ambitions to accelerate progress on UHC service coverage are increasingly unlikely unless concerted action on non-communicable diseases occurs and countries can better translate health spending into improved performance. Focusing on effective coverage and accounting for the world's evolving health needs lays the groundwork for better understanding how close—or how far—all populations are in benefiting from UHC
Wpływ terapii z zastosowaniem okładów borowinowych na dolegliwości związane z chorobą zwyrodnieniową stawu kolanowego
Background: The aim of this study was to evaluate whether mud pack application as a supplementary treatment to physiotherapy and therapy with physical agents allow to achieve better outcome than physiotherapy and therapy with physical agents alone in patients suffering from gonarthrosis.Methods: Twenty patients aged 49 to 70 at II and III stage of gonarthrosis were divided into experimental and control groups each comprising 10 patients. The experimental group was treated by mud pack, exercises and therapy with physical agents, whereas the control group only by exercises and therapy with physical agents. The following parameters were evaluated in all patients before and two weeks after the therapy: range of motion in the knee, leg circumference, self-assessment of disease severity (using WOMAC questionnaire), and pain level (using VAS scale).Results: We observed that joint stiffness (assessed using WOMAC questionnaire) decreased significantly only in the experimental group (p<0.05). Significant decrease in pain level assessed by means of VAS scale was noticed in both groups (p<0.05). After the therapy, a significant improvement in knee flexion (p<0.05) was observed only in the control group.Conclusion: Both treatment modalities had similar effects on pain severity. Reduction of joints stiffness observed 2 weeks following the treatment may suggest that mud pack may be used as a supplementary component in the therapy of osteoarthrosis.Cel: Celem niniejszej pracy było ustalenie czy zastosowanie okładów borowinowych jako elementu uzupełniającego kinezyterapię
i fizykoterapię pozwoli uzyskać lepszy efekt terapeutyczny u pacjentów z chorobą zwyrodnieniową stawów kolanowych
niż zastosowanie leczenia opartego tylko na kinezyterapii i fizykoterapii.
Materiał i metoda: Badaniami objęto 20 kobiet w wieku 49-70 lat, u których stwierdzono II° i III° (wg klasyfikacji Seyfrieda)
choroby zwyrodnieniowej stawu kolanowego. Wszystkich badanych losowo podzielono na dwie grupy: badaną (n=10) i
kontrolną (n=10). W grupie badanej zastosowano: okłady borowinowe, kinezyterapię i fizykoterapię, a w kontrolnej tylko
kinezyterapię i fizykoterapię. Pacjentów badano dwukrotnie: bezpośrednio przed rozpoczęciem leczenia i po 2 tygodniach w
ostatnim dniu zabiegów. U każdego z badanych przeprowadzono pomiar: zakresu ruchomości w stawie kolanowym i obwodu
kończyny, ocenę stopnia dolegliwości wynikających z choroby zwyrodnieniowej przy użyciu kwestionariusza WOMAC,
oraz pomiar stopnia intensywności odczuwania bólu za pomocą skali VAS.
Wyniki: Stwierdzono, iż odczuwana przez pacjentów sztywność w stawie (badana przy pomocy kwestionariusza WOMAC)
statystycznie istotnie zmniejszyła się tylko w grupie badanej (p<0.05). Zauważono, iż w obu grupach po zastosowanej terapii
nastąpiło statystycznie istotne zmniejszenie poziomu bólu (p<0.05), ocenianego za pomocą skali VAS. Po 2 tygodniach
terapii statystycznie istotny przyrost w zakresie zgięcia (p<0.05) zaobserwowano tylko w grupie kontrolnej.
Wnioski: Zarówno leczenie oparte tylko na kinezyterapii i fizykoterapii jak i model uzupełniony o okłady borowinowe wykazuje
zbliżone działanie przeciwbólowe. Obserwowane po 2 tygodniach zabiegów obniżenie sztywności stawowej pozwala
sugerować, że borowina może być włączona jako element uzupełniający terapię choroby zwyrodnieniowej stawów
The Influence of Treadmill Training on the Bioelectrical Activity of the Lower Limb Muscles in Patients with Intermittent Claudication
Aim: Intermittent claudication is the most common symptomatic manifestation of peripheral arterial disease (PAD), presenting as ischemic leg muscle pain and gait dysfunction. The aim of this study was to evaluate the changes in bioelectrical activity of the lower limb muscles activity in claudicating patients over a 12-week period of supervised treadmill training and to verify the hypothesis as to which muscles of lower limbs are activated by training treatment—the proximal, as compensatory mechanism, or the distal, which are the most ischemic. Methods: The study comprised 45 patients aged 60–70 years (height 168.8 ± 6.8 cm, weight 78.9 ± 9.2 kg) with PAD and unilateral intermittent claudication (Fontaine stage IIa/IIb), who participated in a 12-week supervised treadmill training program. Surface electromyography (sEMG) of the gastrocnemius lateralis (GaL), gastrocnemius medialis (GaM), tibialis anterior (TA), biceps femoris (BF), rectus femoris (RF) and gluteus medius (GM) muscles in the claudicated leg were continuously measured during the treadmill test. The average mean amplitude and mean amplitude range of the sEMG signal were analyzed. Results: During the treadmill test, after 12 weeks of training, the average mean amplitude of the GM (105 ± 43 vs. 74 ± 38%, p = 0.000008, ES = 0.76), BF (41 ± 22 vs. 33 ± 12%, p = 0.006, ES = 0.45) and GaM (134 ± 50 vs. 114 ± 30%, p = 0.007, ES = 0.48) muscles was significantly lower compared with baseline. The mean amplitude range was significantly decreased after 12 weeks of training in the GM (229 ± 64 vs. 181 ± 62%, p = 0.008, ES = 0.77) and BF (110 ± 69 vs. 84 ± 31%, p = 0.0002, ES = 0.48) muscles. After 12 weeks of training, the mean amplitude range of the TA muscle was significantly higher compared with baseline (104 ± 46 vs. 131 ± 53%, p = 0.001, ES = 0.54), but without significant changes in the average mean amplitude value. The most favorable changes, suggesting the lowest muscle fatigue and the highest walking capacity, were found in patients with the longest walking time. Conclusions: The obtained results may suggest that after 12 weeks of treadmill training, beneficial changes occurred in both the proximal and distal muscles. Therefore, greater foot plantar flexion and stronger push-off as well as greater hip extension may be considered the main mechanisms of observed gait pattern improvement. It may also be suggested that the therapy of gait alterations in patients with PAD should be focused not only on calf muscle pump improvement, but also on proximal hip extensor strengthening
Analysis of operating conditions of a cooling installation with carbon dioxide
In response to international regulations, natural refrigerants
such as carbon dioxide are more and more frequently used in the refrigeration industry. Due to thermodynamic properties, R-744 is used in the transcritical cycle as an individual refrigerant. In the hereby article, high pressure of CO2 and air temperature values were analysed. The measurements were conducted on the gas cooler side and involved external air temperature values in the summer period between 1 June to 30 September 2018. The “Booster” installation was used in one of Polish supermarkets. Correlations required to determine the optimal pressure of carbon dioxide depending on ambient temperature were presented in the article. The equations presented hereby allowed to maximize the energy efficiency ratio. An optimal high pressure for one of the correlations from literature was calculated on the basis of the measurement of ambient temperature. Actual and optimal pressure values of carbon dioxide were compared in the analysed period of time
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