Study of vibrational kinetics of CO2 and CO in CO2-O2 plasmas under non-equilibrium conditions

This work explores the effect of O2 addition on CO2 dissociation and on the vibrational kinetics of CO2 and CO under various non-equilibrium plasma conditions. A self-consistent model, previously validated for pure CO2 discharges, is further extended by adding the vibrational kinetics of CO, including electron impact excitation and de-excitation (e-V), vibration-to-translation relaxation (V-T) and vibration-to-vibration energy exchange (V-V) processes. The vibrational kinetics considered include levels up to v = 10 for CO and up to v1=2 and v2=v3=5, respectively for the symmetric stretch, bending and asymmetric stretch modes of CO2, and accounts for e-V, V-T in collisions between CO, CO2 and O2 molecules and O atoms and V-V processes involving all possible transfers involving CO2 and CO molecules. The kinetic scheme is validated by comparing the model predictions with recent experimental data measured in a DC glow discharge, operating at pressures in the range 0.4 - 5 Torr (53.33 - 666.66 Pa). The experimental results show a lower vibrational temperature of the different modes of CO2 and a decreased dissociation fraction of CO2 when O2 is added to the plasma but an increase of the vibrational temperature of CO. On the one hand, the simulations suggest that the former effect is the result of the stronger V-T energy-transfer collisions with O atoms which leads to an increase of the relaxation of the CO2 vibrational modes; On the other hand, the back reactions with O2 contribute to the lower CO2 dissociation fraction with increased O2 content in the mixture.Comment: 34 pages 15 figure

Methods for conducting international Delphi surveys to optimise global participation in core outcome set development: a case study in gastric cancer informed by a comprehensive literature review

Copyright © 2021, The Author(s) Open Access. This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.Background: Core outcome sets (COS) should be relevant to key stakeholders and widely applicable and usable. Ideally, they are developed for international use to allow optimal data synthesis from trials. Electronic Delphi surveys are commonly used to facilitate global participation; however, this has limitations. It is common for these surveys to be conducted in a single language potentially excluding those not fluent in that tongue. The aim of this study is to summarise current approaches for optimising international participation in Delphi studies and make recommendations for future practice. Methods: A comprehensive literature review of current approaches to translating Delphi surveys for COS development was undertaken. A standardised methodology adapted from international guidance derived from 12 major sets of translation guidelines in the field of outcome reporting was developed. As a case study, this was applied to a COS project for surgical trials in gastric cancer to translate a Delphi survey into 7 target languages from regions active in gastric cancer research. Results: Three hundred thirty-two abstracts were screened and four studies addressing COS development in rheumatoid and osteoarthritis, vascular malformations and polypharmacy were eligible for inclusion. There was wide variation in methodological approaches to translation, including the number of forward translations, the inclusion of back translation, the employment of cognitive debriefing and how discrepancies and disagreements were handled. Important considerations were identified during the development of the gastric cancer survey including establishing translation groups, timelines, understanding financial implications, strategies to maximise recruitment and regulatory approvals. The methodological approach to translating the Delphi surveys was easily reproducible by local collaborators and resulted in an additional 637 participants to the 315 recruited to complete the source language survey. Ninety-nine per cent of patients and 97% of healthcare professionals from non-English-speaking regions used translated surveys. Conclusion: Consideration of the issues described will improve planning by other COS developers and can be used to widen international participation from both patients and healthcare professionals.This study is funded by the National Institute for Health Research (NIHR) Doctoral Research Fellowship Grant (DRF-2015-08-023). JMB is partially funded by the NIHR Bristol Biomedical Research Centre and the MRC ConDUCT-II Hub for Trials Methodology Research. PRW was funded by the MRC North West Hub for Trials Methodology Research (Grant ref: MR/K025635/01).info:eu-repo/semantics/publishedVersio

Effects of hospital facilities on patient outcomes after cancer surgery: an international, prospective, observational study

Background Early death after cancer surgery is higher in low-income and middle-income countries (LMICs) compared with in high-income countries, yet the impact of facility characteristics on early postoperative outcomes is unknown. The aim of this study was to examine the association between hospital infrastructure, resource availability, and processes on early outcomes after cancer surgery worldwide.Methods A multimethods analysis was performed as part of the GlobalSurg 3 study-a multicentre, international, prospective cohort study of patients who had surgery for breast, colorectal, or gastric cancer. The primary outcomes were 30-day mortality and 30-day major complication rates. Potentially beneficial hospital facilities were identified by variable selection to select those associated with 30-day mortality. Adjusted outcomes were determined using generalised estimating equations to account for patient characteristics and country-income group, with population stratification by hospital.Findings Between April 1, 2018, and April 23, 2019, facility-level data were collected for 9685 patients across 238 hospitals in 66 countries (91 hospitals in 20 high-income countries; 57 hospitals in 19 upper-middle-income countries; and 90 hospitals in 27 low-income to lower-middle-income countries). The availability of five hospital facilities was inversely associated with mortality: ultrasound, CT scanner, critical care unit, opioid analgesia, and oncologist. After adjustment for case-mix and country income group, hospitals with three or fewer of these facilities (62 hospitals, 1294 patients) had higher mortality compared with those with four or five (adjusted odds ratio [OR] 3.85 [95% CI 2.58-5.75]; p<0.0001), with excess mortality predominantly explained by a limited capacity to rescue following the development of major complications (63.0% vs 82.7%; OR 0.35 [0.23-0.53]; p<0.0001). Across LMICs, improvements in hospital facilities would prevent one to three deaths for every 100 patients undergoing surgery for cancer.Interpretation Hospitals with higher levels of infrastructure and resources have better outcomes after cancer surgery, independent of country income. Without urgent strengthening of hospital infrastructure and resources, the reductions in cancer-associated mortality associated with improved access will not be realised

Oral temperature as an index of core temperature during heat transients

Rectal (Tre), oral (Tor) and oesophageal (Tes) temperatures were measured in five exercising subjects exposed for two hours to five conditions (1) a steady condition (WR) involving a constant work load (50 W) at a constant air temperature (Ta = 36.5 degrees C); (2) air temperature variations (delta Ta) between 28 degrees C and 45 degrees C and (3) between 23 degrees C and 50 degrees C at constant work load (50 W); (4) and (5) to work load variations (delta W) between 25 W and 75 W at a constant Ta (= 36.5 degrees C). Oral temperature recordings were taken sublingually and were either continuous or discontinuous. When discontinuous, the time needed for Tor to stabilize after the mouth opening was taken into account. The respective reliability of Tor and Tre as estimates of Tes were compared in each condition. Results showed that the resting (Tor - Tes) difference (+ 0.12 degrees C) was barely modified after two hours of exposure, whereas Tre overestimated Tes by 0.2 degrees C to 0.4 degrees C depending on the condition. The Tor variations were highly correlated with Tes variations under steady condition and under air temperature variations. In these conditions, Tor represented the best estimate of Tes. Under work-load variations, Tor was less closely related to Tes than was Tre. It is suggested that the relative inertia of Tor to step changes in exercise intensity could be ascribed to work induced variations in mouth blood flow