The success of incident reporting in improving safety, although obvious in aviation and other high-risk industries, is yet to be seen in health-care systems. An incident reporting system which would ...improve patient safety would allow front-end clinicians to have easy access for reporting an incident with an understanding that their report will be handled in a non-punitive manner, and that it will lead to enhanced learning regarding the causation of the incident and systemic changes which will prevent it from recurring. At present, significant problems remain with local and national incident reporting systems. These include fear of punitive action, poor safety culture in an organization, lack of understanding among clinicians about what should be reported, lack of awareness of how the reported incidents will be analysed, and how will the reports ultimately lead to changes which will improve patient safety. In particular, lack of systematic analysis of the reports and feedback directly to the clinicians are seen as major barriers to clinical engagement. In this review, robust systematic methodology of analysing incidents is discussed. This methodology is based on human factors model, and the learning paradigm which emphasizes significant shift from traditional judicial approach to understanding how ‘latent errors’ may play a role in a chain of events which can set up an ‘active error’ to occur. Feedback directly to the clinicians is extremely important for keeping them ‘in the loop’ for their continued engagement, and it should target different levels of analyses. In addition to high-level information on the types of incidents, the feedback should incorporate results of the analyses of active and latent factors. Finally, it should inform what actions, and at what level/stage, have been taken in response to the reported incidents. For this, local and national systems will be required to work in close cooperation, so that the lessons can be learnt and actions taken within an organization, and across organizations. In the UK, a recently introduced speciality-specific incident reporting system for anaesthesia aims to incorporate the elements of successful reporting system, as presented in this review, to achieve enhanced clinical engagement and improved patient safety.
Free radicals are common outcome of normal aerobic cellular metabolism. In-built antioxidant system of body plays its decisive role in prevention of any loss due to free radicals. However, imbalanced ...defense mechanism of antioxidants, overproduction or incorporation of free radicals from environment to living system leads to serious penalty leading to neuro-degeneration. Neural cells suffer functional or sensory loss in neurodegenerative diseases. Apart from several other environmental or genetic factors, oxidative stress (OS) leading to free radical attack on neural cells contributes calamitous role to neuro-degeneration. Though, oxygen is imperative for life, imbalanced metabolism and excess reactive oxygen species (ROS) generation end into a range of disorders such as Alzheimers disease, Parkinsons disease, aging and many other neural disorders. Toxicity of free radicals contributes to proteins and DNA injury, inflammation, tissue damage and subsequent cellular apoptosis. Antioxidants are now being looked upon as persuasive therapeutic against solemn neuronal loss, as they have capability to combat by neutralizing free radicals. Diet is major source of antioxidants, as well as medicinal herbs are catching attention to be commercial source of antioxidants at present. Recognition of upstream and downstream antioxidant therapy to oxidative stress has been proved an effective tool in alteration of any neuronal damage as well as free radical scavenging. Antioxidants have a wide scope to sequester metal ions involved in neuronal plaque formation to prevent oxidative stress. In addition, antioxidant therapy is vital in scavenging free radicals and ROS preventing neuronal degeneration in post-oxidative stress scenario.
This paper proposes a protection scheme which utilizes modern voltage-source converters as fast-acting current-limiting circuit breakers. This paper investigates the main challenges of detecting and ...localizing a fault, and interrupting it as quickly as possible in a multiterminal dc system. A system protection scheme consisting of smart relays associated with converters has been developed. The protection relays monitor local quantities to detect and isolate disturbances/faults. It is shown that overcurrent-based schemes can be adopted for these relays to meet the fast response requirements. The effectiveness of the proposed protection scheme is illustrated through simulations
•Metal foam based heat exchanger integrated with TEG is an effective solution for waste heat recovery.•Experimentally validated CFD model elucidates heat transfer performance of metal foam enhanced ...TEG.•Optimal mass flow rates that maximize the net electric power output are reported.•Net electric power output from TEG with metal foam is 6–8 times higher that TEG with no metal foam.
This paper focuses on harvesting heat emitted by exhaust systems efficiently using thermoelectric generators (TEGs) and converting it to electricity. In a TEG that employs gaseous working fluid, up to 80% of the thermal resistance is due to the gas side. Maximizing the energy transferred from the hot exhaust gas to the hot side of the thermoelectric modules by suitable enhancement techniques can result in an efficiency gain for the TEG. To this end, we have investigated the performance of metal foam-based heat exchangers for reducing thermal resistance of the hot side in TEGs. A computational model of the metal foam-enhanced TEG, solving for the coupled thermal and electrical energy transfer processes, was developed to investigate the enhancement in system performance for a range of metal foam porosities and pore densities, and mass flow rates of the exhaust gas. Skutterudites with multiple cofillers were selected as thermoelectric materials. The primary performance metrics that were analyzed include the electrical power output and the associated pressure drop for various inlet conditions of the exhaust gas. Based on the trade-off between the increased pumping power required to offset the increase in pressure drop, and the gain in heat transfer coefficient with increase in mass flow rate of the exhaust gas, an optimal mass flow rate that maximizes the net electric power produced by the metal foam-enhanced TEG was obtained. The results show a critical exhaust flow rate for different pore densities of metal foam beyond which the net electric power produced by the TEG is less than of the TEG with no metal foam. At this critical flow rate, the maximum net electric power produced from exhaust waste heat by metal foam enhanced TEG is 5.7 (20 PPI) to 7.8 (5 PPI) times higher than that generated by the configuration without metal foam.
Categorical neural responses underlie various forms of selection and decision-making. Such binary-like responses promote robust signaling of the winner in the presence of input ambiguity and neural ...noise. Here, we show that a 'donut-like' inhibitory mechanism in which each competing option suppresses all options except itself, is highly effective at generating categorical neural responses. It surpasses motifs of feedback inhibition, recurrent excitation, and divisive normalization invoked frequently in decision-making models. We demonstrate experimentally not only that this mechanism operates in the midbrain spatial selection network in barn owls, but also that it is necessary for categorical signaling by it. The functional pattern of neural inhibition in the midbrain forms an exquisitely structured 'multi-holed' donut consistent with this network's combinatorial inhibitory function for stimulus selection. Additionally, modeling reveals a generalizable neural implementation of the donut-like motif for categorical selection. Self-sparing inhibition may, therefore, be a powerful circuit module central to categorization.
In this paper, we present a comprehensive analytical and experimental investigation for the determination of the effective thermal conductivity (
k
e), permeability (
K) and inertial coefficient (
f) ...of high porosity metal foams. In the first part of the study, we provide an analysis for estimating the effective thermal conductivity (
k
e). Commercially available metal foams form a complex array of interconnected fibers with an irregular lump of metal at the intersection of two fibers. In our theoretical model, we represent this structure by a model consisting of a two-dimensional array of hexagonal cells where the fibers form the sides of the hexagons. The lump is taken into account by considering a circular blob of metal at the intersection. The analysis shows that
k
e depends strongly on the porosity and the ratio of the cross-sections of the fiber and the intersection. However, it has no systematic dependence on pore density. Experimental data with aluminum and reticulated vitreous carbon (RVC) foams, using air and water as fluid media are used to validate the analytical predictions.
The second part of our paper involves the determination of the permeability (
K) and inertial coefficient (
f) of these high porosity metal foams. Fluid flow experiments were conducted on a number of metal foam samples covering a wide range of porosities and pore densities in our in-house wind tunnel. The results show that
K increases with pore diameter and porosity of the medium. The inertial coefficient,
f, on the other hand, depends only on porosity. An analytical model is proposed to predict
f based on the theory of flow over bluff bodies, and is found to be in excellent agreement with the experimental data. A modified permeability model is also presented in terms of the porosity, pore diameter and tortuosity of our metal foam samples, and is shown to be in reasonable agreement with measured data.
A comprehensive study of seasonal variation of uranium distribution in groundwater of Amritsar, Gurdaspur and Pathankot districts of Punjab, India and assessment of associated radiological risks, ...chemical risks and effective radiation dose for different age groups, was conducted to determine its health impact on humans residing in these regions. Physicochemical parameters such as pH, EC, TDS, total hardness and contents of various anions such as carbonates/bicarbonates, chlorides, fluorides, nitrates, sulphates and phosphates in groundwater were also analysed to determine correlation between groundwater chemistry and uranium distribution. The average values of uranium concentration in ground water samples of Amritsar, Gurdaspur and Pathankot districts were found to be 8.6 μg L−1, 4.3 μg L−1 and 3.0 μg L−1, respectively, in pre-monsoon and 8.8 μg L−1, 4.9 μg L−1 and 3.4 μg L−1, respectively, in post-monsoon. The uranium concentration in majority of the ground water samples was found to be below the permissible limit of 30 μg L−1 recommended by World Health Organization (WHO, 2011). In all three districts, TDS, EC and bicarbonates were found to have positive correlation with observed uranium contents in both seasons. The annual effective dose due to ingestion of uranium through drinking water was found to be less than the prescribed limit of 100 μSv y−1 given by WHO (2004). Radiological and chemical toxicity risk assessment of uranium in groundwater was also carried out and found to be within the permissible values of 1.67 × 10−4 and 4.53 μg kg−1 day−1 respectively, recommended by Atomic Energy Regulatory Board (AERB, 2004).
Display omitted
•Uranium distribution in groundwater of 3 districts of Punjab was investigated.•Total 207 groundwater samples were investigated to determine uranium.•Uranium in Amritsar was higher than Gurdaspur and Pathankot districts.•Residents of Amritsar are more prone to cancer risk.
Previous efforts to report estimates of cancer incidence and mortality in India and its different parts include the National Cancer Registry Programme Reports, Sample Registration System cause of ...death findings, Cancer Incidence in Five Continents Series, and GLOBOCAN. We present a comprehensive picture of the patterns and time trends of the burden of total cancer and specific cancer types in each state of India estimated as part of the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2016 because such a systematic compilation is not readily available.
We used all accessible data from multiple sources, including 42 population-based cancer registries and the nationwide Sample Registration System of India, to estimate the incidence of 28 types of cancer in every state of India from 1990 to 2016 and the deaths and disability-adjusted life-years (DALYs) caused by them, as part of GBD 2016. We present incidence, DALYs, and death rates for all cancers together, and the trends of all types of cancers, highlighting the heterogeneity in the burden of specific types of cancers across the states of India. We also present the contribution of major risk factors to cancer DALYs in India.
8·3% (95% uncertainty interval UI 7·9–8·6) of the total deaths and 5·0% (4·6–5·5) of the total DALYs in India in 2016 were due to cancer, which was double the contribution of cancer in 1990. However, the age-standardised incidence rate of cancer did not change substantially during this period. The age-standardised cancer DALY rate had a 2·6 times variation across the states of India in 2016. The ten cancers responsible for the highest proportion of cancer DALYs in India in 2016 were stomach (9·0% of the total cancer DALYs), breast (8·2%), lung (7·5%), lip and oral cavity (7·2%), pharynx other than nasopharynx (6·8%), colon and rectum (5·8%), leukaemia (5·2%), cervical (5·2%), oesophageal (4·3%), and brain and nervous system (3·5%) cancer. Among these cancers, the age-standardised incidence rate of breast cancer increased significantly by 40·7% (95% UI 7·0–85·6) from 1990 to 2016, whereas it decreased for stomach (39·7%; 34·3–44·0), lip and oral cavity (6·4%; 0·4–18·6), cervical (39·7%; 26·5–57·3), and oesophageal cancer (31·2%; 27·9–34·9), and leukaemia (16·1%; 4·3–24·2). We found substantial inter-state heterogeneity in the age-standardised incidence rate of the different types of cancers in 2016, with a 3·3 times to 11·6 times variation for the four most frequent cancers (lip and oral, breast, lung, and stomach). Tobacco use was the leading risk factor for cancers in India to which the highest proportion (10·9%) of cancer DALYs could be attributed in 2016.
The substantial heterogeneity in the state-level incidence rate and health loss trends of the different types of cancer in India over this 26-year period should be taken into account to strengthen infrastructure and human resources for cancer prevention and control at both the national and state levels. These efforts should focus on the ten cancers contributing the highest DALYs in India, including cancers of the stomach, lung, pharynx other than nasopharynx, colon and rectum, leukaemia, oesophageal, and brain and nervous system, in addition to breast, lip and oral cavity, and cervical cancer, which are currently the focus of screening and early detection programmes.
Bill & Melinda Gates Foundation; and Indian Council of Medical Research, Department of Health Research, Ministry of Health and Family Welfare, Government of India.
We present numerical and experimental results for buoyancy-induced flows in high porosity metal foams heated from below. A Brinkman–Forchheimer-extended Darcy flow model and a semi-heuristic ...two-equation energy model obtained by relaxing the local thermal equilibrium (LTE) assumption are adopted. Experiments conducted under natural convection conditions for the same configuration are used to test the numerical model and the validity of the thermal equilibrium assumption for metal foams. Aluminum foam samples of different pore sizes (5–40 PPI) and porosities (0.89⩽
ε⩽0.97) are used to illustrate the effects of metal foam geometry on heat transfer. In addition, several metal foam–fluid combinations (aluminum–air, carbon–air, aluminum–water, and nickel–water) are used to study the heat transfer enhancement relative to the base case in which there is no metal foam but only a heated plate. Thermal dispersion effects and the effects of Darcy number on heat transfer are reported. Our results indicate that the thermal non-equilibrium model provides a superior description of heat transfer in metal foams, especially in the presence of fluid–porous interfaces.
Pectinases are the growing enzymes of biotechnological sector, showing gradual increase in their market. They hold a leading position among the commercially produced industrial enzymes. These enzymes ...are ecofriendly tool of nature that are being used extensively in various industries like wine industry; food industry; paper industry for bleaching of pulp and waste paper recycling; in the processing of fruit–vegetables, tea–coffee, animal feed; extraction of vegetable oil and scouring of plant fibres. Moreover, enzymatic catalysis is preferred over other chemical methods, since it is more specific, less aggressive and saves energy. This is the review which covers the information available on the applicability potential of this group of enzymes in various sectors.
PDF
