Tube Size Research Articles

A Numerical Simulation on the Leakage Event of a High-Pressure Hydrogen Dispenser

For the sake of the increasing demand of hydrogen fuel cell vehicles, there are more concerns on the safety of hydrogen refueling stations. As one of the key pieces of equipment, the hydrogen dispenser has drawn attention on this aspect since it involves massive manual operations and may be bothered by a high probability of failure. In this paper, a numerical study is conducted to simulate the possible leakage events of the hydrogen dispenser based on a prototype in China whose working pressure is 70 MPa. The leakage accident is analyzed with respect to leakage sizes, leak directions, and the time to stop the leakage. It is found that, due to the large mass flow rate under such high pressure, the leak direction and the layout of the components inside the dispenser become insignificant, and the ignitable clouds will form inside the dispenser in less than 1 s if there is a leakage of 1% size of the main tube. The ignitable clouds will form near the vent holes outside the dispenser, which may dissipate quickly if the leakage is stopped. On the other hand, the gas inside the dispenser will remain ignitable for a long time, which asks for a design with no possible ignition source inside. The results can be useful in optimizing the design of the dispenser, regarding the reaction time and sensitivity requirements of the leakage detector, the size and amount of vent holes, etc.

Case Studies on Multistring Isolation Evaluation in P&A Operations

Cement sheath quality assessment is a critical initial step in plug and abandonment (P&A) operations during oil and gas well decommissioning. However, the technologies commonly used require unimpeded access to the casing annuli, thus enforcing the need for production tubing pulling or inner casing milling. Cement integrity or isolation evaluation through multilayered well casing strings will provide the opportunity to significantly reduce operational time and costs and to greatly simplify the traditional P&A process. As desired by the industry for years, recent advancements in isolation evaluation have proven the feasibility to assess cement sheath quality without the removal of production tubing or inner casing. The new development, consisting of a sophisticated logging apparatus with a novel processing methodology, led to a groundbreaking technology evaluating zonal isolation through multiple casing strings in wells. The logging tool is deployed in the borehole using E-line, slickline, or coiled tubing. Then, the acoustic energy that is emitted and received by the tool travels through the tubing and surrounding annulus to reach the isolation barrier behind the casing. A proprietary frequency-domain processing algorithm successfully identifies the desired signal by discriminating it from overwhelming undesired signals such as tubing arrivals. The latest development stage further enables the segmentation of the measurements, providing an improved sensitivity to detect the azimuthal variations in the cement sheath quality. Case histories of applying omnidirectional and segmented multistring isolation evaluation technology in field trials in the North Sea are presented in the paper. The measurement accuracy has been verified through side-by-side comparisons with industry-standard cement bond log (CBL) and ultrasonic logs recorded after the tubing was removed. Additionally, the technology has been proven applicable to various casing or tubing weight and size combinations with tubing eccentric inside the casing. Thus, it is practicable in actual well configurations and suitable for the deviated well sections as well. In conclusion, this innovative technology that exhibits quantitative assessments of bonding or isolation conditions of wells in multistring configurations provides a cost-effective solution during P&A and further demonstrates a great potential to accelerate along the path to a rigless P&A operation.

Role of endotracheal tube size on nasal and laryngeal morbidity during awake fiberoptic nasotracheal intubation: A Randomized controlled trial.

Background and Aims:Awake fibreoptic nasotracheal intubation is associated with adverse airway and hemodynamic complications. The aim of this study was to evaluate the role of endotracheal tube size on nasal and laryngeal morbidity during awake fibreoptic-guided nasotracheal intubation.Material and Methods:Eighty patients recruited to undergo awake fibreoptic intubation were randomly allocated to Group C (standard size endotracheal tube) and Group S (small size endotracheal tube followed by exchange to standard size using Airway Exchange Catheter under general anesthesia). Nasal morbidity was assessed by incidence of epistaxis, olfactory acuity, and mucociliary clearance. Patient discomfort during intubation was assessed using grimace score and hemodynamic parameters were recorded. Postoperatively, the incidence of nasal and laryngeal injury was recorded using nasendoscopy and telelaryngoscopy, respectively.Results:Demographic profile between the two groups was comparable. Epistaxis was noted in 47.5% of patients in group C as compared to 12.5% in group S. Postoperative olfactory acuity was decreased [2 (1-4) vs 4 (2-5)] and saccharin clearance time was prolonged (314 s vs 134 s) in Group C as compared to Group S. (P-value <0.001) Higher grimace score [2 (1-3) vs 1 (0-2)] and increased hemodynamic response was demonstrated in Group C. (P-value <0.001) Incidence of nasal injury [2 (1-4) vs 1 (0-2)] and laryngeal injury [1 (0-2) vs 0 (0-2)] was more in Group C as compared to Group S.Conclusion:Awake fibreoptic nasotracheal intubation with small size endotracheal tube followed by exchange to standard size under general anesthesia reduces nasal, laryngeal, and hemodynamic complications.

Smart Device for Biologically Enhanced Functional Regeneration of Osteo-Tendon Interface.

The spontaneous healing of a tendon laceration results in the formation of scar tissue, which has lower functionality than the original tissue. Moreover, chronic non-healing tendon injuries frequently require surgical treatment. Several types of scaffolds have been developed using the tissue engineering approach, to complement surgical procedures and to enhance the healing process at the injured site. In this work, an electrospun hybrid tubular scaffold was designed to mimic tissue fibrous arrangement and extracellular matrix (ECM) composition, and to be extemporaneously loaded into the inner cavity with human platelet lysate (PL), with the aim of leading to complete post-surgery functional regeneration of the tissue for functional regeneration of the osteo–tendon interface. For this purpose, pullulan (P)/chitosan (CH) based polymer solutions were enriched with hydroxyapatite nanoparticles (HP) and electrospun. The nanofibers were collected vertically along the length of the scaffold to mimic the fascicle direction of the tendon tissue. The scaffold obtained showed tendon-like mechanical performance, depending on HP content and tube size. The PL proteins were able to cross the scaffold wall, and in vitro studies have demonstrated that tenocytes and osteoblasts are able to adhere to and proliferate onto the scaffold in the presence of PL; moreover, they were also able to produce either collagen or sialoproteins, respectively—important components of ECM. These results suggest that HP and PL have a synergic effect, endorsing PL-loaded HP-doped aligned tubular scaffolds as an effective strategy to support new tissue formation in tendon-to-bone interface regeneration.

Axial Behavior of Concrete-Filled Double-Skin Tubular Stub Columns Incorporating PVC Pipes

This experimental study presents concrete-filled double-skin tubular columns and demonstrates their expected advantages. These columns consist of an outer steel tube, an inner steel tube, and concrete sandwiched between two tubes. The influence of the outer-to-inner tube dimension ratio, outer tube to thickness ratio, and type of inner tube material (steel, PVC pipe) on the ultimate axial capacity of concrete-filled double-skin tubular columns is studied. It is found that the yield strength of the inner tube does not significantly affect the ultimate axial capacity of concrete-filled double-skin tubular composites. With the replacement of the inner tube of steel with a PVC pipe, on average, less than 10% strength is reduced, irrespective of size and dimensions of the steel tube. Hence, the cost of a project can be reduced by replacing inner steel tubes with a PVC pipes. Finally, the experimental results are compared with the existing design methods presented in AISC 360-16 (2016), GB51367 (2019), and EC4 (2004). It is found from the comparison that GB51367 (2019) gives better results, followed by AISC (2016) and EC4 (2004).

Olefin Metathesis in Continuous Flow Reactor Employing Polar Ruthenium Catalyst and Soluble Metal Scavenger for Instant Purification of Products of Pharmaceutical Interest.

In recent years, the development of continuous-flow reactors has attracted growing attention from the synthetic community. Moreover, findings in the precise control of the reaction parameters and improved mass/heat transfer have made the flow setup an attractive alternative to batch reactors, both in academia and industry, enabling safe and easy scaling-up of synthetic processes. Even though a majority of the pharmaceutical industry currently rely on batch reactors or semibatch reactors, many are integrating flow technology because of easier maintenance and lower risks. Herein, we demonstrate an operationally simple flow setup for homogeneous ring-closing metathesis, which is applicable to the synthesis of active pharmaceutical ingredients precursors or analogues with high efficiency, low residence time, and in a green solvent. Furthermore, through the addition of a soluble metal scavenger in the subsequent step within the flow system, the level of ruthenium contamination in the final product can be greatly reduced (to less than 5 ppm). To ensure that this method is applicable for industrial usage, an upscale process including a 24 h continuous-flow reaction for more than 60 g of a Sildenafil analogue was achieved in a continuous-flow fashion by adjusting the tubing size and flow rate accordingly.

Active control behavior on the flow pattern in a circular duct

The current analysis aims to review the effectiveness of the flow regulations at Mach 1.87, a considerably large Mach number. The duct radius is11 mm, and the diameter ratio concerning the exit of the nozzle is 2.2. Tests were done at different expansion levels for eight different duct sizes. Here we are pondering in a situation where there is a considerable variation of pressure is noticed. The flow control was located at a PCD of 13 mm from the axis. The control jets of 0.001 m diameter producing a Mach unity jet, used as energetic flow control. For shorter tube sections at smaller NPRs, the pressure undertakes a minimal value. Soon After, with an increase of the tube size and expansion levels, a continuing fall in pressure owing to the decline in the level of adverse pressure and shock waves intensity. Flow fluctuations are witnessed for various duct sizes. The duct size represents a vital part while ascertaining the flow advancement in the duct. Relatively high pressure is seen for duct length L = 132 mm and L = 220 mm for nozzle pressure ratios three and five. The pressure becomes modest due to the effect of duct size. For NPR = 7, an increase in pressure is restricted by the separated zone, and atmospheric restrictions are almost accomplished. For the 10D duct, the realization of the ambient condition is additionally enhanced near the upstream.

Natural gas versus methane: Ignition kinetics and detonation limit behavior in small tubes

Detonation properties of methane and natural gas were studied using ZND simulations and detonation limit experiments. The experiments were performed in two tube sizes, 32 mm and 6.4 mm in inner diameter over a range of initial pressures (between 3.4 kPa and 35 kPa) and with stoichiometric fuel-oxygen compositions. The fuels considered are high purity methane, high purity methane with dopant ozone, a real natural gas, and a family of natural gas surrogates. The natural gas surrogates were developed based on North American natural gas composition variations and designed to capture the expected mean and variance of fundamental combustion properties of natural gases. All natural gases tested in this work show a substantially smaller detonation induction length (about 40%) and lower detonation pressure limit (30% in terms of limiting pressure) than high purity methane. The ozonated methane at 3000 PPMv of ozone doping performed similarly to the natural gases. Overall, the results suggest that in methane-based mixtures, a smaller induction length correlates with a more predictable detonation behavior as evidenced by a lower detonation pressure limit. As such, natural gases are expected to have a wider operating range when used as a fuel for detonation-based engines. As importantly, induction length calculation results reveal that the variability in detonation and combustion behaviors resultant from composition variability is expected to be similar between natural gases and commercial methane. Finally, the results suggest that for safety-related studies, neat methane is a poor surrogate for studying natural gas explosions.

To Compare the Efficacy of Betamethasone Gel and Lignocaine Gel Applied over Endotracheal Tube to Reduce Post Operative Sore Throat and Cough

Background: Post-operative sore throat, cough and hoarseness of the voice are often common, uncomfortable sequelae after tracheal intubation with inflammation being the most common pathogenesis. Post operative sore throat and cough has a multifactorial aetiology that includes patient-related factors such as age, sex, and smoking, as well as intubation factors such as technique, duration, tube size, intracuff pressure, cuff design, trauma to the pharyngolaryngeal mucosa and various factors.&#x0D; Objectives: To compare the incidence of post operative sore throat, cough after endotracheal tube intubation when applying betamethasone gel and lignocaine jelly.&#x0D; Materials and Methods: At Saveetha Medical College and Hospital in Thandalam, Chennai, a prospective controlled double blinded study was done among patients who were scheduled for elective procedures under general anaesthesia with orotracheal intubation. The study comprised 60 patients who met the study's inclusion and exclusion criteria. The 60 patients were divided into two study groups each enrolled with 30 patients. Before the study could begin, approval from the institutional research board was required. Before the study began, an informed, written consent was obtained. The method used was Qualitative observational randomised double blind study by using a computer-generated random number table and the sealed envelope approach, patients were assigned to one of two equal groups.&#x0D; Following a pre-anaesthetic evaluation, 60 patients of either sex, aged 18 to 60 years, with an ASA physical status of I or II, who were undergoing elective surgery (likely to last up to 240 minutes) under general anaesthesia with orotracheal intubation and met the above inclusion criteria were included in the study. The differences between the study groups were analysed by chi square test and the “p” value used as a cut off for estimating statistical significance between groups is 0.05.&#x0D; Results: The incidence and severity of post operative sore throat and cough after endotracheal intubation during 6 and 24 hours was found to be statistically significantly in patients in whom betamethasone was used. The results are significant at p&lt;0.05.&#x0D; At 6 hours the incidence of post operative sore throat for betamethasone and lignocaine was 12% and 30% respectively. At 24 hours the incidence of post operative sore throat for betamethasone and lignocaine was 9.36% and 25.2% respectively.&#x0D; At 6 hours the incidence of post operative cough for betamethasone and lignocaine was 8.4% and 24%.At 24 hours the incidence of post operative cough for betamethasone and lignocaine was 7.2% and 21.6% respectively.&#x0D; Conclusion: The use of 0.05 percent betamethasone gel to lubricate the endotracheal tube before intubation helps to reduce the time it takes for symptoms to resolve.

Microstructure and Its Influence on the Welding Quality of 6063 Aluminum Alloy Porthole Die Extrusion.

Extrusion experiments and 3D numerical modeling were conducted to investigate the dynamic recrystallization and welding quality of a 6063 aluminum alloy hollow square tube extruded by a porthole die at the ram speeds of 3 mm/s, 7 mm/s, 9 mm/s and 11 mm/s. The results showed that average grain size of hollow square tube extruded at the ram speed of 7 mm/s was the smallest. The profile extruded at the ram speed of 3 mm/s exhibited the highest expansion ratio. Dynamic recrystallization (DRX) fractions were highly variable at different ram speeds. DRX fractions in the matrix zones were higher than those in the welding zones, resulting in smaller grain sizes in the matrix zones. Mechanical properties in the welding zones and matrix zones was different. A local strain concentration would occurred during expansion, which would affect the welding quality. Finally, it was found that the uniform microstructure near the welding line would also affect the welding quality.

Characterising coronal turbulence using snapshot imaging of radio bursts in 80–200 MHz

Context. Metrewave solar type-III radio bursts offer a unique means to study the properties of turbulence across coronal heights. Theoretical models have shown that the apparent intensity and size of the burst sources evolve at sub-second scales under the influence of local turbulence. The properties of the evolution vary with observation frequency. However, observational studies remained difficult due to the lack of high fidelity imaging capabilities at these fine temporal scales simultaneously across wide spectral bands. Aims. I present a spectroscopic snapshot imaging (0.5 s, 160 kHz resolution) study of a type-III burst event across the 80–200 MHz band. By modelling the temporal variability of the source sizes and intensity at every observation frequency, the characteristics of coronal turbulence are studied across a heliocentric height range of ≈1.54–1.75 R⊙. Methods. To understand the morphological evolution of the type-III source, a 2D Gaussian fitting procedure is used. The observed trends in the source area and integrated flux density are analysed in the framework of theoretical and data-driven models. Results. The strength of density fluctuations (δN/N) in the corona is derived as a function of height (R). Combined with the archival low frequency data, δN/N values across ≈1.5–2.2 R⊙ agree within a few factors. The burst decay time (τdecay) and the full width at half maximum of the source showed a power-law dependence with frequency, roughly consistent with the results from data-driven models. However, the values of τdecay across frequencies turned out higher than the expected trend. The intrinsic sizes of the burst source were derived, correcting for scatter broadening. This roughly matched the expected size of flux tubes at the coronal heights explored. I also report the observation of an intrinsic anti-phased pulsation in the area and flux density of the source.

Length of the middle finger of hand as a simple and reliable predictor of optimal size of uncuffed endotracheal tube in paediatric patients: An observational study.

Background and Aims:A recent study suggested middle finger length-based formula as a better predictive guide compared with age-based formula for selecting uncuffed endotracheal tubes (ETTs) in children. But that study did not meet sample size requirement. Thus, we primarily aimed to determine the accuracy of formula using length of the middle finger to determine the internal diameter of the uncuffed ETT and to compare its accuracy with the Cole's formula. As a secondary objective, we desired to compare its accuracy with some commonly used length and weight-based formulae.Methods:This prospective observational study included children aged up to 12 years posted for elective surgery under general anaesthesia. The length of the middle finger on the palmar aspect of the hand was measured in the preoperative period and the characteristics of the airway used were noted. A predefined criterion of optimal size of the uncuffed ETT was used.Results:A total of 139 patients were included in the final analysis. It was observed that the formula based on middle finger length can predict the optimal size of uncuffed ETT within an error of 0.5 mm in more than 90% instances and its predictive performance is better than Cole's formula. As a secondary outcome, we also observed that its accuracy is better than other formulae under evaluation.Conclusion:Formula based on middle finger length can be used as a predictor of optimal size of uncuffed ETT in paediatric patients and it is a better predictor than Cole's formula.

Axial compressive behavior of concrete-encased CFST stub columns with open composite stirrups

The existing method to improve the coordination performance of the inner and outer parts of concrete-encased concrete-filled steel tube (CFST) composite columns by increasing the volume-stirrup ratio causes difficulties in construction due to over-dense stirrups. Thus, this paper proposes an open polygonal composite stirrup with high strength and high ductility CRB600H reinforced rebar, and seventeen specimens were constructed, and their axial compressive performance was tested. The main parameters considered were the volume-stirrup ratio, the steel tube size, the stirrup type and the stirrup strength. The test results indicated: For the specimens restrained by open octagonal composite stirrups, compared with the specimen of 0.5% volume-stirrup ratio, the compressive bearing capacity increased by 14.6%, 15.7% and 21.5% for volume-stirrup ratio of 0.73%, 1.07% and 1.61%, respectively. For the specimens restrained by open composite rectangle stirrups, compared with the specimen of 0.79% volume-stirrup ratio, the compressive bearing capacity increased by 7.5%, 6.1%, and -1.4% for volume-stirrup ratio of 1.12%, 1.58% and 2.24%, respectively. The restraint ability and the bearing capacity of the octagonal composite stirrup are better than other stirrup types. The specimens equipped with open polygonal composite stirrup not only had a higher ductility than those with the traditional closed-loop stirrup, but they also had a higher axial bearing capacity than those with an HPB300 strength grades stirrup. Therefore, the open composite stirrup can be used in practical engineering. A new calculation method was proposed based on the stress-strain models for confined concrete under different restrain conditions, and the predicted value was close to the experimental value.

Impacts of common faults on an air conditioner with a microtube condenser and analysis of fault characteristic features

Split system air conditioners are widely used to cool residential buildings, because of their low cost and simplicity. However, their efficiency is impacted by installation faults, which include: improper refrigerant charge (undercharge or overcharge), improper evaporator airflow, liquid line restrictions (LL), and the presence of non-condensable gas (NC) in the refrigerant. No known previously published research has studied the effect of these four faults on a system equipped with a microtube condenser, which has smaller tube size than a traditional condenser and therefore holds less refrigerant charge, but has a different configuration than a microchannel. Furthermore, very few have studied the impacts of LL and NC. This paper describes laboratory fault tests of a microtube-equipped system, compares the fault impacts with those of a traditional system, and considers the characteristic fault features. The tested system uses R-410A refrigerant and has a scroll compressor, a fixed orifice expansion device, and two fin-tube heat exchangers. The tests were carried out under steady operation with a range of fault intensities and operating conditions. The microtube system’s performance degradation from faults is similar to systems with traditional heat exchangers, despite the reduced capacity to hold refrigerant charge.

Large-Bore Aspiration Thrombectomy: Catalyst for a Revolution in Treating Pulmonary Embolism

Large-Bore Aspiration Thrombectomy: Catalyst for a Revolution in Treating Pulmonary Embolism

Self-driven liquid metal cooling connector for direct current high power charging to electric vehicle

Direct current-based high power charging (DC-HPC) technology is expected to shorten the charging time of electric vehicles (EV) significantly and lessen the range anxiety. However, a high charging current would cause a remarkable temperature rise of the charging connector due to the Joule heat, which must be adequately removed to keep its durability and safety. This paper reported a novel concept of the self-driven liquid metal (LM) cooling connector (LMCC) used for DC-HPC. The room-temperature LM of Galinstan filled in the flexible tube is applied as the current-carrying conductor and circulated-cooling fluid simultaneously. The circulation-flow LM is driven by the designed electromagnetic force through coupling the charging current and magnetic field from a pair of permanent magnets, which does not need additional pumping devices. A principle experiment is conducted to demonstrate the driving and cooling performances of LMCC, which shows excellent circulation flow rate (with the flow rate of 0.75 L/min and the driven pressure head of 44.7 kPa) of the LM in the flexible tube (diameter of 6 mm and length of 2.65 m) and only achieves a temperature rise of about 13 °[email protected] Both 3D multi-physics simulation and theoretical models are also established and demonstrated by experiment results to accurately evaluate the impacts of the charging current, magnetic field, and flexible tube size on the performance of self-driven LMCC. The results indicate that increasing the diameter of the flexible tube could significantly reduce its temperature rise induced by a high charging current and does not affect its flexibility. A super-low temperature rise of 10.6 °[email protected] for the charging cable (the diameter of 10 mm and length of 3 m) is designed. This work provides a new strategy for the heat dissipation technology of DC-HPC charging connectors.

Applying Best Practice to Converting Blood Collection Tube Suppliers: Overcoming Laboratory Supply Shortages

Abstract Introduction/Objective Changing blood tube suppliers is a complex process that requires systematic validation. It can serve to expand a laboratory’s options during a supply shortage, and can lead to cost savings. Just prior to the pandemic, our laboratory underwent a large-scale conversion of blood tube suppliers after successful validation of serum, plasma, and whole blood tubes for blood bank, chemistry, immunology, hematology, coagulation, molecular diagnostics, and flow cytometry. Methods/Case Report First, we designed a patient consent form for collecting extra blood samples. Per CLSI standards, validation of blood tubes is needed for each testing methodology but not for each analyte. Hence, we selected high-impact assays to represent each testing methodology used by our instrument platforms. We designed comparison studies to test the new blood tubes for result accuracy, precision and specimen stability that covered an assay’s reportable range. Allowable error limits were set based on Westgard and CAP guidelines. Spiked specimens were used when positive patient samples were not feasible. We also took the opportunity to optimize the blood tube sizes, e.g., converting the lavender-top tubes from 2 ml (vendor A) to 3 ml (vendor B). We then confirmed with our reference labs the acceptability of the new vendor’s products, and administered an electronic survey to solicit staff feedback. Finally, we coordinated supply chain, formulary changes and test catalog updates. Results (if a Case Study enter NA) Data analyses showed 100% acceptable performance of the new supplier’s blood tubes. The survey showed that our phlebotomists supported the new products, citing their ease of use and good vacuum. Our hematology technologists provided favorable feedback on the larger lavender-top tubes that reduced the number of insufficient samples. On the economic front, this supplier conversion has yielded a 26% cost savings. Conclusion To our knowledge, our study is the most comprehensive of all blood collection device comparison analyses published. Our validation strategies that were designed to comply with best practice standards have led to our confidence in the interchangeability of the new and old blood tube products. This initiative serves to elucidate a protocol to add vendor options that can be replicated by other laboratories to mitigate blood tube supply shortages and backorders. It has helped us control supply costs without compromising quality.

Ultrawide bandwidth single-mode polarization beam splitter based on dual-hollow-core antiresonant fiber.

An ultrawide bandwidth and single-mode polarization beam splitter (PBS) based on an air-gap type of dual-hollow-core antiresonant fiber (DHC-ARF) is proposed. Nested tubes are introduced into two cladding tubes between two cores to weaken the wavelength dependence of coupling length in DHC-ARF for obtaining ultrawide bandwidth. By tuning the cladding tube sizes, higher-order core modes with the lowest loss can be coupled with cladding tube modes, and thus, effectively, single-mode operation is achieved. Numerical results demonstrate that an 8.15 cm long DHC-ARF can be used to develop a PBS with an operating bandwidth of 370 nm ranging from 1.28 to 1.65 µm, where a polarization extinction ratio is below -20dB and a high-order mode extinction ratio exceeds 100.

Improvement of Pediatric Advanced Airway Management in General Emergency Departments After a Collaborative Intervention Program.

In general emergency departments, advanced airway management of pediatric patients who are critically ill has been associated with increased adverse events given the varying exposure to pediatric patients and limited resources. Previous studies have shown significant improvement of simulated pediatric airway management in general emergency departments. The aim of this retrospective study was to determine the effect of an in situ simulation-based collaborative intervention program on the actual care of pediatric airway management in general emergency departments. This was a retrospective study of pediatric subjects who were critically ill and required intubation at a diverse set of general emergency departments before referral to the academic medical center. The primary outcome was the quality of clinical care measured by adherence to best practices via a critical action checklist. Secondary outcomes included tracheal intubation associated adverse events and clinical outcomes. A total of 135 pediatric subjects (48 pre- and 87 post-intervention) who were transferred to the academic medical center from 9 general emergency departments between May 2014 and August 2019 were included in the analysis. The use of a cuffed endotracheal tube improved, from 44% to 72% (P = .001), whereas there was no significant change in the appropriate endotracheal tube size. Overall, severe tracheal intubation associated adverse events decreased, from 18.8% to 9.2% (P = .03), and post-intubation cardiac arrest events decreased, from 6.3% to 0% (P = .02). A simulation-based collaborative intervention program led to improvement in pediatric airway management and subject outcomes in general emergency departments. This model demonstrated the transfer of improvement from a simulated setting to a clinical setting and may be targeted in other clinical settings.

Intercalation Behavior of Water-in-Salt Electrolytes in Nanoscale Hydrophobic Carbon Confinement

Intercalation of water-in-salt (WIS) electrolytes in nanoscale confinement is an important phenomenon relevant to the energy storage applications. Here, we use enhanced sampling molecular dynamics simulations to investigate the effects of intersurface separation on the structure and free energy underlying the intercalation of the Li bis(trifluoromethane)sulfonimide ([Li][TFSI]) water-in-salt (WIS) electrolyte confined between nanoscale hydrophobic carbon surfaces. We observe that the confinement separation and the WIS concentration governs the relative stability of the condensed and vapor phases of WIS inside the confinement. The relative height of the free energy barrier separating the condensed and vapor phases of WIS also strongly depends on the concentration of [Li][TFSI] inside the confined space. We find that this concentration dependence is majorly due to changes in line tension. The process of deintercalation of electrolyte passes through a vapor tube formation inside the confined space. The size of the critical vapor tube required for spontaneous evaporation of WIS from the confinement is found to be dependent on the intersurface separation and WIS concentration.