The costs arising from pressure ulcers attributable to malnutrition

Aim To estimate the economic consequences of pressure ulcers attributable to malnutrition. Method Statistical models were developed to predict the number of cases of pressure ulcer, associated bed days lost and the dollar value of these losses in public hospitals in 2002/2003 in Queensland, Australia. The following input parameters were specified and appropriate probability distributions fitted • Number of at risk discharges per annum • Incidence rate for pressure ulcer • Attributable fraction of malnutrition in the development of pressure ulcer • Independent effect of pressure ulcer on length of hospital stay • Opportunity cost of hospital bed day One thousand random re-samples were made and the results expressed as (output) probabilistic distributions. Results The model predicts a mean 16060 (SD 5 671) bed days lost and corresponding mean economic cost of AU$12 968 668 (SD AU$4 924 148) (EUROS 6 925 268 SD 2 629 495; US$ 7 288 391 SD 2 767 371) of pressure ulcer attributable to malnutrition in 2002/2003 in public hospitals in Queensland, Australia. Conclusion The cost of pressure ulcer attributable to malnutrition in bed days and dollar terms are substantial. The model only considers costs of increased length of stay associated with pressure ulcer and not other factors associated with care.

Cost effectiveness of nutrition support in the prevention of pressure ulcer in hospitals

Background/objectives This study estimates the economic outcomes of a nutrition intervention to at-risk patients compared with standard care in the prevention of pressure ulcer. Subjects/methods Statistical models were developed to predict ‘cases of pressure ulcer avoided’, ‘number of bed days gained’ and ‘change to economic costs’ in public hospitals in 2002–2003 in Queensland, Australia. Input parameters were specified and appropriate probability distributions fitted for: number of discharges per annum; incidence rate for pressure ulcer; independent effect of pressure ulcer on length of stay; cost of a bed day; change in risk in developing a pressure ulcer associated with nutrition support; annual cost of the provision of a nutrition support intervention for at-risk patients. A total of 1000 random re-samples were made and the results expressed as output probability distributions. Results The model predicts a mean 2896 (s.d. 632) cases of pressure ulcer avoided; 12 397 (s.d. 4491) bed days released and corresponding mean economic cost saving of euros 2 869 526 (s.d. 2 078 715) with a nutrition support intervention, compared with standard care. Conclusion Nutrition intervention is predicted to be a cost-effective approach in the prevention of pressure ulcer in at-risk patients.

Atmospheric-pressure plasma jets : effect of gas flow, active species, and snake-like bullet propagation

Cold atmospheric-pressure plasma jets have recently attracted enormous interest owing to numerous applications in plasma biology, health care, medicine, and nanotechnology. A dedicated study of the interaction between the upstream and downstream plasma plumes revealed that the active species (electrons, ions, excited OH, metastable Ar, and nitrogen-related species) generated by the upstream plasma plume enhance the propagation of the downstream plasma plume. At gas flows exceeding 2 l/min, the downstream plasma plume is longer than the upstream plasma plume. Detailed plasma diagnostics and discharge species analysis suggest that this effect is due to the electrons and ions that are generated by the upstream plasma and flow into the downstream plume. This in turn leads to the relatively higher electron density in the downstream plasma. Moreover, high-speed photography reveals a highly unusual behavior of the plasma bullets, which propagate in snake-like motions, very differently from the previous reports. This behavior is related to the hydrodynamic instability of the gas flow, which results in non-uniform distributions of long-lifetime active species in the discharge tube and of surface charges on the inner surface of the tube.

Transitional intermittency in boundary layers subjected to pressure gradient

Results are reported from an extensive series of experiments on boundary layers in which the location of pressure gradient and transition onset could be varied almost independently, by judicious use of tunnel wall liners and transition-fixing devices. The experiments show that the transition zone is sensitive to the pressure gradient especially near onset, and can be significantly asymmetric; no universal similarity appears valid in general. Observed intermittency distributions cannot be explained on the basis of the hypothesis, often made, that the spot propagates at speeds proportional to the local free-stream velocity but is otherwise unaffected by the pressure gradient.

Dynamics of dense sheared granular flows. Part II. The relative velocity distributions

The distribution of relative velocities between colliding particles in shear flows of inelastic spheres is analysed in the Volume fraction range 0.4-0.64. Particle interactions are considered to be due to instantaneous binary collisions, and the collision model has a normal coefficient of restitution e(n) (negative of the ratio of the post- and pre-collisional relative velocities of the particles along the line joining the centres) and a tangential coefficient of restitution e(t) (negative of the ratio of post- and pre-collisional velocities perpendicular to line joining the centres). The distribution or pre-collisional normal relative velocities (along the line Joining the centres of the particles) is Found to be an exponential distribution for particles with low normal coefficient of restitution in the range 0.6-0.7. This is in contrast to the Gaussian distribution for the normal relative velocity in all elastic fluid in the absence of shear. A composite distribution function, which consists of an exponential and a Gaussian component, is proposed to span the range of inelasticities considered here. In the case of roughd particles, the relative velocity tangential to the surfaces at contact is also evaluated, and it is found to be close to a Gaussian distribution even for highly inelastic particles.Empirical relations are formulated for the relative velocity distribution. These are used to calculate the collisional contributions to the pressure, shear stress and the energy dissipation rate in a shear flow. The results of the calculation were round to be in quantitative agreement with simulation results, even for low coefficients of restitution for which the predictions obtained using the Enskog approximation are in error by an order of magnitude. The results are also applied to the flow down an inclined plane, to predict the angle of repose and the variation of the volume fraction with angle of inclination. These results are also found to be in quantitative agreement with previous simulations.

Electron energy distributions and transport coefficients in N2 in E times B fields

Using the concept of energy-dependent effective field intensity, electron transport coefficients in nitrogen have been determined in E times B fields (E = electric field intensity, B = magnetic flux density) by the numerical solution of the Boltzmann transport equation for the energy distribution of electrons. It has been observed that as the value of B/p (p = gas pressure) is increased from zero, the perpendicular drift velocity increased linearly at first, reaches a maximum value, and then decreases with increasing B/p. In general, the electron mean energy is found to be a function of Eavet/p( Eavet = averaged effective electric field intensity) only, but the other transport coefficients, such as transverse drift velocity, perpendicular drift velocity, and the Townsend ionization coefficient, are functions of both E/p and B/p.

Effect of pressure on the ionic conductivity of Li+ and Cl- ions in water

A molecular dynamics simulation study of aqueous solution of LiCl is reported as a function of pressure. Experimental measurements of conductivity of Li+ ion as a function of pressure shows an increase in conductivity with pressure. Our simulations are able to reproduce the observed trend in conductivity. A number of relevant properties have been computed in order to understand the reasons for the increase in conductivity with pressure. These include radial distribution function, void and neck distributions, hydration or coordination numbers, diffusivity, velocity autocorrelation functions, angles between ion-oxygen and dipole of water as well as OH vector, mean residence time for water in the hydration shell, etc. These show that the increase in pressure acts as a structure breaker. The decay of the self part of the intermediate scattering function at small wave number k shows a bi-exponential decay at 1 bar which changes to single exponential decay at higher pressures. The k dependence of the ratio of the self part of the full width at half maximum of the dynamic structure factor to 2Dk(2) exhibits trends which suggest that the void structure of water is playing a role. These support the view that the changes in void and neck distributions in water can account for changes in conductivity or diffusivity of Li+ with pressure. These results can be understood in terms of the levitation effect. (C) 2012 American Institute of Physics. http://dx.doi.org/10.1063/1.4756909]

On flame-turbulence interaction in constant-pressure expanding flames

In this paper we present one of the first high-speed particle image velocimetry measurements to quantify flame-turbulence interaction in centrally-ignited constant-pressure premixed flames expanding in nearisotropic turbulence. Measurements of mean flow velocity and rms of fluctuating flow velocity are provided over a range of conditions both in the presence and absence of the flame. The distributions of stretch rate contributions from different terms such as tangential straining, normal straining and curvature are also provided. It is found that the normal straining displays non-Gaussian pdf tails whereas the tangential straining shows near Gaussian behavior. We have further tracked the motion of the edge points that reside and co-move with the edge of the flame kernel during its evolution in time, and found that within the measurement conditions, on average the persistence time scales of stretch due to pure curvature exceed that due to tangential straining by at least a factor of two. (C) 2014 The Combustion Institute. Published by Elsevier Inc. All rights reserved.

Thermally developing combined electroosmotic and pressure-driven flow of nanofluids in a microchannel under the effect of magnetic field

In the present study, the heat transfer characteristics of thermally developing magnetohydroclynamic flow of nanofluid through microchannel are delineated by following a semi analytical approach. The combined influences of pressure driven flow, electroosmotic transport and magnetic field is taken into account for the analysis of the complex microscale thermal transport processes. Solutions for the normalized temperature distributions and the Nusselt number variations, considering the simultaneous interplay of electrokinetic effects (electroosmosis), magnetic effects, Joule heating and viscous dissipation are obtained, for constant wall temperature condition. Particular attention is paid to assess the role of nanolluids in altering the transport phenomena, through variations in the effective nanoparticle volume fractions, as well as the aggregate structure of the particulate phases. It is observed that magnetohydrodynamic effect reduces advective transport of the liquid resulting in gradual reduction of heat transfer. Increase in nanoparticle volume fraction shows decrease in heat transfer. Similar effects are observed with increase in aggregate sizes of the nanoparticles. The effect of the nanofluids on system irreversibility is also studied through entropy generation analysis due to flow and heat transfer in the microchannel. Total entropy generation is found to be dominant at the thermally developing region of the microchannel, whereas it drops sharply at the thermally developed region. Presence of nanoparticles in the base fluid reduces the total entropy generation in the microchannel, thereby indicating decrease in thermodynamic irreversibility with increasing nanoparticle volume fraction. (C) 2014 Elsevier Ltd. All rights reserved.

Fully developed thermal transport in combined pressure and electroosmotically driven flow of nanofluid in a microchannel under the effect of a magnetic field

This paper critically analyzes, for the first time, the effect of nanofluid on thermally fully developed magnetohydrodynamic flows through microchannel, by considering combined effects of externally applied pressure gradient and electroosmosis. The classical boundary condition of uniform wall heat flux is considered, and the effects of viscous dissipation as well as Joule heating have been taken into account. Closed-form analytical expressions for the pertinent velocity and temperature distributions and the Nusselt number variations are obtained, in order to examine the role of nanofluids in influencing the fully developed thermal transport in electroosmotic microflows under the effect of magnetic field. Fundamental considerations are invoked to ascertain the consequences of particle agglomeration on the thermophysical properties of the nanofluid. The present theoretical formalism addresses the details of the interparticle interaction kinetics in tune with the pertinent variations in the effective particulate dimensions, volume fractions of the nanoparticles, as well as the aggregate structure of the particulate system. It is revealed that the inclusion of nanofluid changes the transport characteristics and system irreversibility to a considerable extent and can have significant consequences in the design of electroosmotically actuated microfluidic systems.

Self-consistent kinetic modeling of low-pressure inductively coupled radio-frequency discharges

An efficient method for solving the spatially inhomogeneous Boltzmann equation in a two-term approximation for low-pressure inductively coupled plasmas has been developed. The electron distribution function (EDF), a function of total electron energy and two spatial coordinates, is found self-consistently with the static space-charge potential which is computed from a 2D fluid model, and the rf electric field profile which is calculated from the Maxwell equations. The EDF and the spatial distributions of the electron density, potential, temperature, ionization rate, and the inductive electric field are calculated and discussed. (C) 1996 American Institute of Physics.

Self-consistent kinetic modeling of electron distribution function in a low-pressure inductively coupled plasma

Based upon the spatially inhomogeneous Boltzmann equation in two-term approximation coupled with electromagnetic and fluid model analysis for the recently developed inductively coupled plasma sources, a self-consistent electron kinetic model is developed. The electron distribution function, spatial distributions of the electron density and ionization rate are calculated and discussed.

Distributions of temperature, velocity and viscosity at symmetrical axis of cylindrical plume in earth's mantle with variable viscosity

The parameters at the symmetrical axis of a cylindrical plume characterize the strength of this plume and provide a boundary condition which must be given to investigate the structure of a plume. For Newtonian fluid with a temperature-and pressure-dependence viscosity, an asymptotical solution of hydrodynamic equations at the symmetrical axis of the plume is found in the present paper. The temperature, upward velocity and viscosity at the symmetrical axis have been obtained as functions of depth, The calculated results have been given for two typical sets of Newtonian rheological parameters. The results obtained show that the temperature distribution along the symmetrical axis is nearly independent of the theological parameters. The upward velocity at the symmetrical axis, however, is strongly dependent on the rheological parameters.

Modelling Study On The Plasma Flow and Heat Transfer In A Laminar Arc Plasma Torch Operating At Atmospheric and Reduced Pressure

A modelling study is performed to investigate the characteristics of both plasma flow and heat transfer of a laminar non-transferred arc argon plasma torch operated at atmospheric and reduced pressure. It is found that the calculated flow fields and temperature distributions are quite similar for both cases at a chamber pressure of 1.0 atm and 0.1 atm. A fully developed flow regime could be achieved in the arc constrictor-tube between the cathode and the anode of the plasma torch at 1.0 atm for all the flow rates covered in this study. However the flow field could not reach the fully developed regime at 0.1 atm with a higher flow rate. The arc-root is always attached to the torch anode surface near the upstream end of the anode, i.e. the abruptly expanded part of the torch channel, which is in consistence with experimental observation. The surrounding gas would be entrained from the torch exit into the torch interior due to a comparatively large inner diameter of the anode channel compared to that of the arc constrictor-tube.