The effect of bathymetry interaction with waves and sea currents on the loading and thrust of a tidal turbine

This paper reports work undertaken to advance analytical methods used to evaluate the influence of bathymetry on wave- current interactions with tidal turbines. The model takes in to account the wave transformation due to a sudden depth change in the sea level. The functions developed provide solutions for wave transformation by changes in bathymetry to find how this change effects the torque and thrust exerted over a tidal turbine. Costal site data for the west coast of the US, from the US DoE, has been used to access the robustness of these analytical methods. The high resolution data sets used have monitored wave, sea and climatic conditions over a period of 8 years

Utilization of mechanical power and associations with clinical outcomes in brain injured patients: a secondary analysis of the extubation strategies in neuro-intensive care unit patients and associations with outcome (ENIO) trial

Background: There is insufficient evidence to guide ventilatory targets in acute brain injury (ABI). Recent studies have shown associations between mechanical power (MP) and mortality in critical care populations. We aimed to describe MP in ventilated patients with ABI, and evaluate associations between MP and clinical outcomes. Methods: In this preplanned, secondary analysis of a prospective, multi-center, observational cohort study (ENIO, NCT03400904), we included adult patients with ABI (Glasgow Coma Scale ≤ 12 before intubation) who required mechanical ventilation (MV) ≥ 24 h. Using multivariable log binomial regressions, we separately assessed associations between MP on hospital day (HD)1, HD3, HD7 and clinical outcomes: hospital mortality, need for reintubation, tracheostomy placement, and development of acute respiratory distress syndrome (ARDS). Results: We included 1217 patients (mean age 51.2 years [SD 18.1], 66% male, mean body mass index [BMI] 26.3 [SD 5.18]) hospitalized at 62 intensive care units in 18 countries. Hospital mortality was 11% (n = 139), 44% (n = 536) were extubated by HD7 of which 20% (107/536) required reintubation, 28% (n = 340) underwent tracheostomy placement, and 9% (n = 114) developed ARDS. The median MP on HD1, HD3, and HD7 was 11.9 J/min [IQR 9.2-15.1], 13 J/min [IQR 10-17], and 14 J/min [IQR 11-20], respectively. MP was overall higher in patients with ARDS, especially those with higher ARDS severity. After controlling for same-day pressure of arterial oxygen/fraction of inspired oxygen (P/F ratio), BMI, and neurological severity, MP at HD1, HD3, and HD7 was independently associated with hospital mortality, reintubation and tracheostomy placement. The adjusted relative risk (aRR) was greater at higher MP, and strongest for: mortality on HD1 (compared to the HD1 median MP 11.9 J/min, aRR at 17 J/min was 1.22, 95% CI 1.14-1.30) and HD3 (1.38, 95% CI 1.23-1.53), reintubation on HD1 (1.64; 95% CI 1.57-1.72), and tracheostomy on HD7 (1.53; 95%CI 1.18-1.99). MP was associated with the development of moderate-severe ARDS on HD1 (2.07; 95% CI 1.56-2.78) and HD3 (1.76; 95% CI 1.41-2.22). Conclusions: Exposure to high MP during the first week of MV is associated with poor clinical outcomes in ABI, independent of P/F ratio and neurological severity. Potential benefits of optimizing ventilator settings to limit MP warrant further investigation

May Measurement Month 2018: a pragmatic global screening campaign to raise awareness of blood pressure by the International Society of Hypertension

Aims Raised blood pressure (BP) is the biggest contributor to mortality and disease burden worldwide and fewer than half of those with hypertension are aware of it. May Measurement Month (MMM) is a global campaign set up in 2017, to raise awareness of high BP and as a pragmatic solution to a lack of formal screening worldwide. The 2018 campaign was expanded, aiming to include more participants and countries. Methods and results Eighty-nine countries participated in MMM 2018. Volunteers (≥18 years) were recruited through opportunistic sampling at a variety of screening sites. Each participant had three BP measurements and completed a questionnaire on demographic, lifestyle, and environmental factors. Hypertension was defined as a systolic BP ≥140 mmHg or diastolic BP ≥90 mmHg, or taking antihypertensive medication. In total, 74.9% of screenees provided three BP readings. Multiple imputation using chained equations was used to impute missing readings. 1 504 963 individuals (mean age 45.3 years; 52.4% female) were screened. After multiple imputation, 502 079 (33.4%) individuals had hypertension, of whom 59.5% were aware of their diagnosis and 55.3% were taking antihypertensive medication. Of those on medication, 60.0% were controlled and of all hypertensives, 33.2% were controlled. We detected 224 285 individuals with untreated hypertension and 111 214 individuals with inadequately treated (systolic BP ≥ 140 mmHg or diastolic BP ≥ 90 mmHg) hypertension. Conclusion May Measurement Month expanded significantly compared with 2017, including more participants in more countries. The campaign identified over 335 000 adults with untreated or inadequately treated hypertension. In the absence of systematic screening programmes, MMM was effective at raising awareness at least among these individuals at risk

Mortality from gastrointestinal congenital anomalies at 264 hospitals in 74 low-income, middle-income, and high-income countries: a multicentre, international, prospective cohort study

Summary Background Congenital anomalies are the fifth leading cause of mortality in children younger than 5 years globally. Many gastrointestinal congenital anomalies are fatal without timely access to neonatal surgical care, but few studies have been done on these conditions in low-income and middle-income countries (LMICs). We compared outcomes of the seven most common gastrointestinal congenital anomalies in low-income, middle-income, and high-income countries globally, and identified factors associated with mortality. Methods We did a multicentre, international prospective cohort study of patients younger than 16 years, presenting to hospital for the first time with oesophageal atresia, congenital diaphragmatic hernia, intestinal atresia, gastroschisis, exomphalos, anorectal malformation, and Hirschsprung’s disease. Recruitment was of consecutive patients for a minimum of 1 month between October, 2018, and April, 2019. We collected data on patient demographics, clinical status, interventions, and outcomes using the REDCap platform. Patients were followed up for 30 days after primary intervention, or 30 days after admission if they did not receive an intervention. The primary outcome was all-cause, in-hospital mortality for all conditions combined and each condition individually, stratified by country income status. We did a complete case analysis. Findings We included 3849 patients with 3975 study conditions (560 with oesophageal atresia, 448 with congenital diaphragmatic hernia, 681 with intestinal atresia, 453 with gastroschisis, 325 with exomphalos, 991 with anorectal malformation, and 517 with Hirschsprung’s disease) from 264 hospitals (89 in high-income countries, 166 in middleincome countries, and nine in low-income countries) in 74 countries. Of the 3849 patients, 2231 (58·0%) were male. Median gestational age at birth was 38 weeks (IQR 36–39) and median bodyweight at presentation was 2·8 kg (2·3–3·3). Mortality among all patients was 37 (39·8%) of 93 in low-income countries, 583 (20·4%) of 2860 in middle-income countries, and 50 (5·6%) of 896 in high-income countries (p<0·0001 between all country income groups). Gastroschisis had the greatest difference in mortality between country income strata (nine [90·0%] of ten in lowincome countries, 97 [31·9%] of 304 in middle-income countries, and two [1·4%] of 139 in high-income countries; p≤0·0001 between all country income groups). Factors significantly associated with higher mortality for all patients combined included country income status (low-income vs high-income countries, risk ratio 2·78 [95% CI 1·88–4·11], p<0·0001; middle-income vs high-income countries, 2·11 [1·59–2·79], p<0·0001), sepsis at presentation (1·20 [1·04–1·40], p=0·016), higher American Society of Anesthesiologists (ASA) score at primary intervention (ASA 4–5 vs ASA 1–2, 1·82 [1·40–2·35], p<0·0001; ASA 3 vs ASA 1–2, 1·58, [1·30–1·92], p<0·0001]), surgical safety checklist not used (1·39 [1·02–1·90], p=0·035), and ventilation or parenteral nutrition unavailable when needed (ventilation 1·96, [1·41–2·71], p=0·0001; parenteral nutrition 1·35, [1·05–1·74], p=0·018). Administration of parenteral nutrition (0·61, [0·47–0·79], p=0·0002) and use of a peripherally inserted central catheter (0·65 [0·50–0·86], p=0·0024) or percutaneous central line (0·69 [0·48–1·00], p=0·049) were associated with lower mortality. Interpretation Unacceptable differences in mortality exist for gastrointestinal congenital anomalies between lowincome, middle-income, and high-income countries. Improving access to quality neonatal surgical care in LMICs will be vital to achieve Sustainable Development Goal 3.2 of ending preventable deaths in neonates and children younger than 5 years by 2030

Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Abstract Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries

Wave transformation over obstacles and its influence on a tidal turbine

Tidal and marine energy has been explored extensively in recent years. Part of the studies made in the area includes the resource available, the design challenges, the environmental impact and other important areas for research and development. One of these research areas focuses on the mechanical response of tidal turbines to different operational environments. The operational environment can depend on factors such as wave weather, turbulence and flow velocity. The changes in these factors will affect the mechanical performance of the device. This thesis explores the changes in the mechanical performance markers, which are the turbine torque and thrust, to swell wave systems with moderate to low amplitude. The work also explores how a non-even seabed, characterised here as a regular bathymetry rise, can affect the wave parameters such as wave height and wavelength, changing the unsteady flow before and after the geographical obstacle and resulting in a different mechanical turbine response. The thesis first explores the wave propagation over an uneven bottom using classic theory and expanding into the subject with experiments and validation of the theories using physical scenarios resembling normal turbine deployment in the ocean. As the classical theory of wave propagation is frequency non-variant, theories are explored to expand comprehension of the phenomena by addressing frequency variant solutions under larger depths relative to the wave wavelength, which in our case cover periods from 6s to 14s at depths between 28m and 42m. The formulations explored are validated against experiments in a wave tank. Wave conditions are designed to scale wave heights, depths, and periods to the mentioned depth to ensure a good representation of the dynamic behaviour of the waves propagating in the tank. The experiments show how frequency variant theories can predict more closely the changes in the wave amplitude and wavelength when a wave propagates over obstacles of limited length. Amplitude changes, and also changes in the wavelength and velocity, are measured and detected. However, the latter two prove to be harder to measure. The changes in both the amplitudes and lengths correlate in many cases to each other in the experiments. When the wave path has been obstructed, the length for larger waves is reduced and their amplitude increases consistently for larger waves. Validation shows a close relationship between frequency variant theories and the results obtained in the test campaign. The formulations validated are then used to modify a Blade Element Moment Theory (BEMT) model which calculates the mechanical torque and thrust of a tidal turbine. A sensitivity analysis is carried out using the BEMT model to understand how different parameters such as the wave height, current, wave period, and depth ratio between the original depth and the obstacle affect the mechanical turbine response. The results show how wave height is the most important parameter and current velocity is the second. The formulations are then used to model a specific location for tidal turbine deployment in a real case study with data gathered from real buoy systems. Simulation for the case study occurs in three types of wave weather using long swells with low amplitude, smaller period swells with steeper heights, and a mixed case using some wind-wave components with larger heights. The model output shows the large influence of swells on the mechanical performance of the turbine, being the largest contributor to the torque and thrust variation with the thrust and the torque being 60% and 40% larger, than conditions with shorter periods but steeper waves. The study also shows how the inclusion of a simple irregular seabed interacting with large wave components can affect the expected mechanical response in our model. The results show how these small changes, paired with the wave propagation under larger wave heights, change the simulated mechanical response by 50% of their original value when we compare the different responses to each type of wave weather. Work made here seeks to highlight the importance of other environmental factors different than extreme wave loads, current velocity or turbulence that can affect the mechanical behaviours of a tidal turbine device. Particularly it aims to expand our understanding of how the sudden changes in a field of waves produced by local bathymetry irregularities, could modify the forces on a tidal turbine device by integrating with the waves which later propagate into a tidal turbine. These factors could prove to be important to the turbine fatigue or loads depending on their relative impact compared to other already explored factors such as extra waves.Tidal and marine energy has been explored extensively in recent years. Part of the studies made in the area includes the resource available, the design challenges, the environmental impact and other important areas for research and development. One of these research areas focuses on the mechanical response of tidal turbines to different operational environments. The operational environment can depend on factors such as wave weather, turbulence and flow velocity. The changes in these factors will affect the mechanical performance of the device. This thesis explores the changes in the mechanical performance markers, which are the turbine torque and thrust, to swell wave systems with moderate to low amplitude. The work also explores how a non-even seabed, characterised here as a regular bathymetry rise, can affect the wave parameters such as wave height and wavelength, changing the unsteady flow before and after the geographical obstacle and resulting in a different mechanical turbine response. The thesis first explores the wave propagation over an uneven bottom using classic theory and expanding into the subject with experiments and validation of the theories using physical scenarios resembling normal turbine deployment in the ocean. As the classical theory of wave propagation is frequency non-variant, theories are explored to expand comprehension of the phenomena by addressing frequency variant solutions under larger depths relative to the wave wavelength, which in our case cover periods from 6s to 14s at depths between 28m and 42m. The formulations explored are validated against experiments in a wave tank. Wave conditions are designed to scale wave heights, depths, and periods to the mentioned depth to ensure a good representation of the dynamic behaviour of the waves propagating in the tank. The experiments show how frequency variant theories can predict more closely the changes in the wave amplitude and wavelength when a wave propagates over obstacles of limited length. Amplitude changes, and also changes in the wavelength and velocity, are measured and detected. However, the latter two prove to be harder to measure. The changes in both the amplitudes and lengths correlate in many cases to each other in the experiments. When the wave path has been obstructed, the length for larger waves is reduced and their amplitude increases consistently for larger waves. Validation shows a close relationship between frequency variant theories and the results obtained in the test campaign. The formulations validated are then used to modify a Blade Element Moment Theory (BEMT) model which calculates the mechanical torque and thrust of a tidal turbine. A sensitivity analysis is carried out using the BEMT model to understand how different parameters such as the wave height, current, wave period, and depth ratio between the original depth and the obstacle affect the mechanical turbine response. The results show how wave height is the most important parameter and current velocity is the second. The formulations are then used to model a specific location for tidal turbine deployment in a real case study with data gathered from real buoy systems. Simulation for the case study occurs in three types of wave weather using long swells with low amplitude, smaller period swells with steeper heights, and a mixed case using some wind-wave components with larger heights. The model output shows the large influence of swells on the mechanical performance of the turbine, being the largest contributor to the torque and thrust variation with the thrust and the torque being 60% and 40% larger, than conditions with shorter periods but steeper waves. The study also shows how the inclusion of a simple irregular seabed interacting with large wave components can affect the expected mechanical response in our model. The results show how these small changes, paired with the wave propagation under larger wave heights, change the simulated mechanical response by 50% of their original value when we compare the different responses to each type of wave weather. Work made here seeks to highlight the importance of other environmental factors different than extreme wave loads, current velocity or turbulence that can affect the mechanical behaviours of a tidal turbine device. Particularly it aims to expand our understanding of how the sudden changes in a field of waves produced by local bathymetry irregularities, could modify the forces on a tidal turbine device by integrating with the waves which later propagate into a tidal turbine. These factors could prove to be important to the turbine fatigue or loads depending on their relative impact compared to other already explored factors such as extra waves

La Constitución Política de los Estados Unidos Mexicanos 1917-2017 a 100 años

resultado de la primera revolución social del siglo XX fue la Constitución Política de los Estados Unidos Mexicanos, documento que plasmó las aspiraciones de toda una nación, marcando el rumbo de nuestro país hacia la democracia. Gracias a la Carta Magna hoy tenemos garantizados amplios derechos y podemos ejercer plenamente nuestras libertades. Celebro que la Universidad Autónoma del Estado de México conmemore los cien años de nuestra Constitución con la publicación de este libro, elaborado por un grupo multidisciplinario de investigadores, pertenecientes a diversas instituciones educativas del país, que analizan los diferentes artículos de la Constitución de 1917, desde los ámbitos histórico, filosófico, jurídico, educativo y social. Para el Gobierno del Estado de México, un libro conmemorativo de nuestra Carta Magna es invitación a reflexionar sobre las características de nuestras instituciones, así como la conveniencia de mantener o reformar sus artículos para continuar respondiendo a las necesidades de la ciudadanía. En cada propuesta de este libro, desde sus respectivos campos de estudio, los autores analizan los retos de la sociedad actual; además en su lectura e interpretación demuestran que los 136 artículos no son letra muerta, siguen vigentes

Seminario de Investigación Académica II (Ing) - IN397 - 202100

Seminario de Investigación Académica II es un curso de especialidad en la carrera de Ingeniería Industrial, el objetivo es desarrollar el proyecto de tesis enfocado en resolver problemas del contexto de la realidad del sector. El curso se desarrolla en cinco unidades de aprendizaje, con sesiones teóricas que van desde las etapas básicas del proceso de investigación científica, la propuesta inicial del tema de investigación, la identificación y diagnóstico del problema, la construcción del estado del arte que sustenta el informe final con el tema de tesis. El proceso es sistemático, continuo, enriquecedor en función a las variantes que se presentan durante el tiempo de búsqueda, selección y análisis de la información que sustenta el tema de tesis, en este proceso, es permanente el acompañamiento basado en recomendaciones, técnicas y estrategias por parte del equipo de docentes conformado por el asesor metodológico y el asesor temático. Propósito: El propósito de este curso es que el estudiante inicie el plan de tesis en el que se evidencia la aplicación práctica de su carrera, mediante la gestión de información académica, relevante para su tesis y, a partir de ella, plantear un problema de investigación susceptible a una posible solución. En el curso se contribuye al desarrollo de las competencias generales: comunicación oral, comunicación escrita y manejo de información todas a nivel 2. Por otro lado, también se busca el desarrollo de las competencias específicas de ABET (7): Capacidad de adquirir y aplicar nuevos conocimientos según sea necesario, utilizando estrategias de aprendizaje apropiadas, a nivel 2. Tiene como requisito el nivel 5 de inglés y haber alcanzado los 120 créditos

Genomic surveillance reveals dynamic shifts in the connectivity of COVID-19 epidemics

Summary: The maturation of genomic surveillance in the past decade has enabled tracking of the emergence and spread of epidemics at an unprecedented level. During the COVID-19 pandemic, for example, genomic data revealed that local epidemics varied considerably in the frequency of SARS-CoV-2 lineage importation and persistence, likely due to a combination of COVID-19 restrictions and changing connectivity. Here, we show that local COVID-19 epidemics are driven by regional transmission, including across international boundaries, but can become increasingly connected to distant locations following the relaxation of public health interventions. By integrating genomic, mobility, and epidemiological data, we find abundant transmission occurring between both adjacent and distant locations, supported by dynamic mobility patterns. We find that changing connectivity significantly influences local COVID-19 incidence. Our findings demonstrate a complex meaning of ‘local’ when investigating connected epidemics and emphasize the importance of collaborative interventions for pandemic prevention and mitigation