Multicentre randomised control trial comparing real time teledermatology with conventional outpatient dermatological care:societal cost-benefit analysis

Comparison of real time teledermatology with outpatient dermatology in terms of clinical outcomes, cost-benefits, and patient reattendance.

Detached-Eddy Simulation of a Louver-Cooling Scheme for Turbine Blades

The performance of a louver-cooling scheme on a flat plate was analyzed using a detached-eddy-simulation turbulence model. It was assumed that the louver-cooling scheme was tested in a wind tunnel with the mainstream flow velocity of 20 m/s, equivalent to a Reynolds number of 16,200, based on the jet diameter. Turbulence closure was achieved by a realizable k-e-based detached-eddy-simulation turbulence model. Solutions of two blowing ratios of 0.5 and 1 were successfully obtained by running parallel on 16 nodes on a computer cluster. The flowfields were found to be highly unsteady and oscillatory in nature, with the maximum fluctuation of the adiabatic effectiveness as high as 15% of the time-averaged value. It is shown that the fluctuations in the adiabatic effectiveness are mainly caused by the spanwise fluctuation of the coolant jet and the unsteady vortical structures created by the interaction of the jet and the mainstream.

Unsteady Simulations of a Film Cooling Flow from an Inclined Cylindrical Jet

Film cooling is extensively used to provide protection against the severe thermal environment in gas turbine engines. Most of the computational studies on film cooling flow have been done using steady Reynolds-averaged Navier–Stokes calculation procedures. However, the flowfield associated with a jet in a crossflow is highly unsteady and complex with different types of vortical structures. In this paper, a computational investigation about the unsteady phenomena of a jet in a crossflow is performed using detached eddy simulation. Detailed computation of a single row of 35 deg round holes on a flat plate has been obtained for a 1.0 blowing ratio and a 2.0 density ratio. First, time-step size, grid resolution, and computational domain tests for an unsteady simulation have been conducted. Comparison between the results of unsteady Reynolds-averaged Navier–Stokes calculation, detached eddy simulation, and large eddy simulation is also performed. Comparison of the time-averaged detached eddy simulation prediction with the measured film-cooling effectiveness shows that the detached eddy simulation prediction is reasonable. From present detached eddy simulations, the influential coherent vortical structures of a film cooling flow can be seen. The unsteady physics of jet in a crossflow interactions and a jet liftoff in film cooling flows have been explained.

Numerical Study of Film Cooling Scheme on a Blunt-Nosed Body in Hypersonic Flow

In hypersonic flight, the prediction of aerodynamic heating and the construction of a proper thermal protection system (TPS) are significantly important. In this study, the method of a film cooling technique, which is already the state of the art in cooling of gas turbine engines, is proposed for a fully reusable and active TPS. Effectiveness of the film cooling scheme to reduce convective heating rates for a blunt-nosed spacecraft flying at Mach number 6.56 and 40 deg angle of attack is investigated numerically. The inflow boundary conditions used the standard values at an altitude of 30 km. The computational domain consists of infinite rows of film cooling holes on the bottom of a blunt-nosed slab. Laminar and several turbulent calculations have been performed and compared. The influence of blowing ratios on the film cooling effectiveness is investigated. The results exhibit that the film cooling technique could be an effective method for an active cooling of blunt-nosed bodies in hypersonic flows.

Numerical study of film cooling scheme on a blunt-nosed body in hypersonic flow

In hypersonic flights, the prediction of aerodynamic heating and the construction of a proper thermal protection system (TPS) are significantly important. In this study, the method of a film cooling technique, which is already the state of the art in cooling gas turbine engine, is proposed for a fully reusable and active TPS. Effectiveness of the film cooling scheme to reduce convective heating rates for a blunt nosed spacecraft flying at Mach number 6.56 and 40 degree angle of attack is investigated numerically. The inflow boundary conditions used the standard values at an altitude of 30 km. Computational domain consists of infinite rows of film cooling holes on the bottom of a blunt-nosed slab. Laminar and several turbulent calculations have been performed and compared each other. The influence of blowing ratios on the film cooling effectiveness is investigated. The results exhibit that the film cooling technique could be an effective method for an active cooling of blunt-nosed bodies in hypersonic flows.

Conjugate heat transfer and film cooling of a multi-stage cooling scheme

Cooling techniques play a key role in improving efficiency and power output of modern gas turbines. The conjugate technique of film and impingement cooling schemes is considered in this study. The Multi-Stage Cooling Scheme (MSCS) involves coolant passing from inside to outside turbine blade through two stages. The first stage; the coolant passes through first hole to internal gap where the impinging jet cools the external layer of the blade. Finally, the coolant passes through the internal gap to the second hole which has specific designed geometry for external film cooling. The effect of design parameters, such as, offset distance between two-stage holes, gap height, and inclination angle of the first hole, on upstream conjugate heat transfer rate and downstream film cooling effectiveness performance are investigated computationally. An Inconel 617 alloy with variable properties is selected for the solid material. The conjugate heat transfer and film cooling characteristics of MSCS are analyzed across blowing ratios of Br = 1 and 2 for density ratio, 2. This study presents upstream wall temperature distributions due to conjugate heat transfer for different gap design parameters. The maximum film cooling effectiveness with upstream conjugate heat transfer is less than adiabatic film cooling effectiveness by 24–34%. However, the full coverage of cooling effectiveness in spanwise direction can be obtained using internal cooling with conjugate heat transfer, whereas adiabatic film cooling effectiveness has narrow distribution.

Unsteady heat transfer analysis of a film cooling flow

Unsteady heat transfer in a turbine blade film cooling flow is studied using detached eddy simulation (DES). Detailed computation of a single row of 35 degree round holes on a flat plate has been obtained for a blowing ratio of 1.0 and a density ratio of 2.0. The instantaneous flow fields and heat transfer distributions are found to be highly unsteady and oscillatory in nature. The fluctuation of the adiabatic effectiveness and heat transfer coefficient, for example, can be as high as 15 and 50 percent of the time-averaged value, respectively. The correlation between the coherent vortical structures and the unsteady heat transfer is carefully examined. It is shown that the fluctuations in the adiabatic effectiveness and heat transfer coefficient are mainly caused by the spanwise fluctuation of the coolant jet and the thermal turbulent boundary layer accompanying the unsteady flow structures.

The In Vitro Susceptibility of Biofilm Forming Medical Device Related Pathogens to Conventional Antibiotics

Minimum inhibitory concentration (MIC), minimum bactericidal concentration (MBC), and minimum biofilm eradication concentration (MBEC) and kill kinetics were established for vancomycin, rifampicin, trimethoprim, gentamicin, and ciprofloxacin against the biofilm forming bacteria Staphylococcus epidermidis (ATCC 35984), Staphylococcus aureus (ATCC 29213), Methicillin Resistant Staphylococcus aureus (MRSA) (ATCC 43300), Pseudomonas aeruginosa (PAO1), and Escherichia coli (NCTC 8196). MICs and MBCs were determined via broth microdilution in 96-well plates. MBECs were studied using the Calgary Biofilm Device. Values obtained were used to investigate the kill kinetics of conventional antimicrobials against a range of planktonic and biofilm microorganisms over a period of 24 hours. Planktonic kill kinetics were determined at 4xMIC and biofilm kill kinetics at relative MBECs. Susceptibility of microorganisms varied depending on antibiotic selected and phenotypic form of bacteria. Gram-positive planktonic isolates were extremely susceptible to vancomycin (highest MBC: 7.81 mg L−1: methicillin sensitive and resistant S. aureus) but no MBEC value was obtained against all biofilm pathogens tested (up to 1000 mg L−1). Both gentamicin and ciprofloxacin displayed the broadest spectrum of activity with MIC and MBCs in the mg L−1 range against all planktonic isolates tested and MBEC values obtained against all but S. epidermidis (ATCC 35984) and MRSA (ATCC 43300).

Assessment of a zoomed global model for the North Sea by comparison with a conventional nested regional model

Assessment of marine downscaling of global model simulations to the regional scale is a prerequisite for understanding ocean feedback to the atmosphere in regional climate downscaling. Major difficulties arise from the coarse grid resolution of global models, which cannot provide sufficiently accurate boundary values for the regional model. In this study, we first setup a stretched global model (MPIOM) to focus on the North Sea by shifting poles. Second, a regional model (HAMSOM) was performed with higher resolution, while the open boundary values were provided by the stretched global model. In general, the sea surface temperatures (SSTs) in the two experiments are similar. Major SST differences are found in coastal regions (root mean square difference of SST is reaching up to 2°C). The higher sea surface salinity in coastal regions in the global model indicates the general limitation of this global model and its configuration (surface layer thickness is 16 m). By comparison, the advantage of the absence of open lateral boundaries in the global model can be demonstrated, in particular for the transition region between the North Sea and Baltic Sea. On long timescales, the North Atlantic Current (NAC) inflow through the northern boundary correlates well between both model simulations (R~0.9). After downscaling with HAMSOM, the NAC inflow through the northern boundary decreases by ~10%, but the circulation in the Skagerrak is stronger in HAMSOM. The circulation patterns of both models are similar in the northern North Sea. The comparison suggests that the stretched global model system is a suitable tool for long-term free climate model simulations, and the only limitations occur in coastal regions. Regarding the regional studies focusing on the coastal zone, nested regional model can be a helpful alternative.

Energy balance of SRC willow used for managing farmyard washings - how does it compare to a conventional wastewater treatment works?

The water and wastewater industry in the UK accounts for around 3% of total energy use and just over 1% of total UK greenhouse gas emissions. Targets for greenhouse gas emissions reduction and higher renewable energy penetration, coupled with rising energy costs, growing demand for wastewater services and tightening EU water quality requirements, have led to an increased interest in alternative wastewater treatment methods. The use of short rotation coppice (SRC) willow for the treatment of wastewater effluent is one such alternative, which brings with it the dual benefits of wastewater treatment and production of biomass for energy. In order to assess the effectiveness of SRC willow, it is important to analyse the overall energy balance in terms of energy input versus energy output. This paper carries out an energy life cycle analysis of a specific SRC willow plantation in Northern Ireland to which farmyard washings (dirty water) are applied. The system boundaries include the establishment, maintenance, and harvesting of the plantation, along with the transport and drying of the wood for biomass combustion. The analysis shows that the overall energy balance is positive, and that the direct and indirect energy demands are 12% and 8% of gross energy production respectively. The energy demands of the plantation are compared with the energy required to treat an equivalent nutrient load in a conventional wastewater treatment plant. While a conventional plant consumes 2.6 MJ/m3 , the irrigation system consumes 1.6 MJ/m3 and the net energy production of the scenario is 48 MJ/m3 .

Conventional in vivo irradiation procedures are insufficient to accurately determine tumor responses to non-uniform radiation fields

Purpose: To determine differences in overall tumor responses measured by volumetric assessment and bioluminescence imaging (BLI) following exposure to uniform and non-uniform radiation fields in an ectopic prostate tumor model.

Materials and methods: Bioluminescent human prostate tumor xenografts were established by subcutaneous implantation into male mice. Tumors were irradiated with uniform or non-uniform field configurations using conventional in vivo irradiation procedures performed using a 225 kVp generator with custom lead shielding. Tumor responses were measured using Vernier calipers and by BLI using an in vivo imaging system. Survival was defined as the time to quadroupling of pre-treatment tumor volume. 

Results: The correlation between BLI and tumor volume measurements was found to be different for un-irradiated (R = 0.61), uniformly irradiated (R = 0.34) and partially irradiated (R = 0.30) tumors. Uniformly irradiated tumors resulted in an average tumor growth delay of 60 days with median survival of 75 days, compared to partially irradiated tumors which showed an average growth delay of 24 days and median survival of 38 days. 

Conclusions: Correlation between BLI and tumor volume measurements is lower for partially irradiated tumors than those exposed to uniform dose distributions. The response of partially irradiated tumors suggests non-uniformity in response beyond physical dose distribution within the target volume. Dosimetric uncertainty associated with conventional in vivo irradiation procedures prohibits their ability to accurately determine tumor response to non-uniform radiation fields and stresses the need for image guided small animal radiation research platforms.

Rapid quantification of microRNAs in plasma using a fast real time PCR system

The ability to rapidly detect circulating small RNAs, in particular microRNAs (miRNAs), would further increase their already established potential as biomarkers in a range of conditions. One rate-limiting factor is the time taken to perform quantitative real time PCR amplification. We therefore evaluated the ability of a novel thermal cycler to perform this step in less than 10 minutes. Quantitative PCR was performed on an xxpress® thermal cycler (BJS Biotechnologies, Perivale, UK), which employs a resistive heating system and forced air cooling to achieve thermal ramp rates of 10 °C/s, and a conventional peltier-controlled LightCycler 480 system (Roche, Basel, Switzerland) ramping at 4.8 °C/s. The threshold cycle (Ct) for detection of 18S rDNA from a standard genomic DNA sample was significantly more variable across the block (F-test, p=2.4x10-25) for the xxpress (20.01±0.47SD) than the LightCycler (19.87±0.04SD). RNA was extracted from human plasma, reverse transcribed and a panel of miRNAs amplified and detected using SYBR green (Kapa Biosystems, Wilmington, Ma, USA). The sensitivity of both systems was broadly comparable and both detected a panel of miRNAs reliably and indicated similar relative abundances. The xxpress thermal cycler facilitates rapid qPCR detection of small RNAs and brings point-of care diagnostics based upon circulating miRNAs a step closer to reality.

Evaluating Asymmetric Multicore Systems-on-Chip using Iso-Metrics

The end of Dennard scaling has pushed power consumption into a first order concern for current systems, on par with performance. As a result, near-threshold voltage computing (NTVC) has been proposed as a potential means to tackle the limited cooling capacity of CMOS technology. Hardware operating in NTV consumes significantly less power, at the cost of lower frequency, and thus reduced performance, as well as increased error rates. In this paper, we investigate if a low-power systems-on-chip, consisting of ARM's asymmetric big.LITTLE technology, can be an alternative to conventional high performance multicore processors in terms of power/energy in an unreliable scenario. For our study, we use the Conjugate Gradient solver, an algorithm representative of the computations performed by a large range of scientific and engineering codes.