Effect of heat and moisture exchangers on the prevention of ventilator-associated pneumonia in critically ill patients

Ventilator-associated pneumonia (VAP) remains one of the major causes of infection in the intensive care unit (ICU) and is associated with the length of hospital stay, duration of mechanical ventilation, and use of broad-spectrum antibiotics. We compared the frequency of VAP 10 months prior to (pre-intervention group) and 13 months after (post-intervention group) initiation of the use of a heat and moisture exchanger (HME) filter. This is a study with prospective before-and-after design performed in the ICU in a tertiary university hospital. Three hundred and fourteen patients were admitted to the ICU under mechanical ventilation, 168 of whom were included in group HH (heated humidifier) and 146 in group HME. The frequency of VAP per 1000 ventilator-days was similar for both the HH and HME groups (18.7 vs 17.4, respectively; P = 0.97). Duration of mechanical ventilation (11 vs 12 days, respectively; P = 0.48) and length of ICU stay (11 vs 12 days, respectively; P = 0.39) did not differ between the HH and HME groups. The chance of developing VAP was higher in patients with a longer ICU stay and longer duration of mechanical ventilation. This finding was similar when adjusted for the use of HME. The use of HME in intensive care did not reduce the incidence of VAP, the duration of mechanical ventilation, or the length of stay in the ICU in the study population.

Surface ecophysiological behavior across vegetation and moisture gradients in tropical South America

Surface ecophysiology at five sites in tropical South America across vegetation and moisture gradients is investigated. From the moist northwest (Manaus) to the relatively dry southeast (Pé de Gigante, state of São Paulo) simulated seasonal cycles of latent and sensible heat, and carbon flux produced with the Simple Biosphere Model (SiB3) are confronted with observational data. In the northwest, abundant moisture is available, suggesting that the ecosystem is light-limited. In these wettest regions, Bowen ratio is consistently low, with little or no annual cycle. Carbon flux shows little or no annual cycle as well; efflux and uptake are determined by high-frequency variability in light and moisture availability. Moving downgradient in annual precipitation amount, dry season length is more clearly defined. In these regions, a dry season sink of carbon is observed and simulated. This sink is the result of the combination of increased photosynthetic production due to higher light levels, and decreased respiratory efflux due to soil drying. The differential response time of photosynthetic and respiratory processes produce observed annual cycles of net carbon flux. In drier regions, moisture and carbon fluxes are in-phase; there is carbon uptake during seasonal rains and efflux during the dry season. At the driest site, there is also a large annual cycle in latent and sensible heat flux.

Inactivation of Neosartorya fischeri and Paecilomyces variotii on paperboard packaging material by hydrogen peroxide and heat

This study reports on the influence of heat and hydrogen peroxide combination on the inactivation kinetics of two heat resistant molds: Neosartorya fischeri and Paecilomyces variotii. Spores of different ages (1 and 4 months) of these molds were prepared and D-values (the time required at certain temperature/hydrogen peroxide combination to inactivate 90% of the mold ascospores) were determined using thermal death tubes. D-values found for P. variotii ranged from 1.2 to 25.1 s after exposure to different combinations of heat (40 or 60 degrees C) and hydrogen peroxide (35 or 40% w/w) while for N. fischeri they varied from 2.7 to 14.3 s after exposure to the same hydrogen peroxide concentrations and higher temperatures (60 or 70 degrees C). The influence of temperature and hydrogen peroxide concentration on the d-values varied with the genus of mold and their ages. A synergistic effect of heat and hydrogen peroxide in reducing D-values of Paecilomyces variotti and N. fischeri has been observed. In addition to strict control of temperature, time and hydrogen concentration, hygienic storage and handling of laminated paperboard material must be considered to reduce the probability of package's contamination. All these measures together will ensure package's sterility that is imperative for the effectiveness of aseptic processing and consequently to ensure the microbiological stability of processed foods during shelf-life. (C) 2011 Elsevier Ltd. All rights reserved.

Saturated flow boiling heat transfer and critical heat flux in small horizontal flattened tubes

This paper presents experimental results for flow boiling heat transfer coefficient and critical heat flux (CHF) in small flattened tubes. The tested flattened tubes have the same equivalent internal diameter of 2.2 mm, but different aspect height/width ratios (H/W) of 1/4, 1/2, 2 and 4. The experimental data were compared against results for circular tubes using R134a and R245fa as working fluids at a nominal saturation temperature of 31 degrees C. For mass velocities higher than 200 kg/m(2)s, the flattened and circular tubes presented similar heat transfer coefficients. Such a behavior is related to the fact that stratification effects are negligible under conditions of higher mass velocities. Heat transfer correlations from the literature, usually developed using only circular-channel experimental data, predicted the flattened tube results for mass velocities higher than 200 kg/m(2)s with mean absolute error lower than 20% using the equivalent diameter to account for the geometry effect. Similarly, the critical heat flux results were found to be independent of the tube aspect ratio when the same equivalent length was kept. Equivalent length is a new parameter which takes into account the channel heat transfer area. The CHF correlations for round tubes predicted the flattened tube data relatively well when using the equivalent diameter and length. Furthermore, a new proposed CHF correlation predicted the present flattened tube data with a mean absolute error of 5%. (C) 2012 Elsevier Ltd. All rights reserved.

Occurrence of molds on laminated paperboard for aseptic packaging, selection of the most hydrogen peroxide- and heat-resistant isolates and determination of their thermal death kinetics in sterile distilled water

This study aimed at enumerating molds (heat-labile and heat-resistant) on the surface of paperboard material to be filled with tomato pulps through an aseptic system and at determining the most heat-and hydrogen peroxide-resistant strains. A total of 118 samples of laminated paperboard before filling were collected, being 68 before and 50 after the hydrogen peroxide bath. Seven molds, including heat-resistant strains (Penicillium variotii and Talaromyces flavus) with counts ranging between 0.71 and 1.02 CFU/cm(2) were isolated. P. variotii was more resistant to hydrogen peroxide than T. flavus and was inactivated after heating at 85 degrees C/15 min. When exposed to 35 % hydrogen peroxide at 25 degrees C, T. flavus (F5E2) and N. fischeri (control) were less resistant than P. variotti (F1A1). P. citrinum (F7E2) was shown to be as resistant as P. variotti. The D values (the time to cause one logarithmic cycle reduction in a microbial population at a determined temperature) for spores of P. variotii (F1A1) and N. fischeri (control) with 4 months of age at 85 and 90 degrees C were 3.9 and 4.5 min, respectively. Although the contamination of packages was low, the presence of heat-and chemical-resistant molds may be of concern for package sterility and product stability during shelf-life. To our knowledge, this is the first report that focuses on the isolation of molds, including heat-resistant ones, contaminating paperboard packaging material and on estimating their resistance to the chemical and physical processes used for packaging sterilization.

Influence of moisture and plaque on the performance of a laser fluorescence device in detecting caries lesions in primary teeth

The aim of this study was to evaluate the influence of dental plaque and moisture on performance of a laser fluorescence device in detecting occlusal and proximal caries lesions in primary teeth. Fifty-five occlusal and 58 proximal sites on primary molars were evaluated using a DIAGNOdent pen (LFpen) device. For the drying time study, the evaluations were performed in: (I) moist teeth; (II) teeth dried for 3 s, or (III) dried for 15 s. For the plaque study, the evaluations were done in sites: (I) without plaque; (II) with plaque, and (III) after cleaning. Evaluation of the teeth sections in stereomicroscope was the reference standard method. LF pen values, sensitivity, specificity, and accuracy were compared. The values obtained after 15 s of drying were higher than those obtained with moist teeth or dried for 3 s at both occlusal and proximal surfaces. However, there was no change in the performance in detecting caries lesions. With regard to the presence of plaque, there was no significant change in the readings of the device, but specificity was decreased in occlusal surfaces with plaque. At proximal surfaces, however, no significant differences were observed. In conclusion, the moisture conditions do not influence significantly the performance of the LFpen, but the presence of plaque can affect its performance in detecting occlusal caries lesions in primary teeth.

Bamboo overabundance alters forest structure and dynamics in the Atlantic Forest hotspot

With fast growth rates and clonal reproduction, bamboos can rapidly invade forest areas, drastically changing their original structure. In the Brazilian Atlantic Forest, where recent mapping efforts have shown that woody bamboos dominate large areas, the present study assessed the differences in soil and vegetation between plots dominated (>90% of bamboo coverage) and not dominated (<10% of coverage) by the native Guadua tagoara. Surface soil was physically and chemically analyzed, and trees at three size classes (seedling, sapling, and adult) were counted, identified and measured. New inventories were conducted to assess recruitment, mortality, and damage rates. Bamboo plots had more fertile soils (higher bases saturation and lower potential acidity) due to the preferential occurrence of G. tagoara on more clayey soils. Bamboo-dominated plots had lower density of adult trees (diameter >5 cm) and lower species density. In addition, overall tree diameter distribution was very different between environments, with bamboo plots having greater concentration of small-sized trees. Such differences are probably related to the general tendency of higher mortality, recruitment, and damage rates in bamboo plots. Greater physical (wind and bamboo-induced damages) and physiological stress (heat and light) in bamboo plots are probable causes of bamboo-dominated plots being more dynamic. Finally, we discuss the differences between Atlantic and Amazonian Guadua-dominated forests, causes, and possible consequences of bamboo overabundance to the Atlantic Forest conservation. (C) 2012 Elsevier Ltd. All rights reserved.

A heat transfer model of the human upper limbs

A steady state multi-segmented heat transfer model of the human upper limbs was developed. The main purpose was to evaluate the impact of blood flow through superficial veins and subcutaneous vascular structures in the palm of the hands over the heat transfer between the limbs and the environment. The distinguishing feature of the model is the inclusion of a detailed circulatory network composed of vessels with diameter larger than 1 mm. The model was validated by comparing its results from exposures to a hot, a neutral, and a cold environment to experimental data presented in the literature. (C) 2011 Elsevier Ltd. All rights reserved.

Modeling of continuous thermal processing of a non-Newtonian liquid food under diffusive laminar flow in a tubular system

The classic conservative approach for thermal process design can lead to over-processing, especially for laminar flow, when a significant distribution of temperature and of residence time occurs. In order to optimize quality retention, a more comprehensive model is required. A model comprising differential equations for mass and heat transfer is proposed for the simulation of the continuous thermal processing of a non-Newtonian food in a tubular system. The model takes into account the contribution from heating and cooling sections, the heat exchange with the ambient air and effective diffusion associated with non-ideal laminar flow. The study case of soursop juice processing was used to test the model. Various simulations were performed to evaluate the effect of the model assumptions. An expressive difference in the predicted lethality was observed between the classic approach and the proposed model. The main advantage of the model is its flexibility to represent different aspects with a small computational time, making it suitable for process evaluation and design. (C) 2012 Elsevier Ltd. All rights reserved.

Functional properties of gelatin-based films containing Yucca schidigera extract produced via casting, extrusion and blown extrusion processes: A preliminary study

Gelatin-based films containing both Yucca schidigera extract and low concentrations of glycerol (0.25-8.75 g per 100 g protein) were produced by extrusion (EF) and characterized in relation to their mechanical properties and moisture content. The formulations that resulted in either larger or smaller elongation values were used to produce films via both blown extrusion (EBF) and casting (CF) and were characterized with respect to their mechanical properties, water vapor permeability, moisture content, solubility, morphology and infrared spectroscopy. The elongation of the EF films was significantly higher than that of the CF and EBF films. The transversal section possessed a compact, homogeneous structure for all of the films studied. The solubility of the films (36-40%) did not differ significantly between the different processes evaluated. The EBF films demonstrated lower water vapor permeability (0.12 g mm m-(2) h(-1) kPa(-1)) than the CF and EF films. The infrared spectra did not indicate any strong interactions between the added compounds. Thermoplastic processing of the gelatin films can significantly increase their elongation; however, a more detailed assessment and optimization of the extrusion conditions is necessary, along with the addition of partially hydrophobic compounds, such as surfactants. (C) 2012 Elsevier Ltd. All rights reserved.

Development of heat sink device by using topology optimization

Small scale fluid flow systems have been studied for various applications, such as chemical reagent dosages and cooling devices of compact electronic components. This work proposes to present the complete cycle development of an optimized heat sink designed by using Topology Optimization Method (TOM) for best performance, including minimization of pressure drop in fluid flow and maximization of heat dissipation effects, aiming small scale applications. The TOM is applied to a domain, to obtain an optimized channel topology, according to a given multi-objective function that combines pressure drop minimization and heat transfer maximization. Stokes flow hypothesis is adopted. Moreover, both conduction and forced convection effects are included in the steady-state heat transfer model. The topology optimization procedure combines the Finite Element Method (to carry out the physical analysis) with Sequential Linear Programming (as the optimization algorithm). Two-dimensional topology optimization results of channel layouts obtained for a heat sink design are presented as example to illustrate the design methodology. 3D computational simulations and prototype manufacturing have been carried out to validate the proposed design methodology.