20 research outputs found
Combined heat and mass transfer and thermodynamic irreversibilities in the stagnation-point flow of Casson rheological fluid over a cylinder with catalytic reactions and inside a porous medium under local thermal nonequilibrium
The transport of heat and mass from the surface of a cylinder coated with a catalyst and subject to an impinging flow of a Casson rheological fluid is investigated. The cylinder features circumferentially non-uniform transpiration and is embedded inside a homogeneous porous medium. The non-equilibrium thermodynamics of the problem, including Soret and Dufour effects and local thermal non-equilibrium in the porous medium, are considered. Through the introduction of similarity variables, the governing equations are reduced to a set of non-linear ordinary differential equations which are subsequently solved numerically. This results in the prediction of hydrodynamic, temperature, concentration and entropy generation fields, as well as local and average Nusselt, Sherwood and Bejan numbers. It is shown that, for low values of the Casson parameter and thus strong non-Newtonian behaviour, the porous system has a significant tendency towards maintaining local thermal equilibrium. Furthermore, the results show a major reduction in the average Nusselt number during the transition from Newtonian to non-Newtonian fluid, while the reduction in the Sherwood number is less pronounced. It is also demonstrated that flow, thermal and mass transfer irreversibilities are significantly affected by the fluidâs strengthened non-Newtonian characteristics. The physical reasons for these behaviours are discussed by exploring the influence of the Casson parameter and other pertinent factors upon the thickness of thermal and concentration boundary layers. It is noted that this study is the first systematic investigation of the stagnation-point flow of Casson fluid in cylindrical porous media
Mapping disparities in education across low- and middle-income countries
Analyses of the proportions of individuals who have completed key levels of schooling across all low- and middle-income countries from 2000 to 2017 reveal inequalities across countries as well as within populations. Educational attainment is an important social determinant of maternal, newborn, and child health(1-3). As a tool for promoting gender equity, it has gained increasing traction in popular media, international aid strategies, and global agenda-setting(4-6). The global health agenda is increasingly focused on evidence of precision public health, which illustrates the subnational distribution of disease and illness(7,8); however, an agenda focused on future equity must integrate comparable evidence on the distribution of social determinants of health(9-11). Here we expand on the available precision SDG evidence by estimating the subnational distribution of educational attainment, including the proportions of individuals who have completed key levels of schooling, across all low- and middle-income countries from 2000 to 2017. Previous analyses have focused on geographical disparities in average attainment across Africa or for specific countries, but-to our knowledge-no analysis has examined the subnational proportions of individuals who completed specific levels of education across all low- and middle-income countries(12-14). By geolocating subnational data for more than 184 million person-years across 528 data sources, we precisely identify inequalities across geography as well as within populations.Peer reviewe
Mapping local patterns of childhood overweight and wasting in low- and middle-income countries between 2000 and 2017
A double burden of malnutrition occurs when individuals, household members or communities experience both undernutrition and overweight. Here, we show geospatial estimates of overweight and wasting prevalence among children under 5 years of age in 105 low- and middle-income countries (LMICs) from 2000 to 2017 and aggregate these to policy-relevant administrative units. Wasting decreased overall across LMICs between 2000 and 2017, from 8.4% (62.3 (55.1â70.8) million) to 6.4% (58.3 (47.6â70.7) million), but is predicted to remain above the World Health Organizationâs Global Nutrition Target of <5% in over half of LMICs by 2025. Prevalence of overweight increased from 5.2% (30 (22.8â38.5) million) in 2000 to 6.0% (55.5 (44.8â67.9) million) children aged under 5 years in 2017. Areas most affected by double burden of malnutrition were located in Indonesia, Thailand, southeastern China, Botswana, Cameroon and central Nigeria. Our estimates provide a new perspective to researchers, policy makers and public health agencies in their efforts to address this global childhood syndemic
Global, regional, and national age-sex-specific mortality for 282 causes of death in 195 countries and territories, 1980-2017 : a systematic analysis for the Global Burden of Disease Study 2017
Background Global development goals increasingly rely on country-specific estimates for benchmarking a nation's progress. To meet this need, the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2016 estimated global, regional, national, and, for selected locations, subnational cause-specific mortality beginning in the year 1980. Here we report an update to that study, making use of newly available data and improved methods. GBD 2017 provides a comprehensive assessment of cause-specific mortality for 282 causes in 195 countries and territories from 1980 to 2017. Methods The causes of death database is composed of vital registration (VR), verbal autopsy (VA), registry, survey, police, and surveillance data. GBD 2017 added ten VA studies, 127 country-years of VR data, 502 cancer-registry country-years, and an additional surveillance country-year. Expansions of the GBD cause of death hierarchy resulted in 18 additional causes estimated for GBD 2017. Newly available data led to subnational estimates for five additional countries Ethiopia, Iran, New Zealand, Norway, and Russia. Deaths assigned International Classification of Diseases (ICD) codes for non-specific, implausible, or intermediate causes of death were reassigned to underlying causes by redistribution algorithms that were incorporated into uncertainty estimation. We used statistical modelling tools developed for GBD, including the Cause of Death Ensemble model (CODErn), to generate cause fractions and cause specific death rates for each location, year, age, and sex. Instead of using UN estimates as in previous versions, GBD 2017 independently estimated population size and fertility rate for all locations. Years of life lost (YLLs) were then calculated as the sum of each death multiplied by the standard life expectancy at each age. All rates reported here are age-standardised. Findings At the broadest grouping of causes of death (Level 1), non-communicable diseases (NC Ds) comprised the greatest fraction of deaths, contributing to 73.4% (95% uncertainty interval [UI] 72.5-74.1) of total deaths in 2017, while communicable, maternal, neonatal, and nutritional (CMNN) causes accounted for 186% (17.9-19.6), and injuries 8.0% (7.7-8.2). Total numbers of deaths from NCD causes increased from 2007 to 2017 by 22.7% (21.5-23.9), representing an additional 7.61 million (7. 20-8.01) deaths estimated in 2017 versus 2007. The death rate from NCDs decreased globally by 7.9% (7.08.8). The number of deaths for CMNN causes decreased by 222% (20.0-24.0) and the death rate by 31.8% (30.1-33.3). Total deaths from injuries increased by 2.3% (0-5-4-0) between 2007 and 2017, and the death rate from injuries decreased by 13.7% (12.2-15.1) to 57.9 deaths (55.9-59.2) per 100 000 in 2017. Deaths from substance use disorders also increased, rising from 284 000 deaths (268 000-289 000) globally in 2007 to 352 000 (334 000-363 000) in 2017. Between 2007 and 2017, total deaths from conflict and terrorism increased by 118.0% (88.8-148.6). A greater reduction in total deaths and death rates was observed for some CMNN causes among children younger than 5 years than for older adults, such as a 36.4% (32.2-40.6) reduction in deaths from lower respiratory infections for children younger than 5 years compared with a 33.6% (31.2-36.1) increase in adults older than 70 years. Globally, the number of deaths was greater for men than for women at most ages in 2017, except at ages older than 85 years. Trends in global YLLs reflect an epidemiological transition, with decreases in total YLLs from enteric infections, respirator}, infections and tuberculosis, and maternal and neonatal disorders between 1990 and 2017; these were generally greater in magnitude at the lowest levels of the Socio-demographic Index (SDI). At the same time, there were large increases in YLLs from neoplasms and cardiovascular diseases. YLL rates decreased across the five leading Level 2 causes in all SDI quintiles. The leading causes of YLLs in 1990 neonatal disorders, lower respiratory infections, and diarrhoeal diseases were ranked second, fourth, and fifth, in 2017. Meanwhile, estimated YLLs increased for ischaemic heart disease (ranked first in 2017) and stroke (ranked third), even though YLL rates decreased. Population growth contributed to increased total deaths across the 20 leading Level 2 causes of mortality between 2007 and 2017. Decreases in the cause-specific mortality rate reduced the effect of population growth for all but three causes: substance use disorders, neurological disorders, and skin and subcutaneous diseases. Interpretation Improvements in global health have been unevenly distributed among populations. Deaths due to injuries, substance use disorders, armed conflict and terrorism, neoplasms, and cardiovascular disease are expanding threats to global health. For causes of death such as lower respiratory and enteric infections, more rapid progress occurred for children than for the oldest adults, and there is continuing disparity in mortality rates by sex across age groups. Reductions in the death rate of some common diseases are themselves slowing or have ceased, primarily for NCDs, and the death rate for selected causes has increased in the past decade. Copyright (C) 2018 The Author(s). Published by Elsevier Ltd.Peer reviewe
Measuring progress from 1990 to 2017 and projecting attainment to 2030 of the health-related Sustainable Development Goals for 195 countries and territories: a systematic analysis for the Global Burden of Disease Study 2017
Background: Efforts to establish the 2015 baseline and monitor early implementation of the UN Sustainable Development Goals (SDGs) highlight both great potential for and threats to improving health by 2030. To fully deliver on the SDG aim of âleaving no one behindâ, it is increasingly important to examine the health-related SDGs beyond national-level estimates. As part of the Global Burden of Diseases, Injuries, and Risk Factors Study 2017 (GBD 2017), we measured progress on 41 of 52 health-related SDG indicators and estimated the health-related SDG index for 195 countries and territories for the period 1990â2017, projected indicators to 2030, and analysed global attainment. Methods: We measured progress on 41 health-related SDG indicators from 1990 to 2017, an increase of four indicators since GBD 2016 (new indicators were health worker density, sexual violence by non-intimate partners, population census status, and prevalence of physical and sexual violence [reported separately]). We also improved the measurement of several previously reported indicators. We constructed national-level estimates and, for a subset of health-related SDGs, examined indicator-level differences by sex and Socio-demographic Index (SDI) quintile. We also did subnational assessments of performance for selected countries. To construct the health-related SDG index, we transformed the value for each indicator on a scale of 0â100, with 0 as the 2\ub75th percentile and 100 as the 97\ub75th percentile of 1000 draws calculated from 1990 to 2030, and took the geometric mean of the scaled indicators by target. To generate projections through 2030, we used a forecasting framework that drew estimates from the broader GBD study and used weighted averages of indicator-specific and country-specific annualised rates of change from 1990 to 2017 to inform future estimates. We assessed attainment of indicators with defined targets in two ways: first, using mean values projected for 2030, and then using the probability of attainment in 2030 calculated from 1000 draws. We also did a global attainment analysis of the feasibility of attaining SDG targets on the basis of past trends. Using 2015 global averages of indicators with defined SDG targets, we calculated the global annualised rates of change required from 2015 to 2030 to meet these targets, and then identified in what percentiles the required global annualised rates of change fell in the distribution of country-level rates of change from 1990 to 2015. We took the mean of these global percentile values across indicators and applied the past rate of change at this mean global percentile to all health-related SDG indicators, irrespective of target definition, to estimate the equivalent 2030 global average value and percentage change from 2015 to 2030 for each indicator. Findings: The global median health-related SDG index in 2017 was 59\ub74 (IQR 35\ub74â67\ub73), ranging from a low of 11\ub76 (95% uncertainty interval 9\ub76â14\ub70) to a high of 84\ub79 (83\ub71â86\ub77). SDG index values in countries assessed at the subnational level varied substantially, particularly in China and India, although scores in Japan and the UK were more homogeneous. Indicators also varied by SDI quintile and sex, with males having worse outcomes than females for non-communicable disease (NCD) mortality, alcohol use, and smoking, among others. Most countries were projected to have a higher health-related SDG index in 2030 than in 2017, while country-level probabilities of attainment by 2030 varied widely by indicator. Under-5 mortality, neonatal mortality, maternal mortality ratio, and malaria indicators had the most countries with at least 95% probability of target attainment. Other indicators, including NCD mortality and suicide mortality, had no countries projected to meet corresponding SDG targets on the basis of projected mean values for 2030 but showed some probability of attainment by 2030. For some indicators, including child malnutrition, several infectious diseases, and most violence measures, the annualised rates of change required to meet SDG targets far exceeded the pace of progress achieved by any country in the recent past. We found that applying the mean global annualised rate of change to indicators without defined targets would equate to about 19% and 22% reductions in global smoking and alcohol consumption, respectively; a 47% decline in adolescent birth rates; and a more than 85% increase in health worker density per 1000 population by 2030. Interpretation: The GBD study offers a unique, robust platform for monitoring the health-related SDGs across demographic and geographic dimensions. Our findings underscore the importance of increased collection and analysis of disaggregated data and highlight where more deliberate design or targeting of interventions could accelerate progress in attaining the SDGs. Current projections show that many health-related SDG indicators, NCDs, NCD-related risks, and violence-related indicators will require a concerted shift away from what might have driven past gainsâcurative interventions in the case of NCDsâtowards multisectoral, prevention-oriented policy action and investments to achieve SDG aims. Notably, several targets, if they are to be met by 2030, demand a pace of progress that no country has achieved in the recent past. The future is fundamentally uncertain, and no model can fully predict what breakthroughs or events might alter the course of the SDGs. What is clear is that our actionsâor inactionâtoday will ultimately dictate how close the world, collectively, can get to leaving no one behind by 2030
Measuring progress from 1990 to 2017 and projecting attainment to 2030 of the health-related Sustainable Development Goals for 195 countries and territories: a systematic analysis for the Global Burden of Disease Study 2017.
BACKGROUND: Efforts to establish the 2015 baseline and monitor early implementation of the UN Sustainable Development Goals (SDGs) highlight both great potential for and threats to improving health by 2030. To fully deliver on the SDG aim of 'leaving no one behind', it is increasingly important to examine the health-related SDGs beyond national-level estimates. As part of the Global Burden of Diseases, Injuries, and Risk Factors Study 2017 (GBD 2017), we measured progress on 41 of 52 health-related SDG indicators and estimated the health-related SDG index for 195 countries and territories for the period 1990-2017, projected indicators to 2030, and analysed global attainment. METHODS: We measured progress on 41 health-related SDG indicators from 1990 to 2017, an increase of four indicators since GBD 2016 (new indicators were health worker density, sexual violence by non-intimate partners, population census status, and prevalence of physical and sexual violence [reported separately]). We also improved the measurement of several previously reported indicators. We constructed national-level estimates and, for a subset of health-related SDGs, examined indicator-level differences by sex and Socio-demographic Index (SDI) quintile. We also did subnational assessments of performance for selected countries. To construct the health-related SDG index, we transformed the value for each indicator on a scale of 0-100, with 0 as the 2·5th percentile and 100 as the 97·5th percentile of 1000 draws calculated from 1990 to 2030, and took the geometric mean of the scaled indicators by target. To generate projections through 2030, we used a forecasting framework that drew estimates from the broader GBD study and used weighted averages of indicator-specific and country-specific annualised rates of change from 1990 to 2017 to inform future estimates. We assessed attainment of indicators with defined targets in two ways: first, using mean values projected for 2030, and then using the probability of attainment in 2030 calculated from 1000 draws. We also did a global attainment analysis of the feasibility of attaining SDG targets on the basis of past trends. Using 2015 global averages of indicators with defined SDG targets, we calculated the global annualised rates of change required from 2015 to 2030 to meet these targets, and then identified in what percentiles the required global annualised rates of change fell in the distribution of country-level rates of change from 1990 to 2015. We took the mean of these global percentile values across indicators and applied the past rate of change at this mean global percentile to all health-related SDG indicators, irrespective of target definition, to estimate the equivalent 2030 global average value and percentage change from 2015 to 2030 for each indicator
Al/Ti Nanostructured Multilayers: from Mechanical, Tribological, to Corrosion Properties
Nanostructured metallic multilayers (NMMs) are well-known for their high strength in smaller bilayer thicknesses. Six Al/Ti (NMM) with different individual layer thickness were tested for their mechanical hardness using a nanoindentation tool. Individual layer thicknesses were chosen carefully to cover the whole confined layer slip (CLS) model. Nano-hardness had a reverse relation with the square root of individual layer thickness and reached a steady state at ~ 5 nm bilayer thickness. Decreasing the layer bilayer thickness from ~ 104 nm to ~ 5 nm, improved the mechanical hardness up to ~ 101%. Residual stresses were measured using grazing incident X-ray diffraction (GIXRD). Effect of residual stress on atomic structure and dislocation propagation was then investigated by comparing the amount and type of stresses in both aluminum and titanium phases. Based on the gathered data from GIXRD scans tensile stress in Ti phases, and compressive stress in Al would increase the overall coherency of structure.
Wear rate in coatings is highly dependent on design and architect of the structure. NMM coatings are known to have much better wear resistance compare to their monolithic constituent phases by introducing a reciprocal architect. In current study wear rate of two Al/Ti NMMs with individual layer thicknesses of ~ 2.5 nm and ~ 30 nm were examined under normal loads of 30 ”N, 60 ”N, and 93 ”N. Wears strokes were performed in various cycles of 1, 2, 3, 4 5 and 10. Wear rates were then calculated by comparing the 3D imaging of sample topology before and after tests. Nano-hardness of samples was measured pre and post each cycle of wear using a nanoindentation tool. The microstructure of samples below the worn surface was then characterized using scanning electron microscopy (SEM), transmission electron microscopy (TEM), atomic force microscopy (AFM), focus ion beam (FIB) and an optical profilometer. Orientation mapping was performed to analyze the microstructure of layers beneath the nano indents. TEM imaging from the cross section of worn samples indicated severely plastically deformed layer (SPDL) below the worn surface. Shear bands and twins are visible after wear and below the worn surface. Decreasing the layer thickness from 30 nm to 2.5 nm resulted in ~ 5 timeâs better wear resistance. Nanowear caused surface hardening which consequently increased nano hardness up to ~ 30% in the sample with 2.5 nm individual layer thickness.
Increasing the interfaces density of NMMs will significantly improve the corrosion resistance of coating. Reciprocal layers and consequently interfaces will block the path of aggressive content toward the substrate. Corrosion rate evolution of Al/Ti multilayers was investigated through DC corrosion potentiodynamic test. Results seem to be very promising and demonstrate up to 30 times better corrosion resistance compared to conventional sputtered monolithic aluminum. Corrosion started in the form of pitting and then transformed to the localized galvanic corrosion. Decreasing the bilayer thickness from ~ 10.4 nm to ~ 5 nm will decrease the corrosion current density (icorr) of ~ 5.42 Ă 10-7 (A/cm2) to ~ 6.11 Ă 10-10 (A/cm2). No sign of corrosion has been seen in the sample with ~ 2.5 nm individual layer thickness. Further AFM and TEM analysis from surface and cross section of NMMs indicate that a more coherent layer by layer structure improves the corrosion rate. Interfaces have a significant role in blocking the pores and imperfections inside coating
Expanding the VBN theory on succeeding the transportation demand management policies
The growth of the car fleet has caused many problems, such as environmental problems, uncontrolled energy consumption, and traffic congestion. To resolve the issues caused by transport-related activities, transportation planners should implement policies that reduce car use and move forward to sustainable transportation. The prerequisite of the efficiency of the policies that reduce car use is the acceptance of them by the entire community members. Previously a few studies have tested individualsâ environmental attitudes using the Value-Belief-Norm (VBN) theory. This research aims to analyze and examine car use reduction policy using a comprehensive VBN and Norm-Activation-model (NAM) theories to consider more variables and provide a model with more analytical capability. To address this issue, 500 questionnaires were filled by travelersâ in Tehran, Iran, in the restricted traffic area to describe their behavior. The result shows that the biospheric value significantly affects car use reduction policy, associated with considerable environmental concerns. Besides, it was found that a high ascription of responsibility (A.R.) appeared as the strongest predictor of the policy. The findings have represented initial support for the VBN theory and revealed that the theory could explain the car use reduction policyâs Intention, according to Tehranâs respondentsâ environmental behavior. This studyâs findings can assist policymakers in adopting appropriate policies to reduce car use based on environmental advantages and could target biospheric values and ascription of responsibilities
One Year Survival and Quality of Life in Patients Successfully Discharged From Neuro Critical Care Unit
Objectives: Neuro-critical Intensive Care Units (NICUs) have functioned to deliver intensive medical care services for patients with acute neurology problems. However, physicians and ICU staff do not have any feedback about their patients and their abilities after successful discharge. Various studies have documented short-term survival in ICUs, but the long-term outcome and quality of life (QOL) are less studied.
Methods: This is a retrospective cohort study over a period of one year from February 2011 to February 2012 (Shiraz, South of Iran). Patients' charts were used to collect the data. Survival and QOL after one year following NICU admission were assessed for surviving patients by a telephone interview with patients or their family members using Karnofsky Performance Scale (KPS).
Results: Out of 93 patients, 42(45.2%) were male, and 51(54.8%) were female. Malignant ischemic stroke (34%) was the most common cause followed by Guillain Barre Syndrome (21%). Among the living successfully discharged patients, 45% were able to perform normal activity and work without any special assistance. The patients who were unable to work were 28%, but they were able to live at home and care for their most personal needs. The patients who were unable to care for themselves were 3% and required institutional or hospital care. Over one year following discharge, 24% patients were passed away.
Discussion: is lower in NICU survivors compared with general population; however, if patients' selection and out of hospital care are done appropriately and continuously, more patients can live independently or even come back to their work. Indeed, it is important to identify patients who benefit more from NICU during decision making for ICU admission. As a result, more efficient rehabilitation could be achieved in the future. However, our conclusions are only related to our ward and do not apply to the total population of critical neurology patients