Experimental and computational analysis of microscale wind environmental conditions in the Port of Rotterdam

Abstract: Knowledge of microscale wind conditions is important for maneuvering and mooring of ships and for optimizing the harbor design. The aim of this study is to translate the macroscale wind conditions measured at a near shore reference station to the local (microscale) wind conditions in the harbor docks. In the first part of the project, an extensive experimental campaign has been performed, which consisted of wind velocity measurements with 2D and 3D ultrasonic anemometers during a period of 6 months. These point measurements confirm the unique relation between the macroscale and microscale wind conditions during periods of strong winds. As the measurements only provide information at a number of discrete positions, the second part of the study consists of numerical simulations with Computational Fluid Dynamics (CFD) to map the wind environmental conditions over the entire study area. The measurements and simulations both show very large gradients in mean wind speed over the harbor area, with differences up to 100%. The numerical simulations are currently in progress and will be validated by comparison with the on-site measurements

Perioperative mortality: Analysis of 3 years of operative data across 7 general surgical projects of Médecins Sans Frontières in Democratic Republic of Congo, Central African Republic, and South Sudan.

BACKGROUND: The African continent has the greatest burden of surgical disability-adjusted life years, yet the least is known about operative care here. This analysis describes the surgical patients admitted to 7 hospitals supported by the Médécins Sans Frontières (MSF) over 3 years in 3 conflict-affected countries-Eastern Democratic Republic of Congo, Central African Republic, and South Sudan. METHODS: A standardized operative data collection tool was used for routine collection of operative inpatient data between 2011 and 2013 at 7 MSF surgical facilities. Surgical records of 14,482 patients were analyzed to describe surgical epidemiology, major procedures, and perioperative mortality. The perioperative mortality rate (POMR) was calculated within 2 days of admission (POMR2) and within 30 days from admission (POMR30). The POMR is used as a marker of quality of operative care. RESULTS: Caesarean delivery was the most common major procedure performed and had a POMR30 of 5.28 per 1,000 admissions. The overall inpatient mortality was 19.67 per 1,000 admissions. Children had greater POMR than adults for the same procedure types (47.97 vs 15.89 deaths per 1,000 admissions, P < .001); 85.1% of all major procedures were emergency procedures and between 3 and 30% of admissions were related to violence. After adjustment, perioperative death was associated with emergency surgery, violence, and age younger than 15 years. CONCLUSION: POMRs varied by age group and type of major procedure performed. Collecting surgical data is achievable and can inform future planning and support for national surgical programs. More information is needed on operative outcomes in adults and children in low-resource settings to improve quality and access to care