Changes In Pressure Research Articles

Hemodynamic tolerability and efficacy of hemodialysis modalities in critically ill patients

IntroductionAcute kidney injury (AKI) is frequently seen in critically ill patients and is associated with high mortality and morbidity. However, the optimal dialysis modality in such patients remains controversial. We examined the hemodynamic tolerability of hemodialysis modalities in critically ill individuals with AKI.MethodologyCritically ill patients with AKI who underwent Continuous Renal Replacement Therapy (CRRT), Sustained Low-Efficiency Diafiltration (SLEDD-f), or Sustained Low-Efficiency Dialysis (SLED) dialysis were included in the study. In-hospital mortality, number of dialysis sessions, number of sessions terminated pre-maturely, change in blood pressure during dialysis, and hemodynamic instability during dialysis sessions were noted.ResultsA total of 264 patients were included, of which 78 received Continuous Renal Replacement Therapy (CRRT), 62 received Sustained Low-Efficiency Diafiltration (SLEDD-f), and 124 received Sustained Low-Efficiency Dialysis (SLED), with a total of 682 sessions among 264 patients. The commonest cause for AKI was septic shock (32.6%, n=43). All CRRT and SLEDD-f sessions were delivered without anticoagulation, and SLED was delivered without anticoagulation in 88.7% of sessions. There was a significant decrease in mean arterial pressure in CRRT compared to other modalities, with higher mortality. However, patients undergoing CRRT were more sicker. There was no significant difference between SLEDD-f and SLED in terms of outcomes.ConclusionSLEDD-f and SLED have good hemodynamic tolerability compared to CRRT. There was no significant difference in hemodynamic disturbances between SLEDD-f and SLED despite a higher proportion of patients on SLEDD-f being more critical.

Propagation Laws of Ultrasonic Continuous Signals at the Transmitting Transducer–Soil Interface

Ultrasonic detection is one of the main methods for information detection and has advantages in soil detection. Ultrasonic signals attenuate in soil, resulting in unique propagation laws. This paper studies the propagation laws of ultrasound in soil, focusing on the propagation characteristics of ultrasonic continuous signals at the transducer–soil interface. This study uses excitation frequency and amplitude as experimental factors and employs the discrete element simulation method to analyze the vibration characteristics of soil particles. It reveals the relationship between changes in soil pressure at the interface and the movement of the transducer. The results show that the motion curve of the transmitting transducer lags behind the soil pressure changes, and the energy of the ultrasonic signal increases with higher excitation frequency and amplitude. Specifically, the peak value of the first wave |H0| at 40 kHz and 60 kHz is 210% and 263% of that at 20 kHz, respectively. When the excitation amplitude increases from 0.005 mm to 0.015 mm, the value of the peak value of other waves |H| increases by 323%. This paper preliminarily reveals the propagation laws of ultrasonic continuous signals at the transducer–soil interface, providing theoretical support for the development of ultrasonic soil property detection instruments.

Pressure Transient Solutions for Unbounded and Bounded Reservoirs Produced and/or Injected via Vertical Well Systems with Constant Bottomhole Pressure

Various analytical solutions for computing production and injection-induced pressure changes in aquifers and oil reservoirs have been derived over the past century. All prior solutions assumed a constant well rate as the boundary condition. However, in many practical situations, the fluid withdrawal from and/or injection into such subsurface reservoirs occurs with the aid of pump devices that maintain a constant bottomhole pressure in the well. Until now, how the well rate will decline over time, based on the pressure difference in the well relative to the initial reservoir pressure, could not be rapidly computed analytically (using the diffusivity as the key governing system parameter), because no concise expression had been derived with the boundary condition of a constant bottomhole pressure. The present study shows how the pressure diffusion equation can be readily solved for wells acting as sinks and sources with a constant bottomhole pressure condition. We consider both fractured and unfractured completions, as well as injection and production modes. The new solutions do not require an elaborate time-stepped pressure-matching procedure as in nodal analysis, the only other physics-based analytical method currently available to compute the well rate decline when a constant bottomhole pressure production system is used, which unlike our new method proposed here is limited to single well systems.

Thermal and hydrodynamic analysis inside a channel partially filled with porous material

AbstractIn this work, the transfer of heat and changes in fluid pressure within a rectangular channel fairly packed with porous material have been studied numerically for various Darcy numbers and dimensionless porous layers. The model was run with the following assumptions: laminar flow, forced convection, isotropic porous material, local thermodynamic equilibrium, constant wall temperature boundary condition, and no thermal dissipation. The study covers a broad range for the dimensionless porous layer, 0 ≤ hr < 1, and the Darcy number, 10−4 < Da < 10−2. The fully developed and developing flow over the channel is investigated in numerical study. It was observed that the inertia effect may be disregarded when Da < 10−4. The local dimensionless bulk temperature distribution, pressure drop, and velocity profiles were all shown to be impacted by the Darcy number and dimensionless porous layers, according to the numerical analysis results. The maximum heat transfer rate was attained when the ratio of the porous layer inside the channel was 0.8, and the pressure gradient was the highest. Partial packing of the channel with a porous material has two advantages: it increases the rate heat transmission rate and results in a much smaller pressure drop than a filled porous medium.

Comparative analysis: Exergetic and economic assessment of LNG cold energy power generation systems with different cold utilization methods

Harnessing the cold energy inherent in LNG transportation processes can significantly mitigate energy wastage. Employing an innovative incremental analysis methodology, this study scrutinizes six LNG cold energy power generation systems, featuring a newly proposed parallel and cascade combined cycle (PAC) system. A novel approach that setting the minimum pressure within the systems higher than atmospheric levels has been adopted, for the optimal working fluid selection. The net power output (Wnet) of the direct expansion (DC) system registers at −129.51 kW, while both the Single-Stage Organic Rankine Cycle (SORC) and Combined Cycle (CC) systems yield Wnet of 2868.46 kW and 3081.46 kW with R32 as working fluid. Despite the lower available exergy extraction of the working fluid, the CC system outperforms due to its superior efficiency in converting pressure exergy into power output. Sensitivity analysis suggests the optimal Tcon in CC is limited by the normal boiling point temperature (NBPT) of working fluid, while that in SORC remains unrestricted. The maximum Wnet of two-stage Parallel Combined Cycle (PCC) and Cascade Combined Cycle (CCC) can reach 3291.65 kW and 4268.78 with the optimal working fluid combinations R32 + propane, and ethane + propane. The reason Wnet of CCC outperforms is the cascade utilization of LNG cold exergy enables the working fluid in its second stage obtains significantly 9.49 times higher amount of exergy compared to PCC. Through sensitivity analysis, while Tcon1 mostly predominates the performance of PCC, both Tcon1 and Tcon2 exert substantial influence on CCC. For the three-stage PAC, its Wnet can reach the highest 4700.82 kW with ethane + propane + propane. It is because the PAC not only utilizes LNG’s cold exergy in a cascaded manner, but also obtains the exergy from working fluid. According to economic analysis, the PAC system exhibits an advantage with the highest annul total net income (ATNI). And the CC emerges as a cost-effective choice if the irreversible losses and Wnet are not considered. According to innovatively explores about the impact of direct expansion and changes in NG outlet pressure on working fluid selection and economic feasibility, it shows the optimal combinations remain the same, and the systems incorporating a direct expansion component with lower NG outlet pressure demonstrate a more economically advantageous solution.

Experimental and simulation study of flow field characteristics of a disturbing rotary centrifugal air classifier

In the present study, a new disturbing rotary centrifugal classifier was designed and a method was proposed to characterize its pressure signals. The models for evaluating the classification effects were established based on multi-zones. It was found that the flow field, processing parameters, and material properties significantly affected on the particle force and classification performance. The pressure with high amplitude and energy analyzed using Hilbert-Huang Transform (HHT) concentrated within 200–400 Hz, and the screening cage facilitated energy transfer to lower frequency bands. Correlation analysis demonstrated the correlation coefficients (A5 and A6) between adjacent measurement points increased with frequency, further enhanced by the screening cage. The flow field of simulation was characterized by a low-pressure, high-velocity gradient at the center and a high-pressure, low-velocity gradient at the sidewalls and the gas velocity and flow for experiment achieved the maximum at z = 0.50 m, while the magnitude of pressure change was significant at the inlet end and discharge end, where the velocity gradient and pressure drop had the same trend and small errors for experiments and simulation. The flow field affected the competing relationship between centrifugal and drag forces on the particles with different kinematic behavior during the classification process. The errors between the predicted values of the theoretical, simulated, and experimental cut particle size models and the true values were all within 10 %, based on which the multi-zone classification efficiency model applicable to the disturbing centrifugal classifier was established, and it was found that the models all had high prediction accuracy and suitability. The article delves into the correlation between pressure signals, flow field characteristics and particle behavior, aiming to provide an important reference for the internal flow field and classification performance of air classifiers.

Coupling analysis of multi-annular temperature and pressure gradients in oil and gas wells considering fluid thermodynamic properties

A coupled prediction model for temperature and pressure is developed for the annulus of multiple casings to prevent damaging the integrity of oil and gas wells due to annular pressures. The complex structure of the oil and gas well requires dividing the calculation of the annular pressure into three stages based on the annulus level. The annular temperature and pressure gradients of the wellbore are then studied. The hydrostatic pressure changes of the annular fluid at different temperatures, pressures, and well depths are analyzed considering the influence of the isobaric expansion coefficient and isothermal compression coefficient in annular fluids. The pressure gradients of annular fluids A, B, and C with production time and well depth are discussed along with the deformation of production casings. Results show that the annular fluid density and hydrostatic pressure decrease with the increase of temperature, while they will increase with the increase of annular pressure. The annular pressure increases first and then decreases from the bottom of the well to the wellhead. The annular pressure increases the fastest in the early production stages.

Determining Which Hydrostatic Pressure Regimes Promote Osteogenesis in Human Mesenchymal Stem Cells.

Compressive loading of bone causes hydrostatic pressure changes which have been proposed as an osteogenic differentiation stimulus for mesenchymal stem cells (hMSCs). We hypothesised that hMSCs are adapted to differentiate only in response to cyclic hydrostatic pressures above critical thresholds of magnitude and frequency which correspond to physiological levels of anabolic bone loading. Using a pneumatic-hydrostatic bioreactor, we applied hydrostatic pressure regimes to human hMSCs in 3D collagen hydrogel cultures for 1h/day over 28days to determine which levels of pressure and frequency stimulated osteogenesis in vitro. Stimulation of the 3D cultures with 0-280kPa cyclic hydrostatic pressure at 1Hz resulted in up to 75% mineralisation in the hydrogel (without exogenous growth factors), whilst static culture or variations of the regime with either constant high pressure (280kPa, 0Hz), low-frequency (0.05Hz, 280kPa) or low-magnitude (70kPa, 1Hz) stimulation had no osteogenic effects (< 2% mineralisation). Nuclear translocation of YAP was observed following cyclic hydrostatic pressure in mature MLO-A5 osteoblasts but not in hMSCs, suggesting that cyclic hydrostatic pressure activates different mechanotransduction pathways in undifferentiated stem cells and committed osteoblasts. Hydrostatic pressure is a potent stimulus for differentiating MSC into highly active osteoblasts and may therefore be a versatile tool for translational cell engineering. We have demonstrated that there are minimum levels of force and frequency needed to trigger osteogenesis, i.e. a pressure 'switch', which corresponds to the physiological forces experienced by cells in their native mesenchymal niche. The mechanotransduction mechanisms underpinning these effects are the subject of further study.

Comparative Effectiveness of Single Versus Combination Antihypertensive Therapy in PROLANIS Hypertension Patients: A Retrospective Study in Purbalingga Regency

The PROLANIS program in Indonesia aims to manage chronic diseases like hypertension. While combination antihypertensive therapy is recommended for many patients, evidence on its effectiveness in the PROLANIS setting remains limited. This study investigated the comparative effectiveness of single versus combination antihypertensive therapy in achieving blood pressure control among PROLANIS hypertension patients in Purbalingga Regency. A retrospective cohort study was conducted using data from PROLANIS hypertension patients in Purbalingga Regency from January-December 2023. Patients were categorized into two groups: those receiving single antihypertensive therapy and those receiving combination therapy. The primary outcome was the proportion of patients achieving blood pressure control (&lt;140/90 mmHg). Secondary outcomes included changes in blood pressure, medication adherence, and adverse events. Multivariable logistic regression was used to adjust for potential confounders. A total of 1,250 patients were included, with 680 receiving single therapy and 570 receiving combination therapy. The proportion of patients achieving blood pressure control was significantly higher in the combination therapy group (65%) compared to the single therapy group (52%) (adjusted odds ratio [OR] 1.72, 95% confidence interval [CI] 1.35-2.20). Combination therapy was also associated with greater reductions in systolic and diastolic blood pressure. No significant differences were observed in medication adherence or adverse events between the two groups. Combination antihypertensive therapy is more effective than single therapy in achieving blood pressure control among PROLANIS hypertension patients in Purbalingga Regency. These findings support the use of combination therapy as the preferred approach for managing hypertension in this population.

Design and optimization of power conversion system for a steady state CFETR power plant

A promising magnetic fusion steady state reactor is Chinese Fusion Engineering Testing Reactor (CFETR) and a different power conversion system is required than tokamak reactor. The control and utilization of high outlet temperature and thermal power generated by the fusion reactor efficiently are the main challenges in the field of thermo-fusion technology. An efficient and optimized power conversion system is an urge for the thermo-fusion energy system with a candidate working fluid under high temperature and pressure. Five cycle topologies based on the Brayton cycle have been designed such as multi stage expansion and recompression cycle with intercooling, recompression cycle with intercooling, partial expansion with multistage compression, partial expansion and partial recompression with cooling across range of turbine and compressor inlet temperatures. Brayton cycle with different system configurations have been simulated with He-gas and supercritical Carbon Dioxide (CO2) to conceive high outlet temperature of CFETR about 500 °C and thermal power of 200 MWth for better thermal performance by using REFPROP, EES and analytical model has been developed with MATLAB. The supercritical CO2 has better thermal performance about 36.18 % as compared to He-gas has 29.81 % under same thermal conditions. The Schematic-I with addition of preheat and recompression enhance the thermal performance about 2 % and has been proposed for CFETR. The effect of change in pressure of the system, effect of the working fluid, isentropic efficiency, heat rate and back to work ratio on the thermal performance and network output have been analyzed and optimized based on analytical model with the MATLAB. The system net power is increased from 69.20 MW to 79.71 MW, heat rejected by the system is decreased from 134.46 MW to 127.06 MW and thermal performance is increased about 34.62 %–39.85 % with pressure from 24 MPa to 28 MPa. Using multi stage expansion and recompression cycle with intercooling instead of other topologies can improve the thermal performance up to 6.1 % depends upon the operation conditions and working fluid. The heat rate of the system decreased while back work ratio increased with the pressure and it reveal that calculations are correct.

Observation of TLIESST above Liquid Nitrogen Temperature and Disclosure of Hidden Hysteresis in Multiresponsive Hofmann-type Coordination Polymers.

Photoresponsive spin-crossover (SCO) molecules are an important class of bistable magnetic molecules with intriguing potential in device applications. The light-induced excited spin state trapping (LIESST) and the combined application of light and temperature can provide access to the metastable region of the SCO profile. The primary obstacle in utilizing light stimuli is the manifestation of light-induced trappings at extremely low temperatures. Herein, we report two novel multiresponsive 2D Hofmann-type coordination polymers exhibiting light-induced excited spin state trapping above liquid nitrogen temperature (TLIESST = 82 and 81 K). Stimulating the samples in conjugation with light and temperature successfully unveils hysteresis, which is otherwise concealed. Apart from light and temperature, we found that the SCO phenomenon is also responsive to external hydrostatic pressure and exhibits modulation of the hysteresis width and transition temperature shifts with changes in pressure.

Multi-Modal Assessment of Cerebral Hemodynamics in Resuscitated Out-of-Hospital Cardiac Arrest Patients: A Case-Series

We assessed the feasibility of concurrent monitoring of cerebral hemodynamics in adult, comatose out-of-hospital cardiac arrest (OHCA) patients admitted to the National University Heart Centre Singapore from October 2021 to August 2023. Patients underwent continuous near-infrared spectroscopy (NIRS) monitoring in the first 72 h after return of spontaneous circulation (ROSC) and 30-min transcranial Doppler ultrasound (TCD) monitoring at least once. With constant mechanical ventilatory settings and continuous electrocardiographic, pulse oximeter and end-tidal carbon dioxide monitoring, blood pressure was manipulated via vasopressors and cerebral autoregulation assessed by measuring changes in regional cerebral oxygenation (NIRS) and cerebral blood flow velocities (TCD) in response to changes in mean arterial pressure. The primary outcome was neurological recovery at hospital discharge. Amongst the first 16 patients (median age 61, 94% males), we observed four unique patterns: preserved cerebral autoregulation, loss of cerebral autoregulation, cardio-cerebral asynchrony and cerebral circulatory arrest. Patients with preserved cerebral autoregulation had lower levels of neuro-injury biomarkers (neurofilaments light and heavy) and the majority (86%) were discharged with good neurological recovery. Multi-modal assessment of cerebral hemodynamics after OHCA is feasible and derived patterns correlated with neurological outcomes. The between- and within-patient heterogeneity in cerebral hemodynamics calls for more research on individualized treatment strategies.

Effects of arginine intake during weight training on blood variables.

This experiment studied the effect of arginine intake on blood pressure and blood variables during weight training in 20 men in their 20s. The resistance exercise program was performed 3 times a week at 60% of one repetition maximum for 8 weeks. The arginine intake group consumed 1,000 mg of arginine 2 tablets per day before weight training for 8 weeks. The placebo group was instructed to consume two of placebo with water, the same as the arginine intake group. After 8 weeks, the day after the end of the resistance exercise program, systolic pressure, diastolic pressure, total cholesterol, triglyceride, high-density lipoprotein, low-density lipoprotein, muscle mass, and maximum muscle strength were measured. In changes in systolic blood pressure, the arginine intake group was 118.20±2.40 mmHg, showed a statistically significant decrease compared to the placebo group. Triglyceride in the arginine intake group was 112.62±2.40 mg/dL, showing a statistically significant decrease compared to the placebo group. Based on these results, arginine intake during resistance exercise is judged to have a positive effect on lowering blood pressure, and is also believed to reduce triglycerides, a blood lipid variable, so it is thought to function as a supplement during exercise.

Radiation Monitoring for Volatilized Zinc Contamination Using Gamma-Ray Imaging and Spectroscopy

Abstract Gamma-ray imaging is a tool that has grown in importance in the applications of non-destructive assay (NDA) for radioactive survey and analysis of nuclear facilities. Imaging techniques have shown great promise in providing valuable information involving radioactive waste management and contamination prevention. For the application studied in this work, 65Zn has been identified as a radioactive contaminant during tritium extraction. Due to the volatile nature of 65Zn under the pressure and temperature changes during extraction operations, 65Zn can easily travel through components of the extraction system as vapor, making it difficult to trap. Previous research involving the development of a filtration system showed that the 65Zn can be trapped, mitigating product contamination. However, during the extraction process, direct analysis of the equipment to confirm that zinc contamination is trapped in the filter and has not spread to other components is impractical. In this situation, the need to assay the location of the contamination with little-to-no interference with operations is vital. In this work, we demonstrate the use of a commercialized 3D position-sensitive CdZnTe (CZT) gamma-ray imaging spectrometer to provide analysis of the 65Zn contamination. Onsite measurements during an extraction process are studied to assess the location and migration of the 65Zn. The results obtained from real-time glovebox monitoring demonstrate the feasibility of gamma-ray imaging for localizing the contamination and providing a preliminary qualitative assessment that is intended to be used in future work quantifying the contamination build-up and activity over time.

Effect of Different Breathing Patterns on Heart Rate and Blood Pressure Response to Resisted Exercises in Females Within the Age Group of 25 to 35 Years

Introduction: Blood pressure and heart rate increases in individuals while performing heavy resisted exercises but acquiring different breathing patterns during exercise shows its effect on blood pressure and heart rate, it may or may not exaggerate. Inhalation or exhalation when coupled with concentric phase of resisted exercise may or may not show similar blood pressure response as compare to inhalation or exhalation when coupled with eccentric phase of resisted exercise whereas Valsalva maneuver can exaggerate the blood pressure response. Objective: To study the inhalation, exhalation and Valsalva maneuver on systolic, diastolic blood pressure and heart rate. Research Design: Quasi experimental. Methodology: 30 female subjects were taken which were asked to do a set of bicep curls with 3 different patterns of breathing with each pattern performed on a separate day. Then the recordings were taken and calculated to see in which pattern of breathing blood pressure and heart rate rises. Result: ANOVA was used and the result showed that diastolic blood pressure increases while exhalation coupled with the concentric phase and inhalation coupled with the eccentric Phase but there is a marked increase in diastolic blood pressure during Valsalva maneuver as compared to the inhalation coupled with the concentric phase and exhalation coupled with the eccentric phase. The result showed that the change in the blood pressure due to the different breathing patterns were significant p&gt;0.05 Conclusion: It is concluded that Valsalva maneuver exaggerates the blood pressure response. Keywords: resisted exercises, Valsalva maneuver, exhalation. breathing patterns.

Effect of health extension workers-led home-based multicomponent intervention on blood pressure reduction among hypertensive patients in rural districts of northwest Ethiopia: a cluster-randomised controlled trial.

To evaluate effects of health extension workers-led home-based multicomponent intervention on blood pressure change in hypertensive patients in rural districts of northwest Ethiopia. Two-arm cluster randomised controlled trial was conducted. Hypertensive patients' age ≥25 years were included. 20 clusters or kebeles with 456 participants were randomly assigned to the intervention group (10 clusters with 228 participants) and the control group (10 clusters with 228 participants). Participants in the intervention kebeles received health extension workers-led home-based multicomponent interventions every other month for 40-60 min for 9 months. The primary outcomes were the differences in mean systolic blood pressure (SBP) and diastolic blood pressure (DBP) changes from baseline between patients in the intervention and control groups. Intention-to-treat analysis was used for the primary analyses. Linear mixed effect model was used to evaluate the intervention's effect on change in mean SBP and DBP. Effect sizes of mean difference and relative benefit increase were used. At 9 months, the mean SBP decreased by 15.8 mm Hg (95% CI: 13.5, 18.1) in the intervention and 10.8 mm Hg (95% CI: 8.7, 12.9) in the control groups; with a 5.0 mm Hg (95% CI: 1.9, 8.1) greater reduction in the intervention group. The mean DBP decreased by 12.1 mm Hg (95% CI: 10.6, 13.5) in the intervention and 8.4 mm Hg (95% CI: 7.0, 9.8) in the control group. The proportion of optimal blood pressure control was higher in the intervention group (45.8%) than the control group (28.2%) with percentage difference of 17.6% (95% CI: 8.5, 26.7). Health extension workers-led home-based multicomponent intervention has resulted significant reduction of blood pressure and achieved a higher proportion of optimal blood pressure control. This strategy is effective, but further research is needed to determine its cost effectiveness for scaling up and integrating in primary care settings. The trial is registered with Pan African clinical trial registry (PACTR202102729454417).

Study of the technical parameters dynamics influence on operational performance of hydraulic single-bucket excavators

Introduction. The development of automobile and road construction is a priority in the Russian economy. Timely putting construction projects in commission increases the requirements for planning of execution mechanized works. The operation of transport and technological machines in construction processes for a long time leads to a decrease in their potential capabilities, including operational productivity. The purpose of the proposed article is to improve the method of calculating the performance of a single-bucket hydraulic excavator (EO), taking into account the operating time.Methods and materials. The performance calculation method takes into account the dynamics of the working pressure in the hydraulic system of the working equipment (GRO), the speed of rotation of the crankshaft (PMVC) from the operating time, regression dependencies were used to describe them. The parameters of the law of distribution of the random value of the working pressure in the hydraulic drive and the rate of its fall for the ‘development and recruitment of soil’ operation were also obtained.Results. Processing of the results of production experiments enables to establish the dependence of changes in the working pressure in the hydraulic system during development and gathering soil, as well as for all technological operations of the working cycle, the rotational frequency of the crankshaft of a single-bucket excavator engine on the operating time. The influence of the working pressure in the hydraulic drive, the rotational speed of the crankshaft of the excavator engine on the supply and hydraulic power, the duration of technological operations is studied. The calculation of the operational productivity of a single-bucket excavator is carried out taking into account the dynamics of parameters reflecting its change over operating time.Discussion and conclusions. It has been established that with an increase in operating time, the operating pressure in the hydraulic drive decreases by an average of 12.7-13.0%, and the decrease in the average operating speed of the crankshaft is 4%. The estimated value of the drop in the average hourly operating performance of the EO, taking into account the deterioration of the technical condition, is 55% in the operating time range from 0 to 10,000 operating hours for the Japanese EO ZX 330 model.

Addressing depression and comorbid health conditions through solution-focused brief therapy in an integrated care setting: a randomized clinical trial

BackgroundCo-occurring physical and mental health conditions are common, but effective and sustainable interventions are needed for primary care settings.PurposeOur paper analyzes the effectiveness of a Solution-Focused Brief Therapy (SFBT) intervention for treating depression and co-occurring health conditions in primary care. We hypothesized that individuals receiving the SFBT intervention would have statistically significant reductions in depressive and anxiety symptoms, systolic blood pressure (SBP), hemoglobin A1C (HbA1c), and body mass index (BMI) when compared to those in the control group. Additionally, we hypothesized that the SFBT group would have increased well-being scores compared to the control group.MethodsA randomized clinical trial was conducted at a rural federally qualified health center. Eligible participants scored ≥ 10 on the Patient Health Questionnaire (PHQ-9) and met criteria for co-occurring health conditions (hypertension, obesity, diabetes) evidenced by chart review. SFBT participants (n = 40) received three SFBT interventions over three weeks in addition to treatment as usual (TAU). The control group (n = 40) received TAU over three weeks. Measures included depression (PHQ-9) and anxiety (GAD-7), well-being (Human Flourishing Index), and SFBT scores, along with physical health outcomes (blood pressure, body mass index, and hemoglobin A1c).ResultsOf 80 consented participants, 69 completed all measures and were included in the final analysis. 80% identified as female and the mean age was 38.1 years (SD = 14.5). Most participants were white (72%) followed by Hispanic (15%) and Black (13%). When compared to TAU, SFBT intervention participants had significantly greater reductions in depression (baseline: M = 18.17, SD = 3.97, outcome: M = 9.71, SD = 3.71) and anxiety (baseline: M = 14.69, SD = 4.9, outcome: M = 8.43, SD = 3.79). SFBT intervention participants also had significantly increased well-being scores (baseline: M = 58.37, SD = 16.36, outcome: M = 73.43, SD = 14.70) when compared to TAU. Changes in BMI and blood pressure were not statistically significant.ConclusionThe SFBT intervention demonstrated efficacy in reducing depressive and anxiety symptoms and increasing well-being but did not affect cardio-metabolic parameters over a short period of intervention.Trial RegistrationThe study was pre-registered at ClinicalTrials.gov Identifier: NCT05838222 on 4/20/2023. *M = Mean, SD = Standard deviation.

The freeze-drying performance under pressures from 1.325 to 101.325 kPa

The low drying rate is the main limitation of atmospheric freeze drying. The drying rate depends on the balance between heat and mass transfer. Among the process variables, air pressure changes have the opposite effects on heat and mass transfer simultaneously. The increase in pressure favors heat transfer but hinders mass transfer. Therefore, a conjugate model was proposed and validated to quantitatively investigate the heat and mass transport characteristics of lamellar products during freeze-drying in a tunnel under different pressures (1.325–101.325 kPa). To describe the effects of air pressure, the Navier-Stokes equations of the external fluid were coupled with the adsorption-sublimation model. Results show the regulation of transfer resistance values and drying rate with moisture content during the drying process, indicating that freeze-drying is the external heat transfer control at first, then the internal mass transfer control, and eventually, the heat transfer promotion can accelerate the process. The optimal constant pressure value was found to be 5.325 kPa, with the shortest drying time (17.3 h). It has been demonstrated that freeze drying employing a specific laddering-controlled strategy, offers the benefit of reducing drying time in comparison to the use of optimal constant pressure; however, the impact was not remarkable.

A Transparent Soil Experiment to Investigate the Influence of Arrangement and Connecting Beams on the Pile-Soil Interaction of Micropile Groups.

The use of a micropile group is an effective method for small and medium-sized slope management. However, there is limited research on the pile-soil interaction mechanism of micropile groups. Based on transparent soil and PIV technology, a test platform for the lateral load testing of slopes was constructed, and eight groups of transparent soil slope model experiments were performed. The changes in soil pressure and pile top displacement at the top of the piles during lateral loading were obtained. We scanned and photographed the slope, and obtained the deformation characteristics of the soil interior based on particle image velocimetry. A three-dimensional reconstruction program was developed to generate the displacement isosurface behind the pile. The impacts of various arrangement patterns and connecting beams on the deformation attributes and pile-soil interaction mechanism were explored, and the pile-soil interaction model of group piles was summarized. The results show that the front piles in a staggered arrangement bore more lateral thrust, and the distribution of soil pressure on each row of piles was more uniform. The connecting beams enhanced the overall stiffness of the pile group, reduced pile displacement, facilitated coordinated deformation of the pile group, and enhanced the anti-sliding effect of the pile-soil composite structure.