Background. There are scant data about the effectiveness of high flow nasal cannula (HFNC) oxygen therapy in patients hospitalized with severe acute respiratory failure (ARF) in non-intensive medical wards, particularly regarding the effect on arterial oxygenation compared to conventional oxygen therapy (COT) and non-invasive ventilation (NIV) or continuous positive airway pressure (CPAP). Methods. In a retrospective observational study, oxygenation parameters were measured before and immediately after HFNC initiation in 37 consecutive patients hospitalized in a geriatric ward in 2017. Results. HFNC was used as escalation therapy for untreatable hypoxia after failure of NIV/CPAP (n=18) or COT (n=19). Twenty-two patients died, 2 were transferred to the intensive care unit, while 13 were discharged alive. A “do not intubate” status was identified in 17 of the 22 deceased patients. Partial pressure of oxygen (pO2, p< 0.0001), oxygen saturation (SO2, p< 0.0001), pO2/fraction of inspired oxygen ratio (p=0.004) and peripheral SO2 measured by pulse oximetry (p< 0.0001) significantly increased soon after HFNC application. Oxygenation improvements were greater after escalation from NIV/CPAP and in patients discharged alive. Conclusion. HFNC significantly improved oxygenation in severe ARF after failure of COT or NIV/CPAP and may be particularly suitable for older patients hospitalized in non-intensive medical wards.

Objective: This study aims to construct an early risk warning model to predict the risk of treatment failure in patients undergoing sequential High-Flow Nasal Cannula (HFNC) oxygen therapy following mechanical ventilation weaning. Methods: A retrospective analysis was conducted on clinical data from 145 patients who received HFNC treatment in the Emergency Intensive Care Unit of the Third People's Hospital of Bengbu City from June 2018 to June 2023. A wide range of indicators including general information, comorbidities, laboratory test results, vital signs, disease-related scores, and oxygenation data were collected. Data analysis was performed using R software, starting with the Lasso regression to filter features related to treatment outcomes. Patients were divided into a training set (70%) and a validation set (30%) using random grouping software. The Random Forest algorithm was then employed to evaluate and rank the important features related to outcome indicators. The predictive efficiency and stability of the model were assessed through the Receiver Operating Characteristic (ROC) curve, calibration curve, and decision curve analysis, culminating in the construction of an early risk warning nomogram. Results: The study found that the Random Forest model exhibited high predictive accuracy in the training set (AUC=0.98) and good stability in the validation set (AUC=0.84). Key feature variables identified by the model, such as APACHE II score, BNP, NLR, mROX, and SOFA, were found to significantly impact the prediction of HFNC treatment failure. Based on these variables, an early warning nomogram was further developed, providing clinicians with a convenient and effective risk assessment tool. Conclusion: This study has constructed an early risk warning model based on the Random Forest algorithm, capable of effectively predicting the risk of HFNC treatment failure. The model's high predictive efficiency and stability offer strong support for clinical decision-making, contributing to personalized treatment and improved patient outcomes. Future research should aim to expand the sample size, perform multicenter validation, and explore the integration of the model into Clinical Decision Support Systems for real-time risk assessment and intervention.

Background: Early postoperative airway management after laryngo-tracheal surgery is crucial. Acute respiratory failure due to glottis’ oedema may occur, requiring reintubation. This can prolong ventilatory assistance, jeopardizing the anastomosis. To date, only judicious steroid administration and fluid management are available to avoid more invasive procedures. High-Flow-Oxygen-Therapy(HFOT) is a noninvasive O2 support method providing humidification, warmed air, Positive-End-Expiratory-Pressure(AIRVO2). No data exist about HFOT use to prevent early complications after laryngo-tracheal surgery. Methods: Between Sept.2020-Sept.2022, 107 consecutive patients underwent laryngo-tracheal surgery received HFOT(Group A). Data and long-term results were compared with those of 80 patients operated between Sept.2018-Aug.2020(Group B), when HFOT was not available. All patients were operated in a single center. No pre- or post-operative settings changed, except for HFOT introduction. We analyzed and compared the risk for “delayed” reintubation (unexpected reintubation within the first 24-48 hours after extubating/laryngeal mask removal) in the two groups. Results: No patients reported HFOT-related adverse events. Control group(B) presented “delayed” reintubation in 37% (p= 0.027), Intensive Care Unit admission in 67%(p=0.005) and longer hospital stay(p=0.001) compared to HFOT group(A). Minor complications rate was 3% in both group and overall mortality was 0%. Re-stenosis was described in 4.6% of HFOT group, without a statistically significant difference (p=0.7006). Conclusions: Our study is the first to investigate HFOT use in patients undergoing laryngo-tracheal surgery, potentially representing a consistent innovation in the peri-operative management of these patients. With the limit of a retrospective series, we would suggest HFOT use for preventing post-operative reintubation rate, possibly reducing ICU admission and hospital stay.

Introduction: Hemostatic dysfunction during extracorporeal membrane oxygenation (ECMO) due to blood-circuit interaction and the consequences of shear stress by flow rates lead to rapid activation of the coagulation cascade and thrombus formation in the ECMO system and blood vessels. In this study, we aimed to identify the incidence and risk factors for cannula-associated arterial thrombosis (CaAT) post-decannulation. Methods: A retrospective study of patients undergoing arterial cannula removal following ECMO. We evaluated the incidence of CaAT and compared clinical characteristics, pre-ECMO severity, and daily hemostasis parameters in patients with and without CaAT. Multivariate analysis revealed the risk factors for CaAT. Results: Forty-seven patients requiring venoarterial ECMO or hybrid methods were recruited to be screened for thrombosis. The median SOFA score was 11 (8-13). CaAT occurred in 29 patients (61.7%), with thrombosis in the superficial femoral artery accounting for 51.7%. Limb ischemia complications in the group with CaAT was 17.2%. In multivariate analysis, an ECMO flow rate of 100 mL/min was determined to be the independent factor for CaAT with an OR of 0.84 (95% CI, 0.73–0.95, p=0.008). Conclusion: In patients successfully weaned from ECMO, the incidence of CaAT was 61.7%. Our study found that a low-flow rate of ECMO was an independent risk factor for CaAT.

Acute high altitude illnesses are of great concern for physicians and people traveling to high altitude. High Altitude Pulmonary Edema (HAPE) can be better understood through the Oxygen Transport Triad which involves the Pneumo-Dynamic Pump (Ventilation), the Hemo-Dynamic Pump (Heart and circulation), and Hemoglobin. The two pumps are the first physiologic response upon initial exposure to hypobaric hypoxia. Hemoglobin is the balancing energy-saving time-evolving equilibrating factor. The increased hemoglobin at high altitude reduces the percentage of dissolved oxygen in the arterial oxygen content with respect to sea level. At high altitude, the acid-base balance must be adequately interpreted using the high altitude Van-Slyke correction factors. Pulse-oximetry measurements during breath-holding at high altitude allow for the evaluation of high altitude diseases. The Tolerance to Hypoxia Formula shows that, paradoxically, the higher the altitude the more tolerance to hypoxia. All organisms adapt physiologically and optimally to a high-altitude environment to survive. Reduction of pulmonary hypertension in HAPE through oxygen administration results in a favorable outcome.

Nasal high-frequency oscillatory ventilation (nHFOV) has emerged as an effective initial and rescue noninvasive respiratory support mode for preterm infants with respiratory distress syndrome (RDS). Multiple noninvasive respiratory support modes are currently available in Romania, but little is known about nHFOV use in Romanian neonatal intensive care units (NICUs). We aimed to identify the usage extent and clinical application of nHFOV in Romania. A structured web-based questionnaire was designed to find the rate of nHFOV use and knowledge of this new method of noninvasive respiratory support in Romanian level III NICUs. The questionnaire was addressed to the leaders of all level III Romanian NICUs. Using multiple-choice, open-ended, and yes/no questions, we collected information on the NICU’s size, noninvasive respiratory support modes used, nHFOV use, indications, settings, nasal interfaces, secondary effects, and equipment used. Descriptive statistics and comparisons were performed using IBM SPSS Statistics 26.0. A total of 21/23 (91.3%) leaders from level III NICUs (median [IQR] number of beds of 10 [10-17.5]) responded to the survey. The most frequently used noninvasive ventilation modes were CPAP mode on mechanical ventilators (76.2%), followed by NIPPV (76.2%), heated, humidified high flow nasal cannula (HHHFNC) (61.9%), and nHFOV (11/21 units; 52.4%); 5/11 units reported frequent nHFOV use (in 2 or more newborns/month) in both term and preterm infants. The main indications reported for nHFOV use were CPAP failure (90.9%), hypercapnia (81.8%), and bronchopulmonary dysplasia (72.7%). 10/11 units reported setting a mean airway pressure (MAP) equal to the CPAP level plus 1-2 cmH₂O on rescue nHFOV after CPAP failure. Both dedicated equipment (45.5%) and hybrid ventilators (63.6%) were used for nHFOV delivery, with face/nasal masks and short binasal prongs being the most commonly used nasal interfaces (90.9% and 72.7%, respectively). Air leaks at the interface level (90.9%), thick secretions (81.8%), and airway obstruction (63.6%) were the most frequently mentioned adverse effects of nHFOV; none of the units mentioned pneumothorax as an adverse effect. Only 3 of the NICUs had a written protocol for nHFOV use. Initial, minimum, and maximum amplitude and initial and minimum MAP settings used were significantly higher with hybrid ventilators as compared to dedicated equipment (p<0.05). Most units not yet using nHFOV cited lack of equipment, experience, training, or insufficient information and evidence for the clinical use and outcome of nHFOV use in neonates as the main reasons for not implementing this noninvasive respiratory mode. Our survey showed that nHFOV is already used in more than half of the Romanian level III NICUs to support term and preterm infants with respiratory distress despite a lack of consensus regarding indications and settings during nHFOV. A need for training for nHFOV use was identified, and efforts are needed at the national level to develop courses and training sessions, including using simulation workshops, to offer more information on optimal nHFOV use in clinical practice.

Background: The Davidson Airway Function &amp; Nasal Evaluation (DAFNE) Scoring System was developed as an intuitive and research-based scoring system that could be validated through beta testing and easily introduced to healthcare providers of several subspecialties who treat nasal obstruction and breathing disorders (MDs, PAs, PTs, APRNs, DDSs, and DCs). This scoring system was shown to increase the knowledge of airway function, nasal measurement parameters, and identification of proper treatment options for sleep and breathing disorders. The basis for the DAFNE score was developed from a systematic review of nasal measurement data. Methods: Electronic searches of PubMed, MEDLINE, EMBASE Cochrane Library, and Scopus of publications between 1988-2022 were used to identify studies validating nasal function measurement parameters to create the algorithm for the DAFNE Score™. The systematic review was accomplished using the 2020 ‘Preferred Reporting Items for Systematic Reviews’ (PRISMA) guidelines. Results: Twenty studies met the inclusion criteria for systematic review. Primary outcomes measurements demonstrated reliability, repeatability and validity of the DAFNE measurement technologies, data and output. Conclusions: The data analysis and systematic review uncovered a need and framework to develop and validate a web-based software algorithm for global access to improve the understanding of data interpretation of nasal measurements from three nasal measurement technologies. DAFNE Scoring should be used as an adjunct tool in routine clinical practice and research to further understand the technology data output and how to collaborate with other healthcare providers to improve patient outcomes.

This study re-introduces a protein-free rapid test method for nucleic acids on paper based lateral flow assays utilizing special multichannel nitrocellulose membranes and DNA-Gold conjugates, achieving significantly enhanced sensitivity, easier protocols, reduced time of detection, reduced costs of pro-duction and advanced multiplexing possibilities. It is shown for the first time a protein-free nucleic acid based lateral flow assay (NALFA) with a limit of detection of 1 pmol of DNA. The total production duration of such an assay was successfully reduced from the currently known several days to just a few hours. The simplification and acceleration of the protocol make the method more accessible and practical for various applications. The developed method supports multiplexing, enabling the sim-ultaneous detection of up to six DNA targets. This multiplexing capability is a significant improve-ment over traditional line tests and offers more comprehensive diagnostic potential in a single assay. The approach significantly reduces the run time compared to traditional line tests, which enhances the efficiency of diagnostic procedures. The protein-free aspect of this assay minimizes the prevalent complications of cross-reactivity in immunoassays especially in cases of multiplexing. It is also demonstrated that the NALFA developed in this study is amplification-free and hence does not rely on specialized technicians, nor does it involve labour-intensive steps like DNA extraction and PCR processes. Overall, this study presents a robust, efficient, and highly sensitive platform for DNA or RNA detection, addressing several limitations of current methods documented in the literature. The advancements in sensitivity, cost reduction, production time, and multiplexing capabilities mark a substantial improvement, holding great potential for various applications in diagnostics, forensics, and molecular biology.

Increasing the loading density of nanoparticles on carbon support is essential for making Pt-alloy/C catalysts practical in H2-air fuel cells. The challenge lies in increasing the load-ing while suppressing the sintering of Pt-alloy nanoparticles. This work presents a 40% Pt-weighted sub-3 nm PtCo/C alloy catalysts via a simple incipient wetness impregnation method. By carefully optimizing the synthetic conditions such as Pt/Co ratios, calcination temperature and time, the size of supported PtCo alloy nanoparticles is successfully con-trolled below 3 nm, and a high electrochemical surface area achieves of 94 m2/g is achieved, which is 2.8 times of commercial PtCo/C-TKK catalysts. Demonstrated by elec-trochemical oxygen reduction reaction, PtCo/C alloy catalysts present an enhanced mass activity of 0.45 A/mg at 0.9 V vs. RHE, which is 1.7 times that of PtCo/C-TKK catalyst. Therefore, the developed PtCo/C alloy catalyst can potentially be a highly practical cata-lyst for H2-air fuel cells.

This research work studies the characteristics of wear and wear resistance of composite powder coatings, deposited by high-velocity oxygen fuel, which contain composite mixtures Ni-Cr-B-Si having different chromium concentrations – 9.9%; 13.2%; 14%; 16% and 20% , at one and the same size of the particles and the same content of the remaining elements. The coating of 20% Cr does not contain B and Si. Out of each powder, composite coatings have been prepared without any preliminary thermal treatment of the substrate and with preliminary thermal treatment of the substrate up to 650оС. The coatings have been tested under identical conditions of dry friction over a surface of solid firmly attached abrasive particles using the tribological testing device „Pin-on-disk“. Results have been obtained and the dependences of the hardness, mass wear, intensity of the wearing process, absolute and relative wear resistance on the Cr concentration under identical conditions of friction. It has been found out that for all the coatings the preliminary thermal treatment of the substrate leads to a decrease in the wear intensity. Upon increasing Cr concentration the wear intensity diminishes and it reaches minimal values at 16% Cr. In the case of coatings having 20% Cr concentration, the wear intensity is increased, which is due to the absence of the components B and Si in the composite mixture, whereupon no inter-metallic structures are formed having high hardness and wear resistance. The obtained results have no analogues in the current literature and they have not been published by the authors.

The coronavirus disease 2019 (COVID-19) has spread over the world for more than one year. COVID-19 often develops life-threatening hypoxemia. Endothelial injury caused by the viral infection leads to intravascular coagulation and ventilation-perfusion mismatch. However, besides above pathogenic mechanisms, the role of alveolar edema in the disease progression has not been discussed comprehensively. Since the exudation of pulmonary edema fluid was extremely serious in COVID-19 patients, we bring out a hypothesis that severity of alveolar edema may determine the size of poorly-ventilated area and the blood oxygen content. Treatments to pulmonary edema (alcohol-oxygen vapor therapy and fluid management) may be great helpful for reducing occurrence of severe cases. Given that late mechanical ventilation may cause mucus (edema fluid) to be blown to the deep of the small airways, oxygen therapy should be given at the early stages. The optimal time and SpO₂ threshold for oxygen therapy are also discussed.

Knee osteoarthritis (KO) is an important health condition, affecting one third of the people aged 65 years or more. Pain is the main cause of disability. Pain management in KO includes pharmacological and non-pharmacological modalities. Patient education, lifestyle changes, physical exercise and physical agents are prescribed as a first approach for pain control. Laser therapy is part of many therapeutical protocols, with two forms, low-level laser therapy (LLLT) and high-intensity laser therapy (HILT). The paper aimed at stressing the advantages of HILT, based on a greater wavelength, higher energy delivery and deeper tissue penetration. Research on 23 published trials revealed that analgesic effect is rapid, cumulative and long lasting. Compared to sham, to LLLT or to other associations of therapeutical modalities, HILT provided significantly better results on pain reduction and functional improvement. Ultrasound examination showed reduction of intraarticular inflammation.

The turbulent Poiseuille flow between two parallel plates is one of the simplest possible physical situations, and it has been studied intensively. In this paper, we propose a modified Prandtl-van Driest mixing length that satisfies both boundary conditions and wall damping effects. With our new formulations, we numerically solve the problem and, moreover, propose an approximate analytical solution of mean velocity. As applications of our solution, an approximate analytical friction coefficient of turbulent Poiseuille flow is proposed.

Abstract: Background: The diagnosis of nasal airway disorders relies on questionnaires, subjective data, and objective data. Interpretation of objective data obtained from measurement technology is not well understood by providers and researchers who use the equipment to test nasal airway function, justifying the need to cre-ate a new clinical tool. The Davidson Airway Function & Nasal Evaluation (DAFNE) Scoring System is a web-based scoring system that allows healthcare providers (MDs, PAs, PTs, APRNs, DMDs, DDSs, SLPs, and DCs) and researchers who treat nasal obstruction and breathing disorders to make more accurate diagnostic decisions, select the appropriate treatment for individualized patient care, monitor treatment progression and outcomes, and show how to approach a collaborative care model with other healthcare professionals. The current technologies, such as 4-phase rhinomanometry, use a simple approach that relies on a measurement tracing intersecting a color-coded y-axis on a four-quadrant graph with diagnostic numeric data output de-scribing nasal airflow and resistance. This is a good source of biofeedback demonstrating abnormal nasal breathing patterns but lacks interpretation guidelines to describe the severity of disease. The more sophisti-cated proprietary DAFNE approach uses multiple parameters which include airflow restriction, speed, vol-ume, and patient characteristics to identify patients’ disease progression much more accurately. Additionally, it explains how to segregate patients into appropriate treatment options which minimizes risks and compli-cations associated with sleep and breathing disorders while improving patient outcomes. Methods: Electronic searches of PubMed, MEDLINE, EMBASE Cochrane Library, and Scopus of publications between 1988-2022 were necessary to identify studies which determined the ranges of nasal function measurement parameters among three airway measurement technologies used in writing the DAFNE Score algorithm. The performance of DAFNE was evaluated compared to the research data and patient demographics used in previous studies. Results: By using primary outcome measurements from the literature, we were able to create a reliable, re-peatable, and validated tool to facilitate patient identification, treatment stratification, and collaboration for sleep and nasal breathing dysfunction. Subsequently, we found DAFNE could be used to identify the appro-priateness of a sleep study. Conclusions: DAFNE Scoring System has demonstrated the ability to detect high risk patients in the pediatric and adult populations susceptible of sleep apnea and breathing dysfunction needing a sleep study and treatment to improve nasal airway function and sleep. DAFNE Scoring System should be used as an adjunct tool in routine clinical practice and research to further understand the technol-ogy data output, identify patients at risk, stratify treatment options, progress, and stabilization after treatment, and how to collaborate with other healthcare providers to improve patient outcomes.

Cryptococcosis is one of the most serious opportunistic diseases in patients living with HIV. For this reason, it is important to have early diagnosis and appropriate treatment. Objectives. The aim of the study was to know the evolution of patients diagnosed with cryptococcosis by detection of Cryptococcus antigen in serum by lateral flow (CrAg LFA) without nervous system involvement and with treatment in accordance with the results. Materials and Methods. A retrospective, longitudinal, analytical study was performed. Seventy patients with cryptococcosis initially diagnosed by serum CrAg LFA without meningeal involvement between January 2019 and April 2022 were analyzed for medical records. The treatment regimen was adapted to the results of blood culture, respiratory material or pulmonary tomography imaging. Results. Seventy patients were included, 13 had probable pulmonary cryptococcosis, 4 had proven pulmonary cryptococcosis, 3 had fungemia and 50 had pre-emptive therapy without microbiological or imaging findings compatible with cryptococcosis. Among the 50 patients with pre-emptive therapy, none had meningeal involvement or cryptococcosis recurrences to date. Conclusion. Pre-emptive therapy avoided progression to meningitis in patients with CrAg LFA-positive patients. Pre-emptive therapy with dose adjustment of fluconazole in patients with the mentioned characteristics was useful despite the use of lower doses than recommended.

In recent years, excessive heat in the urban texture has become the main problem in the humid and calm wind city of Babolsar with high density, especially in high-rise areas. Therefore, in order to create comfort in this region, it is necessary to establish and continue the wind circulation in space with an environmentally compatible and optimal configuration. The study applies combination of literature, field measurement, experimental validation of CFD simulation output, and comparative analysis. After field measurement and validation of FLOW-3D simulation software (V11.2.2), the relationship between these parameters (height, the width of passages, enclosure between buildings, and buildings' orientation) will be studied which affects the wind’s velocity and direction. The factors of the buildings' orientation and enclosure based on the passages' width have opposite reactions in the direction of the prevailing wind especially from perpendicular side. In this study, two effective factors are on wind velocity: 1- The orientation of the buildings towards the wind flow by creating permeability 2- Reducing the enclosure by increasing the width of the passage's perpendicular to the wind flow (w '= 3w, E' = 0.33E). According to the theoretical and practical study, first, the creation of permeability in the body of the block and the separation of buildings instead of aggregation has been studied, and then reducing the confinement of streets perpendicular to the wind flow has been discussed as effective solutions to improve the wind velocity and circulation between the urban environment.

_{Superconducting foams of YBa$_2$Cu$_3$O$_y$ (YBCO) are proposed as trapped field magnets or supermagnets. The foams with an open-porous structure are light-weight, mechanically strong and can be prepared in large sample sizes. The trapped field distributions were measured using a scanning Hall probe on various sides of an YBCO foam sample after field-cooling in a magnetic field of 0.5 T produced by a square Nd-Fe-B permanent magnet. The maximum trapped field (TF) measured is about 400 G (77 K) at the bottom of the sample. Several details of the TF distribution, the current flow and possible applicatons of such superconducting foam samples in space applications, e.g., as active elements in flux-pinning docking interfaces (FPDI) or as portable strong magnets to collect debris in space, are outlined.}

Prostate cancer (PCa) is most commonly observed in male patients. Although PCa progresses relatively slowly, high-risk PCa is associated with an increased risk of lymph nodes, distant metastases, and PCa-related death. Several guidelines recommend radiation therapy (RT) of the prostate combined with long-term androgen deprivation therapy for high-risk PCa. A comparison of clinical outcomes between radical prostatectomy (RP) and RT for high-risk PCa by propensity score-matched analysis showed that RP had a significantly higher risk of biochemical recurrence than RT. However, the combination of neoadjuvant chemohormonal therapy followed by RP may be more likely to achieve a cure when overall survival is considered the primary endpoint. In this review, we aimed to confirm the oncological outcomes of RP and RT for high-risk PCa and highlight the importance of neoadjuvant therapy followed by RP for high-risk PCa.

In order to create a smart mine, it is necessary to digitize the existing emulsion pumping station. Existing research does not achieve this task, this paper designs and manufactures a high-pressure, high-flow, high-water-based mining digital controlled unloading valve (abbreviated as HLHMDCUV), which achieves good results in both theoretical analysis and experimental testing. In order to obtain the accurate dynamic characteristics, this valve was analyzed by simulation using AMESim. Based on the dynamic performance analysis and the flow field analysis inside the valve body, the structure has been optimized to improve the performance of HLHMDCUV. The results show that the HLHMDCUV has a better dynamic characteristics, which were also demonstrated in the experiment. At the same time, the HLHMDCUV is easy to disassemble and maintain. This paper provides a theoretical basis for the design of such valves, which is conducive to the subsequent promotion of intelligent mine transformation.

Background: Oscillation and pulmonary expansion (OPE) therapy can decrease postoperative pulmonary complications in a general surgical population, but its effect after cardiac surgery has not been reported, to our knowledge. We hypothesized that using an OPE device after cardiac surgery before extubation would decrease pulmonary complications. Methods: This retrospective cohort study included adults undergoing elective open cardiac surgery at our institution from January 2018 through January 2019, who had an American Society of Anesthesiologists score of 3 or greater. For mechanically ventilated patients after cardiac surgery, a new OPE protocol was adopted July 1, 2019, comprising an initial 10-minute OPE treatment administered in-line with the ventilator circuit, then continued treatments for 48 hours after extubation. Severe postoperative respiratory complications (primary outcome measure) included need for antibiotics, increased supplemental oxygen use, and prolonged hospital length of stay (LOS). Demographic, clinical, and outcomes data were compared for patients before (usual care with postextubation hyperinflation) and after protocol implementation (OPE). Results: Of 104 patients, 54 patients received usual care, and 50 received OPE. Usual-care recipients had more men (74% vs 62%; P=.19) and were older (median, 70 vs 67 years; P=.009) than OPE recipients. The OPE group had a significantly shorter hospital LOS than the usual-care group (mean, 6.2 vs 7.4 days; P=.04). Other measures improved with OPE but did not reach significance: shorter ventilator duration (mean, 0.6 vs 1.1 days with usual care; P=.06) and shorter LOS in the intensive care unit (mean, 2.7 vs 3.4 days; P=.06). On multivariate analysis, intensive care unit LOS was significantly shorter for the OPE group (mean difference, 0.85 days; 95% CI, 1.65 to 0.06; P=.04). The OPE group had a lower percentage of postoperative complications (10% vs 20%). Conclusion: OPE therapy after cardiac surgery is associated with decreased ICU and hospital LOS.

Background/Objectives: Encouraging results reported of Platelet-Rich Plasma (PRP) treatment for knee osteoarthritis (KOA). The present retrospective study reports the efficacy and safety of a high dose of neutrophile and red blood cell-depleted PRP to treat 212 patients with KOA. Methods: 212 consecutive patients diagnosed with Kellgren-Lawrence (KL) grading 1-3 KOA chronic knee pain for at least 1 year were treated with 3 injections at 15-day intervals with a high dose of neutrophil-depleted PRP (4 billion platelets). Clinical outcomes were retrospectively recorded as a percentage of responders at 3,6, and 12-month follow-up, following the OMERACT-OARSI criteria. Pain through VAS score and WOMAC score have also been recorded. Results: 4ml of PRP containing 4X109 platelets were obtained by single spin centrifugation and injected intra-articular into each patient with no pre-activation. The overall responder rate of patients responding to OMERACT-OARSI criteria at 3,6,12 months was 68.9%, 72,7% and 70,6%. There was a significant improvement in VAS and WOMAC scores at 3-, 6- and 12-month follow-up compared to the pre-treatment value (p&lt; 0.01). The lowest VAS score was observed at 6 months overall and in all three-grade KL groups. KL2 groups showed the best results regarding pain reduction and WOMAC score at 6 months (p&lt; 0.01). Conclusions: a high dose of neutrophil-depleted PRP is an effective treatment for KL1-3 KOA. It provides symptomatic relief, can potentially reduce disease progression, and has sustained effects for up to 12 months.

FLASH-RT represents a novel therapeutic radiation modality that holds remarkable potential for mitigating radiation therapy’s adverse side effects. This cutting-edge technology allows for the sparing of healthy tissue while precisely targeting cancerous cells by administering an ultra-high dose-rates of typically between 10 and 30 Gy in less than a few hundred milliseconds. FLASH-RT has demonstrated impressive results in small-animal models, prompting scientists to adapt and advance existing technologies to make it a viable treatment option for humans. However, producing the ultra-high-dose-rate radiation required for the therapy remains a significant challenge. Several radiation sources, such as very high energy electrons (VHEEs), low energy electrons, x-rays, and protons, have been studied for their ability to deliver the necessary dose. Among them, FLASH-x-ray has gained the most attention owing to its capacity to penetrate deeply seated tumours. Despite the complexity of the process, the potential advantages of FLASH-RT make it an exciting area of research. To achieve the FLASH effect, high-frequency, pulsed irradiated accelerator technology can be employed. Sparing healthy tissue, it may allow for more aggressive and effective cancer treatments, leading to a better quality of life for patients. Ongoing research and development will be necessary to refine and optimize this approach to radiation therapy.

In the process of oil and gas development and production, when the flow rate in the wellbore is large, the materials underground will be eroded, causing the operation to be unable to proceed smoothly and reducing the efficiency of oil and gas production. Therefore, optimizing the anti-erosion coating under high-speed flow conditions in wellbore is a very interesting thing. It can greatly improve operational efficiency. In this paper, laser cladding was used to prepare the new coating used in the PDC drill bit. Then, the effects of tungsten carbide and multi-layer graphene on the microstructure and properties of the tungsten carbide coating were studied. The research results indicate that, for new coatings, 60% tungsten carbide and 0.3% graphene are the optimal ratios. After adding WC, the hardness has significantly improved. However, when the WC content further increases more than 30%, the increase in hardness is relatively small. In addition, when the content of graphene is more than 0.3%, the branched structure became thicker, and not only the segregation of Cr, Si and W became very obvious again, but also the segregation of Fe occurred at the Ni enrichment site. The research results contribute to improving oil and gas production and operational efficiency under high-speed fluid flow conditions in the wellbore.

Bronchiolitis is an acute viral infection of the lower respiratory tract that affects infants and young children. Respiratory syncytial virus (RSV) is the most common causative agent, however other viruses can be the reason of the disease. We retrospectively reviewed the clinical features of infants aged less than 12 months referred to our Pediatric Units of Chivasso, Cirié and Ivrea for acute bronchiolitis requiring hospitalization over two consecutive bronchiolitis seasons. Patient-, disease- and treatment related variables were analyzed in this retrospective study. We were able to show how with the high flow oxygen support (HFNC) only a very low number of children (8 out of 192) need to be trasferred to our HUB referral centers. The probability of success were 96% for all patients and 93% for RSV vs. 98% for non-RSV patients (P=NS). Factor associated to failure of treatment were age below 1 months and the failure of HFNC. The wide and increasing use of HFNC in pediatric inpatients improved management of bronchiolitis in Spoke hospitals, reducing transfer to a Hub hospital provided with Intensive Care Units.

Retinoids are vitamin A derivatives and include trans-retinoic acid, isotretinoin, tamibarotene, and bexarotene, all of which are currently available for clinical use. The clinical development of retinoid therapy for neuroblastoma has a history spanning more than four decades. The most promising agent is isotretinoin, which can contribute to improving event-free survival in patients with high-risk neuroblastoma by approximately 10 % when administered over six months as maintenance therapy. Although isotretinoin is regarded as an essential component in the standard clinical management of high-risk neuroblastoma, its use for this purpose in the US and EU is off-label. To promote isotretinoin use in Japan as a treatment for neuroblastoma, our clinical research team is planning to launch an investigator-initiated, registration-directed clinical trial. The present review article discusses the basic science behind retinoid therapy, pre-clinical / clinical evidence on neuroblastoma, the concept of the proposed clinical trial, and prospects for this therapy.

This study investigated the aerodynamic performances of various trains with different nose shapes, using as design variables two angles α,β for the heads shape and the bluntness angle γ, without crosswind. The effect on aerodynamic performances, such as the train drag coefficient, pressure distribution along the train surface, flow structures around the train and the wake, head pressure pulse, were analyzed. The results indicate that the increase of the train nose length for flat shapes decreases the CD values by 21.47% and 19.11%, decreasing the high-pressure region in the leading head. The duck-nose configuration emerges as a compromise between drag reduction and nose length. Increasing the angle γ a further drag reduction of 8.5% is featured. Drag formation along the train is also analyzed. The steeper the variation of the geometry, the higher the peak intensity and the slope of the curve. Regarding the flow features around the train, two-main counter-rotating vortices are captured in the wake. Moreover, the higher the nose length and the higher the bluntness angle γ, the weaker and narrower the wake. Again, a longer nose shape yields to a softer jump in terms of pressure difference, crucial for train homologation and safety.

Background: During the pandemic, Emergency departments were overcrowded with critically ill patients and confronted ethical dilemmas to assign respiratory support to them due to scarce resources. Quick tools to evaluate patients at admission were needed; many scores were used but inaccurate to predict outcomes. The Rox Index is an easy and fast score that reflects the respiratory status in acute respiratory failure patients, this score could predict the outcome of covid 19 patients. Hypothesis: The 24-hour difference in the Rox Index discriminate accurately the mortality and needs for mechanical ventilation of patients with covid-19. Methods: Study design: Prospective analytic study. Population: 204 Patients admitted to the emergency department from May to August 2020. Data were collected from the clinical records. The Rox Index was calculated at admission and 24h later, the difference was used to establish the outcome, a logistic regression model adjusting for age, sex, presence of comorbidities and disease severity to build and perform ROC analysis. Results: Difference in respiratory ROX Index between admission and 24h is a good predictor for death AUC 0.92 and for mechanic ventilation AUC: 0.75. Each decrease in one unit of the difference at 24h had an Odds Ratio for death risk: 1.48 (95%CI: 1.31-1.67) and for mechanic ventilation: 1.16 (95%IC: 1.1-1.23). Conclusion: The 24-hour variation of Rox Index has good predictive value and allows healthcare professionals to identify which patients will benefit from invasive treatment, especially in low resource settings where emergency physicians deal with survival.

Tissue engineering is an emerging field of research due to its growing impact on the regeneration of tissue injured from damage and organ failure. Small hydrogel microspheres containing regenerative cells and stimulators can be used as building blocks to regenerate tissue by injecting them into damaged areas; a microneedle is used to minimize the incision and any associated infections. To address the need for production of a large number of microspheres for use in tissue engineering, we developed a 3D coaxial multi-nozzle flow-focusing device fabricated via a simple 3D-printing method that demonstrates a high rate of microsphere production per nozzle. This device has six coaxial microscale nozzles that produce hydrogel microspheres. Two individual parts—the inlet and nozzle—can be made separately by a 3D printer and bonded together using uncured photo-curable resin as glue. The dimensions of the microspheres are between 100 μm and 1200 μm. They are produced by adjusting the flow rate ratio between the dispersed and continuous media. A flow rate ratio of 180 demonstrated the highest microsphere production rate of 2.12e+5 microspheres per sec (0.25 mL/min). This microsphere production rate per nozzle is four times higher than that of currently available devices.

The critical hypoxia in COVID-19 patients during this pandemic, has taken away many lives all around the globe. The mechanism has been poorly understood and initially, word got around that it was a SARS (Severe Acute Respiratory Syndrome) pneumonia. The atypical images in lung computerized axial tomography (CAT) scans were alarming. This immediately alerted everyone including poor countries to purchase lacking sophisticated ventilator equipment. However, in some countries, even 88% of the patients on ventilators lost their lives. New observations and pathological findings are gradually clarifying the disease. What seems evident is that it is not only one disease but several, with different responses in different countries and different altitudes. The critical hypoxia and «gasping» present in some patients are not totally understood. It was mentioned that it could be like a High-Altitude Pulmonary Edema (HAPE). Hereby, as high-altitude medicine and hypoxia physiology specialists, we compare the pathophysiology with that of high-altitude exposure in order to understand the mechanisms involved. Some differences in lung radiological images along with transmission and viral attack mechanisms are discussed. The oxygen transport triad used at high-altitude can be applied on this pathology in order to propose even the use of erythropoietin (EPO) early in the treatment. The immune system is the most important long-term survival tool, so we suggest a short-term strategy: the use of special Earth open-circuit astronaut-resembling suits with effective outside air filtering re-breathing mechanisms in order to return to work and daily activities, without contamination risk. Thereby, the curve can be flattened without quarantine and the economy could recover.

Nitric oxide (NO) is a key molecule in cardiovascular homeostasis and its abnormal delivery is highly associated with the occurrence and development of cardiovascular disease (CVD). The assessment and manipulation of NO delivery is crucial to the diagnosis and therapy of CVD, such as endothelial dysfunction, atherosclerotic progression, pulmonary hypertension, and cardiovascular manifestations of Coronavirus (COVID-19). However, due to the low concentration and fast reaction characteristics of NO in cardiovascular system, the clinical applications centered on the NO delivery are challenging. In this tutorial review, we first summarized the methods to estimate the in vivo NO delivery process based on the clinical images and mathematical modeling to assess the endothelial function and vulnerability of atherosclerotic plaque. Then, the emerging bioimaging technologies that have the potential to directly measure the arterial NO concentration were discussed, including the Raman spectroscopy and electrochemical sensor. Aside from the diagnostic methods, therapies aimed at controlling NO delivery to regulate CVD were reviewed, including the inhaled NO therapy to treat the pulmonary hypertension and COVID-19, stem cell therapy and NO-releasing platform to treat endothelial dysfunction and atherosclerosis.

The pharmaceutical industry is undergoing a shift in processing methods for small-scale production (250-1000 kg/a), leading to an increased focus on continuous production research. Various concepts were developed to overcome challenges in small-scale crystallization for the production of high-quality products. However, further optimization is needed to enhance the industrial applicability of these concepts. This study aims to demonstrate the practical applicability of the Slug Flow Crystallizer (SFC) in the pharmaceutical industry by extending its use to a wider range of substance systems for small-scale API production. Employing an experimental strategy, the research seeks to rapidly assess the SFC's potential for achieving uniform, high-purity product yields, emphasizing the importance of factors such as slug flow stability, residence time distribution, and substance-specific crystallization criteria. This, coupled with our previously published model-based strategy, forms a comprehensive methodology to explore crystallization behavior and modeling for a variety of substance systems within the SFC. The ultimate goal of this study is to showcase the practicality of the SFC in the pharmaceutical industry, enabling the way for its reliable use in long-term, small-scale continuous crystallization and the production of high-quality pharmaceutical products.

We present a mixing length based algebraic turbulence model calibrated to pipe flow; the main purpose of the model is to capture the increasing turbulence production-to-dissipation ratio observed in connection with the high Reynolds number transition region. The model includes the mixing length description by Gersten and Herwig which takes the observed variation of the von Kármán number with Reynolds number into account. Pipe wall roughness effects are included in the model. Results are presented for area-averaged (integral) quantities which can be used both as a self-contained model and as initial inlet boundary conditions for computational fluid dynamics simulations.

In the diagnosis of olfactory neuroblastoma (ONB), the presence of S-100–positive sustentacular cells surrounding the tumor is important; however, these are also present in normal nasal sinus epithelium. Although ONB often has a different final diagnosis, complete resection of the tumor has a good prognosis and minimally affects the patient's treatment plan. When the tumor extends around the internal carotid artery (ICA), complete resection is difficult due to the high risk of vascular injury; revascularization using a high-flow bypass can avoid this complication. In the present case, the tumor was located in the left sphenoid sinus and extended around the ICA. Preoperative biopsy tissue was positive for neuroendocrine markers and slightly positive for S-100 protein, leading to a diagnosis of ectopic ONB. High-flow bypass revascularization with trapping of the ICA allowed complete tumor resection. The postoperative histopathological diagnosis was neuroendocrine carcinoma, showing no S-100 protein–positive cells. There was no sign of recurrence two and a half years after surgery without additional treatment. This case demonstrates that the presence of S-100 protein–positive cells in ONB may be misleading. Although misdiagnosis of ectopic ONB should be anticipated, a complete resection of the tumor is an effective treatment strategy.

High-grade gliomas present a significant challenge in neuro-oncology because of their aggressive nature and resistance to current therapies. Boron neutron capture therapy (BNCT) is a potential treatment method; however, the boron carrier compounds used — such as 4-borono-L-phenylalanine (L-BPA) — have limitations. This study evaluated the use of boron-conjugated 4-iodophenylbutanamide (BC-IP), a novel boron compound in BNCT, for the treatment of glioma. Using in vitro drug exposure experiments and in vivo studies, we compared BC-IP and BPA, with a focus on boron uptake and retention characteristics. The results showed that although BC-IP had a lower boron uptake than BPA, it exhibited superior retention. Furthermore, despite lower boron accumulation in tumors, BC-IP showed significant survival improvement in glioma-bearing rats compared to controls. These results suggest that BC-IP, with its unique properties, may be an alternative boron carrier for BNCT. Further research is required to optimize this potential treatment modality, which could significantly contribute to advancing the treatment of high-grade gliomas.

Background: Low-level (LLLT) and high-intensity laser therapy (HILT) can be beneficial additions to knee osteoarthritis (KOA) rehabilitation exercises; however, it is still being determined which modality is more effective. Aim: To compare the effects of LLLT and HILT as adjuncts to rehabilitation exercise (LL+EX and HL+EX) on clinical outcomes in KOA. Methods: Thirty-four adults with mild to moderate KOA were randomly allocated to either LL+EX (n = 17) or HL+EX (n = 17) groups. All participants underwent their designated laser treatment combined with rehabilitation exercises weekly for twelve consecutive weeks. The Knee Injury and Osteoarthritis Outcome Score (KOOS), Numerical Pain Rating Scale (NPRS), active knee flexion, and Timed Up-and-Go test (TUG) were assessed at baseline and immediately post-intervention. Results: Post-intervention, both groups significantly improved their KOOS, NPRS, active knee flexion, and TUG scores compared to baseline (p &lt; 0.01). The mean difference of change in KOOS, NPRS, and active knee flexion scores for the HL+EX group surpassed the minimal clinically important difference threshold. In contrast, the LL+EX group only demonstrated clinical significance in NPRS scores. Conclusions: Incorporating HILT as an adjunct to usual KOA rehabilitation led to significantly higher improvements in pain, physical function, and knee-related disability compared to LLLT.

Oxidoreductase (OXR) enzymes are in high demand for biocatalytic applications in food industry and cosmetics: glucose oxidase (GOx), cellobiose dehydrogenase (CBDH), bioremediation: horseradish peroxidase (HRP), laccase (LAC), and medicine for biosensors and miniature biofuel cells (GOx, CBDH, LAC, HRP). They can be used in a soluble form and/or within the yeast cell walls expressed as chimeras on the surface of yeast cells (YSD), such as P. pastoris and S. cerevisiae. However, most of the current studies suffer from either low yield for soluble enzyme expression or low enzyme activity when expressed as chimeric proteins using YSD. This is always the case in studies dealing with heterologous expression of oxidoreductase enzymes, since there is requirement not only for multiple OXR genes integrations into the yeast genome (super transformations), and codon optimization, but also very careful design of fermentation media composition, and fermentation conditions during expression due to need for adding transition metals (copper, iron), and metabolic precursors of FAD and heme. Therefore, scientists are still trying to find optimal formula using above mentioned approaches, and most recently also using protein engineering and directed evolution for additional increase in the yield of recombinant enzyme production. In this review article we will cover all the current state of the art technologies and most recent advances in the field that yielded high expression level for some of these enzymes in specially designed expression/fermentation systems. We will also tackle and discuss new possibilities for further increase in fermentation yield by the cutting-edge technologies such are directed evolution, protein and strain engineering, high-throughput screening methods based on in vitro compartmentalization, flow cytometry and microfluidics.

Transarterial embolization (TAE) for high-flow pancreaticoduodenal artery (PDA) aneurysms in patients with celiac-trunk stenosis by the median arcuate ligament (MAL) has been found effective both after rupturing and to prevent rupture. The objective was to describe the TAE techniques used and their effectiveness in excluding PDA aneurysms due to MAL syndrome. This single-center retrospective study done at the Dijon-Bourgogne University Hospital included all patients treated by TAE in 2010–2022 for ruptured or unruptured high-flow PDA aneurysms caused by MAL syndrome. We identified 14 patients (7 women and 7 men; mean age, 64 years). Packing and trapping techniques were used alone or together. Occlusion was with microcoils, co-polymer, or cyanoacrylate glue, used separately or combined. Technical success was achieved in 13 (93%) patients. Clinical success was achieved in 12 (86%) patients. One major and two minor complications were recorded within the first 30 days. No complications occurred after 30 days. Follow-up ranged from 1 to 84 months. No cases of aneurysm recanalization were recorded to date. TAE had high technical and clinical success rates in our patients with unruptured or ruptured PDA aneurysms due to MAL syndrome.

Predictive simulation of concurrent debris flow using only pre-disaster information has proven to be difficult as a result of problems in predicting the location of debris-flow initiation (i.e., slope failure). However, because catchment topography has concave characteristics, with all channels in a catchment joining each other as they flow downstream, it is possible to predict damage to downstream area using relatively inaccurate initiation points. Based on this, this paper presents methodologies employing debris-flow initiation points generated randomly using statistical slope failure prediction. A many-case simulation across numerous initiation points was performed to quantify the effect of slope-failure location in terms of deviations in the predicted water level and terrain deformation. It was found that the relative standard deviation diminished as the points approached the downstream area, indicating a location-based predictability effect.

Objectives: To rate the effects of low molecular weight hyaluronic acid (LMWHA) solution and high concentration oxygen (HCO) through a specific medical device (Caress Flow©), compared to topical administration of hyaluronic acid (HA) alone on symptoms of mild and moderate stress and mixed urinary incontinence in women with genitourinary syndrome of menopause (GSM). Methods: A total of 68 postmenopausal women were enrolled (from October 2021 to September 2023). Patients were separated in two groups: one group used therapy with LMWHA solution and HCO combined and the second group used therapy with HA alone. Patient Global Impres-sion of Improvement (PGI-I) as the first outcome was used. As secondary outcomes International Consultation on Incontinence Questionnaire - short form (ICIQ-SF) questionnaire and Internation-al Quality of Life (IQoL) questionnaire were used. Results: Sixty-eight (68) women, 35 (51%) and 33 (49%), were treated with LMWHA solution and HCO combined and HA alone for 10 weeks, respectively. 28 (80%) versus 7 (20%) women reported an improvement (PGI-I score ≤3) of the symptoms in LMWHA solution and HCO com-bined group versus HA alone group. According to the ICIQ-SF, a statistically significant differ-ence was recorded after treatment between the two groups (median, 7 [5-11] vs 10 [8-11]; P = 0.03). According to the IQoL questionnaire, a statistically significantly lower median score was recorded in the LMWHA solution and HCO combined compared with the HA group, before (71 [IQR 55-81] vs 89 [IQR 67-94]; P < 0.01) and after (78 [IQR 65-86] vs 88 [IQR 72-99]; P = 0.04) treatment. Conclusions: LMWHA solution and HCO combined might improve the mild and moderate stress and mixed urinary incontinence in this set of women and that it is superior to HA therapy alone. However, these results need to be confirmed in further studies with a controlled design and a larger population.

Human pluripotent stem cells (hPSCs) have widespread potential biomedical applications. There is a need for large-scale in vitro production of hPSCs, and optimal culture methods are vital in achieving this. Physiological oxygen (2% O2) improves key hPSCs attributes, including genomic integrity, viability, and clonogenicity, however, its impact on hPSC metabolism remains un-clear. Here, Selected Ion Flow Tube-Mass Spectrometry (SIFT-MS) was used to detect and quantify metabolic Volatile Organic Compounds (VOCs) in the headspace of hPSCs and their differentiated progeny. hPSCs were cultured in either 2% O2 or 21% O2. Media was collected from cell cultures and transferred into glass bottles for SIFT-MS measurement. The VOCs acetaldehyde and dimethyl sulfide (DMS)/ethanethiol were significantly increased in undifferentiated hPSCs compared to their differentiating counterparts, and these observations were more apparent in 2% O2. Pluripotent marker expression was consistent across both O2 concentrations tested. Transcript levels of ADH4, ADH5, and CYP2E1, encoding enzymes involved in converting ethanol to acetaldehyde, were upregulated in 2% O2, and chemical inhibition of ADH and CYP2E1 decreased acetaldehyde levels in hPSCs. Acetaldehyde and DMS/ethanethiol may be indicators of altered metabolism pathways in physiological oxygen culture conditions. The identification of non-destructive biomarkers for hPSC characterization has the potential to facilitate large-scale in vitro manufacture for future biomedical application.

Conventional radiation therapy uses white X-rays that consist of a mixture of X-ray waves with various energy levels. In contrast, a monochromatic X-ray (monoenergetic X-ray) has a single energy level. Irradiation of high Z elements with a synchrotron generated monochromatic X-ray with the energy at or higher than the K-edge energy of the element results in the production of the Auger electrons that cause DNA damage leading to cell killing. Delivery of high Z elements into cancer cells and tumor mass can be facilitated by the use of nanoparticles. Mesoporous silica nanoparticles (MSNs) have been shown to be effective in delivering high Z elements to cancer cells. A proof of principle experiment was reported that demonstrated the feasibility of this approach. This opens up a possibility to pursue the Auger cancer therapy by the combined use of MSNs loaded with high Z elements and monochromatic X-rays. Similar cancer therapies using other types of quantum beams such as neutron, proton and carbon ion beams can be envisioned.

During the COVID-19 pandemic, individuals with symptoms other than cough or fever have refrained from seeking medical advice. However, a delay in treatment might lead to serious consequences. At the same time, digital health initiatives have emerged to overcome this bottleneck of healthcare. Herein, we report the results of a multi-center initiative using a combination of patient history and artificial intelligence (AI) to identify individuals with rare neuromuscular diseases. First, a questionnaire with 46 items was developed by interviewing patients with muscular dystrophies, amyotrophic lateral sclerosis, Morbus Pompe, neuropathies, and myasthenia gravis. Second, patients with proven neurological diseases answered the questionnaire. Third, a combination of classifiers (artificial neural network, support vector, and random forest) was trained and, finally, the system was challenged with new questionnaires. Users with an abnormal questionnaire pattern received a unique code for data privacy and contact details for a neurologist for further advice. The neurologists confirmed or refuted the AI-based diagnosis. The questionnaire was accessed 3122 times, leading to 853 unique codes. Only for a few patients the computer-based diagnoses and the confirmed final diagnoses were reported to us. However, for these few patients, the genetic testing and high CK levels finally ended their long-lasting diagnostic odyssey.

Unsupervised physics-informed deep learning can be used to solve computational physics problems by training neural networks to satisfy the underlying equations and boundary conditions without labeled data. Parameters such as network architecture and training method determine the training success. However, the best choice is unknown a priori as it is case specific. Here, we investigated network shapes, sizes, and types for unsupervised physics-informed deep learning of the two-dimensional Reynolds-averaged flow around cylinders. We trained mixed-variable networks and compared them to traditional models. Several network architectures with different shape factors and sizes were evaluated. The models were trained to solve the Reynolds-averaged Navier-Stokes equations incorporating Prandtl's mixing length turbulence model. No training data were deployed to train the models. The superiority of the mixed-variable approach was confirmed for the investigated high Reynolds number flow. The mixed-variable models were sensitive to the network shape. For the two cylinders, differently deep networks showed superior performance. The best fitting models were able to capture important flow phenomena such as stagnation regions, boundary layers, flow separation, and recirculation. We also encountered difficulties when predicting high Reynolds number flows without training data

Pressure drop and flow pattern of oil-water flows were investigated in a 19 mm ID clear polyvinyl chloride pipe consisting of U-bend with radius of curvature of 100 mm. The range for oil and water superficial velocities tested were and respectively. Measurements were carried out under different flow conditions in a test section that consisted of four different parts: upstream of the bend, at the bend and at two redeveloping flow locations after the bend. The result indicated that the bend had limited influence on downstream flow patterns. However, the shear forces imposed by the bend caused some shift flow pattern transition and bubble characteristics in the redeveloping flow section after the bend relative to develop flow before the bend. Generally, pressure gradient at all the test sections increased with both oil fraction and water superficial velocity and there was a sharp change of pressure gradient profile during phase inversion. The transition point where phase inversion occurred was always within the range of . Pressure losses differed at the various test sections and the difference was strongly linked to the superficial velocity of the phases and the flow pattern. At high mixture velocity, pressure losses at the redeveloping section after the bend were higher than that at the bend and that for fully developed flows. At low mixture velocity, pressure losses at the bend are higher than in the straight sections. Pressure drop generally decreased with level of flow development downstream of the bend.

The aim of the study was to compare the standard baseline imaging, with extended radiological staging. To assess our hypothesis, we performed a prospective, single-centre study which included 132 participants recruited between October 2015 and March 2020. Descriptive statistics, the Friedman and chi-squared tests were performed and p &lt; 0.05 was considered significant. Patients were grouped into two cohorts, CT scan cohort (n=87) and PET-CT cohort (n=43). In the first group the originally determined disease stage changed in 36.8 % of cases, in second group in 51.2 %. The consistency between assessment of axillary lymph nodes by imaging (cN) and the postoperative pathology report (pN) was evaluated. In most cases, clinical and pathological evaluation of involved nodes was consistent, for CT scan the result was χ2(1) = 18.98; p &lt; 0.001, for PET-CT the result was χ2(1) = 6.41; p = 0.03. Highly customized radiation therapy defined as dose boost within the involved lymph nodes, not covered by surgeon, was applied in nine patients.

The flow properties of pellets or granules are crucial for further processing the drug dosage forms. Optimal compression or filling the multiparticulate dosage forms into capsules is influenced by forces between discrete particles, which could be partially characterized by flow properties. Several techniques were developed for the examination of flowability, including static and dynamic methods applying empirical studies and the up-to-date chaos theory; however newest methods seem only to be powerful with the supplement of empirical principles. Our experiments try to refine both the technique of analysis and the methods by finding new, alternative ways. Our approach to the flowability measurements was to set up a dynamic time-dependent model which combines empirical observations and the chaos theory on a geometrical basis, thus find new aspects regarding flow properties of pellets and granules that could be relevant for drug developers.

The new unique technology for granulation of metals and nonmetallic melts is presented in the paper. It was created on the newly developed controlled film flow disintegration with rapid cooling of the droplets and solidified granules in amorphous state. Three new phenomena discovered by us created the base for 3 different methods for granulation of metals and nonmetallic melts in a wide range of granules’ sizes. Electromagnetic resonance method allows producing granules of metals in the range of 1 mm and over. The soliton-like vibrational regime is available for production of any granulation material in the range 0.1-1 mm. Moreover, the shockwave regime is applicable for producing particles from 10 micrometers by size. All methods produce particles of the stated size with a narrow distribution by size: deviation from the average size no more than 50%. The other known methods do not produce granules with such high cooling rate, which can realize the amorphous state and cannot regulate size of particles in such bright but narrow range from 10 micrometers to 1-2 mm.

Background: Antiplatelet medications such as aspirin and clopidogrel are used following thrombotic stroke or transient ischemic attack (TIA) to prevent a recurrent stroke. However, the antiplatelet treatments fail frequently, and patients experience recurrent stroke. One approach to lower the rates of recurrence, may be the individualized antiplatelet therapies (antiplatelet therapy modification (ATM)) based on the results of platelet function analysis (PFA). This review was undertaken to gather and analyse the evidence about the effectiveness of such approaches. Methods: We searched Medline, CINAHL, Embase, Web of Science and Cochrane databases to 7 January 2020. Results: Two observational studies involving 1136 patients were included. The overall effects of PFA-based ATM on recurrent strokes (OR 1.05; 95% CI 0.69 to 1.58), any bleeding risk (OR 1.39; 95% CI 0.92 to 2.10) or death hazard from any cause (OR 1.19; 95% CI 0.62 to 2.29) were not significantly different from the standard antiplatelet therapy without ATM. Conclusions: The two studies showed opposite effects of PFA-guided ATM on the recurrent strokes in aspirin non-responders, leading to an insignificant difference in the subgroup meta-analysis (OR 1.59; 95% CI 0.07 to 33.77), while the rates of any bleeding events (OR 1.04; 95% CI 0.49 to 2.17) or death from any cause (OR 1.17; 95% CI 0.41 to 3.35) were not significantly different between aspirin non-responders with ATM and those without ATM. There is a need for large randomized controlled trials which account for potential confounders such as ischemic stroke subtypes, technical variations in the testing protocols, patient adherence to therapy, and pharmacogenetic differences.

This study will present a comprehensive review of the two-phase flow boiling heat transfer coefficient of hydrocarbons such propane (R-290), butane (R-600) and iso-butane (R-600a) and ethanol at various experimental conditions. Studying the multiphase flow heat transfer coefficient has a crucial importance for many heat transfer equipment to achieve higher efficiency for more compact design and cost reduction. One reason behind choosing hydrocarbons as refrigerants in this study is because hydrocarbons have zero ozone depletion potential (ODP=0) and insignificant direct global warming potential (GWP = 3). Moreover, thermodynamic and thermophysical characteristics of hydrocarbons qualify them to be a strong candidate for more heat transfer applications. Initially, by constructing a database for the working fluids from various experimental work available in the literature. The current data that this study has collected for the flow boiling of spans wide ranges of parameters, such as: mass flux, heat flux, operating pressure, and saturation temperature, etc. Furthermore, by comparing the experimental multiphase heat transfer coefficient database with the anticipated values of each correlation, the prediction performance of 26 correlations found in the literature was assessed. This study leads to the selection of the best prediction method based on the minimum deviation of predicted results from the experimental database provided by calculated mean absolute error (MAE) from the assessed correlations. The findings of this study can also be useful in the development of more accurate correlation methods for these fluids and improve the prediction of their flow boiling characteristics.

Obesity and overweight are associated with many metabolic diseases, such as hypertension, diabetes, and dyslipidemia, which are closely related to a sedentary lifestyle and lack of exercise. Aerobic exercise effectively increases the high-density lipoproteins-cholesterol (HDL-C) levels and decreases the triglyceride (TG) levels. The consumption of Cuban policosanol (Raydel®) is also effective in enhancing the HDL-C quantity and HDL functionality to treat dyslipidemia and hypertension. On the other hand, no study has examined the effects of a combination of high-intensity exercise and policosanol consumption in obese subjects to improve metabolic disorders. In the current study, 17 obese subjects (average BMI 30.0±1.1 kg/m2, eight male and nine female) were recruited to participate in a program combining exercise and policosanol (20 mg) consumption for 12 weeks. After completion, their BMI, waist circumference, total fat mass, systolic blood pressure (SBP), and diastolic blood pressure (DBP) decreased by approximately 15% (p=0.022), 12.7% (p=0.008), 33% (p=0.006), 11% (p<0.046), and 13% (p=0.007), respectively. In the serum lipid profile, at week 12, they showed a remarkable decrease in the total cholesterol (TC) and triglyceride (TG) levels, up to 17% (p<0.019) and 54% (p<0.002) from the baseline, respectively. Although the serum HDL-C was increased by approximately +12% from the baseline, the percentage of HDL-C in TC, HDL-C/TC (%), was increased by up to +32% (p=0.007) at week 12. The serum coenzyme Q10 (CoQ10) level was increased 1.2-fold in all participants at week 12 from the baseline. In particular, the male participants showed a 1.4-fold increase (p=0.027) from the baseline. The larger increase in serum CoQ10 was correlated with the larger increase in the serum HDL-C during 12 weeks. The hepatic function parameters were improved; the serum -glutamyl transferase decreased at week 12 by up to 55% (p<0.007), while the aspartate aminotransferase and alanine transaminase levels decreased within the normal range. In the lipoprotein level, the extent of oxidation and glycation were reduced significantly in VLDL and LDL, with a remarkable decrease in the TG content in particles. The antioxidant abilities of HDL2 and HDL3, such as paraoxonase (PON) and ferric ion reduction ability (FRA), were enhanced significantly by up to 1.8-fold (p<0.001) and 1.6-fold (p<0.001) at week 12. The particle size and number of HDL2 were increased up to +10% during the 12 weeks with a remarkable decrease in the TG content, glycation extent, oxidation up to 32% (p=0.032), 18% (p=0.043), and 11% (p=0.023), respectively. The particle number and diameter of HDL3 were increased by up to +9% with a remarkable increase in the PON activity, FRA activity, and TC content of +82% (p<0.001), +56% (p<0.001), and +32% (p=0.009), respectively. Expression of apolipoproteinA-I in HDL2 and HDL3 were significantly elevated more in both gender around 30~48% with more distinct band intensity and less glycation at week 12. These improvements in HDL quality and functionality were linked to the higher survivability of adult zebrafish and their embryos. Under the co-presence of carboxymethyllysine (CML), a microinjection of HDL2 to zebrafish embryo from week 0 resulted in approximately 47% survivability with developmental defects and attenuated speed. On the other hand, the HDL2 microinjection from week 12 resulted in remarkably higher survivability (~ 70%). In conclusion, 12 weeks of Cuban policosanol (Raydel®, 20 mg) consumption with high-intensity exercise showed significant improvement in blood pressure, body fat mass, blood lipid profile without liver damage, CoQ10 metabolism, and renal impairment. At week 12, all participants showed a remarkable decrease in oxidation and glycation extent in the VLDL and LDL with a decrease in the TC and TG content. Significant enhancement of the qualities and functionalities in HDL2 and HDL3 by the policosanol consumption were also detected: increase in apoA-I content, TC content, particle size, and particle numbers along with antioxidant abilities, such as PON and FRA.

The article presents a multiphase numerical computational fluid dynamics (CFD) for simulating hydrothermal liquefaction of sewage sludge in a continuous plug-flow reactor. The discrete particle method (DPM) was used to analyze the solid particle interaction in liquid-solid high shear flows to investigated coupling computational fluid dynamics (CFD) and discrete phase model (DPM) method. Increasing solid particles interaction were observed with increasing liquid velocity. The study examined the influence of parameters such as flow rate, temperature and residence time on the efficiency of bio-oil production. Furthermore, the trajectories of the solid particles are affected significantly by the ash flow and the solid particle size, thus the trajectories of particles resembles the streamlines. A parametric study is performed to investigate the effect of slurry flow rate, temperature and external heat transfer coefficient on the biocrude oil productions performance. This simulation data will be used in the future to design and scale up a large-scale HTL reactor.

Optical micro-angiography (OMAG) is a new method of detecting flow rate and widely used for in vivo imaging. Although OMAG can distinguish between flowing and stationary parts, it cannot obtain accurate flow rate information. This study proposed a range formula for OMAG and the ultrahigh-sensitivity OMAG (UHS-OMAG) method to quantify the measurement range of an entire system. The parameters of the angle between beam scanning and flow directions, the angular velocity of the galvanometer, and the offset of incident light were introduced, and a formula for calculating the range was derived. Experiments were conducted to measure fine and ultra-fine flow rates by using OMAG and UHS-OMAG methods. The minimum measured flow rate was approximately 30 μm/s, and the maximum measured flow rate was approximately 8 mm/s. Experimental results are in good agreement with the preset results.

Mechanical ventilation systems, which are used for breathing support when a person is not able to do it by their own, requires a device for measuring the air flow to the patient in order to monitoring and a assure the magnitude establish by a medical staff. Flow sensors are the conventional devices used for the air flow measuring; however, there were not available in Peru, because of the international demand during COVID-19 pandemic. In this sense, a novel air flow sensor based on orifice plate and an intelligent transducer stage were developed as an integrated design. Advanced methodologies in simulations and experiments using specially designed equipment for this application were carried out. The obtained data was used for a mathematical characterization and dimensions validation of the integrated design. The device was tested in its real working conditions, it was implemented in a breathing circuit connected to a low-cost mechanical ventilation system based on cams. Results indicate that the designed air flow sensor/transducer is a low-cost complete medical device for mechanical ventilators able to provide satisfactorily all the ventilation parameters air flow, pressure and volume over time by measuring the air flow and calculating the others. Furthermore, this device provides directly a filtered equivalent electrical signal for a display or a computer.

An analogy between magneto-fluid dynamics (MFD/MHD) and geostrophic flow in a rotating frame of reference including the existence of electromagnetic columns identical to Taylor-Proudman columns is identified and demonstrated theoretically. The latter occurs in the limit of large values of a dimensionless group representing the magnetic field number. Such conditions are shown to be easily satisfied in reality. Consequently, the electromagnetic fluid flow subject to these conditions is two dimensional and the streamlines are being shown to be identical to the pressure lines in complete analogy to rotating geostrophic flows. An experimental setup is suggested to confirm the theoretical results experimentally.

Imaging flow cytometry (ImFC) represents a significant technological advancement in the field of cytometry, effectively merging the high-throughput capabilities of flow analysis with the image-based features of microscopy. In this comprehensive review article, we take a historical perspective and delve into the evolution of this methodology, presenting its past, exploring current state-of-the-art and forecasting potential future advancements. The inception of ImFC arose from the innovative combination of a flow cytometer's hydraulics with the technology of an advanced camera. This synergistic coupling facilitated the morphological analysis of cell populations at a high-throughput scale, effectively evolving the landscape of cytometry. However, the application of ImFC faced several challenges. Among the most prominent ones, is the development and implementation of software systems that can reliably and efficiently handle the robust data acquisition and analysis inherent in ImFC. The scale and complexity of the data generated by ImFC necessitates the creation of novel analytical tools that can effectively manage and interpret this data, thus allowing us to unlock the full potential of ImFC. Interestingly, artificial intelligence (AI) algorithms have begun to be implemented on ImFC, offering a promise for enhancing analytical capabilities. The adaptability and learning capacity of AI may prove to be essential in knowledge mining from high-dimensional data produced by ImFC, potentially enabling more accurate analyses. Looking forward, we project that ImFC may become an indispensable tool, not only in research laboratories but also in clinical settings. Given the unique combination of high-throughput cytometry and detailed imaging offered by ImFC, we foresee a critical role for this technology in the next generation of scientific research and diagnostics. As such, we encourage both current and future scientists to consider the integration of ImFC as an addition to their research toolkit and clinical diagnostic routine.

Objectives: The purposes of this study were to 1) analyze the disruption of intracardiac flow by flow components and kinetic energy (KE) parameters in single ventricle physiology patients and compare with controls; 2) investigate left ventricular diastolic dysfunction in terms of 4D flow parameters in repaired Fontan (rFontan) group; 3) compare intracardiac flow parameters in morphologic LV and RV rFontan patient groups. Methods: Twenty-five rFontan patients (age: 10±3, M/F: 15/10) and fourteen controls (age: 10±2, M/F: 8/6) were prospectively recruited. All underwent cine and 4D flow cardiovascular magnetic resonance (CMR) on 3.0T scanner. Cardiac function and inter-ventricular mechanical dyssynchrony were analyzed using cine images. From 4D flow CMR, ventricular flow components were assessed: direct flow, retained inflow, delayed ejection flow and residual volume. Global and regional blood flow KE parameters, normalized to end-diastolic volume (EDV) were analyzed for functional single ventricle (FSV). Left ventricular (LV) diastolic dysfunction was assessed on echocardiography guidelines. Results: In comparison of rFontan vs. controls, median FSV residual volume (28% vs. 23%, P= 0.034) were higher in rFontan; median FSV direct flow (32% vs. 40%, P=0.005) and delayed ejection flow (17% vs. 24%, P=0.024) were lower in rFontan. FSV KEiEDV parameters were all lower in rFontan (all P<0.05). No significant differences were observed for flow components and KE parameters between patients with and without inter-ventricular dyssynchrony. FSV direct flow (AUC=0.76, Sensitivity=86%, Specificity=70%) was an independent predictor of LV diastolic dysfunction. Residual volume and E-wave KEiEDV were significantly different between morphologic RV and morphologic LV patient group. Conclusions: The changed flow pattern and decreased KE may be hemodynamic disturbances and impaired ventricular filling in rFontan patients. Reduced direct flow is associated with LV diastolic dysfunction. Morphologic right ventricular subgroup is worse than morphologic left ventricular group in terms of the intracardiac hemodynamics.

This study focuses on traffic condition analysis, especially in under developing country India and makes more visible of traffic flow by using traffic flow theory in order to understand real traffic condition. India is one of rapid economic growing countries and large market with second largest population 1.3 billion in 2018. On the other hand, there are social issues such as environment air pollution and global warming by traffic CO2 emission of transportation. This kind of condition is not only in India, but in other South East Asia and Africa in future. From recent more than one-month traffic observation in a typical major city Ahmedabad in Gujarat state, which has about 8 million population and industrialized city. In terms of traffic data collection, 14 CCTV cameras are used in the city. Based on multiple traffic cameras monitoring, author found the unique traffic flow characteristics and compares traffic flow theory. In this study, it is described what is key parameters to show real traffic congestion condition and how these congestion occurs.

The aim of this study is to model hydrodynamic processes of the Istanbul Strait with its stratified flow characteristic and calibrate the most important parameters using local and global search algorithms. For that two open boundary conditions are defined, which are in the North and South part of the Strait. Observed bathymetric, hydrographic, meteorological and water level data are used to set up the Delft3D-FLOW model. First, the sensitivities of model parameters on the numerical model outputs are assessed using PEST toolbox. Then, the model is calibrated based on the objective functions focusing on the flowrates of upper and lower layers. The salinity and temperature profiles of the Strait are only used for model validation. The results show that the calibrated model outputs of Istanbul Strait are reliable and consistent with the in-situ measurements. The sensitivity analysis reveals that the Spatial Low-Pass Filter Coefficient, Horizontal Eddy Viscosity, Prandtl-Schmidt Number, Slope in log-log Spectrum and Manning Roughness Coefficient are most sensitive parameters affecting flowrate performance of the model. The agreement between observed salinity profiles and simulated model outputs is promising whereas the match between observed and simulated temperature profiles is weak showing that the model can be improved particularly for simulating the mixing layer.

Physics-informed neural networks can be trained to serve as surrogate models by learning how spatial physical fields develop with change of parameters. This is an advantage over traditional numerical methods that can only be used to calculate a single solution field for a single discrete setting of a parameter. While many studies report accurate results of physics-informed deep learning of laminar flows, evaluations of surrogate modeling of high Reynolds number flows remain sparse. To contribute to this question, we here explore the capabilities and limits of physics-informed deep learning to solve the Reynolds-averaged Navier-Stokes equations for the flow around two airfoils under variable angles of attack. No labeled training data were provided and a single network was trained to simultaneously learn several solution fields in a single training run. The network captured essential flow features such as boundary layers and high and low pressure regions. Moreover, the qualitative correlations of lift and drag with the angle of attack and the higher drag of the thicker airfoil were captured. However, comparisons with reference simulations revealed an underestimation of the shear layer gradients as well as deviations of the fields' extrema. Thus, we also debate potential future improvements to increase the accuracy of the predicted flow. This work offers a prospect on the capabilities and current limitations of physics-informed neural networks for surrogate modeling of high Reynolds number flows. We argue that the method is promising and this work is aimed to encourage further research and development of the method when applied to Reynolds-averaged flows at high Reynolds numbers.

Hospital bed shortage is a worldwide concern. Beds unavailability has caused elective surgery cancellations, at our hospital peaking in spring 2016 at over 50%. This is often due to difficult patient step-down from intensive care (ICU) and high-dependency units (HDU). In our general/digestive surgery service admitting approximately 1000 patients yearly, ward rounds were run on a consultant firm basis. We report a quality improvement (ISRCTN13976096) introducing in our service a structured daily multi-disciplinary board round framework (SAFER Surgery R2G) adapted from the “SAFER patient flow bundle” and the "Red to Green days” approaches to enhance flow, comparing the previous year to 2017, when our framework was applied for 12 months.We used a Plan-Do-Study-Act (PDSA) methodology. Our intervention consisted in 1) systematic communication of the key care plan after the afternoon ward rounds to the nurse in charge; 2) 30’ 10AM Monday-to-Friday multidisciplinary board rounds, attended daily by the senior-team and weekly by hospital and site managers, revising the key care plan aiming at safe, early discharges, assessing the appropriateness of each inpatient day and tackling any cause of delay. We measured patient flow by average length of stay (LOS), ICU/HDU step-downs and operation cancellations count, monitoring safety through early 30-day readmissions. Compliance was assessed by board round attendance and staff satisfaction rate surveys.After 12 months (PDSA 2, N=1032), LOS significantly decreased from 7.2(±8.9) to 6.3(±7.4) days (p=0.003); ICU/HDU bed step-down flow increased by 9.3% from 345 to 375 (p=0.197), surgery cancellations dropped from 38 to 15 (p=0.100). 30-day re-admissions increased from 0.9% (N=9) to 1.3% (N=14)(p=0.390). Average cross-specialty attendance was 80%. Satisfaction rates were >75%, regarding enhanced teamwork and faster decisions.The SAFER Surgery R2G framework has shown an increase in patient flow in the context of an enhanced multidisciplinary approach, requiring senior staff commitment to remain sustainable.

This study aimed to enhance a micro hydroelectric generator system driven by free-flow vortex and to compare efficiency of Propeller and Crossflow turbines. Series of turbines in each type were designed and tested at water-flowrate of 0.02 m3/s. The turbine housing has 1 meter in diameter and 0.5-meter height with 2 meters outlet drain at the bottom. The best efficiency extracted from Crossflow turbines with the same height (0.3 meter) but different in diameter (0.4, 0.5, 0.6, and 0.7 meter) and numbers of blade (12, 18, 24, 30, and 23) was from an 18 blades turbine at 23.01% of efficiency. The best efficiency extracted from Propeller turbines with 5 blades was from a 0.4-meter-high turbine with a diameter of 0.7 meter at 13.92% of efficiency. There were 12 Propeller turbines designed in this study. They were different in height (0.2, 0.3, and 0.4 meter) and, in each height, 0.4, 0.5, 0.6, and 0.7 of diameter was applied. The result revealed that Cross Flow turbine had more efficiency to the system than Propeller turbine (9.09%) at the water-flowrate of 0.02 m3/s

Design criteria for coastal defenses exposed to wave overtopping are usually assessed by mean overtopping discharges and maximum individual overtopping volumes. However, it is often difficult to give clear and precise limits of tolerable overtopping for all kind of layouts. A few studies analyzed the relationship between wave overtopping flows and hazard levels for people on sea dikes, confirming that one single value of admissible mean discharge or individual overtopping volume is not a sufficient indicator of the hazard, but detailed characterization of flow velocities and depths is required. This work presents the results of an experimental campaign aiming at characterizing the flow characteristics associated to maximum individual overtopping volumes for an urbanized stretch of a town along the Catalan coast, where a walking and bike path and a railway run along the coastline are exposed to significant overtopping events every stormy season. The work compares different safety criteria for pedestrian. Results prove that safety of pedestrian on a sea dike can be still guaranteed even for overtopping volumes larger than 1000 l/m. Pedestrian hazard is rather proved to be linked to the combination of overtopping flow velocity and flow depth.

High dimensional statistical analysis for the yield of large-scale circuits is quite difficult due to expensive simulations, especially for the memory circuits with high sigma requirement (e.g., SRAM). In this paper, we developed an efficient sparse additive model to substitute simulations. To fit high sigma region accurately, the modeling center is moved to near failure boundary searched by scaling the shape of sampling function. To solve the model efficiently, the process variables are grouped by standard cells so that the model can be solved by our developed blockwise greedy algorithm. The experiments on the 28nm memory circuits validate that our method achieves high accuracy and efficiency compared with other state-of-art works.

The paper presents a modeling framework to analyze the effect of episodic rainfall supply on groundwater dynamics in the Ionian coastal plain multilayered aquifer. The focus is essentially on the short-term behavior of the shallowest layer, with a specific analysis on episodic rainfall events. In the studied aquifer, groundwater level responds sensitively to rainfall events, highlighting the presence of preferential recharge zones. The hydraulic head peak is a function of groundwater level antecedent to the rainfall event. A kinematic dispersion wave model was used to model infiltration processes via preferential pathways. A one-dimensional and non-linear particle based numerical model was developed. Particles with constant water volume travel according to celerity and hydraulic dispersion to simulate the infiltration rate wave through the vadose zone. The flow rate that reaches the water table represents the input function to determine groundwater level fluctuations along groundwater flow direction and according to the lithological features of the surficial levels of the multilayered aquifer, its storage capacity changes passing from unconfined to confined conditions. The model was validated with high time resolution time series of precipitation and groundwater level coming from Terra Montonata meteo-climatic and groundwater level monitoring station. The developed model represents a basis for evaluating and predicting groundwater discharge of the shallowest layers of the Ionian coastal multilayered aquifer under natural conditions including episodic rainfall.

This article examines experiments with elastic material, specifically the deformation of an elastic tube under hydrostatic pressure with a constant flow of fluid inside. This flow induces a pulsatile movement within the elastic tube. Preliminary results are compared with a theoretical model that combines longitudinal and transverse waves. During the experiment, images at various stages of deformation were captured and analyzed. The objective is to better understand the behavior of elastic materials under these conditions and validate the proposed theoretical model through detailed experimental observations, providing a deeper insight into the dynamics of deformation in deformable materials.

Heart attacks and strokes are one of the leading causes of death in the world today, and heart attacks caused by clogged arteries that carry blood to the heart muscle are a significant part of these strokes. These are caused by the accumulation of fat particles in the walls of the arteries and the reduction of blood flow through it over a long process. The process of fat penetration in the underlying layers of the Artery wall has been the focus of many researchers, and various researches and Simulations have been done on it, in each of them, the effect of specific parameters has been considered. In the present study, the effect of blood flow rate on the flow pattern in a bifurcate artery with two ducts has been investigated using FLUENT software with Computation fluid dynamic Method. The effect of the angle between the two ducts of the Artery on the flow pattern has been investigated.

In the evolving landscape of pharmaceutical manufacturing, a comprehensive continuous production process is being crafted for small-scale active pharmaceutical ingredient production. This study focuses on continuous crystallization with separate nucleation and crystal growth units, as well as continuous downstream processing, encompassing filtration, washing, and drying until the formation of free-flowing particles. We introduce a novel continuous nucleator designed based on solubility data and produced via 3D printing, enabling a fast and precise small-scale manufacturing of a nucleator meeting the requirements for nucleation and for the further growth processes. The nucleator was evaluated with regard to its suitability for continuous long-term operation across various coupled crystallizers. As a practical application example it is connected to a slug flow crystallizer to enable high-quality continuous crystallization. Additionally, the full integration of downstream processes using the continuous vacuum screw filter to achieve free-flowing product particles is realized. Even under non-optimized process conditions, with the help of in-situ generation of nuclei free-flowing product particles were successfully obtained. This is particularly useful during drug development when no material is available for seed addition and quickly obtain product for further characterization.

Multi-board electronic cases with high density and high power modules are widely used in industrial power supply management. With the improvement of case performance and miniaturization requirements, heat dissipation becomes one of the important factors to be considered in the design process. First,The existing small electronic thermal design methods focus on heat dissipation structure or heat source layout optimization,and ignores on-load test for modeling analysis. Second,The selected power module has on-load power consumption, resulting in relatively low calorific value and the effectiveness of thermal design cannot be verified. Third, The thermal lacks Intelligent monitoring and feedback control mechanism. In order to solve these problems, this paper designs a kind of heat dissipation case with intelligent temperature control based on high-power and high-density power supply array. Based on the extremely miniaturization design principle, we adopt the composite heat dissipation mode based on conduction and supplemented by forced air cooling . The case is made of magnesium and aluminum alloy with a perforated design. Finally, we compare and analyze with the existing cooling design. The results show that the case is smaller in volume, and the cooling performance parameters are slightly better than the existing case. Under the condition of high-density and high-power design, The output power of the whole system is not less than 10kw and the lowest packing-level density is not less than 47w/cm2 with high reliability, portability and practicability. It also provides technical support and prototype support for the standardized design of similar power arrays.

Variable flow emitters are a new type of emitter for underground drip irrigation that are used in locations where soil moisture is difficult to transport to the surface, which leads to crop emer-gence difficulties. The flow channel structure parameters of emitters affect the hydraulic per-formance of the emitter and its anticlogging ability. In this study, the variable flow emitter at the conventional low–flow water supply stage is taken as the research object. A combination of CFD numerical simulation of a two–phase flow of water and sand and clear water testing of test samples is applied to study the influence laws of 10 groups of variable flow emitter structural combinations on the effluent flow rate (q), flow index (x), particle passage rate and flow field inside the flow channel. The results show that the Realizable k–ε turbulence model can be used to simulate the flow field inside the variable flow emitter flow channel. The nRMSE between the measured and simulated values of q is 11.23%, and the relative error between the measured and simulated values of x is 4.66%, which gives a high simulation accuracy. The polar analysis shows that the tooth angle A has the smallest effect on the effluent flow rate q0.1 under 0.1 MPa, x, and particle passage rate of the variable flow emitter. The depth of the flow channel D, the spacing of the teeth B, and the height of the teeth E have a different order of precedence in the influence of the three indices, which are D > B > E > A, B > E > D > A, and E > B > D > A, respectively. The value of particle passage rate is positively correlated with the mean flow velocity (v) and the mean turbulent kinetic energy (k) in the flow channel, and particle passage rate tends to increase and then decrease with the increase of x. The retention time (t) of the particles in the flow channel is closely related to the magnitude of v and k. Three multivariate linear regression equations (R2 = 0.883 ~ 0.995) were constructed for q0.1, x, and particle passage rate versus the flow channel structural parameters. Using the scipy.optimize.minimize function in Python, we de-termined the three optimal combinations of flow channel structural parameters corresponding to better hydraulic performance: q0.1 is 1.5 or 2 L/h (objective function y = min x), better clogging resistance (y = max particle passage rate), and both (y = min (0.5 x - 0.5 particle passage rate)). The research results can provide a ref-erence for the optimal design of variable flow emitters.

Debris flows have generated major disasters worldwide due to their great destructive capacity, which is associated with their high energy levels and short response times. To achieve an adequate risk management of these events, it is necessary to define as accurately as possible the different hazard levels to which the territory is exposed. This article develops a new methodology to estimate this hazard based on the hydrodynamic characteristics of the flow and the granulometry of the sediments that can be mobilized by the flow. The hydrodynamic characteristics of the flow are determined through a mathematical modeling that considers the rheology of non-Newtonian flows and the different volumes of sediments that could be transported during events corresponding to different return periods. The proposed methodology was implemented in the Jamundí River basin (Colombia). The results obtained indicate that in the upper part of this basin there is a low hazard level, while in the lower part of the basin approximately 15% of the affected territory has a medium hazard level and the remaining 85% has a low hazard level. The methodology developed is simple to implement but technically rigorous since it considers all relevant aspects in the generation of debris flows.

The two-phase flow of water and reactive gas in the channel of proton exchange membrane fuel cell (PEMFC) plays an important role in high-quality water management. In this study, the removal effect of 3D wave channel and 2D straight channel for liquid water was studied by volume of fluid method. The dynamic behavior of droplet emerge from the gas diffusion layer (GDL) into the channel under the influence of gas flow was investigated. The effects of droplet growth, deformation, detachment, force, pore size on water critical behavior and water content in the channel are discussed. The results show that the 3D wave channel is superior to the removal of liquid water than the 2D straight channel. The increase of velocity is conducive to the discharge liquid water. While infinite increase of velocity will cause more parasitic power loss. The larger pore size of GDL is not advantageous to the performance of PEMFC, but the appropriate increase of pore size is conducive to the discharge of liquid water. The basic knowledge obtained in this study will help to deepen the understanding of droplet dynamics in PEMFC gas channels, and help to optimize the design and working conditions of these channels.

Dams design and their operation cause strong environmental alteration and therefore a long-term debate is ongoing for the scale of these projects. At the same time, the concept of Environmental Flow Assessment (EFA) is a crucial element of modified ecosystems featuring large infrastructure such as dams and reservoirs for mitigating potential environmental degradation while they operate. Nowadays, integrated scientific frameworks are required to quantify the risks caused by large infrastructure. Through the use of stochastic analysis, it is possible to quantify these uncertainties, and present a solution that incorporates long-term persistence and environmental sustainability into a balanced reservoir simulation model. In this work, an attempt is made to determine a benchmark reservoir size incorporating hydrological and ecological criteria though stochastic analysis. The primary goal is to ensure the best possible conditions for the ecosystem, and then secondarily to allow a steady supply of water for other uses. Using a synthetic timeseries based on historical inputs, it is possible to determine and preserve essential statistical characteristics of a river’s streamflow, and use these to detect the optimal reservoir capacity that maximizes environmental and local water demand reliability.

Unsteady flow is the most common and complicated form of fluid motion in nature. This paper takes the beaches of key waterways in the middle and lower reaches of the Yangtze River as the research object, analyzes the water surface distribution and average flow velocity distribution near the beach, and analyzes the differences. The relationship between the flow pattern of the steep slope and the water flow pattern of the entire survey area and the steep slope of the beach and its nearby water flow structure. The water flow near the beach is divided into four major blocks: the swelling water area, the falling water area, the backwater area and the maximum flow rate area. The water flow structure characteristics and the cause of each block are analyzed.

Widely used in hydraulics, the Colebrook equation for flow friction relates implicitly to the input parameters; the Reynolds number, Re and the relative roughness of inner pipe surface, ε/D with the output unknown parameter; the flow friction factor, λ; λ=f(λ, Re, ε/D). In this paper, a few explicit approximations to the Colebrook equation; λ≈f(Re, ε/D), are generated using the ability of artificial intelligence to make inner patterns to connect input and output parameters in explicit way not knowing their nature or the physical law that connects them, but only knowing raw numbers, {Re, ε/D}→{λ}. The fact that the used genetic programming tool does not know the structure of the Colebrook equation which is based on computationally expensive logarithmic law, is used to obtain better structure of the approximations which is less demanding for calculation but also enough accurate. All generated approximations are with low computational cost because they contain a limited number of logarithmic forms used although for normalization of input parameters or for acceleration, but they are also sufficiently accurate. The relative error regarding the friction factor λ, in best case is up to 0.13% with only two logarithmic forms used. As the second logarithm can be accurately approximated by the Padé approximation, practically the same error is obtained also using only one logarithm.

The oscillating heat pipe (OHP) is a new member in the family of heat pipes, and it has great potential applications in energy conservation. However, the fluid flow and heat transfer in the OHP as well as the fundamental effects of inner diameter on them have not been fully understood, which are essential to the design and optimization of the OHP in real applications. Therefore, by combining the high-speed visualization method and infrared thermal imaging technique, the fluid flow and thermal performance in the OHPs with inner diameters of 1, 2 and 3 mm are presented and analyzed. The results indicate that three fluid flow motions, including small oscillation, bulk oscillation and circulation, coexist or, respectively, exist alone with the increasing heating load under different inner diameters, with three flow patterns occurring in the OHPs, viz. bubbly flow, slug flow and annular flow. These fluid flow motions are closely correlated with the heat and mass transfer performance in the OHPs, which can be reflected by the characteristics of infrared thermal images of condensers. The decrease in the inner diameter increases the frictional flow resistance and capillary instability while restricting the nucleate boiling in OHPs, which leads to a smaller proportion of bubbly flow, a larger proportion of short slug flow, a poorer thermal performance, and easier dry-out of working fluid. In addition, when compared with the 2 mm OHP, the increasing role of gravity induces the thermosyphon effect and weakens the 'bubble pumping' action, which results in a little smaller and bigger thermal resistances of 3 mm OHP under small and bulk oscillation of working fluid, respectively.

In this paper, we present the extension of the pressure-based solver designed for the simulation of compressible and/or incompressible two-phase flows of viscous fluids. The core of the numerical scheme is based on the hybrid Kurganov— Noele — Petrova/PIMPLE algorithm. The governing equations are discretized in the conservative form and solved for velocity and pressure, with the density evaluated by an equation of state. The acoustic-conservative interface discretization technique helps to prevent the unphysical instabilities on the interface. The solver was validated on various cases in wide range of Mach number, both for single-phase and two-phase flows. The numerical algorithm was implemented on the basis of the well-known open-source Computational Fluid Dynamics library OpenFOAM in the solver called interTwoPhaseCentralFoam. The source code and the pack of test cases are available on GitHub: https://github.com/unicfdlab/hybridCentralSolvers

Super-high (x400) magnification dermoscopy (D400) is a new non-invasive imaging technique that has been shown to add information for the differential diagnosis of melanocytic lesions in a pilot study. Our study aimed to confirm if D400 can add details for the discrimination of clinically atypical nevus and melanoma. This is a retrospective observational, multicentric study enrolling patients who received an x20 (D20) and x400 (D400) magnification dermoscopic examination of pigmented skin lesions. Dermoscopic images were retrospectively evaluated by three observers for the presence/absence of nine D20 and twenty D400 dermoscopic features defined in the previous pilot study. Univariate and multivariate analyses were carried out to find predictors of benign and malignant behaviors. At D20 atypical pigment network, blue-whitish veil, atypical vascular pattern, regression, and homogenous pattern were more frequent in melanoma than in nevi (p&lt;0.001). At D400 melanoma showed more frequently than benign lesions melanocytes with an irregular arrangement and irregular in shape and size (p&lt;0.001). Network with edged papillae was more frequent in benign lesions than melanomas (p&lt;0.001). Our study confirms that D400 can identify melanocytes with an irregular arrangement and irregular in shape and size in melanomas, adding information to the conventional D20 examination.

Chitosan (CTS) is widely used in agriculture as a soil amendment, plant growth regulator and promoter of cold resistance. However, the effects of CTS on strawberry seedlings under the combined stress of high-temperature and high-light are unclear. In this study, Xuelixiang strawberry was used as a test material, and 100 mg·kg-1 CTS solution was sprayed onto the leaves. We measured the chlorophyll content, membrane peroxidation, reactive oxygen species content, antioxidant enzyme content, AsA-GSH cycle activity and other related indicators of strawberry seedling leaves under the combined stress of high-temperature and high-light and found that CTS can increase the contents of antioxidants, increase the contents of osmotic adjustment substances, increase the activity of antioxidant enzymes activity,; remove reactive oxygen species over time, reduce the damage of reactive oxygen species to photosynthetic organs and cell membranes, and improve the photosynthesis efficiency of leaves of strawberry plants under high-temperature and high-light stress, thereby reducing damage to strawberry seedlings caused by high-temperature and high-light.

In-situ injection of steam for heating of the subsurface is an efficient method for the recovery of oil and gas from oil shale where permeability typically evolves with temperature. We reported measurements on Jimusar oil shales(Xinjiang, China) at different temperatures to 600℃ and under recreated in situ triaxial stresses to obtain permeability evolution with temperature and stress. Permeability of tight oil shales evolves with temperature to a threshold temperature and peak temperature. The threshold temperature was subjected to triaxial stresses. For Jimusar oil shale, the threshold temperature ranges from 200℃ to 250℃ at ground stress of buried depth of 500m and from 350℃ to 400℃ at buried depth of 1000m. The peak temperature was almost not subjected to triaxial stress and the range is from 450℃ to 500℃ for all Jimusar samples. Pyrolysis plays an important role in permeability evolution and fundamentally changes permeability tendency and magnitude. At high temperature permeability exhibits a little reduction due to stress effect but still remains a high level due to pyrolysis. The above results show that oil shale mass can change from tight porous media into highly permeable media and oil & gas can easily flow through oil shale stratum.

In the process of game development, identifying and deleting currently abandoned assets as content iterates can effectively reduce the size of game packages. But the built-in reference checking tool in UE4 can only check static references of assets and cannot identify dynamically referenced resources in the program. We have developed a static analysis tool for analyzing unused assets in the UE4 project to address this issue. This tool checks the function parameters of all loading points, analyzes the value range of the parameter string based on the data dependency relationship of the actual parameter variable, and considers that the assets that match within the range are referenced. Due to the fact that in some cases, the exact data stream of the actual parameter variable is not computable (resulting in false negatives), the reverse analysis tool supports manually marking the parameter range at the loading point. This tool can generate asset collections that are dynamically referenced. The union of its results with the built-in reference checking tool in UE4 is the set of all referenced assets. The difference set between all asset sets and the referenced asset set is the abandoned asset set. This achieves a more complete cleaning of redundant resources and reduces the size of game packages.

Flow over a cluster of three equally spaced circular cylinders was studied by numerical simulation on base of the turbulent mode k-kl-ω for two incidence angles β=0° and 60°, at different Reynolds number,in this paper, flow interference pattern characteristics between cylinders, characteristics of force parameters and Strouhal number of each cylinder with different spacing ratios ranging from 1.5 to 4 at Re 8×104, 2×105and 2×106 had been obtained. At incidence angle β=0° and 60°, the wake was nearly symmetric if S/D≥2.0; at β=60°,S/D=1.5 and Re=2×105, the asymmetric periodic flow pattern occurred in the wake region which leaded to the significant effect on the surface mechanical parameters and Strouhal number which was found for the first time; the periodic flow regime of the wake region also occurred at S/D=1.35 and 1.5, without the same phenomenon at S/D=1.7 and 2.0; the phenomenon of periodic flow regime of the wake region was intrinsic and related to Reynolds number and space ratio. in addition, characteristics of force parameters of three cylinders mainly were affected by the interference between cylinders, at 1.5&lt;S/D&lt;4, which leaded to that the drag coefficient of three cylinders reduced with different Reynolds numbers. At incidence angle 60°, in subcritical and critical regime, the Strouhal numbers of the upstream cylinders were more than that of single cylinder, and with the enlargement of spacing ratio, the Strouhal number decreased; for the downstream cylinder , the Strouhal number is far less than that of single cylinder and with the enlargement of spacing ratio, the Strouhal number increases, which were another prominent flow inference influence. The results indicated the effect of flow interference between cylinders subjected to a cross flow over a cluster of three equally spaced cylinders on the flow pattern,surface mechanical parameters and Strouhal number.

The Lower Mekong Basin has had extensive hydropower dam development, which changes hydrologic conditions and threatens the exceptional aquatic biodiver-sity. This study quantifies the degree of hydrologic change between pre-impact (1965-1968) and post-impact (2018-2021) peak hydropower development in two major tributaries of the Lower Mekong Basin, the Sekong River with the fewest dams and the Sesan River with the most dams. Both rivers historically supported migratory fishes. We use daily pre- and post-impact data and the Indicators of Hydrologic Alteration framework to evaluate streamflow changes from dam development. We found signifi-cant changes in low and high magnitude flows in the pre- and post-impact periods of dam development. For the Sekong River, minimum flow had large fluctuations that ranged 290% to 412% more than the pre-impact period, while the Sesan River ranged 120% to 160% more than pre-impact. Dry season flows increased by 200±63% on av-erage in the Sekong River, which is caused by releases from upstream dams. Mean-while, Sesan River dry season flows increased by 100±55% on average. This study in-dicates that seasonal flow changes and extreme flow events occurred more frequently in the two basins following dam construction, which may threaten the ecosystem func-tions.

The problem of fluid dynamics can be greatly simplified if, for every point in space, the strain-rate tensor is diagonalized. This tensor is introduced into the Navier-Stokes equations via material law and divergence of the stress tensor. This article shows that local SO(3)xU(1) gauge fields can be used to locally diagonalize the diffusion components of the strain-rate tensor. The gauge fields resulting from the connection can be interpreted as convection components of the flow, they show properties of quasiparticles and can be interpreted as elementary vortices. Thus, the proposed approach not only offers new insights for the solution and situative simplification of the Navier-Stokes equations, it also uncovers hidden symmetries within the flow convection, allowing - depending on boundary conditions - further interpretation.

Aero-fuel centrifugal pumps are important power plants in aero-engines. Unlike most of the existing centrifugal pumps, a combination impeller is integrated with the pump to improve its performance. First, the critical geometrical parameters of combination impeller and volute are given. Then, the effects of combination impeller on flow characteristics inside the impeller and volute are clarified by comparing simulation results with that of the conventional impeller, where the effectiveness of selected numerical method is validated by an acceptable agreement between simulation and experiment. Finally, the experiment is performed to test the external performance of studied pump. A significant feature of this study is that the flow characteristics are significantly ameliorated by reducing the flow losses emerged in impeller inlet, impeller outlet and volute tongue. Correspondingly, the head and efficiency of combination impeller are higher with comparison to conventional impeller. Consequently, it is a promising approach in ameliorating flow field and improving external performance by applying a combination impeller to an aero-fuel centrifugal pump.

Deformation flows are flows incorporating shear, strain and rotational components. These flows are ubiquitous in the geophysical flows, such as the ocean and atmosphere. They appear near almost any salience, such as isolated coherent structures (vortices and jets), various fixed obstacles (submerged obstacles, continental boundaries). Fluid structures subject to such deformation flows may exhibit drastic changes in motion. In this review paper, we focus on the motion of a small number of coherent vortices embedded in deformation flows. Problems involving isolated one and two vortices are addressed. When considering a single-vortex problem, the main focus is on the evolution of the vortex boundary and its influence on the passive scalar motion. Two vortex problems are addressed with the use of point vortex models, and the resulting stirring patterns of neighbouring scalars are studied by a combination of numerical and analytical methods from the dynamical system theory. Many dynamical effects are reviewed with emphasis on the emergence of chaotic motion of the vortex phase trajectories and the scalars in their immediate vicinity.

High-strength wastewaters from a variety of sources, including the food industry, domestic septage and landfill leachate, are often hauled to municipal wastewater treatment plants (WWTPs) for co-treatment. Due to their high organic loadings, these wastewaters can cause process upsets in both the WWTP’s liquid and solids treatment trains and consume organic treatment capacity, leaving less capacity available to service customers in the catchment area. A novel pre-treatment method, the Waste Activated Sludge-High Rate (WASHR) process, is proposed to optimize the co-treatment of high-strength wastewaters. The WASHR process combines the contact stabilization and sequencing batch reactor processes. It utilizes waste activated sludge from the municipal WWTP as its biomass source, allowing rapid start-up. Bench scale treatment trials of winery wastewater confirm the WASHR process can reduce loadings on the downstream WWTP’s liquid treatment and solids treatment trains. A case study approach is used to confirm the economic viability and environmental sustainability of the WASHR process compared to direct co-treatment using life cycle cost analyses and greenhouse gas emissions estimates.

Background Although high-density lipoprotein has cardioprotective effects, the association between serum high-density lipoprotein cholesterol (HDL-C) and hypertension is poorly understood. Objective We investigated whether low and high concentrations of HDL-C are associated with hypertension using a large healthcare dataset. Methods In a community-based cross-sectional study of 1,493,152 Japanese people aged 40–74 years who underwent a health checkup, blood pressures and clinical parameters, including nine HDL-C concentrations (20–110 mg/dL or over) were investigated. Results A crude U-shaped relationship was observed between the nine HDL-C concentrations and blood pressure in males (n = 830,669), while a left-to-right inverted J-shaped relationship was observed in females(n = 662,483). An age-adjusted logistic regression analysis showed J-shaped relationships (left-to-right inversion in females) between HDL-C and odds ratios for hypertension (≥140/90 mmHg), with lower limits of 60–79 mg/dL in males and 90–99 mg/dL in females, which were unchanged after adjusting for smoking, habitual exercise, alcohol consumption, and pharmacotherapy for hypertension, dyslipidemia, and diabetes. However, further adjustment for body mass index and serum triglyceride concentration revealed latent positive linear associations between HDL-C and hypertension, although the association between extremely high HDL-C (≥100 mg/dL) and hypertension was attenuated in non-alcohol drinkers. Conclusion Both low and extremely high HDL-C concentrations are associated with hypertension. The former association may be dependent on excess fat mass, which is often concomitant with low HDL-C, whereas the latter association may be dependent on frequent alcohol consumption.

Since its introduction almost 50 years ago, the concept of ‘flow’ has been descriptive of optimal experiences, also in relation to play. However, the explorative nature of play leads to some discrepancies between flow and the optimal experience of play. In this paper the differences between flow and play are explored, leading to proposing the state of ‘wonder’ (directed at exploration) as an alternative to ‘flow’. From this perspective, the study further explores how we may design toys that enable meaningful experiences of play, identifying opportunities in designing for toys as the enablers of immersed experiences of wonder.

There is a long standing ‘two times problem’ in that a satisfactory reconciliation between the time of physics and that of psychology has not been realized. A partial solution to the past/present/future phenomenon has been successfully given by the Hartle information gathering and processing system (IGUS) view. That model IGUS robot is enhanced here for the entire ‘two times problem’ to deal with not only the temporal experiences of the flow of time but also those of manifest time. A dualistic robot is proposed which has a veridical system of temporal experiences that are compatible with various spacetime cosmologies. It also has an illusory system of corresponding temporal experiences. This dualistic IGUS robot was made possible by discovering temporal experience within the brain that correspond to those of physics. The dualistic theory suggests that the veridical system, as a result of evolution, begets the illusory system to enhance behavioral adaptation. Thus, there is just one fundamental physical time which the brain does, indeed, possess and then enhances with illusory counterparts. Therefore, there should no longer be a need to reify illusory temporal experiences as modern spacetime cosmologies tend to do. Physical time already resides within human time.

In this study, the author proposes to evaluate the effect of sales growth, Receivable Turnover and operating cash flow on the liquidity of PT. Unilever Indonesia Plc. The research method used is descriptive method with a quantitative approach. In this statement, the population used in this study is the financial statement data from PT. Unilever Indonesia Plc. from 2010 to 2018, the technique of determining the sampling uses Purposive Sampling. This research data uses secondary data from PT. Unilever Indonesia Plc financial statements from 2010 to 2018. All data sources were obtained from the website of the Indonesia Stock Exchange at https://www.idx.co.id, the company's website and Google search. Our analysis reveals that sales growth and accounts receivable turnover from PT. Unilever Indonesia Plc. has no influence on the liquidity of PT. Unilever Indonesia Plc, while operating cash flow has an influence on the Liquidity of PT Unilever Indonesia Plc. This means the ups and downs of the value of sales and accounts receivable turnover of a company has no influence on the liquidity of PT. Unilever Indonesia Plc, while operating cash flow has increased or decreased has an influence on the liquidity of PT Unilever Indonesia Plc. The value of sales growth, accounts receivable turnover and operating cash flow can explain the liquidity of PT Unilever Indonesia Plc. by 78%, while 22% is explained by other factors which are not included in this study.

With the ever-increasing rate, obesity has become an epidemiological problem throughout the globe comprising about 39% of the world population as of now. Among several reasons, disruption of the gut microbial ecosystem might contribute to the pathogenesis of metabolic disorders, including obesity, metabolic syndrome, type 2 diabetes, and other associated comorbidities. Though the mechanisms related to dysbiosis are unclear, diet might play a modulating role where different dietary approaches manipulate microbial richness and abundance as well as stability. For instance, shifting of Firmicutes and Bacteroidetes ratio in the gut might have a role in association with the dietary approaches and ingestion duration. Along with altered gut microbial composition, microbial metabolites such as short-chain fatty acids (SCFA) after ingestion of non-digestible dietary starches may have an impact on host metabolism by regulating lipogenesis, gluconeogenesis, and inflammation with potential associations to health and obesity. The dietary approaches like carbohydrates, fibre, protein, and/or fat diet at various arrangements can make a shift in the composition of gut microbiota if introduced for a short period. However, the unique pattern of the gut microbes usually remains the same along with the longer period of habitual diet. Though the short-term dietary intervention or circadian rhythm influences a transient change in gut microbes, other than habitual diet, the understanding related to long-term dietary change-induced permanent alterations is minimum. Alternatively, the usage of prebiotics, probiotics as well as postbiotics could be beneficial to overcome dysbiosis. This review highlights the current knowledge and the interaction between the human intestinal microbiota and diet as a modifying factor, in obesity allowing the scientists to uncover novel targets and tools to use as customized therapy.

This article discusses a focused study on visualizing the flow patterns in a two-phase pulsating heat pipe (PHP) using Fe₃O₄/water as the working fluid at 3 V/V% concentration. The research also aims to meticulously examine phase change phenomena in the heating section, particularly focusing on bubble formation and expansion processes. A high-speed video camera was utilized to capture dynamic insights into the behavior of the Fe₃O₄/water mixture. Based on the findings, a straightforward model was developed to explain bubble generation and growth in the mixture, serving as a useful reference for future PHP designs and optimizations. Visual observations also noted the stable nature of the Fe₃O₄/water nanofluid over a four-day period, confirming its consistency throughout the experiments. Moreover, the impact of heat load variation on the evaporator section was assessed using controlled heat inputs ranging from 10 to 80 Watts. Observations on the arrangement of slugs and plugs at a 50% filling ratio revealed interesting self-adjusting flow patterns in response to increasing heat inputs, providing valuable insights into PHP operational dynamics. Notably, the oscillatory flow behavior of Fe₃O₄/water, the chosen working fluid, exhibited greater activity in comparison to water. This distinctive flow behavior contributed to achieving heightened thermal performance efficiency for the Fe₃O₄/water system, attributed to its faster attainment of the annular flow condition.

Rainfall is the main driver of hydrological processes in dryland environments and characterising the rainfall variability and processes of runoff generation are critical for understanding ecosystem function of catchments. Using remote sensing and in situ data sets, we assess the spatial and temporal variability of the rainfall, rainfall-runoff response, and effects of antecedent soil moisture and ground cover at different spatial scales on runoff coefficients in the Upper Burdekin catchment, northeast Australia, which is a major contributor of sediment and nutrients to the Great Barrier Reef. The high temporal and spatial variability of rainfall exerts significant controls on runoff generation processes. Rainfall amount and intensity are the primary runoff controls, and runoff coefficients for wet antecedent conditions were higher than for dry conditions. The majority of runoff occurred via surface runoff generation mechanisms, with subsurface runoff likely contributing little runoff due to the intense nature of rainfall events. At annual to seasonal temporal scales and for relatively large catchments, we could not detect a significant effect of ground cover on runoff. We conclude that in the range of moderate to large catchments (193 – 36,260 km²) runoff generation processes are sensitive to both antecedent soil moisture and ground cover. A higher runoff-ground cover correlation in drier months with sparse ground cover highlighted the critical role of cover at the onset of the wet season and how runoff generation is more sensitive to cover in drier months than in wetter months. The monthly water balance analysis indicates that runoff generation in wetter months (January and February) is partially influenced by saturation overland flow, most likely confined to saturated soils in riparian corridors, swales, and areas of shallow soil. By March and continuing through October, the soil ‘bucket’ progressively empties by evapotranspiration, and Hortonian overland flow becomes the dominant, if not exclusive, flow generation process. The results of this study can be used to better understand the rainfall-runoff relationships in dryland environments and subsequent exposure of coral reef ecosystems in Australia and elsewhere to terrestrial runoff.

The salt marshes, lying at the land-sea temperate interface, furnish a plethora of ecosystems services such as biodiversity niche support, ocean-climate change regulation, ornithology recreo-tourism or plant gathering by hand. They undergo significant worldwide losses due to their conversion into crop fields and to their spatial compression between the rising sea-level and the armoring shoreline. Their monitoring however requires to use a suite of remote sensing sensors to embrace the regional scale while capturing the plant details. This research innovatively adopts a multiscale approach using a cascading spaceborne and airborne process, from the 10-m Sentinel-2, through the 3-m Dove, to the 0.03-m unmanned airborne vehicle (UAV) imageries. The high to very high temporal resolution of the Sentinel-2 and Dove enabled to cover twenties and tens of km2 over five and four years, respectively, in the form of normalized difference vegetation index (NDVI) classes, associated with microphytobenthos, low, medium and high salt marsh vegetation, including the opportunistic Elyma genus. The NDVI was then modelled at the UAV scale (a few km2) using a three-layered NN prediction, providing the final near-infrared (NIR), and the intermediate red, green and blue reflectance imageries, calibrated/validated/tested with the Dove reflectance imageries (R2NIR=0.98, R2red=0.88, R2green=0.84, and R2blue=0.90). The 100fold increase in pixel size allowed to detect the decimeter-scale objects of the tidal flats and salt marshes, to enlarge the NDVI class ranges, and hold great promise to model other spectral bands at the UAV scale for further deeply enhancing the salt marsh mapping.

The cornerstone of molecular magnetism is a detailed understanding of the relationship between structure and magnetic behaviour, i.e. the development of magneto-structural correlations. Traditionally, the synthetic chemist approaches this challenge by making multiple compounds that share a similar magnetic core but differ in peripheral ligation. Changes in the ligand framework induce changes in the bond angles and distances around the metal ions which are manifested in changes to magnetic susceptibility and magnetisation data. This approach requires the synthesis of series of different ligands and assumes that the chemical/electronic nature of the ligands and their coordination to the metal, the nature and number of counter ions and how they are positioned in the crystal lattice, and the molecular and crystallographic symmetry have no effect on the measured magnetic properties. In short, the assumption is that everything outwith the magnetic core is innocent, which is a huge oversimplification. The ideal scenario would be to have the same complex available in multiple structural conformations, and this is something that can be achieved through the application of external hydrostatic pressure, correlating structural changes observed through high pressure single crystal X-ray crystallography with changes observed in high pressure magnetometry, in tandem with high pressure inelastic neutron scattering (INS), high pressure electron paramagnetic resonance (EPR) spectroscopy and high pressure absorption/emission/Raman spectroscopy. In this review, which summarises our work in this area over the last 15 years, we show that the application of pressure to molecule-based magnets can (reversibly): (1) lead to changes in bond angles, distances and Jahn-Teller orientations; (2) break and form bonds; (3) induce polymerisation/depolymerisation; (4) enforce multiple phase transitions; (5) instigate piezochromism; (6) change the magnitude and sign of pairwise exchange interactions and magnetic anisotropy and (7) lead to significant increases in magnetic ordering temperatures.

This review is a first attempt at bringing together various concepts from research on wall- and magnetically-bounded turbulent flows. Brief reviews of both fields are provided: The main similarities identified are coherent (turbulent) structures, flow generation and transport barriers. Examples are provided and discussed.

Part II, like Part I, discusses geometry, kinematics and statics in detail without taking into account power losses in meshing. The main goal of Part II, however, is to prove that there are complex and structurally coupled planetary gear systems, i.e. containing a closed circuit in which no circulation of power flow is generated. The power flow analysis is also carried out using the direct method, with a slight modification in the way of writing the equations identifying active and passive gears, i.e. at the same time the directions of power flow on all transmission paths. The analysed planetary gear system (PGS) is characterised by mobility equal to 1, i.e. single degree of freedom (DoF). It consists of three subsystems in the form of the 2KH type planetary units connected in series-parallel, specially selected to demonstrate the thesis of this paper. It consists of three subsystems in the form of single planetary subsystems of the 2KH type connected series-parallel, specially chosen to illustrate the thesis of this paper.

Maxwell equations governing electromagnetic effects are being shown to be equivalent to the compressible inviscid Navier-Stokes equations applicable in fluid dynamics and representing conservation of mass and linear momentum. The latter applies subject to a generalized Beltrami condition to be satisfied by the magnetic field. This equivalence indicates that the compressible inviscid Navier-Stokes equations are Lorentz invariant as they derive directly from the Lorentz invariant Maxwell equations subject to the same Beltrami condition. In addition, the derivation results provide support for the claim that electromagnetic potentials have physical significance as demonstrated by Aharonov-Bohm effect, and are not only a convenient mathematical formulation.

Temporary streams are a key component of the hydrological cycle in arid and semi-arid regions, but their flow is highly variable and difficult to measure. In this paper, we present a novel approach that could be used to assess the flow of temporary streams and characterize their environmental status. Specifically, we apply the Image Velocimetry method to estimate surface velocity in temporary streams using unmanned aerial vehicles (UAVs) equipped with optical sensors (IV-UAV method). The IV-UAV method enables the easy, safe and quick estimation of the velocity on the water’s surface. This method was applied in different temporary streams in Lesvos Island, Greece. The produced results show that the IV-UAV can be implemented at low discharges, at temporary streams and at small streams. However, there were many occasions that measurements were unable due to various reasons such as dense vegetation or archaeological sites. Despite of this, the proposed methodology could be incorporated in optical protocols which are used to assess the environmental status of temporary streams of Mediterranean conditions. Finally, this would become a valuable tool for understanding the dynamics of these eco-systems and monitoring changes over time.

High-power lasers play an important role in modern science, industry, and medicine. A signifi-cant milestone was reached on December 5, 2022, when Inertial Confinement Nuclear Fusion (ICF) achieved scientific breakeven, releasing more energy than the input laser energy. Additionally, Extreme Ultraviolet Lithography (EUVL) has enabled the development of microchips with 3 nm process nodes, marking a leap in semiconductor technology. These examples together with the recent achievement of a 10 PW (1015 W) laser output heralds remarkable advancements in technology and science soon. Laser systems are broadly classified based on their operating re-gimes into two main categories: Continuous Wave (CW) operation, where the laser is continuously pumped and emits a steady beam of light, and the pulsed regime, in which the laser pro-duces single or multiple pulses at various repetition rates. This review will primarily focus on pulsed laser systems, exploring their various types and recent technological advancements.