Multiphase Droplet Interactions with a Single Fiber

Abstract Multiphase Droplet Interactions with a Single Fiber By: Noor M. Farhan A dissertation submitted in partial fulfillment of the requirements for the degree of Doctor of Philosophy at Virginia Commonwealth University. Virginia Commonwealth University, 2019 Director: Hooman V. Tafreshi, Professor, Department of Mechanical and Nuclear Engineering Formulating the physics of droplet adhesion to a fiber is interesting intellectually and important industrially. A typical example of a droplet–fiber system in nature is the dew droplets on spider webs, where droplets first precipitate and grow on the fibers, but they eventually fall when they become too heavy. Obviously, quantifying the force of adhesion between a droplet and a fiber is crucial in designing fog harvesting devices or manufacturing filtration media for liquid–gas or liquid–liquid separation, among many other industrial applications. This study is aimed at developing a mathematical framework for the mechanical forces between a droplet and a fiber in terms of their physical and wetting properties. To this end, a series of experiments were conducted to detach ferrofluid droplets of varying volumes from fibers with different diameters and Young–Laplace contact angles (YLCAs) in a controlled magnetic field. The force of detachment was measured using a sensitive scale and used along with the results of numerical simulations to develop a semi-analytical expression for the force required to detach a droplet from a fiber. This universally-applicable expression allows one to predict the force detachment without the need to run an experiment or a computer simulation. This work also reports on the use of magnetic force to measure the force of detachment for nonmagnetic droplets for the first time. This is accomplished by adding a small amount of a ferrofluid to the original nonmagnetic droplet to create a compound droplet with the ferrofluid nesting inside or cloaking the nonmagnetic droplet. The ferrofluid is then used to induce a body force to the resulting compound droplet and thereby detach it from the fiber. The recorded detachment force is used directly (the case of nesting ferrofluid) or after scaling (the case of cloaking ferrofluid) to obtain the force of detachment for the original nonmagnetic droplet. The accuracy of these measurements was examined through comparison with numerical simulations as well as available experimental data in the literature. In addition, a simple method is developed to directly measure the intrinsic contact angle of a fiber (i.e., Young–Laplace Contact angle of the fiber material) with any arbitrary liquid. It is shown that the intrinsic contact angle of a fiber can be obtained by simply measuring the angle between the tangent to the fiber surface and the tangent to the droplet at the contact line, if the droplet possesses a clamshell conformation and is viewed from the longitudinal direction. The novelty of the proposed method is that its predictions are not affected by the volume of the droplet used for the experiment, the wettability of the fiber, the surface tension of the liquid, or the magnitude of the body force acting on the droplet during the experiment. Also, a liquid droplet interaction with granular coatings is simulated and the droplet apparent contact angle (ACA) and the transition from Cassie (fully dry) to Wenzel (fully wet) state as a function to the roughness wavelength have been studied. For a fixed droplet volume, two different granular coatings have been used, spherical and hemispherical bumps. It is demonstrated that the chemistry (YLCA) and geometrical parameters for the granular microtexture play an important effect on the droplet ACA and its transition from Cassie to Wenzel state

Perlindungan Hukum Terhadap Nasabah Akibat Kelalaian Bank Menghapus Informasi Debitur Individual (IDI) History Black List Debitur Yang Telah Lunas Dalam Perjanjian Kredit (Studi Putusan Mahkamah Agung Nomor 2678 K/Pdt/2019)

Abstrak Kelalaian dan kesalahan pihak bank dalam melakukan pelaporan pelunasan kredit maka hal ini dapat menjadi kerugian bagi nasabah. Rumusan masalah dalam skripsi ini adalah  bagaimana perlindungan hukum terhadap nasabah y akibat kelalaian bank menghapus Informasi Debitur Individual  (IDI) History Black List debitur yang  telah lunas dalam perjanjian kredit, bagaimana tanggung jawab bank yang melaporkan nasabah debitur yang tidak bermasalah dalam Sistem Informasi Debitur Bank Indonesia, bagaimana pertimbangan hukum hakim dalam putusan Mahkamah Agung Nomor 2678 K/Pdt/2019. Perlindungan hukum bagi nasabah yang masuk dalam daftar hitam akibat kelalaian bank menghapus Informasi Debitur Individual  (IDI) History Black List debitur yang  telah lunas dalam perjanjian kredit adalah bank harus memberikan ganti kerugian jika  telah memberikan informasi yang tidak benar sehingga nasabah tersebut dirugikan karena tidak dapat meminjam kredit dari bank. Tanggung jawab bank terhadap kerugian nasabahnya yang timbul sebagai akibat dari kelalaian bank dalam melaporkan nasabah debitur yang tidak bermasalah dalam Sistem Informasi Debitur ditinjau dari Undang-Undang Nomor 10 Tahun 1998 Tentang Perbankan adalah mewajibkan bank yang melakukan kelalaian tersebut untuk memberikan ganti rugi kepada nasabah atau debitur yang dirugikan tersebut dan mengoreksi data debitur sesuai dengan yang seharusnya. Berdasarkan pembahasan, maka diperoleh kesimpulan bahwa pertimbangan hukum hakim dalam putusan Mahkamah Agung Nomor 2678 K/Pdt/2019 adalah PT. Bank Tabungan Negara (persero), Tbk. Kantor Cabang Banjarmasin melakukan perbuatan melawan hukum dengan tidak melakukan tata kelola dan kerja pelayanan yang buruk sehingga merugikan nama baik penggugat selaku debitur yang telah melunasi hutangnya tetapi diinformasikan secara keliru sehingga masuk dalam black list dalam lembaga keuangan terkait. Disarankan agar untuk lebih mengefektifkan program program perlindungan nasabah, diperlukan suatu upaya yang sifatnya berkelanjutan melalui edukasi masyarakat mengenai hak hak nasabah dalam berhubungan dengan bank.Kata Kunci       : Perlindungan Hukum, Debitur, Perjanjian Kredit, Black List AbstractNegligence and errors on the part of the bank in reporting credit repayments, this can be a loss for customers. The formulation of the problem in this thesis is how is legal protection for customers due to bank negligence in deleting Individual Debtor Information (IDI) History Black List debtors who have been paid off in the credit agreement, how is the responsibility of banks reporting debtor customers who are not problematic in the Bank Indonesia Debtor Information System , how are the judges' legal considerations in the Supreme Court's decision Number 2678 K/Pdt/2019. Legal protection for customers who are blacklisted due to bank negligence in deleting Individual Debtor Information (IDI). credit from the bank. The responsibility of the bank for the losses of its customers that arise as a result of the bank's negligence in reporting debtor customers who are not problematic in the Debtor Information System in terms of Law Number 10 of 1998 concerning Banking is to require the bank that commits the negligence to provide compensation to the customer or debtor. the aggrieved party and correct the debtor's data as appropriate. Based on the discussion, it was concluded that the judge's legal considerations in the Supreme Court's decision Number 2678 K/Pdt/2019 were PT. State Savings Bank (Persero), Tbk. The Banjarmasin Branch Office committed acts against the law by not carrying out poor governance and service work so that it harmed the good name of the plaintiff as a debtor who had paid off his debt but was misinformed so that it was included in the black list of the relevant financial institution. It is recommended that in order to make customer protection programs more effective, an ongoing effort is needed through public education about customer rights in dealing with banks.Keywords: Legal Protection, Debtors, Credit Agreements, Black Lis

Antimicrobial resistance among migrants in Europe: a systematic review and meta-analysis

BACKGROUND: Rates of antimicrobial resistance (AMR) are rising globally and there is concern that increased migration is contributing to the burden of antibiotic resistance in Europe. However, the effect of migration on the burden of AMR in Europe has not yet been comprehensively examined. Therefore, we did a systematic review and meta-analysis to identify and synthesise data for AMR carriage or infection in migrants to Europe to examine differences in patterns of AMR across migrant groups and in different settings. METHODS: For this systematic review and meta-analysis, we searched MEDLINE, Embase, PubMed, and Scopus with no language restrictions from Jan 1, 2000, to Jan 18, 2017, for primary data from observational studies reporting antibacterial resistance in common bacterial pathogens among migrants to 21 European Union-15 and European Economic Area countries. To be eligible for inclusion, studies had to report data on carriage or infection with laboratory-confirmed antibiotic-resistant organisms in migrant populations. We extracted data from eligible studies and assessed quality using piloted, standardised forms. We did not examine drug resistance in tuberculosis and excluded articles solely reporting on this parameter. We also excluded articles in which migrant status was determined by ethnicity, country of birth of participants' parents, or was not defined, and articles in which data were not disaggregated by migrant status. Outcomes were carriage of or infection with antibiotic-resistant organisms. We used random-effects models to calculate the pooled prevalence of each outcome. The study protocol is registered with PROSPERO, number CRD42016043681. FINDINGS: We identified 2274 articles, of which 23 observational studies reporting on antibiotic resistance in 2319 migrants were included. The pooled prevalence of any AMR carriage or AMR infection in migrants was 25·4% (95% CI 19·1-31·8; I2 =98%), including meticillin-resistant Staphylococcus aureus (7·8%, 4·8-10·7; I2 =92%) and antibiotic-resistant Gram-negative bacteria (27·2%, 17·6-36·8; I2 =94%). The pooled prevalence of any AMR carriage or infection was higher in refugees and asylum seekers (33·0%, 18·3-47·6; I2 =98%) than in other migrant groups (6·6%, 1·8-11·3; I2 =92%). The pooled prevalence of antibiotic-resistant organisms was slightly higher in high-migrant community settings (33·1%, 11·1-55·1; I2 =96%) than in migrants in hospitals (24·3%, 16·1-32·6; I2 =98%). We did not find evidence of high rates of transmission of AMR from migrant to host populations. INTERPRETATION: Migrants are exposed to conditions favouring the emergence of drug resistance during transit and in host countries in Europe. Increased antibiotic resistance among refugees and asylum seekers and in high-migrant community settings (such as refugee camps and detention facilities) highlights the need for improved living conditions, access to health care, and initiatives to facilitate detection of and appropriate high-quality treatment for antibiotic-resistant infections during transit and in host countries. Protocols for the prevention and control of infection and for antibiotic surveillance need to be integrated in all aspects of health care, which should be accessible for all migrant groups, and should target determinants of AMR before, during, and after migration. FUNDING: UK National Institute for Health Research Imperial Biomedical Research Centre, Imperial College Healthcare Charity, the Wellcome Trust, and UK National Institute for Health Research Health Protection Research Unit in Healthcare-associated Infections and Antimictobial Resistance at Imperial College London

Global economic burden of unmet surgical need for appendicitis

Background: There is a substantial gap in provision of adequate surgical care in many low-and middle-income countries. This study aimed to identify the economic burden of unmet surgical need for the common condition of appendicitis. Methods: Data on the incidence of appendicitis from 170 countries and two different approaches were used to estimate numbers of patients who do not receive surgery: as a fixed proportion of the total unmet surgical need per country (approach 1); and based on country income status (approach 2). Indirect costs with current levels of access and local quality, and those if quality were at the standards of high-income countries, were estimated. A human capital approach was applied, focusing on the economic burden resulting from premature death and absenteeism. Results: Excess mortality was 4185 per 100 000 cases of appendicitis using approach 1 and 3448 per 100 000 using approach 2. The economic burden of continuing current levels of access and local quality was US $92 492 million using approach 1 and$73 141 million using approach 2. The economic burden of not providing surgical care to the standards of high-income countries was $95 004 million using approach 1 and$75 666 million using approach 2. The largest share of these costs resulted from premature death (97.7 per cent) and lack of access (97.0 per cent) in contrast to lack of quality. Conclusion: For a comparatively non-complex emergency condition such as appendicitis, increasing access to care should be prioritized. Although improving quality of care should not be neglected, increasing provision of care at current standards could reduce societal costs substantially

Pooled analysis of WHO Surgical Safety Checklist use and mortality after emergency laparotomy

Background The World Health Organization (WHO) Surgical Safety Checklist has fostered safe practice for 10 years, yet its place in emergency surgery has not been assessed on a global scale. The aim of this study was to evaluate reported checklist use in emergency settings and examine the relationship with perioperative mortality in patients who had emergency laparotomy. Methods In two multinational cohort studies, adults undergoing emergency laparotomy were compared with those having elective gastrointestinal surgery. Relationships between reported checklist use and mortality were determined using multivariable logistic regression and bootstrapped simulation. Results Of 12 296 patients included from 76 countries, 4843 underwent emergency laparotomy. After adjusting for patient and disease factors, checklist use before emergency laparotomy was more common in countries with a high Human Development Index (HDI) (2455 of 2741, 89.6 per cent) compared with that in countries with a middle (753 of 1242, 60.6 per cent; odds ratio (OR) 0.17, 95 per cent c.i. 0.14 to 0.21, P <0001) or low (363 of 860, 422 per cent; OR 008, 007 to 010, P <0.001) HDI. Checklist use was less common in elective surgery than for emergency laparotomy in high-HDI countries (risk difference -94 (95 per cent c.i. -11.9 to -6.9) per cent; P <0001), but the relationship was reversed in low-HDI countries (+121 (+7.0 to +173) per cent; P <0001). In multivariable models, checklist use was associated with a lower 30-day perioperative mortality (OR 0.60, 0.50 to 073; P <0.001). The greatest absolute benefit was seen for emergency surgery in low- and middle-HDI countries. Conclusion Checklist use in emergency laparotomy was associated with a significantly lower perioperative mortality rate. Checklist use in low-HDI countries was half that in high-HDI countries.Peer reviewe

Left Main Coronary Artery Revascularization in Patients with Impaired Renal Function: Percutaneous Coronary Intervention versus Coronary Artery Bypass Grafting

Introduction: The evidence about the optimal revascularization strategy in patients with left main coronary artery (LMCA) disease and impaired renal function is limited. Thus, we aimed to compare the outcomes of LMCA disease revascularization (percutaneous coronary intervention [PCI] vs. coronary artery bypass grafting [CABG]) in patients with and without impaired renal function. Methods: This retrospective cohort study included 2,138 patients recruited from 14 centers between 2015 and 2,019. We compared patients with impaired renal function who had PCI (n= 316) to those who had CABG (n = 121) and compared patients with normal renal function who had PCI (n = 906) to those who had CABG (n = 795). The study outcomes were in-hospital and follow-up major adverse cardiovascular and cerebrovascular events (MACCE). Results: Multivariable logistic regression analysis showed that the risk of in-hospital MACCE was significantly higher in CABG compared to PCI in patients with impaired renal function (odds ratio [OR]: 8.13 [95% CI: 4.19–15.76], p &lt; 0.001) and normal renal function (OR: 2.59 [95% CI: 1.79–3.73]; p &lt; 0.001). There were no differences in follow-up MACCE between CABG and PCI in patients with impaired renal function (HR: 1.14 [95% CI: 0.71–1.81], p = 0.585) and normal renal function (HR: 1.12 [0.90–1.39], p = 0.312). Conclusions: PCI could have an advantage over CABG in revascularization of LMCA disease in patients with impaired renal function regarding in-hospital MACCE. The follow-up MACCE was comparable between PCI and CABG in patients with impaired and normal renal function

Familial hypercholesterolaemia in children and adolescents from 48 countries: a cross-sectional study

Background: Approximately 450 000 children are born with familial hypercholesterolaemia worldwide every year, yet only 2·1% of adults with familial hypercholesterolaemia were diagnosed before age 18 years via current diagnostic approaches, which are derived from observations in adults. We aimed to characterise children and adolescents with heterozygous familial hypercholesterolaemia (HeFH) and understand current approaches to the identification and management of familial hypercholesterolaemia to inform future public health strategies. Methods: For this cross-sectional study, we assessed children and adolescents younger than 18 years with a clinical or genetic diagnosis of HeFH at the time of entry into the Familial Hypercholesterolaemia Studies Collaboration (FHSC) registry between Oct 1, 2015, and Jan 31, 2021. Data in the registry were collected from 55 regional or national registries in 48 countries. Diagnoses relying on self-reported history of familial hypercholesterolaemia and suspected secondary hypercholesterolaemia were excluded from the registry; people with untreated LDL cholesterol (LDL-C) of at least 13·0 mmol/L were excluded from this study. Data were assessed overall and by WHO region, World Bank country income status, age, diagnostic criteria, and index-case status. The main outcome of this study was to assess current identification and management of children and adolescents with familial hypercholesterolaemia. Findings: Of 63 093 individuals in the FHSC registry, 11 848 (18·8%) were children or adolescents younger than 18 years with HeFH and were included in this study; 5756 (50·2%) of 11 476 included individuals were female and 5720 (49·8%) were male. Sex data were missing for 372 (3·1%) of 11 848 individuals. Median age at registry entry was 9·6 years (IQR 5·8-13·2). 10 099 (89·9%) of 11 235 included individuals had a final genetically confirmed diagnosis of familial hypercholesterolaemia and 1136 (10·1%) had a clinical diagnosis. Genetically confirmed diagnosis data or clinical diagnosis data were missing for 613 (5·2%) of 11 848 individuals. Genetic diagnosis was more common in children and adolescents from high-income countries (9427 [92·4%] of 10 202) than in children and adolescents from non-high-income countries (199 [48·0%] of 415). 3414 (31·6%) of 10 804 children or adolescents were index cases. Familial-hypercholesterolaemia-related physical signs, cardiovascular risk factors, and cardiovascular disease were uncommon, but were more common in non-high-income countries. 7557 (72·4%) of 10 428 included children or adolescents were not taking lipid-lowering medication (LLM) and had a median LDL-C of 5·00 mmol/L (IQR 4·05-6·08). Compared with genetic diagnosis, the use of unadapted clinical criteria intended for use in adults and reliant on more extreme phenotypes could result in 50-75% of children and adolescents with familial hypercholesterolaemia not being identified. Interpretation: Clinical characteristics observed in adults with familial hypercholesterolaemia are uncommon in children and adolescents with familial hypercholesterolaemia, hence detection in this age group relies on measurement of LDL-C and genetic confirmation. Where genetic testing is unavailable, increased availability and use of LDL-C measurements in the first few years of life could help reduce the current gap between prevalence and detection, enabling increased use of combination LLM to reach recommended LDL-C targets early in life

Surgical site infection after gastrointestinal surgery in high-income, middle-income, and low-income countries: a prospective, international, multicentre cohort study

Background: Surgical site infection (SSI) is one of the most common infections associated with health care, but its importance as a global health priority is not fully understood. We quantified the burden of SSI after gastrointestinal surgery in countries in all parts of the world. Methods: This international, prospective, multicentre cohort study included consecutive patients undergoing elective or emergency gastrointestinal resection within 2-week time periods at any health-care facility in any country. Countries with participating centres were stratified into high-income, middle-income, and low-income groups according to the UN's Human Development Index (HDI). Data variables from the GlobalSurg 1 study and other studies that have been found to affect the likelihood of SSI were entered into risk adjustment models. The primary outcome measure was the 30-day SSI incidence (defined by US Centers for Disease Control and Prevention criteria for superficial and deep incisional SSI). Relationships with explanatory variables were examined using Bayesian multilevel logistic regression models. This trial is registered with ClinicalTrials.gov, number NCT02662231. Findings: Between Jan 4, 2016, and July 31, 2016, 13 265 records were submitted for analysis. 12 539 patients from 343 hospitals in 66 countries were included. 7339 (58·5%) patient were from high-HDI countries (193 hospitals in 30 countries), 3918 (31·2%) patients were from middle-HDI countries (82 hospitals in 18 countries), and 1282 (10·2%) patients were from low-HDI countries (68 hospitals in 18 countries). In total, 1538 (12·3%) patients had SSI within 30 days of surgery. The incidence of SSI varied between countries with high (691 [9·4%] of 7339 patients), middle (549 [14·0%] of 3918 patients), and low (298 [23·2%] of 1282) HDI (p < 0·001). The highest SSI incidence in each HDI group was after dirty surgery (102 [17·8%] of 574 patients in high-HDI countries; 74 [31·4%] of 236 patients in middle-HDI countries; 72 [39·8%] of 181 patients in low-HDI countries). Following risk factor adjustment, patients in low-HDI countries were at greatest risk of SSI (adjusted odds ratio 1·60, 95% credible interval 1·05–2·37; p=0·030). 132 (21·6%) of 610 patients with an SSI and a microbiology culture result had an infection that was resistant to the prophylactic antibiotic used. Resistant infections were detected in 49 (16·6%) of 295 patients in high-HDI countries, in 37 (19·8%) of 187 patients in middle-HDI countries, and in 46 (35·9%) of 128 patients in low-HDI countries (p < 0·001). Interpretation: Countries with a low HDI carry a disproportionately greater burden of SSI than countries with a middle or high HDI and might have higher rates of antibiotic resistance. In view of WHO recommendations on SSI prevention that highlight the absence of high-quality interventional research, urgent, pragmatic, randomised trials based in LMICs are needed to assess measures aiming to reduce this preventable complication