2,085 research outputs found
Supercritical fluid recycle for surge control of CO2 centrifugal compressors
AbstractThis paper presents computer-based design and analysis of control systems for centrifugal compressors when the operating fluid is supercritical CO2.It reports a non-linear dynamic model including a main forward compression line and two different configurations for the recycle antisurge line. Disturbance scenarios are proposed for testing the configurations and performance indicators are suggested to evaluate control performance and power consumption of the compression system.The paper demonstrates that compared to the hot recycle, the process configuration including a cold gas recycle has better overall stability, but higher power consumption and lower values for the control performance indicators. Based on the previous considerations, the paper gives suggestions regarding the choice of the recycle configuration. Moreover it compares subcritical and supercritical compression during surge prevention and highlights the importance of the selection of the gas recycle configuration when full recycle is needed
Disability in young people and adults one year after head injury: prospective cohort study
OBJECTIVE: To determine the frequency of disability in young people and adults admitted to hospital with a head injury and to estimate the annual incidence in the community.
DESIGN: Prospective, hospital based cohort study, with one year follow up of sample stratified by coma score.
SETTING: Five acute hospitals in Glasgow. SUBJECTS: 2962 patients (aged 14 years or more) with head injury; 549 (71%) of the 769 patients selected for follow up participated.
MAIN OUTCOME MEASURES: Glasgow outcome scale and problem orientated questionnaire.
RESULTS: Survival with moderate or severe disability was common after mild head injury (47%, 95% confidence interval 42% to 52%) and similar to that after moderate (45%, 35% to 56%) or severe injury (48%, 36% to 60%). By extrapolation from the population identified (90% of whom had mild injuries), it was estimated that annually in Glasgow (population 909 498) 1400 young people and adults are still disabled one year after head injury.
CONCLUSION: The incidence of disability in young people and adults admitted with a head injury is higher than expected. This reflects the high rate of sequelae previously unrecognised in the large number of patients admitted to hospital with an apparently mild head injury
Wireless Communication in Process Control Loop: Requirements Analysis, Industry Practices and Experimental Evaluation
Wireless communication is already used in process automation for process monitoring. The next stage of implementation of wireless technology in industrial applications is for process control. The need for wireless networked control systems has evolved because of the necessity for extensibility, mobility, modularity, fast deployment, and reduced installation and maintenance cost. These benefits are only applicable given that the wireless network of choice can meet the strict requirements of process control applications, such as latency. In this regard, this paper is an effort towards identifying current industry practices related to implementing process control over a wireless link and evaluates the suitability of ISA100.11a network for use in process control through experiments
Comparison of opioid prescribing by dentists in the United States and England
Importance: The United States consumes most of the opioids worldwide despite representing a small portion of the world\u27s population. Dentists are one of the most frequent US prescribers of opioids despite data suggesting that nonopioid analgesics are similarly effective for oral pain. While oral health and dentist use are generally similar between the United States and England, it is unclear how opioid prescribing by dentists varies between the 2 countries.
Objective: To compare opioid prescribing by dentists in the United States and England.
Design, Setting, and Participants: Cross-sectional study of prescriptions for opioids dispensed from outpatient pharmacies and health care settings between January 1 and December 31, 2016, by dentists in the United States and England. Data were analyzed from October 2018 to January 2019.
Exposures: Opioids prescribed by dentists.
Main Outcomes and Measures: Proportion and prescribing rates of opioid prescriptions.
Results: In 2016, the proportion of prescriptions written by US dentists that were for opioids was 37 times greater than the proportion written by English dentists. In all, 22.3% of US dental prescriptions were opioids (11.4 million prescriptions) compared with 0.6% of English dental prescriptions (28 082 prescriptions) (difference, 21.7%; 95% CI, 13.8%-32.1%; P \u3c .001). Dentists in the United States also had a higher number of opioid prescriptions per 1000 population (35.4 per 1000 US population [95% CI, 25.2-48.7 per 1000 population] vs 0.5 per 1000 England population [95% CI, 0.03-3.7 per 1000 population]) and number of opioid prescriptions per dentist (58.2 prescriptions per dentist [95% CI, 44.9-75.0 prescriptions per dentist] vs 1.2 prescriptions per dentist [95% CI, 0.2-5.6 prescriptions per dentist]). While the codeine derivative dihydrocodeine was the sole opioid prescribed by English dentists, US dentists prescribed a range of opioids containing hydrocodone (62.3%), codeine (23.2%), oxycodone (9.1%), and tramadol (4.8%). Dentists in the United States also prescribed long-acting opioids (0.06% of opioids prescribed by US dentists [6425 prescriptions]). Long-acting opioids were not prescribed by English dentists.
Conclusions and Relevance: This study found that in 2016, dentists in the United States prescribed opioids with significantly greater frequency than their English counterparts. Opioids with a high potential for abuse, such as oxycodone, were frequently prescribed by US dentists but not prescribed in England. These results illustrate how 1 source of opioids differs substantially in the United States vs England. To reduce dental opioid prescribing in the United States, dentists could adopt measures similar to those used in England, including national guidelines for treating dental pain that emphasize prescribing opioids conservatively
Cruciate-retaining TKA Is an Option in Patients With Prior Patellectomy
The recommendation for using posterior-stabilized (PS) implants in patellectomy patients undergoing total knee arthroplasty (TKA) is based on older case series with heterogeneous patient populations. The use of cruciate-retaining implants in these patients has not been evaluated with more contemporary implant designs. The purpose of this study was to evaluate the survivorship and functional outcomes (Knee Society score, presence of an extensor lag, and range of motion) of cruciate-retaining (CR) TKA in patients with prior patellectomy. Between 1986 and 2012, we performed 27 CR TKAs in 25 patients after patellectomy. Of those, 23 CR TKAs in 21 patients were available for followup at a minimum of 2 years (mean, 11.2 years; range, 2.3-25.1 years). In this retrospective study, we queried a prospectively maintained database to assess functional outcomes and survivorship. Aseptic loosening-free survival was 100% at 5 and 10 years, and survival with revision for any reason as the outcome was 96% at 5 years (95% confidence interval [CI], 87.7%-100%) and 84% at 10 years (95% CI, 69.5%-100%). One patient was revised for aseptic loosening at 10.2 years postoperatively. Mean Knee Society scores improved from 36 +/- A 13 preoperatively to 92 +/- A 9.6 at followup. Extensor lag was present in seven patients preoperatively and only three at followup. Average knee flexion at followup was 112A degrees A A +/- A 12.5A degrees. In this study we found good long-term survivorship and functional outcomes with a CR implant design in patients following patellectomy. Earlier studies have favored PS over CR implants for patients with patellectomies. We believe this series suggests that CR TKA is indeed an option in patients with patellectomy. Level IV, therapeutic study. See Guidelines for Authors for a complete description of levels of evidence
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