Early mobilization for mechanically ventilated patients in the intensive care unit:a systematic review and meta-analysis

Background: Early mobilization(EM) is a regimen that was carried out by physiotherapists in a relatively early stage. It has been investigated by an increasing number of researchers. However, there has not been a meta-analysis concerning whether EM could benefit the clinical outcomes of critically ill patients requiring mechanical ventilation(MV). The present systematic review aims to evaluate the effect of EM compared with immobilization for mechanically ventilated patients.Methods: A computerized literature search was performed in six databases for related articles from inception to June 2017. We included randomized controlled trials and controlled clinical trials and used the Physiotherapy Evidence Database scale to assess the quality of included studies. Primary outcomes were measures of muscle function, duration of MV, and incidence of mortality.Secondary outcomes were adverse effects and length of stay(LOS) in intensive care unit(ICU) and hospital.Results: Eight trials were included; of those, only one study without standard EM reported that the intervention was invalid to improve the outcomes. The result of meta-analysis indicated that EM shortened the duration of MV; however, it had no positive effect on mortality and LOS in ICU.Conclusions: This review suggests that EM improves the muscle function and ventilation duration. Further research highlighting standard intervention and specific groups is needed.

Impact of non-alcoholic fatty liver disease on coronavirus disease 2019: A systematic review

BACKGROUND Many studies have revealed a link between non-alcoholic fatty liver disease(NA-FLD)and coronavirus disease 2019(COVID-19),making understanding the relationship between these two conditions an absolute requirement.AIM To provide a qualitative synthesis on the currently present data evaluating COVID-19 and NAFLD.METHODS This systematic review was conducted in accordance with the guidelines pro-vided by preferred reporting items for systematic reviews and meta-analyses and the questionnaire utilized the population,intervention,comparison,and outcome framework.The search strategy was run on three separate databases,PubMed/MEDLINE,Scopus,and Cochrane Central,which were systematically searched from inception until March 2024 to select all relevant studies.In addition,ClinicalTrials.gov,Medrxiv.org,and Google Scholar were searched to identify grey literature.RESULTS After retrieval of 11 studies,a total of 39282 patients data were pooled.Mortality was found in 11.5%and 9.4%of people in NAFLD and non-NAFLD groups.In all,23.2%of NAFLD patients and 22%of non-NAFLD admissions diagnosed with COVID-19 were admitted to the intensive care unit,with days of stay varying.Ventilatory support ranged from 5%to 40.5%in the NAFLD cohort and from 3.1%to 20%in the non-NAFLD cohort.The incidence of acute liver injury showed significance.Clinical improvement on days 7 and 14 between the two classifications was significant.Hospitalization stay ranged from 9.6 days to 18.8 days and 7.3 days to 16.4 days in the aforementioned cohorts respectively,with 73.3%and 76.3%of patients being discharged.Readmission rates varied.CONCLUSION Clinical outcomes except mortality consistently showed a worsening trend in patients with NAFLD and concomitant COVID-19.Further research in conducting prospective longitudinal studies is essential for a more powerful conclusion.

Application Effect of Stratified Nursing Intervention for ICU Mechanically Ventilated Patients in the Context of Aspiration Risk Assessment

Objective:To explore the application effect of stratified nursing intervention based on the background of misinspiration risk assessment in mechanically ventilated patients in intensive care unit(ICU).Methods:100 cases of mechanically ventilated patients who were admitted to the ICU of our hospital from March 2022 to March 2023 were selected and divided into an observation group and a control group according to the random number table method,with 50 cases in each of the two groups.The control group was given routine care in ICU,and the observation group was given stratified nursing interventions based on the background of the risk of aspiration assessment on the basis of the control group,and both groups were cared for until they were transferred out of the ICU,and the mechanical ventilation time,ICU stay time,muscle strength score,complication rate,adherence,and satisfaction were observed and compared between the two groups.Results:The mechanical ventilation time and ICU stay time of the observation group were shorter than that of the control group after the intervention;the muscle strength score,compliance and satisfaction of the observation group were higher than that of the control group after the intervention;and the complication rate of the observation group was lower than that of the control group after the intervention,all of which were P<0.05.Conclusion:The application of stratified nursing intervention based on the background of misaspiration risk assessment in ICU mechanically ventilated patients can improve the patient's muscle strength,shorten the time of mechanical ventilation,promote the patient's recovery,reduce the occurrence of complications,and improve the patient's compliance and satisfaction.

Analysis on the Effect of Yiqi Huoxue Decoction Combined with Neuromuscular Electrical Stimulation in Improving ICU-Acquired Debility in Mechanically Ventilated Patients

Objective:To investigate the effect of Yiqi Huoxue decoction combined with neuromuscular electrical stimulation on improving intensive care unit(ICU)acquired debility in mechanically ventilated patients.Methods:50 patients who were admitted to the ICU and received mechanical ventilation treatment in our hospital from June 2022 to June 2023 and were complicated with ICU-acquired neurasthenia were selected,and randomly grouped using the randomized envelope method into two groups:control group with 25 patients who received neuromuscular electrical stimulation alone;observation group with 25 patients who received the traditional Chinese medicine Yiqi Huoxue decoction.Comparison indexes:treatment efficiency,degree of emotional recovery(APACHEⅡscore),muscle strength status(MRC score),motor status(FAC rating),and self-care ability(BI index score).Results:The treatment efficiency of patients in the observation group patients was higher as compared to those in the control group(P<0.05).There was no significant difference in the comparison of the results of the scores(ratings)of each index between the two groups before treatment(P>0.05).After the treatment,the APACHEⅡscores of patients in the observation group were significantly lower as compared to those in the control group,while the MRC scores,FAC ratings,and BI index scores were higher in the observation group than those of the control group patients(P<0.05).Conclusion:The combined application of Yiqi Huoxue decoction and neuromuscular electrical stimulation in the treatment of patients with ICU-acquired neurasthenia complicated by mechanical ventilation significantly enhanced the clinical efficacy,the patient’s muscle strength,motor status,and ability of self-care.Hence,it has high application value and is worthy to be popularized.

Practice and analysis of recycling non-drinking water from air-condition and reverse-osmosis system into rainwater collection system

This paper is based on the rainwater collection project in the retrofit of the Dongyi teaching block in Zhejiang University Xixi Campus.The analysis incorporates the local meteorological data, recycling water utilization, and precipitation adjustment.The rainwater collection system in this program also adds the condensation water from the heating, ventilation and air conditioning （ HVAC） system and the concentration from the reverse-osmosis system used for watering greens and supplying waterscapes.By calculating, the quantity of the HVAC condensation water in summer is 3.48 m3/d, and the quantity of the reverse-osmosis concentrated water is 198 to 396 L/d.This method solves the water shortage caused by high evaporation in summer and low precipitation in winter.Supported by empirical monitoring data, the proposed method significantly increases the economic efficiency of the system during the summer period.

Smoke distribution in naturally ventilated urban transportation tunnels with multiple shafts

The smoke spreading law of urban transportation tunnels with multiple shafts under natural ventilation is studied.A full-scale burning experiment is conducted in an actual tunnel.The study shows that smoke temperatures below the tunnel ceiling reduce rapidly along the longitudinal towards the tunnel exits. A noticeable temperature stratification is observed near the fire source.Most fire smoke is exhausted out of the shafts while the number of the smoke shafts in the downstream is more than that in the upstream.Large eddy simulation LES based on computational fluid dynamics CFD is carried out using the fire dynamics simulator FDS software with parallel processing in which the grid size of the fire-domain is set to be 0.083 m.The simulation results of temperatures under the ceiling the smoke fronts and the shafts＇smoke exhaust or air supply agree reasonably with the experimental data. Further simulations indicate that the decreasing ambient temperature or shaft spacing might reduce smoke temperatures under the tunnel ceiling and increase mass flow rates out of the shafts.This study provides technical scientific evidence and supports for the design and construction of such kinds of tunnels.

Development of underground mine monitoring and communication system integrated ZigBee and GIS

An automated underground mine monitoring and communication system based on the integration of new technologies is introduced to promote safety and health,operational management and cost-effectiveness.The proposed system integration considering Wireless Sensor Network(WSN) assisted Geographic Information System(GIS) enables to monitor and control underground mining applications from surface office.Based on the capabilities of WSNs,ZigBee network is adapted for near real-time monitoring,ventilation system control and emergency communication in underground mine.ZigBee nodes were developed to sense environmental attributes such as temperature,humidity and gases concentration;switching ON and OFF ventilation fans;and texting emergency messages.A trigger action plan for monitored attributes above normal and threshold value limits is programmed in the surface GIS management server.It is designed to turn the auxiliary fans on remotely or automatically in orange condition and sending evacuation messages for underground miners in unsafe(red) condition.Multi-users operation and 3D visualisations are other successful achievements of the proposed system for the underground monitoring and communication.

Gas drainage from different mine of drainage systems for deep coal areas： optimal placement seams with high gas emissions

The techniques of stress relief mining in low-permeability coal seams and pillarless gob side retained roadway entry using Y-type ventilation and gas drainage systems were developed to control gas outbursts and applied successfully. However, as the mining depth increasing, parts of the gas drainage system are not suitable for mines with high gas emissions. Because larger mining depths cause higher ground stresses, it becomes extremely difficult to maintain long gob side roadways. The greater deformation suffered by the roadway is not favorable lor borehole drilling for continuous gas drainage. To solve these problems, Y-type ventilation and gas drainage systems installed from a roof roadway were designed for drainage optimization. This system was designed based on a gas-enrichment zone analysis developed from mining the 11-2 coal seam in the Zhuji Mine at Huainan, Anhui Province, China. The method of Y-type gas extraction from different mine areas was applied to the panel 1112（1） in the Zhuji Mine. The absolute gas emission rate was up to 116.3 m^3/min with an average flow of 69.1 m^3/min at an average drainage concentration of nearly 85 %. After the Y-type method was adopted, the concentration of gas in the return air was 0.15 %-0.64 %, averaging 0.39 % with a ventilation rate of 2100-2750 m^3/min. The gas management system proved to be efficient, and the effective gas control allowed safe production to continue .

Fault Diagnosis Approach of Local Ventilation System in Coal Mines Based on Multidisciplinary Technology

In order to reduce the probability of fault occurrence of local ventilation system in coal mine and prevent gas from exceeding the standard limit, an approach incorporating the reliability analysis, rough set theory, genetic algorithm (GA), and intelligent decision support system (IDSS) was used to establish and develop a fault diagnosis system of local ventilation in coal mine. Fault tree model was established and its reliability analysis was performed. The algorithms and software of key fault symptom and fault diagnosis rule acquiring were also analyzed and developed. Finally, a prototype system was developed and demonstrated by a mine instance. The research results indicate that the proposed approach in this paper can accurately and quickly find the fault reason in a local ventilation system of coal mines and can reduce difficulty of the fault diagnosis of the local ventilation system, which is significant to decrease gas exploding accidents in coal mines.

Cloud model-clustering analysis based evaluation for ventilation system of underground metal mine in alpine region

Ventilation system is significant in underground metal mine of alpine region.Reasonable evaluation of ventilation effectiveness will lead to a practical improvement for the maintenance and management of ventilation system.However,it is difficult to make an effective evaluation of ventilation system due to the lack of classification criteria with respect to underground metal mine in alpine region.This paper proposes a novel evaluation method called the cloud model-clustering analysis(CMCA).Cloud model(CM)is utilized to process collected data of ventilation system,and they are converted into cloud descriptors by CM.Cloud similarity(CS)based Euclidean distance(ED)is proposed to make clustering analysis of assessed samples.Then the classification of assessed samples will be identified by clustering analysis results.A case study is developed based on CMCA.Evaluation results show that ventilation effectiveness can be well classified.Moreover,CM is used alone to make comparison of evaluation results obtained by CMCA.Then the availability and validity of CMCA is verified.Meanwhile,difference of CS based ED and classical ED is analyzed.Two new clustering analysis methods are introduced to make comparison with CMCA.Then the ability of proposed CMCA to meet evaluation requirements of ventilation system is verified.

Stability of mine ventilation system based on multiple regression analysis

In order to overcome the disadvantages of diagonal connection structures that are complex and for which it is difficult to derive the discriminant of the airflow directions of airways, we have applied a multiple regression method to analyze the effect, of changing the rules of mine airflows, on the stability of a mine ventilation system. The amount of air （ Qj ） is determined for the major airway and an optimum regression equation was derived for Qi as a function of the independent variable （ Ri ）, i.e., the venti- lation resistance between different airways. Therefore, corresponding countermeasures are proposed according to the changes in airflows. The calculated results agree very well with our practical situation, indicating that multiple regression analysis is simple, quick and practical and is therefore an effective method to analyze the stability of mine ventilation systems.

Effects of diabetic ketoacidosis in the respiratory system

Diabetes affects approximately 30 million persons in the United States. Diabetes ketoacidosis is one of the most serious and acute complications of diabetes. At the time of presentation and during treatment of diabetic ketoacidosis(DKA), several metabolic and electrolyte derangements can ultimately result in respiratory compromise. Most commonly, hypokalemia, hypomagnesemia and hypophosphatemia can eventually lead to respiratory muscles failure.Furthermore, tachypnea, hyperpnea and more severely, Kussmaul breathing pattern can develop. Also, hydrostatic and non-hydrostatic pulmonary edema can occur secondary to volume shifts into the extracellular space and secondary to increased permeability of the pulmonary capillaries. The presence of respiratory failure in patients with DKA is associated with higher morbidity and mortality. Being familiar with the causes of respiratory compromise in DKA, and how to treat them, may represent better outcomes for patients with DKA.

Heat and hazardous contaminant transports in ventilated high-rise industrial halls

Performances and efficiencies of displacement ventilation(DV) and partial ventilation(PV) for industrial halls of different configurations as well as the heat and mass transports within the industrial halls were numerically investigated. Three levels of Rayleigh number(5.8×1010, 1.0×1012 and 2.1×1012) and two values of source contaminant flux(5 mg/s and 50 mg/s) were considered. The inlet Reynolds numbers were 2×104, 5×104, 1.5×105 and 4.5×105 for DV and 5×105, 1×106, 2×106 and 4×106 for PV, respectively. From the results, it is concluded that the above parameters have very complex impacts on the conjugated heat and mass transports. From points of view of acceptable indoor air quality and ventilation efficiency, PV at Re=1×106 with side-located sources and 65% of the supply air extracted through floor level outlets is the best choice when Ra=5.8×1010. However, DVs at Re=5×104 and Re=1.5×105with center-located sources and floor-mounted air suppliers are the best choices for Ra=1.0×1012 and Ra=2.1×1012, respectively. When source contaminant flux reaches 50 mg/s, local extraction as a supplement of general ventilation is recommended. The results can be a first approximation to 3D numerical investigation and preliminary ventilation system design guidelines for high-rise industrial halls.

Field study on thermal comfort of naturally ventilated residences in southwest China

Kunming,a city in southwest China,has a climate that is different from most of the other places in the world because of its unique geographical characteristics.Due to its temperate climate,most of the residential buildings in this region are naturally ventilated.Accordingly,a winter thermal comfort study was conducted in Kunming to reveal the thermal response of residents.Indoor and outdoor environmental parameters were measured,and participants were investigated about their clothing,thermal sensations,thermal preferences,and thermal acceptance using online questionnaires.Data from 162 valid questionnaires were collected in the survey.Although the climate is referred to as“mild”,the survey showed that the indoor temperature during winter was lower than the typical comfort range.Nevertheless,the participants responded that most of them felt neutral and comfortable.The neutral temperature of participants living in Kunming was determined to be 16.96℃.The acceptable thermal sensation vote(TSV)range of the residents is-0.72 to 1.52.The acceptable indoor air temperature range is 15.03℃ to 19.55℃,and the optimum indoor air temperature is 17.2℃.According to this study,the existing thermal comfort evaluation models can hardly predict residents’thermal responses in Kunming well.

Sensitivity analysis on parameter changes in underground mine ventilation systems

A more efficient mine ventilation system, the ventilation-on-demand （VOD） system, has been proposed and tested in Canadian mines recently. In order to supply the required air volumes to the production areas of a mine, operators need to know the cause and effect of any changes requested from the VOD system. The sensitivity analysis is developed through generating a cause and effect matrix of sensitivity factors on given parameter changes in a ventilation system. This new utility, which was incorporated in the 3D-CANVENT mine ventilation simulator, is able to predict the airflow distributions in a ventilation network when underground conditions and ventilation controls are changed. For a primary ventilation system, the software can determine the optimal operating speed of the main fans to satisfy the airflow requirements in underground workings without necessarily using booster fans and regulators locally. An optimized fan operating speed time-table would assure variable demand-based fresh air delivery to the production areas effectively, while generating significant savings in energy consumption and operating cost.

Computational Fluid Dynamics Simulation of Indoor Air Quality and Thermal Stratification of an Underfloor Air Distribution System(UFAD)with Various Vent Layouts

The underfloor air distribution(UFAD)system has not been able to penetrate the residential and commercial air conditioning industry significantly until now.To date,the most notable applications are found in datacenters because of their more demanding thermal stratification and cooling requirements.In addition to highlighting the advantages of the UFAD system over the traditional overhead(OH)system,this study compares various ventilation layouts for a UFAD system.Four different UFAD ventilation layouts are compared and one OH layout.The results show that using multiple swirl-type diffusers creates a more uniform floor-to-knee temperature and less air recirculation than the rectangular grille-type diffusers.Placing the return vents on the sides of the room creates a cooler environment by isolating recirculating air to a smaller space.At the end of the study,a design guide matrix is presented to summarize how the supply and return vent layout affects air conditioning performance.

Design of push-pull system to control diesel particular matter inside a dead-end entry

Diesel particulate matter （DPM） is considered to be carcinogenic after prolonged exposure. With more diesel- powered equipment used in underground mines, miners＇ exposure to DPM has become an increasing concern. This paper used computational fluid dynamics method to study the DPM dispersion in a dead-end entry with loading operation. The effects of different push-pull ventilation systems on DPM distribution were evaluated to improve the working conditions for underground miners. The four push-pull systems considered include： long push and short pull tubing; short push and long pull tubing, long push and curved pull tubing, and short push and curved pull tubing. A species transport model with buoyancy effect was used to examine the DPM dispersion pattern with unsteady state analysis. During the 200 s of loading operation, high DPM levels were identified in the face and dead-end entry regions. This study can be used for mining engineer as guidance to design and setup local ventilation, select DPM control strategies and for DPM annual training for underground miners.

Fuzzy Evaluation of Thermal Comfort in Naturally Ventilated Residential Buildings in China

In order to assess the differences between the human body thermal sensation in naturally ventilated space and that in air-conditioned space,the fuzzy evaluation model was adopted in the research of thermal sensation in naturally ventilated space.Based on the questionnaires and field measurements,the membership functions were presented by the statistic of the covering frequency to the fuzzy subset.Dry-bulb temperature was taken as the only independent variable for membership functions.The maximum values of membership grades are all at 0.5 or so,which is a distinction character on thermal comfort of naturally ventilated space.By the calculating results of membership grades value to different fuzzy evaluation subsets,the Predicted Mean Vote(PMV)was obtained.Furthermore,energy coefficient(Ea)was introduced to calculate the energy consumption,and the prediction methods of residential building energy consumption were also discussed.Finally,the importance of evaluation model of thermal sense is shown through the energy consumption prediction in a specific residential building.

Closed-loop bulk air conditioning: A renewable energy-based system for deep mines in arctic regions

With depletion of shallow deposits,the number of underground mines expected to reach more than 3 km depth during their lifetime is growing.Although surface cooling plants are mostly effective in mine airconditioning,usually secondary cooling units are needed below 2 kmdepth.This need emerges due to the elevated thermal impacts caused by auto-compression of mine air as well as heat emissions from strata and mine machinery.As a result,in cold climates,like Canada,ultra-deep mines need their secondary underground cooling plants running year-round while the intake air must be heated to protect the sensitive machinery and liners from freezing during the winter season.To cool mine air,horizontal bulk-airconditioners with direct spray cooling systems are commonly used due to their high performance.Conventionally,sprayed water in bulk-air-coolers are mechanically circulated and refrigerated in coupled refrigeration plants.This set up can be transformed to a natural cooling/heating process by resurfacing the warm underground bulk-air-cooler spray water for mine air heating on the surface and re-sinking the chilled water for cooling in the underground bulk air coolers.This could significantly cut-down the fossil-fuel consumption in burners for mine air pre-conditioning and refrigeration cost when applicable.This paper presents an anonymous real-life example to study the feasibility of the proposed idea for an ultra-deep Canadian mine.

A Review on Effects of Personalized Ventilation Systems on Air Quality and Thermal Comfort in Aircraft Cabin Mini-Environments

This study conducts an evaluation of air quality,dispersion of airborne expiratory pollutants and thermal comfort in aircraft cabin mini-environments using a critical examination of significant studies conducted over the last20 years.The research methods employed in these studies are also explained in detail.Based on the current literature,standard procedures for airplane personal ventilation and air quality investigations are defined for each study approach.Present study gaps are examined,and prospective study subjects for various research approaches are suggested.