High-heat-producing granites of East Dharwar Craton around Gugi, Karnataka, and their possible influence on the evolution of Rajapur thermal springs, Deccan Volcanic Province, India

Background: The thermal springs of Rajapur situated along the west coast of Maharashtra and parts of high-heat-generating granites of Gugi in Karnataka (India) seem to be genetically related. The present investigation involves quantification of the heat generated by the Gugi Granites using the the U, Th and K contents in the rock samples and probing their possible influence on the evolution of the Rajapur springs, based on the geochemistry of the thermal waters, published Bouguer gravity anomaly data, and the overall geological setup. Methods: Fourteen water samples from Rajapur including thermal and groundwater samples were analysed for major ions and five rock samples from the gugi area were analysed for U, Th and K. Results: Rajapur thermal spring is of Na-HCO3 type, while other thermal springs along the west coast are either Na-Cl type or Na-Cl-CO3 type. The stable isotope data of the thermal waters signifies mixing with the ground water. The gravity anomaly data supports the extension of the Gugi Granites below the Deccan Volcanics of the study area. Conclusions: The present investigation suggests that the Gugi Granites could be the main source of heat for these thermal springs, even though the springs issue through the Deccan volcanic flows

An experimental study of creation of optimal fracture network for heat extraction from engineered geothermal reservoirs

Enhanced geothermal system has been successfully able to increase the permeability of the reservoir and hydro-fracturing is the conventional method of creating artificial fracture system. But more precise technique is required to reduce the cost of the geothermal energy extraction and this will require proper understanding of the thermo-mechanical behaviour of the reservoir rocks i.e. Granites. Current research work has focused on the thermo-mechanical properties of granites under various temperature and strain rate condition. Granites of two different areas i.e. Bundelkhand granite, India and Harcourt granite, Australia have been investigated for the research work. 4 different strain rates i.e. 0.05 mm/min, 0.5 mm/min, 5.0 mm/min and 50 mm/min at 3 different temperatures i.e. room temperature (25 °C), 200 °C and 400 °C were considered for experimental analysis. It was observed that at room temperature, with increasing strain rate the uniaxial compressive strength of the rock increases and the same trend is also observed at higher temperatures conditions. Whereas at low strain rate the compressive strength decreases with increase in temperature, while the trend is irregular at higher strain rates. Bundelkhand granites have thermal conductivity values between 3.1 to 3.6 W/m.K whereas that of Harcourt granite is 2.4 W/m.K. Sieve analysis of the fragmented particles due to UCS test suggested that there is no effect of strain rate on particle size distribution whereas higher temperatures produces more finer particles. It was observed that more than 75% of the fragmented particles are having diameter of greater than 11.3 mm. Effective size i.e. D10 was analysed and found that at room temperature (25 °C) 10% of fragmented particles are finer than 3.0 mm whereas at 200 °C and 400 °C 10% of finer particles are finer than 1.9 mm and 1.5 mm respectively. Numerical simulation results of the numerical simulation are quite analogous to the lab experimental data.Thesis submitted in partial fulfillment of the requirements for the degree of Doctor of Philosophy of the Indian Institute of Technology Bombay, India and Monash University, Australia

An experimental study of creation of optimal fracture network for heat extraction from engineered geothermal reservoirs

Enhanced geothermal system has been successfully able to increase the permeability of the reservoir and hydro-fracturing is the conventional method of creating artificial fracture system. But more precise technique is required to reduce the cost of the geothermal energy extraction and this will require proper understanding of the thermo-mechanical behaviour of the reservoir rocks i.e. Granites. Current research work has focused on the thermo-mechanical properties of granites under various temperature and strain rate condition. Granites of two different areas i.e. Bundelkhand granite, India and Harcourt granite, Australia have been investigated for the research work. 4 different strain rates i.e. 0.05 mm/min, 0.5 mm/min, 5.0 mm/min and 50 mm/min at 3 different temperatures i.e. room temperature (25 °C), 200 °C and 400 °C were considered for experimental analysis. It was observed that at room temperature, with increasing strain rate the uniaxial compressive strength of the rock increases and the same trend is also observed at higher temperatures conditions. Whereas at low strain rate the compressive strength decreases with increase in temperature, while the trend is irregular at higher strain rates. Bundelkhand granites have thermal conductivity values between 3.1 to 3.6 W/m.K whereas that of Harcourt granite is 2.4 W/m.K. Sieve analysis of the fragmented particles due to UCS test suggested that there is no effect of strain rate on particle size distribution whereas higher temperatures produces more finer particles. It was observed that more than 75% of the fragmented particles are having diameter of greater than 11.3 mm. Effective size i.e. D10 was analysed and found that at room temperature (25 °C) 10% of fragmented particles are finer than 3.0 mm whereas at 200 °C and 400 °C 10% of finer particles are finer than 1.9 mm and 1.5 mm respectively. Numerical simulation results of the numerical simulation are quite analogous to the lab experimental data. Thesis submitted in partial fulfillment of the requirements for the degree of Doctor of Philosophy of the Indian Institute of Technology Bombay, India and Monash University, Australia

Physico-chemical characteristics of Jharkhand and West Bengal thermal springs along SONATA mega lineament, India

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Intubation Practices and Adverse Peri-intubation Events in Critically Ill Patients from 29 Countries

Importance: Tracheal intubation is one of the most commonly performed and high-risk interventions in critically ill patients. Limited information is available on adverse peri-intubation events. Objective: To evaluate the incidence and nature of adverse peri-intubation events and to assess current practice of intubation in critically ill patients. Design, Setting, and Participants: The International Observational Study to Understand the Impact and Best Practices of Airway Management in Critically Ill Patients (INTUBE) study was an international, multicenter, prospective cohort study involving consecutive critically ill patients undergoing tracheal intubation in the intensive care units (ICUs), emergency departments, and wards, from October 1, 2018, to July 31, 2019 (August 28, 2019, was the final follow-up) in a convenience sample of 197 sites from 29 countries across 5 continents. Exposures: Tracheal intubation. Main Outcomes and Measures: The primary outcome was the incidence of major adverse peri-intubation events defined as at least 1 of the following events occurring within 30 minutes from the start of the intubation procedure: cardiovascular instability (either: systolic pressure <65 mm Hg at least once, <90 mm Hg for >30 minutes, new or increase need of vasopressors or fluid bolus >15 mL/kg), severe hypoxemia (peripheral oxygen saturation <80%) or cardiac arrest. The secondary outcomes included intensive care unit mortality. Results: Of 3659 patients screened, 2964 (median age, 63 years; interquartile range [IQR], 49-74 years; 62.6% men) from 197 sites across 5 continents were included. The main reason for intubation was respiratory failure in 52.3% of patients, followed by neurological impairment in 30.5%, and cardiovascular instability in 9.4%. Primary outcome data were available for all patients. Among the study patients, 45.2% experienced at least 1 major adverse peri-intubation event. The predominant event was cardiovascular instability, observed in 42.6% of all patients undergoing emergency intubation, followed by severe hypoxemia (9.3%) and cardiac arrest (3.1%). Overall ICU mortality was 32.8%. Conclusions and Relevance: In this observational study of intubation practices in critically ill patients from a convenience sample of 197 sites across 29 countries, major adverse peri-intubation events - in particular cardiovascular instability - were observed frequently

International Nosocomial Infection Control Consortiu (INICC) report, data summary of 43 countries for 2007-2012. Device-associated module

We report the results of an International Nosocomial Infection Control Consortium (INICC) surveillance study from January 2007-December 2012 in 503 intensive care units (ICUs) in Latin America, Asia, Africa, and Europe. During the 6-year study using the Centers for Disease Control and Prevention's (CDC) U.S. National Healthcare Safety Network (NHSN) definitions for device-associated health care–associated infection (DA-HAI), we collected prospective data from 605,310 patients hospitalized in the INICC's ICUs for an aggregate of 3,338,396 days. Although device utilization in the INICC's ICUs was similar to that reported from ICUs in the U.S. in the CDC's NHSN, rates of device-associated nosocomial infection were higher in the ICUs of the INICC hospitals: the pooled rate of central line–associated bloodstream infection in the INICC's ICUs, 4.9 per 1,000 central line days, is nearly 5-fold higher than the 0.9 per 1,000 central line days reported from comparable U.S. ICUs. The overall rate of ventilator-associated pneumonia was also higher (16.8 vs 1.1 per 1,000 ventilator days) as was the rate of catheter-associated urinary tract infection (5.5 vs 1.3 per 1,000 catheter days). Frequencies of resistance of Pseudomonas isolates to amikacin (42.8% vs 10%) and imipenem (42.4% vs 26.1%) and Klebsiella pneumoniae isolates to ceftazidime (71.2% vs 28.8%) and imipenem (19.6% vs 12.8%) were also higher in the INICC's ICUs compared with the ICUs of the CDC's NHSN

International Nosocomial Infection Control Consortium report, data summary of 50 countries for 2010-2015: Device-associated module

•We report INICC device-associated module data of 50 countries from 2010-2015.•We collected prospective data from 861,284 patients in 703 ICUs for 3,506,562 days.•DA-HAI rates and bacterial resistance were higher in the INICC ICUs than in CDC-NHSN's.•Device utilization ratio in the INICC ICUs was similar to CDC-NHSN's. Background: We report the results of International Nosocomial Infection Control Consortium (INICC) surveillance study from January 2010-December 2015 in 703 intensive care units (ICUs) in Latin America, Europe, Eastern Mediterranean, Southeast Asia, and Western Pacific. Methods: During the 6-year study period, using Centers for Disease Control and Prevention National Healthcare Safety Network (CDC-NHSN) definitions for device-associated health care-associated infection (DA-HAI), we collected prospective data from 861,284 patients hospitalized in INICC hospital ICUs for an aggregate of 3,506,562 days. Results: Although device use in INICC ICUs was similar to that reported from CDC-NHSN ICUs, DA-HAI rates were higher in the INICC ICUs: in the INICC medical-surgical ICUs, the pooled rate of central line-associated bloodstream infection, 4.1 per 1,000 central line-days, was nearly 5-fold higher than the 0.8 per 1,000 central line-days reported from comparable US ICUs, the overall rate of ventilator-associated pneumonia was also higher, 13.1 versus 0.9 per 1,000 ventilator-days, as was the rate of catheter-associated urinary tract infection, 5.07 versus 1.7 per 1,000 catheter-days. From blood cultures samples, frequencies of resistance of Pseudomonas isolates to amikacin (29.87% vs 10%) and to imipenem (44.3% vs 26.1%), and of Klebsiella pneumoniae isolates to ceftazidime (73.2% vs 28.8%) and to imipenem (43.27% vs 12.8%) were also higher in the INICC ICUs compared with CDC-NHSN ICUs. Conclusions: Although DA-HAIs in INICC ICU patients continue to be higher than the rates reported in CDC-NSHN ICUs representing the developed world, we have observed a significant trend toward the reduction of DA-HAI rates in INICC ICUs as shown in each international report. It is INICC's main goal to continue facilitating education, training, and basic and cost-effective tools and resources, such as standardized forms and an online platform, to tackle this problem effectively and systematically