Analysis of friction factor reduction in turbulent water flow using a superhydrophobic coating

This study provides experimental and theoretical evidence that the coating of the inner surface of copper pipes with superhydrophobic (SH) materials induces a Cassie state flow regime on the flow of water. This results in an increase in the fluid's dimensionless velocity distribution coefficient, a, which gives rise to an increase in the apparent Reynolds number, which may approach the "plug flow state". Experimental evidence from the SH coating of a classic unsteady-state flow system resulted in a significant decrease in the friction factor and associated energy loss. The friction factor decrease can be attributed to an increase in the apparent Reynolds number. The study demonstrates that the Cassie effects imposed by SH coating can be quantitatively shown to decrease the frictional resistance to flow in commercial pipes.

Comparison of DES predictions of turbulent flow and heat transfer in a 45° ribbed duct

Numerical predictions of the turbulent flow and heat transfer of a stationary duct with square ribs 45° angled to the main flow direction are presented. The rib height to channel hydraulic diameter is 0.1, the rib pitch to rib height is 10. The calculations have been carried out for a bulk Reynolds number of 50,000. The flows generated by ribs are dominated by separating and reattaching shear layers with vortex shedding and secondary flows in the cross-section. The hybrid RANS-LES approach is adopted to simulate such flows at a reasonable computation cost. The capability of the various versions of DES method, depending the RANS model, such as DES-SA, DES-RKE, DES-SST, have been compared and validated against the experiment. The significant effect of RANS model on the accuracy of the DES prediction has been shown. The DES-SST method, which was able to reproduce the correct physics of flow and heat transfer in a ribbed duct showed better performance than others.

Intraclonal heterogeneity is a critical early event in the development of myeloma and precedes the development of clinical symptoms.

The mechanisms involved in the progression from monoclonal gammopathy of undetermined significance (MGUS) and smoldering myeloma (SMM) to malignant multiple myeloma (MM) and plasma cell leukemia (PCL) are poorly understood but believed to involve the sequential acquisition of genetic hits. We performed exome and whole-genome sequencing on a series of MGUS (n=4), high-risk (HR)SMM (n=4), MM (n=26) and PCL (n=2) samples, including four cases who transformed from HR-SMM to MM, to determine the genetic factors that drive progression of disease. The pattern and number of non-synonymous mutations show that the MGUS disease stage is less genetically complex than MM, and HR-SMM is similar to presenting MM. Intraclonal heterogeneity is present at all stages and using cases of HR-SMM, which transformed to MM, we show that intraclonal heterogeneity is a typical feature of the disease. At the HR-SMM stage of disease, the majority of the genetic changes necessary to give rise to MM are already present. These data suggest that clonal progression is the key feature of transformation of HR-SMM to MM and as such the invasive clinically predominant clone typical of MM is already present at the SMM stage and would be amenable to therapeutic intervention at that stage.

Conservative fluid management or deresuscitation for patients with sepsis or acute respiratory distress syndrome following the resuscitation phase of critical illness: a systematic review and meta-analysis

Background

It is unknown whether a conservative approach to fluid administration or deresuscitation (active removal of fluid using diuretics or renal replacement therapy) is beneficial following haemodynamic stabilisation of critically ill patients.

Purpose

To evaluate the efficacy and safety of conservative or deresuscitative fluid strategies in adults and children with acute respiratory distress syndrome (ARDS), sepsis or systemic inflammatory response syndrome (SIRS) in the post-resuscitation phase of critical illness.

Methods

We searched Medline, EMBASE and the Cochrane central register of controlled trials from 1980 to June 2016, and manually reviewed relevant conference proceedings from 2009 to the present. Two reviewers independently assessed search results for inclusion and undertook data extraction and quality appraisal. We included randomised trials comparing fluid regimens with differing fluid balances between groups, and observational studies investigating the relationship between fluid balance and clinical outcomes.

Results

Forty-nine studies met the inclusion criteria. Marked clinical heterogeneity was evident. In a meta-analysis of 11 randomised trials (2051 patients) using a random-effects model, we found no significant difference in mortality with conservative or deresuscitative strategies compared with a liberal strategy or usual care [pooled risk ratio (RR) 0.92, 95 % confidence interval (CI) 0.82–1.02, I2 = 0 %]. A conservative or deresuscitative strategy resulted in increased ventilator-free days (mean difference 1.82 days, 95 % CI 0.53–3.10, I2 = 9 %) and reduced length of ICU stay (mean difference −1.88 days, 95 % CI −0.12 to −3.64, I2 = 75 %) compared with a liberal strategy or standard care.

Conclusions

In adults and children with ARDS, sepsis or SIRS, a conservative or deresuscitative fluid strategy results in an increased number of ventilator-free days and a decreased length of ICU stay compared with a liberal strategy or standard care. The effect on mortality remains uncertain. Large randomised trials are needed to determine optimal fluid strategies in critical illness.