Evaluation of Upwelling Infrared Radiance in a Nonhomogeneous Nonequilibrium Atmosphere

The primary purpose of this study was to investigate the influence of vibrational nonequilibrium upon upwelling infrared radiance from the earth\u27s atmosphere. Basic equations are presented for calculating the atmospheric transmittance, heating rates, and equilibrium and nonequilibrium upwelling radiances. By employing the Lorentz line-by-line model for spectral absorption, heating rates and upwelling radiances were calculated for equilibrium as well ·as nonequilibrium conditions in the spectral range of 4.6 μ CO and 3.3 μ \u27CH4 bands. For the spectral range of CO fundamental band, the influence of different 1~arameters on the upwelling radiance was also investigated. The results indicate that for CO the assumption of LTE is not justified at tropospheric pressures and temperatures. For CH4 , however, the assumption is justified up to 60 kilometers. This information is very useful in developing an accurate data reduction scheme for the measurement of CO and CH4 concentrations in the atmosphere

Influence of Nonequilibrium Radiation and Shape Change on the Flowfield of a Jupiter Probe With Ablation and Mass Injection

The influence of nonequilibrium radiative energy transfer and the effect of probe configuration changes on the flow phenomena around a Jovian entry body is investigated. The radiating shock-layer flow is assumed to be axisymmetric, viscous, laminar and in chemical equilibrium. The radiative transfer equations are derived under nonequilibrium conditions which include multi-level energy transitions. The equilibrium radiative transfer is calculated with an existing nongray radiation model which accounts for molecular band, atomic line and continuum transitions. The nonequilibrium results are obtained with and without ablation injection in the shock layer. The nonequilibrium results are found to be influenced greatly by the temperature distribution in the shock layer. In the absence of ablative products, the convective and radiative heating to the entry body are reduced significantly under nonequilibrium conditions. The influence of nonequilibrium is found to be greater at higher entry altitudes. With coupled ablation and carbon phenolic injection, 16 chemical species are used in the ablation layer for radiation absorption. Equilibrium and nonequilibrium results are compared under peak heating conditions. For the study of the probe shape change effects, the initial body shapes considered are 45-degree sphere cone, 35-hyperboloid, and 45-degree ellipsoid. In all three cases, the results indicate that the shock-layer flowfield and heat transfer to the body are influenced significantly by the probe shape change. The effect of shape change on radiative heating of the after-bodies is found to be considerably larger for the sphere cone and ellipsoid than for the hyperboloid

A Study of Mobile User Movements Prediction Methods

For a decade and more, the Number of smart phone users count increasing day by day. With the drastic improvements in Communication technologies, the prediction of future movements of mobile users needs also have important role. Various sectors can gain from this prediction. Communication management, City Development planning, and locationbased services are some of the fields that can be made more valuable with movement prediction. In this paper, we propose a study of several Location Prediction Techniques in the following area

Association between socioeconomic status and self-reported diabetes in India: a cross-sectional multilevel analysis

Objectives: To quantify the association between socioeconomic status (SES) and type 2 diabetes in India. Design: Nationally representative cross-sectional household survey. Setting: Urban and rural areas across 29 states in India. Participants: 168 135 survey respondents aged 18–49 years (women) and 18–54 years (men). Primary outcome measure: Self-reported diabetes status. Results: Markers of SES were social caste, household wealth and education. The overall prevalence of self-reported diabetes was 1.5%; this increased to 1.9% and 2.5% for those with the highest levels of education and household wealth, respectively. In multilevel logistic regression models (adjusted for age, gender, religion, marital status and place of residence), education (OR 1.87 for higher education vs no education) and household wealth (OR 4.04 for richest quintile vs poorest) were positively related to self-reported diabetes (p40% of the population is living in poverty

Management of Tracheo Bronchial Foreign Bodies in Children – A Retrospective Study of series of 50 cases

Abstract             This retrospective study of series of 50 cases of inhaled foreign bodies in pediatric patients in one year, deals with which the cases presented and the types of foreign body removed. Diagnostic flexible bronchoscopy aid in the diagnosis of unsuspected foreign body aspiration, or with doubtful history of foreign body aspiration without physical or X-ray signs and can proceed with definitive treatment in the same preparation without delay. Tracheotomy is indicated for foreign body that cannot be removed through glottis. A team work of anesthetist, endoscopist, and assistants are essential to ensure the safety of procedure with no compromise on availability of instruments.  Key words Tracheo Bronchial · Foreign Bodies · Children · Management

A Study on factors for conversion from Laproscopic cholecystectomy to open cholecystectomy

INTRODUCTION: First performed in the year 1882 by Langenbuch, Open cholecystectomy has been the primary treatment of gallstone disease for most of the past century (Beal, 1984). The prevailing public perception of this operation as one that resulted in pain, disability, and a disfiguring scar engendered many attempts in the 1980s and 1990s at non-operative treatment of gallstones (Schoenfield & Lachin, 1981; Schoenfield et al, 1990). Despite successful removal or dissolution of gallstones with some of these techniques, each is limited by the persistence of a diseased gallbladder. In 1985, Mühe in Böblingen, Germany, performed the first laparoscopically assisted cholecystectomy (Mühe, 1986). Even though facing early skepticism from the surgical community, laparoscopic cholecystectomy was accepted rapidly and recognized as the new “gold standard” for the treatment of gallstone disease. An NIH Consensus Development Conference in 1992stated that laparoscopic cholecystectomy “provides a safe and effective treatment for most patients with symptomatic gallstones. Indeed it appears to have become the procedure of choice.” The advantages of laparoscopic cholecystectomy over open cholecystectomy were earlier return of bowel function, decreased postoperative pain, improved cosmesis, shorter hospital stay, earlier return to activity, and decreased overall cost. Surgeons should not hesitate to convert to open cholecystectomy if the anatomy is unclear, if complications arise, or if there is failure to make reasonable progress in a timely manner. It is “better to open one too many than to open one too few,” even if it means a longer hospital stay for the patient. Some complications requiring laparatomy are obvious, such as massive hemorrhage, bowel perforation, or major injury to the bile duct. Open laparatomy allows the additional tool of manual palpation and tactile sensation and should be performed when the anatomy cannot be delineated because of inflammation, adhesions, or anomalies. The demonstration of potentially resectable gallbladder carcinoma also dictates an open exploration. Finally, cases with CBD stones that cannot be removed laparoscopically and are unlikely to be extracted endoscopically should be converted to open operation without hesitation. AIMS AND OBJECTIVES: 1. To study the factors that lead to conversion from Laparoscopic cholecystectomy to open method inregard toage, sex, clinical presentation, laboratory values, Ultrasonogram and Operative findings. 2. To assess preoperative factors that might predict the chances of conversion 3. To assess the intra operative reason that results to conversion. MATERIALS AND METHODS: This study was conducted in the Department of General surgery and Department of Surgical Gastroenterology in Madurai Medical College and Government Rajaji Hospital, Madurai from October 2010 to September 2012 for a period of two years. Sample Size: 1. Total No. of patients who were posted for laparoscopic method. 2. No of patients converted to open cholecystectomy (study group). METHODOLOGY: This is a retrospective study done in the Madurai Medical College and Government Rajaji Hospital. The details of all the patients who underwent and attempted Laparoscopic cholecystectomy in the Department of General surgery and Department of Surgical Gastroenterology in Madurai Medical College and Government Rajaji Hospital, Madurai were collected from the Medical Records Department and entered in the proforma. (Annexure2). The details collected were collected from the case sheets and entered into the proforma: 1. Age, 2. Sex, 3. Clinical History, 4. Physical Examination findings, 5. Laboratory findings, 6. Ultrasound findings, 7. Procedure performed, 8. Intraoperative findings, 9. Reason for conversion, 10. Other treatments. Inclusion Criteria: Cases above age 15 years of age diagnosed as cholelithiasis /cholecystitis treated surgically by laparoscopic approach for cholecystectomy and in whom the laparoscopic procedure was abandoned and open conventional cholecystectomy resorted to for any intra operative reason. Exclusion Criteria: 1. Patients below 15 years of age. 2. Patients who were diagnosed as having choledocholithiasis preoperatively with or without biliary obstruction. 3. Patients who underwent a planned open cholecystectomy. SUMMARY: The most common reason for conversion was inability to define anatomy in patients with inflamed gallbladder. • Conversion is more common in males with features of acute cholecystitis than in females. • Conversion is still more common in uncontrolled diabetic patients with feautures of acute cholecystitis and Risk of empyma gall bladder and gangrenous gall bladder and its complications with early precipitation of sepsis are common. • Conversion is more common if surgery is delayed > 72 hours in the setting of acute cholecystitis from the onset of symptoms. • Degree of difficulty relates to disease process, patient stability and technical ability. • Safety measures for difficult cholecystectomy. • Selective open technique of pneumoperitoneum. • Surgeons should be familiar with the angled scope. • Intra operative cholangiography if needed to indentity biliary anatomy and Bile duct stone. • Adequate instrumentation. • Hydrodissection. • Preliminary decompression. • Additional parts for retraction & exposure. • Two hand technique of suturing & knotting capability. CONCLUSION: An appreciation of these factors would predict the conversion that will allow appropriate planning by the patient, the institution, and the surgeon. Of the 276 patients in whom laparoscopic cholecystectomy was attempted, 26(9.4%) required conversion to open surgery. The most common reason for conversion was inability to define anatomy in patients with inflamed gallbladder (n = 13). Significant predictive factors for conversion were male gender, previous abdominal surgery, associated dibetes, acute cholecystitis and thickened gallbladder wall with pericholecytitic collection on preoperative ultrasonography.These factors are of more of importance when these factors are associated with each other than its independent presence in predicting difficult cholecystectomy

A study on the factors that affect the implementation of COQ

Cost of quality (COQ) is usually understood as the sum of the price paid for prevention of poor quality and the cost incurred due to product and service failure. It is a significant cost driver that firms need to control effectively in order to sustain competitive advantage. Nevertheless, the literature suggests that only very few firms in fact track and report quality cost data and use it for management control purposes. The lack of the COQ use among the companies is frequently blamed on the implementation difficulties which can easily deter the organizations from undertaking a systematic analysis of their quality costs. In spite of that, there is only little research-based literature that addresses the practicalities of implementing COQ. Furthermore, none of the research studies so far has gone into the depth of the issue in order to investigate factors that affect the implementation of COQ in organizations. The main objective of this thesis is thus to thoroughly examine the use, the practicalities and the obstacles in implementing the COQ programs. A worldwide-launched questionnaire was used to gather the data from the quality professionals in the companies of various sizes, industrial sectors and geographical locations. A series of focused semi-structured personal interviews with managers and persons responsible for quality in several multinational companies were carried out in order to add the depth to the investigation, to validate the questionnaire and to verify the results. Graphical representations were generated to analyze the results and to determine the positive and negative impacts of various factors on the COQ implementation. Moreover, the areas on which each specific type of company, industry and department should concentrate in order to maximize the success of the COQ implementation were highlighted. The findings of this thesis can be used by companies to help in developing quality improvement processes and in increasing their effectiveness

Change in the Body Mass Index Distribution for Women: Analysis of Surveys from 37 Low- and Middle-Income Countries

Background There are well-documented global increases in mean body mass index (BMI) and prevalence of overweight (BMI≥25.0 kg/m2) and obese (BMI≥30.0 kg/m2). Previous analyses, however, have failed to report whether this weight gain is shared equally across the population. We examined the change in BMI across all segments of the BMI distribution in a wide range of countries, and assessed whether the BMI distribution is changing between cross-sectional surveys conducted at different time points. Methods and Findings We used nationally representative surveys of women between 1991–2008, in 37 low- and middle-income countries from the Demographic Health Surveys ([DHS] n = 732,784). There were a total of 96 country-survey cycles, and the number of survey cycles per country varied between two (21/37) and five (1/37). Using multilevel regression models, between countries and within countries over survey cycles, the change in mean BMI was used to predict the standard deviation of BMI, the prevalence of underweight, overweight, and obese. Changes in median BMI were used to predict the 5th and 95th percentile of the BMI distribution. Quantile-quantile plots were used to examine the change in the BMI distribution between surveys conducted at different times within countries. At the population level, increasing mean BMI is related to increasing standard deviation of BMI, with the BMI at the 95th percentile rising at approximately 2.5 times the rate of the 5th percentile. Similarly, there is an approximately 60% excess increase in prevalence of overweight and 40% excess in obese, relative to the decline in prevalence of underweight. Quantile-quantile plots demonstrate a consistent pattern of unequal weight gain across percentiles of the BMI distribution as mean BMI increases, with increased weight gain at high percentiles of the BMI distribution and little change at low percentiles. Major limitations of these results are that repeated population surveys cannot examine weight gain within an individual over time, most of the countries only had data from two surveys and the study sample only contains women in low- and middle-income countries, potentially limiting generalizability of findings. Conclusions Mean changes in BMI, or in single parameters such as percent overweight, do not capture the divergence in the degree of weight gain occurring between BMI at low and high percentiles. Population weight gain is occurring disproportionately among groups with already high baseline BMI levels. Studies that characterize population change should examine patterns of change across the entire distribution and not just average trends or single parameters

Social and Geographical Inequalities in Suicide in Japan from 1975 through 2005: A Census-Based Longitudinal Analysis

Background: Despite advances in our understanding of the countercyclical association between economic contraction and suicide, less is known about the levels of and changes in inequalities in suicide. The authors examined social and geographical inequalities in suicide in Japan from 1975 through 2005. Methods: Based on quinquennial vital statistics and census data, the authors analyzed the entire population aged 25–64 years. The total number of suicides was 75,840 men and 30,487 women. For each sex, the authors estimated odds ratios (ORs) and 95% credible intervals (CIs) for suicide using multilevel logistic regression models with “cells” (cross-tabulated by age and occupation) at level 1, seven different years at level 2, and 47 prefectures at level 3. Prefecture-level variance was used as an estimate of geographical inequalities in suicide. Results: Adjusting for age and time-trends, the lowest odds for suicide was observed among production process and related workers (the reference group) in both sexes. The highest OR for men was 2.52 (95% CI: 2.43, 2.61) among service workers, whereas the highest OR for women was 9.24 (95% CI: 7.03, 12.13) among security workers. The degree of occupational inequalities increased among men with a striking change in the pattern. Among women, we observed a steady decline in suicide risk across all occupations, except for administrative and managerial workers and transport and communication workers. After adjusting for individual age, occupation, and time-trends, prefecture-specific ORs ranged from 0.76 (Nara Prefecture) to 1.36 (Akita Prefecture) for men and from 0.79 (Kanagawa Prefecture) to 1.22 (Akita Prefecture) for women. Geographical inequalities have increased primarily among men since 1995. Conclusions: The present findings demonstrate a striking temporal change in the pattern of social inequalities in suicide among men. Further, geographical inequalities in suicide have considerably increased across 47 prefectures, primarily among men, since 1995