Exergetic, exergoeconomic and exergoenvironmental analysis of intercooled gas turbine engine

Exergetic and exergoeconomic and exergoenvironmental analyses have been performed for an advanced aero-derivative intercooled gas turbine engine. The proposed system was modelled using the IPSEpro software package and validated using manufacturer’s published data. The exergoeconomic model evaluates the cost-effectiveness of the gas turbine engine based on the Specific Exergy Costing [SPECO] method. The CO2 emissions per KWh were estimated using a generic combustor model, HEPHAESTUS, developed at Cranfield University. It is well known that the exergetic analysis can determine the magnitudes, locations and types of losses within an energy system. The effect of load and ambient temperature variations on gas turbine performance were investigated for two different configurations. The first system, Case-I, was a simple gas turbine (SCGT) engine, and the second, Case-II, an intercooling gas turbine (ICGT) system. The latter enhances gas turbine efficiency but, at the same time, has an adverse effect on the combustion chamber due to reduced compressed air temperature. It was confirmed that full load and low ambient temperature are preferable due to the low waste exergy. The unit exergy cost rate for both SCGT and ICGT have been calculated as 8.59 and 8.32 US$/GJ respectively. The exergoenvironmental results show the ICGT achieved lower emission levels and is more environmentally friendly than the SCGT

Energetic and exergetic analysis of combined cycle power plant: Part-1 operation and performance

Energetic and exergetic analyses are conducted using operating data for Sabiya, a combined cycle power plant (CCPP) with an advanced triple pressure reheat heat recovery steam generator (HRSG). Furthermore, a sensitivity analysis is carried out on the HRSG using a recent approach to differentiate between the sources of irreversibility. The proposed system was modelled using the IPSEpro software and further validated by the manufacturer’s data. The performance of the Sabiya CCPP was examined for different climatic conditions, pressure ratios, pinch point temperatures, high-pressure steam, and condenser pressure values. The results confirmed that 60.9% of the total exergy destruction occurs in the combustion chamber, which constitutes the main source of irreversibilities within a system. The exergy destruction was significantly affected by both the pressure ratio and the high-pressure steam, where the relation between them was seen to be inversely proportional. The high-pressure stage contributes about 50% of the exergy destruction within the HRSG compared to other stages and the reheat system, due to the high temperature difference between the streams and the large number of components, which leads to high energy loss to the surroundings. Numerous possibilities for improving the CCPP’s performance are introduced, based on the obtained results

Triangle of Safety Technique: A New Approach to Laparoscopic Cholecystectomy

Backgrounds and Study Aims. Common bile duct (CBD) injury is one of the most serious complications of laparoscopic cholecystectomy (LC). Misidentification of the CBD during dissection of the Calot's triangle can lead to such injuries. The aim of the authors in this study is to present a new safe triangle of dissection. Patients and Method. 501 patients under went LC in the following approach; The cystic artery is identified and mobilized from the gall bladder (GB) medial wall down towards the cystic duct which would simultaneously divide the medial GB peritoneal attachment. This is then followed by dividing the lateral peritoneal attachment. The GB will be unfolded and the borders of the triangle of safety (TST) are achieved: cystic artery medially, cystic duct laterally and the gallbladder wall superiorly. The floor of the triangle is then divided to delineate both cystic duct and artery in an area relatively far from CBD. Results. There were little significant immediate or delayed complications. The mean operating time was 68 minutes, nearly equivalent to the conventional method. Conclusions. Dissection at TST appears to be a safe procedure which clearly demonstrates the cystic duct and may help to reduce the CBD injuries

Kuwaiti EFL Students’ Perceptions of the Effectiveness of the Remedial English Course 099 at the College of Technological Studies

The study aims to evaluate the English remedial course 099 taught in the College of Technological Studies (PAAET) as part of the English program which disseminates English Language Skills to EFL students studying at this college. This study is expected to provide sufficient information to policymakers and educators involved with this program at all levels, with the intention to help them evaluate this course and make useful decisions to improve English Language Teaching in order to combat the deficiency in the English language suffered by college students in Kuwait. A number of 155 students participated in a questionnaire of 15 statements divided into four areas: reading, grammar, writing, and speaking skills. The findings of the study showed that most EFL students benefited from the English course 099, and their language skills were improved. However, there were some drawbacks and weaknesses of the program in terms of learners’ assessments and follow up. The significance of the study arises from the fact that it would enable decision-makers and course evaluators to pinpoint the strengths and weaknesses of the course and hence find ways to improve it

Knowledge of community pharmacists in Saudi Arabia regarding human monkeypox, its management, prevention and vaccination : findings and implications

Many cases of monkeypox have recently been reported in countries where this disease is not endemic raising a global health concern. Consequently, healthcare professionals (HCPs) including pharmacists need to be aware of the disease, its prevention, including the role of vaccines, and its management to reduce transmission. A cross-sectional, questionnaire-based study was con-ducted among conveniently sampled community pharmacists in Qassim region, Saudi Arabia. 189 community pharmacists participated in the study giving a response rate of 72.97%. From these, 86.77% were male, 51.32% were ≤ 30 years old, 36.51% were aged between 31-40 years and 43.39% had 1-5 years of experience as community pharmacists. Their overall knowledge was 17.72 ± 5.56 out of a maximum of 28. The overall rate of correct answers for the knowledge statements was 63.29%, with 52.4% answering the knowledge questions correctly ≥ 50

Head and Neck Surgery: A Differential Diagnosis in Otolaryngology

Introduction: In otolaryngology of the head and neck surgery; differential diagnosis is a practical and comprehensive guide that is organized uniquely by signs and symptoms instead of by diseases. Aim: This study will describe the keys to diagnostic evaluation and differential diagnosis of presenting symptoms for problems affecting each otolaryngology organ system.Methods: Each symptom opens with the patient’s presentation followed by an easily accessible list of potential diagnoses and supplementary data on the features of the different diseases to help correctly identify the problem. And identify features labeled by signs and symptoms, not by disease, and then enable quick clinical reference In-depth coverage of the diagnostic and treatment evaluation of all ENT disorders.

Exploring factors affecting undergraduate medical students’ study strategies in the clinical years: a qualitative study

The aim of this study is to explore the effects of clinical supervision, and assessment characteristics on the study strategies used by undergraduate medical students during their clinical rotations. We conducted a qualitative phenomenological study at King Saud Bin Abdulaziz University for Health Sciences, College of Medicine, Riyadh, Saudi Arabia during the period from November 2007 to December 2008. We conducted semi-structured focus groups interviews with students and conducted individual interviews with teachers and students to explore students’ and clinical teachers’ perceptions and interpretations of factors influencing students’ study strategies. Data collection was continued until saturation was reached. We used Atlas-ti Computer Software (Version 5.2) to analyse the data, apply the obtained themes to the whole dataset and rearrange the data according to the themes and sub-themes. Analysis of data from interviews with twenty-eight students and thirteen clinical supervisors yielded three major themes relating to factors affecting students’ study strategies: “clinical supervisors and supervision”, “stress and anxiety” and “assessment”. The three themes we identified played a role in students’ adoption of different study strategies in the “community of clinical practice”. It appeared that teachers played a key role, particularly as assessors, clinical supervisors and as a source of stress to students

Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Abstract Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries

Dual energy CT angiography in peripheral arterial stents: optimal scanning protocols with regard to image quality and radiation dose

Background: To determine the optimal scanning protocols of dual energy computed tomography angiography (DECTA) in terms of radiation dose and image quality assessment at different keV levels, and compare it with conventional computed tomography angiography (CTA) in patients treated with peripheral arterial stents. Methods: Twenty-nine patients with previous stent placement in peripheral arteries were evaluated with DECTA. Images were reconstructed with virtual monochromatic spectral imaging (VMS) at 65, 68, 70 and 72 keV and adaptive statistical iterative reconstruction (ASIR) at 50% compared with CTA. Image quality comprising image noise, signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) were assessed, and radiation dose was compared. Effects of different type of peripheral arterial stents on image quality were also evaluated. Fifty-six uniquely identified stents that were located in common iliac arteries (CIA), external iliac arteries (EIA) and superficial femoral arteries (SFA) were evaluated. Results: Within subjects, the results showed that DECTA images (VMS) had less noise than the CTA images for CIA, EIA and SFA stents, with the lowest noise at 72 keV. Also, the VMS images had greater SNR than the CTA images for the EIA stents (P<0.05); and the VMS images had greater CNR than the CTA images for CIA, EIA, and SFA stents (P<0.001). Also, on CT attenuation, VMS continued to outperform CTA, but to a lesser extent. Between subjects, average VMS noise varied significantly with the type of the stent used (P=0.025) for CIA stents. Radiation dose was highly significant between DECTA and conventional CTA scans (6.98 vs. 7.40 mSv, P=0.047). Conclusions: We conclude that an optimal scanning protocol consisting of 72 keV and 50% ASIR leads to better image quality for DECTA in peripheral arterial stenting when compared to conventional CTA