39 research outputs found

    Mathematical Modeling of Oscillating Water Columns Wave-Structure Interaction in Ocean Energy Plants

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    Oscillating Water Column (OWC)-based power take-off systems are one of the potential solutions to the current energy problems arising from the use of nuclear fission and the consumption of fossil fuels. This kind of energy converter turns wave energy into electric power by means of three different stages: firstly wave energy is transformed into pneumatic energy in the OWC chamber, and then a turbine turns it into mechanical energy and finally the turbogenerator module attached to the turbine creates electric power from the rotational mechanical energy. To date, capture chambers have been the least studied part. In this context, this paper presents an analytical model describing the dynamic behavior of the capture chamber, encompassing the wave motion and its interaction with the OWC structure and turbogenerator module. The model is tested for the case of the Mutriku wave power plant by means of experimental results. For this purpose, representative case studies are selected from wave and pressure drop input-output data. The results show an excellent matching rate between the values predicted by the model and the experimental measured data with a small bounded error in all cases, so that the validity of the proposed model is proven

    The clinical relevance of oliguria in the critically ill patient : Analysis of a large observational database

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    Funding Information: Marc Leone reports receiving consulting fees from Amomed and Aguettant; lecture fees from MSD, Pfizer, Octapharma, 3 M, Aspen, Orion; travel support from LFB; and grant support from PHRC IR and his institution. JLV is the Editor-in-Chief of Critical Care. The other authors declare that they have no relevant financial interests. Publisher Copyright: © 2020 The Author(s). Copyright: Copyright 2020 Elsevier B.V., All rights reserved.Background: Urine output is widely used as one of the criteria for the diagnosis and staging of acute renal failure, but few studies have specifically assessed the role of oliguria as a marker of acute renal failure or outcomes in general intensive care unit (ICU) patients. Using a large multinational database, we therefore evaluated the occurrence of oliguria (defined as a urine output 16 years) patients in the ICON audit who had a urine output measurement on the day of admission were included. To investigate the association between oliguria and mortality, we used a multilevel analysis. Results: Of the 8292 patients included, 2050 (24.7%) were oliguric during the first 24 h of admission. Patients with oliguria on admission who had at least one additional 24-h urine output recorded during their ICU stay (n = 1349) were divided into three groups: transient - oliguria resolved within 48 h after the admission day (n = 390 [28.9%]), prolonged - oliguria resolved > 48 h after the admission day (n = 141 [10.5%]), and permanent - oliguria persisting for the whole ICU stay or again present at the end of the ICU stay (n = 818 [60.6%]). ICU and hospital mortality rates were higher in patients with oliguria than in those without, except for patients with transient oliguria who had significantly lower mortality rates than non-oliguric patients. In multilevel analysis, the need for RRT was associated with a significantly higher risk of death (OR = 1.51 [95% CI 1.19-1.91], p = 0.001), but the presence of oliguria on admission was not (OR = 1.14 [95% CI 0.97-1.34], p = 0.103). Conclusions: Oliguria is common in ICU patients and may have a relatively benign nature if only transient. The duration of oliguria and need for RRT are associated with worse outcome.publishersversionPeer reviewe

    The evolution of the ventilatory ratio is a prognostic factor in mechanically ventilated COVID-19 ARDS patients

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    Background: Mortality due to COVID-19 is high, especially in patients requiring mechanical ventilation. The purpose of the study is to investigate associations between mortality and variables measured during the first three days of mechanical ventilation in patients with COVID-19 intubated at ICU admission. Methods: Multicenter, observational, cohort study includes consecutive patients with COVID-19 admitted to 44 Spanish ICUs between February 25 and July 31, 2020, who required intubation at ICU admission and mechanical ventilation for more than three days. We collected demographic and clinical data prior to admission; information about clinical evolution at days 1 and 3 of mechanical ventilation; and outcomes. Results: Of the 2,095 patients with COVID-19 admitted to the ICU, 1,118 (53.3%) were intubated at day 1 and remained under mechanical ventilation at day three. From days 1 to 3, PaO2/FiO2 increased from 115.6 [80.0-171.2] to 180.0 [135.4-227.9] mmHg and the ventilatory ratio from 1.73 [1.33-2.25] to 1.96 [1.61-2.40]. In-hospital mortality was 38.7%. A higher increase between ICU admission and day 3 in the ventilatory ratio (OR 1.04 [CI 1.01-1.07], p = 0.030) and creatinine levels (OR 1.05 [CI 1.01-1.09], p = 0.005) and a lower increase in platelet counts (OR 0.96 [CI 0.93-1.00], p = 0.037) were independently associated with a higher risk of death. No association between mortality and the PaO2/FiO2 variation was observed (OR 0.99 [CI 0.95 to 1.02], p = 0.47). Conclusions: Higher ventilatory ratio and its increase at day 3 is associated with mortality in patients with COVID-19 receiving mechanical ventilation at ICU admission. No association was found in the PaO2/FiO2 variation

    Ten golden rules for optimal antibiotic use in hospital settings: the WARNING call to action

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    Antibiotics are recognized widely for their benefits when used appropriately. However, they are often used inappropriately despite the importance of responsible use within good clinical practice. Effective antibiotic treatment is an essential component of universal healthcare, and it is a global responsibility to ensure appropriate use. Currently, pharmaceutical companies have little incentive to develop new antibiotics due to scientific, regulatory, and financial barriers, further emphasizing the importance of appropriate antibiotic use. To address this issue, the Global Alliance for Infections in Surgery established an international multidisciplinary task force of 295 experts from 115 countries with different backgrounds. The task force developed a position statement called WARNING (Worldwide Antimicrobial Resistance National/International Network Group) aimed at raising awareness of antimicrobial resistance and improving antibiotic prescribing practices worldwide. The statement outlined is 10 axioms, or “golden rules,” for the appropriate use of antibiotics that all healthcare workers should consistently adhere in clinical practice

    Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

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    Funder: European Society of Intensive Care Medicine; doi: http://dx.doi.org/10.13039/501100013347Funder: Flemish Society for Critical Care NursesAbstract: Purpose: Intensive care unit (ICU) patients are particularly susceptible to developing pressure injuries. Epidemiologic data is however unavailable. We aimed to provide an international picture of the extent of pressure injuries and factors associated with ICU-acquired pressure injuries in adult ICU patients. Methods: International 1-day point-prevalence study; follow-up for outcome assessment until hospital discharge (maximum 12 weeks). Factors associated with ICU-acquired pressure injury and hospital mortality were assessed by generalised linear mixed-effects regression analysis. Results: Data from 13,254 patients in 1117 ICUs (90 countries) revealed 6747 pressure injuries; 3997 (59.2%) were ICU-acquired. Overall prevalence was 26.6% (95% confidence interval [CI] 25.9–27.3). ICU-acquired prevalence was 16.2% (95% CI 15.6–16.8). Sacrum (37%) and heels (19.5%) were most affected. Factors independently associated with ICU-acquired pressure injuries were older age, male sex, being underweight, emergency surgery, higher Simplified Acute Physiology Score II, Braden score 3 days, comorbidities (chronic obstructive pulmonary disease, immunodeficiency), organ support (renal replacement, mechanical ventilation on ICU admission), and being in a low or lower-middle income-economy. Gradually increasing associations with mortality were identified for increasing severity of pressure injury: stage I (odds ratio [OR] 1.5; 95% CI 1.2–1.8), stage II (OR 1.6; 95% CI 1.4–1.9), and stage III or worse (OR 2.8; 95% CI 2.3–3.3). Conclusion: Pressure injuries are common in adult ICU patients. ICU-acquired pressure injuries are associated with mainly intrinsic factors and mortality. Optimal care standards, increased awareness, appropriate resource allocation, and further research into optimal prevention are pivotal to tackle this important patient safety threat

    Evaluación del poder calorífico superior en biomasa

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    Para la evaluación del poder calorífico superior de la biomasa vegetal, mediante una bomba calorimétrica, se presentan los siguientes problemas: a) Las pastillas de la muestra han de tener un peso inferior a un gramo, b) Se debe conocer la corrección de azufre y c) Se debe conocer la corrección de ácido nítrico. En este trabajo se estudian, mediante un diseño factorial utilizando los tres factores a dos niveles distintos cada uno de ellos, los efectos principales y las interacciones, así como su grado de significación, que provocan la variación de los factores indicados anteriormente en la determinación del valor exacto del Poder Calorífico Superior (PCS) en muestras de biomasa vegetal. Los resultados obtenidos, en los ensayos realizados, indican que ninguno de los tres factores estudiados ni sus interacciones provocan cambios significativos en los valores obtenidospara la evaluación del PCS de la biomasa

    Ovulation induction in rabbit does submitted to artificial insemination by adding buserelin to the seminal dose

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    This study was aimed at determining if a GnRH analogue, buserelin, could be used for ovulation induction in rabbit does submitted to artificial insemination (AI) by intravaginal administration, by adding the hormone to the seminal dose. In a first experiment, 39 secondiparous experimental does (Hyplus strain PS19, Grimaud Frères, France, of about 30 weeks of age) were divided into 3 groups of 13 does each, which at the moment of AI received the following treatments, respectively: (1) control: an intramuscular injection of buserelin (0.8 μ\mug/doe), (2) 8 μ\mug/doe of buserelin added to the insemination dose, and (3) 16 μ\mug/doe of buserelin added to the insemination dose. The experiment was done using 3 consecutive cycles at 42 day-intervals (n = 39). Four does from each of the 3 groups had blood taken at the fourth cycle for LH determination at 0, 60, 90, 120 and 150 min relative to AI. Kindling rates were 82% (28/34), 56% (29/36) and 85% (33/39), respectively for treatments 1, 2 and 3. In the does of groups 2 and 3, LH peaks were detected 60 min after AI, whereas in the does from group 1, the LH peak was detected 90 min after AI. Prolificacy was not different for the 3 treatments (average litter sizes ranged from 10.4 to 10.8). In a second experiment, 3 buserelin concentrations (8, 12 and 16 μ\mug/doe) were used intravaginally and compared with the control treatment (0.8 μ\mug/doe, via intramuscular). This experiment was done using 100 nulliparous rabbit does (Hyplus strain PS19, Grimaud Frères, France, of about 19 weeks of age) (4 groups of 25 does each) located on a commercial farm, to test if the previous results would be confirmed under field conditions. Kindling rates were no different (P < 0.05) for the 4 treatment groups [91.7% (22/24), 79.2% (19/24), 87.0% (20/23) and 87.5% (21/24) respectively for the control, 8, 12 and 16 μ\mug of intravaginal buserelin], however, prolificacy was higher when using the maximal dose of intravaginal buserelin (11.7 vs. 9.4 for the control group). It was concluded that buserelin can be used for ovulation induction in rabbit does when included in the seminal dose, with similar AI results as those obtained when the hormone is administered intramuscularly
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