This paper deals with the application of two different injection strategies in a natural gas direct injection spark ignition single-cylinder engine model. The analysis includes the air flow characterization during com...This paper deals with the application of two different injection strategies in a natural gas direct injection spark ignition single-cylinder engine model. The analysis includes the air flow characterization during compression stroke and also the charge stratification. Two different swirl ratios are applied and piston bowl effects are analyzed during the gas jet deflection towards the spark plug. Achieving wall-guided effect, consequently, the charge stratification in spark plug region is obtained. The goal is to study the mixture formation differences for a single and a bi pulsed CNG (compressed natural gas) injection profiles and check the evolution of the methane concentration at the spark plug at the start of combustion.展开更多
Airway management is a skill necessary for healthcare providers who manage patients. Intubation is a skill that both anesthesiologists and intensivists use daily. We present a case of a neonate that developed signific...Airway management is a skill necessary for healthcare providers who manage patients. Intubation is a skill that both anesthesiologists and intensivists use daily. We present a case of a neonate that developed significant worsening stridor after a successful intubation for a hernia repair. After 4 intubation attempts, with easy visualization of the vocal cords and unsuccessful placement of the endotracheal tube, the patient was emergently brought to the operating room for evaluation.展开更多
Background: Flow FL-100 is a transcranial direct current stimulation (tDCS) device self-administered by a patient at home in combination with a software application delivered wellbeing behaviour therapy training. tDCS...Background: Flow FL-100 is a transcranial direct current stimulation (tDCS) device self-administered by a patient at home in combination with a software application delivered wellbeing behaviour therapy training. tDCS has evidence of effectiveness in treating symptoms of depression. Purpose/Aim: This post marketing study evaluated the effect of Flow on depression for primary care general practice patients with depression symptoms. Methods: Open-label patient cohort design with no control group. Inclusion criteria were aged 18 years or over and reporting depression symptoms. Participants self-administered five 30 minute tDCS sessions per week for the first three weeks, and then 3 sessions per week following this. Three, six and ten week assessment with participant self-report measure: Montgomery- Åsberg Depression Rating Scale (MADRS-S). Results: MADRS-S remission rates were between 29% - 30% at three weeks, 33% - 34% at six-weeks and 50% at 10-weeks treatment. There was a significant improvement in MADRS-S with large effect sizes at all time points. Conclusions: Flow tDCS can be delivered through a primary healthcare general practice service and patients will choose to use. Flow tDCS provides an effective depression treatment in addition and as an alternative to antidepressants and psychotherapy. tDCS has evidence as an effective depression treatment, and the widespread availability of tDCS in primary care general practice should be considered.展开更多
Background: Transcranial direct current stimulation (tDCS) has research evidence that it can reduce symptoms of depression. Flow FL-100 is a transcranial direct current stimulation (tDCS) device self-administered by a...Background: Transcranial direct current stimulation (tDCS) has research evidence that it can reduce symptoms of depression. Flow FL-100 is a transcranial direct current stimulation (tDCS) device self-administered by a patient at home in combination with a software application that delivers wellbeing behaviour therapy training. Purpose/aim: The purpose of this study was to investigate if Flow can be introduced to a Crisis Resolution & Home Treatment (CRT) service and the impact of Flow in treating depression. The study addresses the questions: 1) “what are the depression reliable improvement and remission rates?” and 2) “can Flow significantly reduce depressive symptoms and improve real world functioning (every-day, social and occupational functioning) and health-related quality of life?”. Methods: An open-label patient cohort design with no control group. Pre-intervention and 6-week follow-up intervention assessments using the participant self-report measures: Patient Health Questionnaire (PHQ-9), Work and Social Adjustment Scale (WSAS), and EuroQol five-dimension (EQ-5D-5L). Participants were 49 CRT patients, 19 males and 30 females, with an age range of 20 to 66 years, and average age of 42 years. Results: PHQ-9 reliable improvement and remission rates were 57.1% and 14.3%. PHQ-9 scores significantly improved, from 23.1 (SD 3.44) to 14.8 (SD 6.82) at 6 weeks, with a large effect size. PHQ-9 suicide/self-harm related question significantly improved from 2.51 (SD 0.77) to 1.08 (SD 1.17), with a large effect size. WSAS scores significantly improved, from 33.6 (SD 5.22) to 21.9 (SD 10.82) at 6 weeks, with a large effect size. EQ-5D-5L results showed significant improvements in the health index score, global assessment of health EQ-VAS from 34.2 (22.26) to 51.6 (24.95), and three EQ-5D-5L dimensions (“self-care”, “usual activity”, and “anxiety/depression”). Conclusion: A CRT service effectively integrated Flow tDCS treatment. Flow was beneficial in terms of improving functioning and quality of life and reducing depression symptoms and thoughts of suicide/self-harm. Flow FL100 tDCS and wellbeing behaviour therapy training could be offered through all CRT services to treat depression, reduce thoughts of suicide/self-harm, enable better functioning, and improve quality of life.展开更多
The treatment of hepatitis C has undergone a significant boom since the advent of direct acting antivirals (DAA). Indeed, the interferon-ribavirin combination that has been used to treat hepatitis C has a virological ...The treatment of hepatitis C has undergone a significant boom since the advent of direct acting antivirals (DAA). Indeed, the interferon-ribavirin combination that has been used to treat hepatitis C has a virological response in only 45% of cases with significant side effects. The advent of direct-acting antivirals has changed the prognosis of cirrhotic patients with hepatitis C. DAAs have ensured a sustained viral response in the majority of patients. Our work aims to see the evolution of hepatitis C patients at the cirrhosis stage under DAA. We conducted a retrospective study over 15 years (January 2009, January 2024) including all patients with post-viral cirrhosis C, whom we divided into two groups: group A, cirrhotic patients who received ribavirin and interferon, and group B, patients on DAA. From January 2009 to January 2024, we conducted a study of 182 patients with viral hepatitis C, including 102 cirrhotic patients. The mean age was 55 years. 66% of patients were initially treated with the ribavirin interferon combination, while 34% received direct-acting antivirals (DAAs). Since the introduction of DAAs, the most commonly used regimens have been sofosbuvir/daclatasvir with or without ribavirin and sofosbuvir/ledipasvir with or without ribavirin. Group A achieved sustained virological response (SVR) in 60% of cases, with notable side effects. In Group B, SVR was 98.18%, with improved tolerability and fewer side effects than previous treatments. Fifteen patients developed hepatocellular carcinoma (HCC), with a significantly lower mortality rate in those treated with DAAs compared with pegylated dual therapy (p: 0.001).展开更多
Introduction: In the last thirty years, brain neuromodulation techniques have been used as an alternative to pharmacological treatment of neurological disorders. Parkinson’s disease (PD) is a neurodegenerative disord...Introduction: In the last thirty years, brain neuromodulation techniques have been used as an alternative to pharmacological treatment of neurological disorders. Parkinson’s disease (PD) is a neurodegenerative disorder leading to bradykinesia, rest tremor, postural changes, and non-motor symptoms such as depression, anxiety, sleep disorders, pain, and cognitive decline that compromises executive functions (EFs), responsible for the orderly execution of behaviors and tasks of daily life and intentional and directed actions. To this date, a few studies with transcranial direct current stimulation (tDCS) have shown beneficial effects in PD patients concerning specific motor and non-motor symptoms, targeting the motor cortex and/or prefrontal regions. Objective: The main objective of this study was to evaluate the effects of left prefrontal tDCS across a broad spectrum of motor and non-motor symptoms of PD using established validated scales. Method: Single-blind randomized clinical trial with 18 volunteers with PD, aged between 45 and 80 years (66.1 ± 9.65), who met inclusion and exclusion criteria. Participants were submitted to assessments of motor and non-motor functions employing psychometric scales and tests to evaluate EFs and were randomly divided into two groups: control (sham stimulation) and experimental (active stimulation). All participants were involved in three separate tDCS sessions. The anode was positioned over the left dorsolateral prefrontal cortex and the cathode over the right supraorbital region, with a direct current intensity of 2 mA, lasting 20 minutes. At the end of the three sessions, all participants were reassessed. Results: Significant effects of tDCS on non-motor functions were observed for cognition (verbal fluency of actions, clock copy test, appointment by visual confrontation, and verbal memory with immediate free recall) and subjective assessment of sleep quality (overall restlessness and discomfort in the arms and legs at night, leg and arm cramps at night and distressing dreams). There was also an improvement in the rate of errors and successes for congruent and incongruent stimuli of the Stroop Test. The beneficial effects on motor function were decreased rigidity, improved gait, and greater agility in the finger-tapping test. Conclusion: Three tDCS sessions showed positive results for participants with PD, producing significant improvements in various motor and non-motor functions, including sleep quality, cognition, and EFs. Additionally, the present results indicate that tDCS neuromodulation of the left dorsolateral prefrontal cortex region is feasible, safe, and provides significant objective benefits for PD patients.展开更多
Background: Working memory is an executive function that plays an important role in many aspects of daily life, and its impairment in patients with attention-deficit/hyperactivity disorder (ADHD) affects quality of li...Background: Working memory is an executive function that plays an important role in many aspects of daily life, and its impairment in patients with attention-deficit/hyperactivity disorder (ADHD) affects quality of life. The dorsolateral prefrontal cortex (DLPFC) has been a good target site for transcranial direct current stimulation (tDCS) due to its intense involvement in working memory. In our 2018 study, tDCS improved visual-verbal working memory in healthy subjects. Objective: This study examines the effects of tDCS on ADHD patients, particularly on verbal working memory. Methods: We conducted an experiment involving verbal working memory of two modalities, visual and auditory, and a sustained attention task that could affect working memory in 9 ADHD patients. Active or sham tDCS was applied to the left DLPFC in a single-blind crossover design. Results: tDCS significantly improved the accuracy of visual-verbal working memory. In contrast, tDCS did not affect auditory-verbal working memory and sustained attention. Conclusion: tDCS to the left DLPFC improved visual-verbal working memory in ADHD patients, with important implications for potential ADHD treatments.展开更多
Laser Directed Energy Deposition (LDED) marks a critical advance in intelligent manufacturing, enabling efficient near-net shape production of metal parts. This method is especially beneficial for aerospace and defens...Laser Directed Energy Deposition (LDED) marks a critical advance in intelligent manufacturing, enabling efficient near-net shape production of metal parts. This method is especially beneficial for aerospace and defense applications that require high precision. However, issues such as deformation and heat accumulation during production still affect the quality of the final products, necessitating further optimization of process parameters. This paper studies the effects of three deposition strategies on 316L stainless steel parts using LDED. The three strategies based on unidirectional scanning (US), zigzag scanning (ZS), and square spiral scanning (SS) are investigated by solid samples and samples with a central hole. The surface smoothness, defects, and mechanical properties of 316L samples manufactured with the above strategies are discussed by means of surface topography tests and metallographic characterization. Experimental results indicate that the zigzag scanning strategy yielded better results for solid components, and the square spiral scanning strategy is suitable for samples with a central hole.展开更多
The emergence of mechanically one-way materials presents an exciting opportunity for materials science and engineering. These substances exhibit unique nonreciprocal mechanical responses, enabling them to selectively ...The emergence of mechanically one-way materials presents an exciting opportunity for materials science and engineering. These substances exhibit unique nonreciprocal mechanical responses, enabling them to selectively channel mechanical energy and facilitate directed sound propagation, controlled mass transport, and concentration of mechanical energy amidst random motion. This article explores the fundamentals of mechanically one-way materials, their potential applications across various industries, and the economic and environmental considerations related to their production and use.展开更多
文摘This paper deals with the application of two different injection strategies in a natural gas direct injection spark ignition single-cylinder engine model. The analysis includes the air flow characterization during compression stroke and also the charge stratification. Two different swirl ratios are applied and piston bowl effects are analyzed during the gas jet deflection towards the spark plug. Achieving wall-guided effect, consequently, the charge stratification in spark plug region is obtained. The goal is to study the mixture formation differences for a single and a bi pulsed CNG (compressed natural gas) injection profiles and check the evolution of the methane concentration at the spark plug at the start of combustion.
文摘Airway management is a skill necessary for healthcare providers who manage patients. Intubation is a skill that both anesthesiologists and intensivists use daily. We present a case of a neonate that developed significant worsening stridor after a successful intubation for a hernia repair. After 4 intubation attempts, with easy visualization of the vocal cords and unsuccessful placement of the endotracheal tube, the patient was emergently brought to the operating room for evaluation.
文摘Background: Flow FL-100 is a transcranial direct current stimulation (tDCS) device self-administered by a patient at home in combination with a software application delivered wellbeing behaviour therapy training. tDCS has evidence of effectiveness in treating symptoms of depression. Purpose/Aim: This post marketing study evaluated the effect of Flow on depression for primary care general practice patients with depression symptoms. Methods: Open-label patient cohort design with no control group. Inclusion criteria were aged 18 years or over and reporting depression symptoms. Participants self-administered five 30 minute tDCS sessions per week for the first three weeks, and then 3 sessions per week following this. Three, six and ten week assessment with participant self-report measure: Montgomery- Åsberg Depression Rating Scale (MADRS-S). Results: MADRS-S remission rates were between 29% - 30% at three weeks, 33% - 34% at six-weeks and 50% at 10-weeks treatment. There was a significant improvement in MADRS-S with large effect sizes at all time points. Conclusions: Flow tDCS can be delivered through a primary healthcare general practice service and patients will choose to use. Flow tDCS provides an effective depression treatment in addition and as an alternative to antidepressants and psychotherapy. tDCS has evidence as an effective depression treatment, and the widespread availability of tDCS in primary care general practice should be considered.
文摘Background: Transcranial direct current stimulation (tDCS) has research evidence that it can reduce symptoms of depression. Flow FL-100 is a transcranial direct current stimulation (tDCS) device self-administered by a patient at home in combination with a software application that delivers wellbeing behaviour therapy training. Purpose/aim: The purpose of this study was to investigate if Flow can be introduced to a Crisis Resolution & Home Treatment (CRT) service and the impact of Flow in treating depression. The study addresses the questions: 1) “what are the depression reliable improvement and remission rates?” and 2) “can Flow significantly reduce depressive symptoms and improve real world functioning (every-day, social and occupational functioning) and health-related quality of life?”. Methods: An open-label patient cohort design with no control group. Pre-intervention and 6-week follow-up intervention assessments using the participant self-report measures: Patient Health Questionnaire (PHQ-9), Work and Social Adjustment Scale (WSAS), and EuroQol five-dimension (EQ-5D-5L). Participants were 49 CRT patients, 19 males and 30 females, with an age range of 20 to 66 years, and average age of 42 years. Results: PHQ-9 reliable improvement and remission rates were 57.1% and 14.3%. PHQ-9 scores significantly improved, from 23.1 (SD 3.44) to 14.8 (SD 6.82) at 6 weeks, with a large effect size. PHQ-9 suicide/self-harm related question significantly improved from 2.51 (SD 0.77) to 1.08 (SD 1.17), with a large effect size. WSAS scores significantly improved, from 33.6 (SD 5.22) to 21.9 (SD 10.82) at 6 weeks, with a large effect size. EQ-5D-5L results showed significant improvements in the health index score, global assessment of health EQ-VAS from 34.2 (22.26) to 51.6 (24.95), and three EQ-5D-5L dimensions (“self-care”, “usual activity”, and “anxiety/depression”). Conclusion: A CRT service effectively integrated Flow tDCS treatment. Flow was beneficial in terms of improving functioning and quality of life and reducing depression symptoms and thoughts of suicide/self-harm. Flow FL100 tDCS and wellbeing behaviour therapy training could be offered through all CRT services to treat depression, reduce thoughts of suicide/self-harm, enable better functioning, and improve quality of life.
文摘The treatment of hepatitis C has undergone a significant boom since the advent of direct acting antivirals (DAA). Indeed, the interferon-ribavirin combination that has been used to treat hepatitis C has a virological response in only 45% of cases with significant side effects. The advent of direct-acting antivirals has changed the prognosis of cirrhotic patients with hepatitis C. DAAs have ensured a sustained viral response in the majority of patients. Our work aims to see the evolution of hepatitis C patients at the cirrhosis stage under DAA. We conducted a retrospective study over 15 years (January 2009, January 2024) including all patients with post-viral cirrhosis C, whom we divided into two groups: group A, cirrhotic patients who received ribavirin and interferon, and group B, patients on DAA. From January 2009 to January 2024, we conducted a study of 182 patients with viral hepatitis C, including 102 cirrhotic patients. The mean age was 55 years. 66% of patients were initially treated with the ribavirin interferon combination, while 34% received direct-acting antivirals (DAAs). Since the introduction of DAAs, the most commonly used regimens have been sofosbuvir/daclatasvir with or without ribavirin and sofosbuvir/ledipasvir with or without ribavirin. Group A achieved sustained virological response (SVR) in 60% of cases, with notable side effects. In Group B, SVR was 98.18%, with improved tolerability and fewer side effects than previous treatments. Fifteen patients developed hepatocellular carcinoma (HCC), with a significantly lower mortality rate in those treated with DAAs compared with pegylated dual therapy (p: 0.001).
文摘Introduction: In the last thirty years, brain neuromodulation techniques have been used as an alternative to pharmacological treatment of neurological disorders. Parkinson’s disease (PD) is a neurodegenerative disorder leading to bradykinesia, rest tremor, postural changes, and non-motor symptoms such as depression, anxiety, sleep disorders, pain, and cognitive decline that compromises executive functions (EFs), responsible for the orderly execution of behaviors and tasks of daily life and intentional and directed actions. To this date, a few studies with transcranial direct current stimulation (tDCS) have shown beneficial effects in PD patients concerning specific motor and non-motor symptoms, targeting the motor cortex and/or prefrontal regions. Objective: The main objective of this study was to evaluate the effects of left prefrontal tDCS across a broad spectrum of motor and non-motor symptoms of PD using established validated scales. Method: Single-blind randomized clinical trial with 18 volunteers with PD, aged between 45 and 80 years (66.1 ± 9.65), who met inclusion and exclusion criteria. Participants were submitted to assessments of motor and non-motor functions employing psychometric scales and tests to evaluate EFs and were randomly divided into two groups: control (sham stimulation) and experimental (active stimulation). All participants were involved in three separate tDCS sessions. The anode was positioned over the left dorsolateral prefrontal cortex and the cathode over the right supraorbital region, with a direct current intensity of 2 mA, lasting 20 minutes. At the end of the three sessions, all participants were reassessed. Results: Significant effects of tDCS on non-motor functions were observed for cognition (verbal fluency of actions, clock copy test, appointment by visual confrontation, and verbal memory with immediate free recall) and subjective assessment of sleep quality (overall restlessness and discomfort in the arms and legs at night, leg and arm cramps at night and distressing dreams). There was also an improvement in the rate of errors and successes for congruent and incongruent stimuli of the Stroop Test. The beneficial effects on motor function were decreased rigidity, improved gait, and greater agility in the finger-tapping test. Conclusion: Three tDCS sessions showed positive results for participants with PD, producing significant improvements in various motor and non-motor functions, including sleep quality, cognition, and EFs. Additionally, the present results indicate that tDCS neuromodulation of the left dorsolateral prefrontal cortex region is feasible, safe, and provides significant objective benefits for PD patients.
文摘Background: Working memory is an executive function that plays an important role in many aspects of daily life, and its impairment in patients with attention-deficit/hyperactivity disorder (ADHD) affects quality of life. The dorsolateral prefrontal cortex (DLPFC) has been a good target site for transcranial direct current stimulation (tDCS) due to its intense involvement in working memory. In our 2018 study, tDCS improved visual-verbal working memory in healthy subjects. Objective: This study examines the effects of tDCS on ADHD patients, particularly on verbal working memory. Methods: We conducted an experiment involving verbal working memory of two modalities, visual and auditory, and a sustained attention task that could affect working memory in 9 ADHD patients. Active or sham tDCS was applied to the left DLPFC in a single-blind crossover design. Results: tDCS significantly improved the accuracy of visual-verbal working memory. In contrast, tDCS did not affect auditory-verbal working memory and sustained attention. Conclusion: tDCS to the left DLPFC improved visual-verbal working memory in ADHD patients, with important implications for potential ADHD treatments.
文摘Laser Directed Energy Deposition (LDED) marks a critical advance in intelligent manufacturing, enabling efficient near-net shape production of metal parts. This method is especially beneficial for aerospace and defense applications that require high precision. However, issues such as deformation and heat accumulation during production still affect the quality of the final products, necessitating further optimization of process parameters. This paper studies the effects of three deposition strategies on 316L stainless steel parts using LDED. The three strategies based on unidirectional scanning (US), zigzag scanning (ZS), and square spiral scanning (SS) are investigated by solid samples and samples with a central hole. The surface smoothness, defects, and mechanical properties of 316L samples manufactured with the above strategies are discussed by means of surface topography tests and metallographic characterization. Experimental results indicate that the zigzag scanning strategy yielded better results for solid components, and the square spiral scanning strategy is suitable for samples with a central hole.
文摘The emergence of mechanically one-way materials presents an exciting opportunity for materials science and engineering. These substances exhibit unique nonreciprocal mechanical responses, enabling them to selectively channel mechanical energy and facilitate directed sound propagation, controlled mass transport, and concentration of mechanical energy amidst random motion. This article explores the fundamentals of mechanically one-way materials, their potential applications across various industries, and the economic and environmental considerations related to their production and use.