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The use of a metofluthrin-impregnated spatial repellent device (MSRD) is a new and effective method for preventing mosquito blood feeding. Indoor environmental factors such as room temperature and ventilation rate are thought to be important for MSRD activity. Measurements of room temperature and vaporization of metofluthrin from MSRD in typical rural metal-roof and thatched-roof houses in southeastern Malawi were conducted. The relationship between house structure and the number of collected Anopheline mosquitoes with and without MSRD treatment was also investigated. The difference between daytime and nighttime room temperature was significantly higher in metal-roof houses than in thatched-roof houses. The vaporization of metofluthrin from the MSRD was not accelerated by the high room temperature, but by the high indoor air flow by ventilation. The number of mosquito collections was significantly higher in thatched-roof houses than in metal-roof houses. MSRD-treated thatched-roof houses have a higher probability of mosquito infestation, but the vaporization of metofluthrin is also higher because of indoor air flow, resulting in a reduction in mosquito numbers. Metal-roof houses with closed eaves reduce the probability of mosquito invasion, and a longer predicted effectiveness occurs with MSRD because of the controlled release of metofluthrin through lower indoor air flow., Japanese Journal of Infectious Diseases, 75(3), pp. 288-295; 2022

Uniform ventilation is important for the safety of long tunnel in underground buildings, it is difficult to install the large size air duct to ensure the centerline of each cross-section of the traditional variable cross-section ventilation system(VCVS) superimposed on the same horizontal axis, which is significant to the ventilation uniformity, energy consumption and installation convenience of the VCVS. On the contrary, each cross-section of the Equal Cross-section Ventilation System (ECVS) has the same horizontal axis, therefore, it is more convenient to manufacture and install the large size air duct in the underground long tunnel and achieve uniform ventilation. This study proposes an ECVS, using computational fluid dynamics(CFD) numerical simulation analyzed the influences of main duct velocity, aspect ratio, and outlet numbers on uniformity and energy consumption per unit air volume(ECPV). It revealed that when each ventilation equalizer's valve Angle β is given, uniformity of air supply decreases slightly with an increase in the inlet velocity. When the air supply main duct aspect ratio increases, the outlet velocity standard deviation range is from 0.22 to 0.34. When outlet numbers N=7~12 and β are constant, air supply uniformity and resistance coefficient ξ also decrease with the decrease of outlet numbers. The outlet number has a significant influence on the uniformity of system air supply, main duct velocity, and aspect ratio are relatively small. ECPV is positively correlated with the main duct velocity and outlet number, and is negatively correlated with aspect ratio.

A novel dual source vapor injection heat pump (DSVIHP) using exhaust and ambient air is proposed. The air exhausted from the building first releases energy to the medium-pressure evaporator and is then mixed with the ambient air to heat the low-pressure evaporator. A vapor injection (VI) compressor of two inlets is connected with the low and medium pressure evaporators. It's first time that a VI compressor is employed to recover the ventilation heat. The system can minimize the ventilation heat loss and provide a unique defrosting approach by using the exhaust waste heat. Fundamentals of the proposed DSVIHP are illustrated. Mathematical models are built. Both energetic and exergetic analyses are carried out under variable conditions. The results indicate that the DSVIHP has superior thermodynamic performance. The superiority is more appreciable at a lower ambient temperature. It has a higher COP than the conventional vapor injection heat pump and air source heat pump by 11.3% and 23.2% respectively at an ambient temperature of -10 °C and condensation temperature of 45 °C. The waste heat recovery ratio from the exhaust air is more than 100%. The novel DSVIHP has great potential in the cold climate area application.

Volatile anesthetics are increasingly used for sedation in intensive care units. The most common administration system is AnaConDa-100 mL (ACD-100; Sedana Medical, Uppsala, Sweden), which reflects volatile anesthetics in open ventilation circuits. AnaConDa-50 mL (ACD-50) is a new device with half the volumetric dead space. Carbon dioxide (CO2) can be retained with both devices. We therefore compared the CO2 elimination and isoflurane reflection efficiency of both devices.A test lung constantly insufflated with CO2 was ventilated with a tidal volume of 500 mL at 10 breaths/min. End-tidal CO2 (EtCO2) partial pressure was measured using 3 different devices: a heat-and-moisture exchanger (HME, 35 mL), ACD-100, and ACD-50 under 4 different experimental conditions: ambient temperature pressure (ATP), body temperature pressure saturated (BTPS) conditions, BTPS with 0.4 Vol% isoflurane (ISO-0.4), and BTPS with 1.2 Vol% isoflurane. Fifty breaths were recorded at 3 time points (n = 150) for each device and each condition. To determine device dead space, we adjusted the tidal volume to maintain normocapnia (n = 3), for each device. Thereafter, we determined reflection efficiency by measuring isoflurane concentrations at infusion rates varying from 0.5 to 20 mL/h (n = 3), for each device.EtCO2 was consistently greater with ACD-100 than with ACD-50 and HME (ISO-0.4, mean ± standard deviations: ACD-100, 52.4 ± 0.8; ACD-50, 44.4 ± 0.8; HME, 40.1 ± 0.4 mm Hg; differences of means of EtCO2 [respective 95% confidence intervals]: ACD-100 - ACD-50, 8.0 [7.9-8.1] mm Hg, P.001; ACD-100 - HME, 12.3 [12.2-12.4] mm Hg, P.001; ACD-50 - HME, 4.3 [4.2-4.3] mm Hg, P.001). It was greatest under ATP, less under BTPS, and least with ISO-0.4 and BTPS with 1.2 Vol% isoflurane. In addition to the 100 or 50 mL "volumetric dead space" of each AnaConDa, "reflective dead space" was 40 mL with ACD-100 and 25 mL with ACD-50 when using isoflurane. Isoflurane reflection was highest under ATP. Under BTPS with CO2 insufflation and isoflurane concentrations around 0.4 Vol%, reflection efficiency was 93% with ACD-100 and 80% with ACD-50.Isoflurane reflection remained sufficient with the ACD-50 at clinical anesthetic concentrations, while CO2 elimination was improved. The ACD-50 should be practical for tidal volumes as low as 200 mL, allowing lung-protective ventilation even in small patients.

Surges of COVID-19 infections could lead to insufficient supply of mechanical ventilators, and rationing of needed care. Multiplexing mechanical ventilators (co-MV) to serve multiple patients is a potential temporary solution. However, if patients are ventilated in parallel ventilation, there is currently no means to match ventilation requirements or patients, with no guidelines to date for co-MV. This research uses patient-specific clinically validated respiratory mechanics models to propose a method for patient matching and mechanical ventilator settings for two-patient co-MV under pressure control mode. The proposed method can simulate and estimate the resultant tidal volume of different combinations of co-ventilated patients. With both patients fulfilling the specified constraint under similar ventilation settings, the actual mechanical ventilator settings for co-MV are determined. This method allows clinicians to analyze in silico co-MV before clinical implementation.

Improving the utilization efficiency of cold airflow in data center (DC) has already attracted widespread concern. A broad consensus has been reached that cold/hot‐aisle containment technologies can reduce the mixture of cold and hot air to weaken the overheating phenomenon of the rack in a certain extent. However, local hot spots still occur in the front racks due to lower tile flow rate at the entrance of the cold aisle, which means the thermal environment of front racks can be further improved to achieve the more uniform airflow distribution horizontally and vertically in DC. In this paper, an innovative method of airflow optimization applying jet fans in the cold aisles is proposed to make up the lower tile flow rate, adjust the flow path of cold air from the perforated tiles to racks, and balance temperature heterogeneity. In addition, inductive velocity, nozzle height, horizontal position, and attachment distance of jet fans are optimized to explore the optimal parameters. Results show that the incorporation of jet‐induced ventilation can effectively improve the cooling performance and overall thermal environment in DC, while the amount of IT equipment that exceeded the ASHRAE recommended supply air temperature (SAT) is reduced by about 38%. The jet fan with optimal parameters has a broad application space in the raised floor DC.

OBJECTIVES: To explore the level and time course of patient-ventilator asynchrony in mechanically ventilated children and the effects on duration of mechanical ventilation, PICU stay, and Comfort Behavior Score as indicator for patient comfort.DESIGN: Secondary analysis of physiology data from mechanically ventilated children.SETTING: Mixed medical-surgical tertiary PICU in a university hospital.PATIENTS: Mechanically ventilated children 0-18 years old were eligible for inclusion. Excluded were patients who were unable to initiate and maintain spontaneous breathing from any cause.MEASUREMENTS AND MAIN RESULTS: Twenty-nine patients were studied with a total duration of 109 days. Twenty-two study days (20%) were excluded because patients were on neuromuscular blockade or high-frequency oscillatory ventilation, yielding 87 days (80%) for analysis. Patient-ventilator asynchrony was detected through analysis of daily recorded ventilator airway pressure, flow, and volume versus time scalars. Approximately one of every three breaths was asynchronous. The percentage of asynchronous breaths significantly increased over time, with the highest prevalence on the day of extubation. There was no correlation with the Comfort Behavior score. The percentage of asynchronous breaths during the first 24 hours was inversely correlated with the duration of mechanical ventilation. Patients with severe patient-ventilator asynchrony (asynchrony index > 10% or > 75th percentile of the calculated asynchrony index) did not have a prolonged duration of ventilation.CONCLUSIONS: The level of patient-ventilator asynchrony increased over time was not related to patient discomfort and inversely related to the duration of mechanical ventilation.

Introduction: INTELLiVENT–Adaptive Support Ventilation (INTELLiVENT–ASV), an advanced closed–loop ventilation mode for use in intensive care unit (ICU) patients, is equipped with algorithms that automatically adjust settings on the basis of physiologic signals and patient’s activity. Here we describe its effectiveness, safety, and efficacy in various types of ICU patients. Areas covered: A systematic search conducted in MEDLINE, EMBASE, the Cochrane Central register of Controlled Trials (CENTRAL), and in Google Scholar identified 10 randomized clinical trials. Expert opinion: Studies suggest INTELLiVENT–ASV to be an effective automated mode with regard to the titrations of tidal volume, airway pressure, and oxygen. INTELLiVENT–ASV is as safe as conventional modes. However, thus far studies have not shown INTELLiVENT–ASV to be superior to conventional modes with regard to duration of ventilation and other patient–centered outcomes. Future studies are needed to test its efficacy.

Mit der High-Flow-Sauerstofftherapie („high flow nasal cannula“ [HFNC]), bei der ein Sauerstoff-Luft-Gasgemisch mit Flüssen zwischen 30 und 70 l/min appliziert wird, steht ein technisch einfaches und hocheffektives Verfahren zur Therapie einer respiratorischen Insuffizienz zur Verfügung. Des Weiteren kann die HFNC während einer Bronchoskopie zur Oxygenierung, vor einer Intubation zur Präoxygenierung und nach Extubation zur Vermeidung einer Re-Intubation verwendet werden. Durch die hohen Gasflüsse wird vermieden, dass der Patient Umgebungsluft inspiriert, sodass eine präzise Einstellung einer inspiratorischen Sauerstofffraktion möglich ist, des Weiteren wird durch einen entstehenden Staudruck ein positiver endexspiratorischer Druck aufgebaut, durch die Anfeuchtung und Erwärmung der Atemluft die mukoziliäre Clearance verbessert sowie die Atemarbeit durch Auswaschen der oberen Atemwege verringert. Im Vergleich zur konventionellen Sauerstofftherapie ist die Aerosolbildung durch eine HFNC nicht erhöht, sodass dieses Verfahren auch bei COVID-19 eingesetzt werden kann. Beim hyperkapnischen Lungenversagen liegen bisher keine konklusiven Daten für die Effekte der HFNC vor, hier sollte bevorzugt eine nichtinvasive Beatmung statt einer HFNC erfolgen. Bei der Anwendung darf nicht vergessen werden, dass die mit HFNC behandelten Patienten kritisch krank sind und daher kontinuierlich überwacht werden müssen. So muss sichergestellt sein, dass jederzeit eine Eskalation z. B. auf eine Intubation und invasive Beatmung erfolgen kann.

The association between the footwear microclimate and microbial community on the foot plantar skin was investigated by experiments with three participants. Novel methods were developed for measuring in-shoe temperature and humidity at five footwear regions, as well as the overall ventilation rate inside the footwear. Three types of footwear were tested including casual shoes, running shoes, and perforated shoes for pairwise comparison of footwear microclimate and corresponding microbial community on the skin. The major findings are as follows: (1) footwear types make a significant difference to in-shoe temperature at the instep region with the casual shoes sustaining the warmest of all types; (2) significant differences were observed in local internal absolute humidity between footwear types, with the casual shoes sustaining the highest level of humidity at most regions; (3) the perforated shoes provided the highest ventilation rate, followed by running and casual shoes, and the faster the gait, the larger the discrepancy in ventilation rate between footwear types; (4) the casual shoes seemed to provide the most favorable internal environment for bacterial growth at the distal plantar skin; and (5) the bacterial growth at the distal plantar skin showed a positive linear correlation with the in-shoe temperature and absolute humidity, and a negative linear correlation with the ventilation rate. The ventilation rate seemed to be a more reliable indicator of the bacterial growth. Above all, we can conclude that footwear microclimate varies in footwear types, which makes contributions to the bacterial growth on the foot plantar skin.

Objective: To study the post-operative outcomes of two-lung ventilation in patients undergoing prone position thoracoscopicesophagectomy. Study Design: Prospective comparative study. Place and Duration of Study: Department of Thoracic Surgery, Combined Military Hospital, Rawalpindi Pakistan, from Jan to Dec 2019. Methodology: A total of 60 patients operated for both groups of thoraco-esophagectomy in which 34 patients for TLV (two-lung ventilation) and 26 patients for One-lung ventilation were studied. Patients position was prone for Two-lung ventilation in Thoracoscopic-esophagectomy. Post-op blood loss, Hospital stay, duration of anesthesia and operative morbidity was calculated. Results: A total of 60 patients underwent two-lung ventilation in prone position out of which patient of thoracoscopicesophagectomy were 34, while 26 underwent One-lung ventilation in semi-decubitus position thoracoscopic-esophagectomy. All of them were successfully performed without conversion to open thoracotomy. In the study with preparation span for anesthesia induction, mean time of mobilization of thoracic esophagus, mean blood loss during the thoracic mobilization phase, the mean Intensive care unit stay and total hospital stay in two-lung ventilation was less than one-lung ventilation (p

BackgroundUntil recently, relatively little research has been done on how mosquitoes behave around the occupied bed net in the indoor environment. This has been partly remedied in the last few years through laboratory and field studies, most of these using video methods and mosquito flight tracking. Despite these recent advances, understanding of the mosquito-bed net environment system, and the principles that underlie mosquito behaviour within it, is limited. This project aimed to further understand this system by studying the effects of gently moving air (such as might be introduced through room design to make the indoor environment more comfortable and conducive to ITN use) and warmer vs. cooler ambient conditions on mosquito activity around ITNs and other bed nets.MethodsThe activity of colonized femaleAnopheles gambiaearound an occupied untreated bed net set up in a mosquito-proof tent in a large laboratory space was recorded under different ambient conditions using a laser detection-video recording system. Conditions tested were ‘cool’ (23–25 °C) and ‘warm’ (27–30 °C) air temperatures and the presence or absence of a cross-flow produced by a small central processing unit (CPU) fan pointed at the side of the net so that it produced a ‘low-’ or ‘high-’ speed cross-draught (approx. 0.1 and 0.4 m/s, respectively). Near-net activity in recordings was measured using video image analysis.ResultsIn cool, still air conditions, more than 80% of near-net activity byAn. gambiaeoccurred on the net roof. Introduction of the low-speed or high-speed cross-draught resulted in an almost total drop off in roof activity within 1 to 2 min and, in the case of the high-speed cross-draught, a complementary increase in activity on the net side. In warm, still conditions, near-net activity appeared to be lower overall than in cool, still air conditions and to be relatively less focussed on the roof. Introduction of the high-speed cross-draught in warm conditions resulted in a decrease in roof activity and increase in side activity though neither effect was statistically significant.ConclusionsResults are interpreted in terms of the flow of the stimulatory odour plume produced by the net occupant which, consistent with established principles of fluid dynamics, appears to rise quickly and remain more intact above the net occupant in cool, still air than in warm, still air. Cross-draught effects are ascribed to the changes they cause in the flow of the host odour plume as opposed to mosquito flight directly. The implications of these results for house designs that promote indoor air movement, on bed net design, and on other vector control measures are discussed. How mosquitoes approach a net is influenced both by indoor temperature and ventilation and their interaction. This system is in need of further study.

Exposure to bioaerosols in the air of hospitals is associated with a wide range of adverse health effects due to the presence of airborne microorganisms. Intensity and type of health effects depend on many factors such as the type, density, and diversity of bioaerosols in hospital environments. Therefore, identifying and determining their distribution in hospital environment contribute to reduce their adverse effects and maintain the physical health of patients and staff, as well as find the source of infections and possible allergies due to the presence of bioaerosols. Therefore, the present study was conducted to determine the type and concentration of the bacterial and fungal bioaerosols, and their distribution in the indoor and outdoor air of a teaching hospital to establish a reference for future studies or measures. The air samples were collected with a one-stage Anderson sampler and particle mass counter for a period of four months in the fall and winter of 2019. In total, 262 bacterial and fungal samples were collected from the air of the wards of Tohid Hospital, Sanandaj, Iran. Antibiotic resistance test, bacterial identification by PCR method, and modeling the dispersion of concentrations of bio-aerosols were also conducted. In order to identify bacteria and fungi, some biochemical and molecular tests and microscopic and macroscopic characteristic methods were applied, respectively. The results showed that the highest and lowest densities of the bioaerosols were observed in lung and operating wards (336.67 and 15.25 CFU/m3). Moreover, the highest and least concentrations of particles were seen in the emergency and operating wards, respectively. The most common fungi isolated from the hospital air were Penicillium (24.7%), Cladosporium (23. 4%), Aspergillus niger (13.3%), and Aspergillus Flavus (11.4%). Furthermore, the highest concentration of the isolated bacterium was Staphylococcus hemolyticus (31.84%). Most bacteria showed the highest resistance to gentamicin. The overall average hospital air pollution to bioaerosols was slightly higher than the standards proposed by international organizations. Due to the high concentration of bioaerosols and particles in the studied hospital, providing suitable conditions such as temperature, humidity, proper ventilation, and intelligent air conditioning system using efficient ventilation systems, and restricting the entrance of wards can reduce airborne particles in hospital environment.

The different shading devices originally used in heritage buildings (if existed) might not be the optimal shading device to conserve the electrical energy consumed by the heating, ventilation, and air conditioning systems (HVAC). However, finding a suitable shading device that can improve thermal comfort without compromising the electrical energy consumption is considered a challenge since utilizing an inappropriate one could result in consuming more electrical energy than it should. This study aimed to propose an approach to selecting the best shading device between external and internal alternatives with controlling the HVAC system temperature setpoint to increase energy efficiency and achieve thermal comfort in south-oriented facades of heritage buildings in Alexandria in Egypt. The results showed that using the external horizontal blinds and microlouvre at certain HVAC temperature setpoints could save up to 46% and 35% of the HVAC annual electrical energy consumption and achieving thermal comfort on 228 and 261 days, respectively. Meanwhile, applying the optimal annual operating schedule approach achieved 365 thermally comfortable days, saving around 35% of the HVAC annual electrical energy consumption.

Real-time onsite monitoring of indoor airborne microbes in a residential property in central Tokyo was carried out in 2020 and 2021, following the onset of the COVID-19 pandemic. A microbial sensor utilizing fluorescence emitted by microorganisms was used to measure bioaerosol concentrations in the living room and children’s bedroom as well as on the balcony. Indoor PM2.5 was also monitored simultaneously at certain time points using a PM2.5 sensor. The behavior of the residents was also recorded during some monitoring periods. The average number concentration of microbes as fungi in the living room was 15,100, 58,800, and 10,600 counts m-3 in spring, summer, and winter, respectively, increasing in summer when the outside temperature was high. Microbial number concentrations were closely related to human behavior, increasing rapidly during periods of physical activity, but decreasing again within 20-30 min of the activity ending. There was no clear correlation between indoor microbial number concentrations and PM2.5 concentrations, suggesting that indoor microorganisms are concentrated in coarse particles, such as dust, which are quickly removed via gravitational settling. The concentration of indoor airborne microorganisms decreased significantly after ventilation, and although an occasional increase was observed immediately after ventilation, concentrations decreased again rapidly within 10-20 min. These results suggest that even a short period of ventilation can significantly reduce the indoor bioaerosol © 2021 by Asian Association for Atmospheric Environment

Background The aim of this manikin study was to evaluate the quality of cardiopulmonary resuscitation (CPR) with restricted patient access during simulated avalanche rescue using over-the-head and straddle position as compared to standard position. Methods In this prospective, randomised cross-over study, 25 medical students (64% male, mean age 24) performed single-rescuer CPR with restricted patient access in over-the-head and straddle position using mouth-to-mouth ventilation or pocket mask ventilation. Chest compression depth, rate, hand position, recoil, compression/decompression ratio, hands-off times, tidal volume of ventilation and gastric insufflation were compared to CPR with unrestricted patient access in standard position. Results Only 28% of all tidal volumes conformed to the guidelines (400–800 ml), 59% were below 400 ml and 13% were above 800 ml. There was no significant difference in ventilation parameters when comparing standard to atypical rescuer positions. Participants performed sufficient chest compressions depth in 98.1%, a minimum rate in 94.7%, correct compression recoil in 43.8% and correct hand position in 97.3% with no difference between standard and atypical rescuer positions. In 36.9% hands-off times were longer than 9 s. Conclusions Efficacy of CPR from an atypical rescuer position with restricted patient access is comparable to CPR in standard rescuer position. Our data suggest to start basic life-support before complete extrication in order to reduce the duration of untreated cardiac arrest in avalanche rescue. Ventilation quality provided by lay rescuers may be a limiting factor in resuscitation situations where rescue ventilation is considered essential.

Hazardous area classification design is required to reduce the explosion risk in process plants. Among the international design guidelines, only IEC 60079-10-1 proposes a new type of zone, namely zone 2 NE, to prevent explosion hazards. We studied how to meet the zone 2 NE grade for a facility handling hydrogen gas, which is considered as most dangerous among explosive gases. Zone 2 NE can be achieved considering the grade of release, as well as the availability and effectiveness of ventilation, which are factors indicative of the facility condition and its surroundings. In the present study, we demonstrate that zone 2 NE can be achieved when the degree of ventilation is high by accessing temperature, pressure, and size of leak hole. The release characteristic can be derived by substituting the process condition of the hydrogen gas facility. The equations are summarized considering relation of the operating temperature, operating pressure, and size of leak hole. Through this relationship, the non-hazardous condition can be realized from the perspective of inherent safety by the combination of each parameter before the initial design of the hydrogen gas facility.

Resource-scarce regions with serious COVID-19 outbreaks do not have enough ventilators to support critically ill patients, and these shortages are especially devastating in developing countries. To help alleviate this strain, we have designed and tested the accessible low-barrier in vivo-validated economical ventilator (ALIVE Vent), a COVID-19-inspired, cost-effective, open-source, in vivo-validated solution made from commercially available components. The ALIVE Vent operates using compressed oxygen and air to drive inspiration, while two solenoid valves ensure one-way flow and precise cycle timing. The device was functionally tested and profiled using a variable resistance and compliance artificial lung and validated in anesthetized large animals. Our functional test results revealed its effective operation under a wide variety of ventilation conditions defined by the American Association of Respiratory Care guidelines for ventilator stockpiling. The large animal test showed that our ventilator performed similarly if not better than a standard ventilator in maintaining optimal ventilation status. The FiO2, respiratory rate, inspiratory to expiratory time ratio, positive-end expiratory pressure, and peak inspiratory pressure were successfully maintained within normal, clinically validated ranges, and the animals were recovered without any complications. In regions with limited access to ventilators, the ALIVE Vent can help alleviate shortages, and we have ensured that all used materials are publicly available. While this pandemic has elucidated enormous global inequalities in healthcare, innovative, cost-effective solutions aimed at reducing socio-economic barriers, such as the ALIVE Vent, can help enable access to prompt healthcare and life saving technology on a global scale and beyond COVID-19. Supplementary Information The online version contains supplementary material available at 10.1007/s42242-021-00164-1.

Health Canada's cross-Canada residential radon survey from 2012 demonstrated roughly 7% of Canadian homes contain radon levels above the national guideline of 200 Bq/m3. British Columbia (BC) is the first province in Canada to mandate a full stack passive soil depressurization (PSD) system installed within homes in radon prone areas. All other provinces within Canada require a sealed and capped rough-in pipe. In this study, PSD systems were installed in fifteen new construction homes and retrofitted in six existing homes across three provinces in Canada. This study demonstrated the potential of well-designed PSD systems to reduce radon exposure in Canadian homes, reducing indoor radon concentration below 200 Bq/m3 in all 21 homes during multiple 30-day periods. During the winter, the PSD system was less effective in several new construction homes, whereas it appeared to operate more consistently in retrofitted existing homes. Further investigation revealed homes with a heat recovery ventilator (HRV), a ground floor bathroom, or no stack insulation were susceptible to degradation in the PSD system performance from the shoulder to winter season. Such performance degradation might be attributed to 1) HRV defrost mode causing a reduction in the ventilation air supply, 2) unsealed ground floor cut outs for the bathroom increasing the building stack effect and inducing more radon ingress through the floor slab during the winter, and 3) stacks without insulation causing frost and restricting the airflow within the stack.

Aim To calculate fallow time (FT) required following dental aerosol generating procedures (AGPs) in both a dental hospital (mechanically ventilated) and primary care (non-mechanically ventilated). Secondary outcomes were to identify spread and persistence of aerosol in open clinics compared to closed surgeries (mechanically ventilated environment), and identify if extraoral scavenging (EOS) reduces FT and production of aerosol. MethodsIn vitro simulation of fast handpiece cavity preparations using a manikin was conducted in a mechanically and non-mechanically ventilated environment using Optical Particle Sizer and NanoScan at baseline, during the procedure and fallow period. Results AGPs carried out in the non-mechanically, non-ventilated environment failed to achieve baseline particle levels after one hour. In contrast, when windows were opened after AGPs, there was an immediate reduction in all particle sizes. In mechanically ventilated environments, the baseline levels of particles were very low and particle count returned to baseline within ten minutes following the AGP. There was no detectable difference between particles in mechanically ventilated open bays and closed surgeries. The effect of the EOS on reducing the particle count was greater in the non-mechanically ventilated environment; additionally, it also reduced the spikes in particle counts in mechanically ventilated environments. Conclusion High-efficiency particulate, air-filtered mechanical ventilation, along with mitigation (high-volume suction), resulted in reduction of fallow time (ten minutes). Non-ventilated rooms failed to reach baseline level even after one hour of fallow time. There was no difference in particle counts in open bays or closed surgeries in mechanically ventilated settings with an extraoral suction device reducing particulate spikes. This study confirms that AGPs are not recommended in dental surgeries where no ventilation is possible., Key points Mechanical ventilation for aerosol generating procedures (AGPs) should be gold standard; where not available or practical, then the use of natural ventilation with extraoral suction helps reduce fallow time.AGPs can be carried out in open bay environments with a minimum of six air changes per hour of mechanical ventilation.Four-handed dentistry with high-volume suction and a saliva ejector are essential mitigating factors during AGPs.

Background Intrapulmonary percussive ventilation (IPV) facilitates the mobilization and clearance of bronchial secretions. Cricothyroidotomy using a Mini-Trach II device is a minimally invasive method used for secretion clearance. To our knowledge, there are no previous reports regarding IPV combined with Mini-Trach II. Case presentation An 82-year-old man underwent controlled mechanical ventilation and IPV via an endotracheal tube to treat atelectasis following emergency surgical repair of a traumatic diaphragm laceration. He underwent cricothyroidotomy using Mini-Trach II for ensuring airway management after extubation. On resumption, IPV through a mouthpiece or face mask was unsuccessful owing to air leakage from his mouth. However, IPV via the already inserted Mini-Trach II could deliver the percussion flow and led to a marked improvement in his condition. Conclusion This experience indicates that Mini-Trach II is beneficial as a minimally invasive interface for IPV that can deliver percussion flow efficiently.

Background Behavioral economic insights have yielded strategies to overcome implementation barriers. For example, default strategies and accountable justification strategies have improved adherence to best practices in clinical settings. Embedding such strategies in the electronic health record (EHR) holds promise for simple and scalable approaches to facilitating implementation. A proven-effective but under-utilized treatment for patients who undergo mechanical ventilation involves prescribing low tidal volumes, which protects the lungs from injury. We will evaluate EHR-based implementation strategies grounded in behavioral economic theory to improve evidence-based management of mechanical ventilation. Methods The Implementing Nudges to Promote Utilization of low Tidal volume ventilation (INPUT) study is a pragmatic, stepped-wedge, hybrid type III effectiveness implementation trial of three strategies to improve adherence to low tidal volume ventilation. The strategies target clinicians who enter electronic orders and respiratory therapists who manage the mechanical ventilator, two key stakeholder groups. INPUT has five study arms: usual care, a default strategy within the mechanical ventilation order, an accountable justification strategy within the mechanical ventilation order, and each of the order strategies combined with an accountable justification strategy within flowsheet documentation. We will create six matched pairs of twelve intensive care units (ICUs) in five hospitals in one large health system to balance patient volume and baseline adherence to low tidal volume ventilation. We will randomly assign ICUs within each matched pair to one of the order panels, and each pair to one of six wedges, which will determine date of adoption of the order panel strategy. All ICUs will adopt the flowsheet documentation strategy 6 months afterwards. The primary outcome will be fidelity to low tidal volume ventilation. The secondary effectiveness outcomes will include in-hospital mortality, duration of mechanical ventilation, ICU and hospital length of stay, and occurrence of potential adverse events. Discussion This stepped-wedge, hybrid type III trial will provide evidence regarding the role of EHR-based behavioral economic strategies to improve adherence to evidence-based practices among patients who undergo mechanical ventilation in ICUs, thereby advancing the field of implementation science, as well as testing the effectiveness of low tidal volume ventilation among broad patient populations. Trial registration ClinicalTrials.gov, NCT04663802. Registered 11 December 2020.

Ventilation and soil moisture influence greenhouse cultivation. Experiments were conducted at Xinxiang Irrigation Research Base of the Chinese Academy of Agricultural Sciences, Henan Province, China, to identify how ventilation and irrigation affected the greenhouse microenvironment. To develop ventilation and irrigation protocols that increase crop yield and improve the quality of drip-irrigated tomatoes grown in the greenhouse, three ventilation modes (T1, T2, and T3) were developed by opening vents in different locations in a completely randomized pattern. T1 had open vents on the north wall and roof of the greenhouse. T2 had open vents on the north and south walls and the roof. T3 had open vents on the north and south walls. Three irrigation treatments (W1, W2, and W3) were designed based on the accumulated water surface evaporation (Ep) of a standard 20-cm evaporation pan. The irrigation quantities were 0.9×Ep (W1), 0.7×Ep (W2), and 0.5×Ep (W3). The spatial and temporal distributions of temperature and humidity were analyzed for different combinations of ventilation and irrigation to identify their effects on tomato yield and fruit quality. Major results were as follows: 1) In addition to solar radiation, ventilation had an important influence on Ep and, on a daily scale, ventilation had a significant effect on Ep (P < 0.05). 2) Ventilation had a significant effect on indoor wind speed, but the effect varied during different growth stages. During the flowering and fruit setting stage, wind speed for T2 significantly differed from those of T1 and T3 (P < 0.01). During the harvest stage, the three ventilation treatments had significantly different effects (P < 0.01). A correlation analysis showed high correlation between T2 wind speed and T3 wind speed (R = 0.831), but low correlation between T2 wind speed and T1 wind speed (R = 0.467). 3) The effect of ventilation on greenhouse humidity and temperature was greater than the effect of irrigation. The differences in air temperature among various combined treatments of ventilation and irrigation were significant for the flowering and fruiting stages (P < 0.05), but they were not significant for the late harvest stage (P > 0.05). There were significant differences in humidity on sunny days (P < 0.01), but no significant differences on cloudy or rainy days (P > 0.05). Air temperature at 2 m was greater than canopy temperature, but humidity at 2 m was less than that at canopy level. 4) Irrigation water quantity was positively correlated with tomato yield and negatively correlated with the fruit quality indicators total soluble solids, vitamin C content, organic acid content, and soluble sugars content. Ventilation had an effect primarily during the harvest period; it had no significant effect on yield (P > 0.05). However, it had a significant effect on vitamin C content and the sugar:acid ratio (P < 0.01). The combination treatment of T2W2 is recommended as the optimal treatment for greenhouse tomatoes using drip irrigation to produce an optimal combination of crop yield and fruit quality. This study provides theoretical and technical support for the improvement of greenhouse climate control by optimizing greenhouse ventilation and irrigation techniques to promote tomato yield and improve fruit quality.

Background: This study evaluated the association between knowledge and management of ventilation and air-conditioning systems (VAC) to avoid the spread of the SARS-CoV-2 virus in health facilities by dentists and demographic variables. Material and Methods: A cross-sectional digital media survey was administered to dentists as part of global research. The core questionnaire was used including four additional questions on VAC (Q1: knowledge, Q2: work settings, Q3: temperature, and Q4: maintenance). A descriptive analysis was conducted for sociodemographic and VAC variables, and bivariate analysis was carried out using different tests. Results: 5370 dentists answered the survey (median age of 45 years;72.22% women). About half of the respondents said that they knew about the guidelines issued for the management of air conditioners (AC) during the pandemic, and 16.77% have made modifications to their VAC systems during this period. The most frequent AC temperature range used in the dentists' offices during the pandemic was 18degreeC to 20degreeC. As age increased, self-reported knowledge about VAC guidelines expanded. Remote and rural regions were perceived to have less knowledge of the guidelines. Conclusions: Although perceptions of knowledge about VAC systems during the COVID-19 pandemic was high, the temperature in dental offices was colder than that recommended. Greater disclosure of VAC management practices and adherence to VAC management guidelines are required. Key words: Air conditioning, dentistry, coronavirus.

The authors have developed an improved version of the vapor compression system for heating and cooling civil buildings on the basis of the soil and ventilation air integrated energy. It is characterized by increased energy efficiency and the possibility of redistribution with automatic regulation of generated heat in subsystems. The results of the analytical study of the system established a multifactorial dependence of the actual conversion factor and led to greater efficiency in the transformation of the extracted heat from the soil and ventilation air. It simulates the multifactorial effect of the initial parameters and operating conditions on the possibility of highly efficient use of integrated energy in cold, warm and transitional periods of the year. The integrated use of soil energy and air flows in heat pump heating systems is distinguished by the possibility of its controlled redistribution with a decrease in the intensity of heat extraction via a ground heat exchanger, as well as the possibility of reducing the depth of the wells and the corresponding costs for the arrangement and operation of probe heat exchangers.

Background Hypoxia is one of the life-threatening complications of endotracheal intubation. Supplemental oxygen and ventilation play a vital role in preventing hypoxia. Bag-valve mask (BVM) ventilation is frequently used before intubation, and its ability to improve oxygenation was recently confirmed. It is still unclear if positive end-expiratory pressure (PEEP) added to BVM ventilation can further reduce hypoxia during intubation. Methods This will be a prospective, randomized, double-blind trial to determine if PEEP combined with BVM ventilation can reduce the incidence of hypoxia during intubation compared with conventional BVM ventilation. The lowest oxygen saturation and incidence of complications will be compiled to verify the comparative effectiveness and safety of the two groups. Discussion BMV ventilation with PEEP is hoped to further reduce the incidence of hypoxia during intubation. Trial registration Chinese Clinical Trial Registry ChiCTR2000035156. Registered on August 2, 2020. It had begun enrollment after passing ethical review but before registration.

Coronavirus disease (COVID-19), caused by the severe acute respiratory syndrome coronavirus 2 (SARS-Cov-2), has claimed many victims worldwide due to its high virulence and contagiousness. The person-to-person transmission of SARS-Cov-2 when in close contact is facilitated by respiratory droplets containing the virus particles, and by skin contact with contaminated surfaces. However, the large number of COVID-19 infections cannot be explained only by droplet deposition or contact contamination. It seems very plausible that aerosols are important in transmitting SARS-Cov-2. It has been demonstrated that SARS-CoV-2 remains viable in aerosols for hours, facilitating rapid distribution of the virus over great distances. Aerosols may, therefore, also be responsible for so-called super-spreader events. Indirect evidence points to a correlation between ventilation and the transmission and spread of SARS-Cov-2, supporting ventilation as an important factor in preventing airborne transmission. Further actions to avoid transmission of COVID-19 include social distancing, hygiene measures, and barrier measures, such as face-coverings. Professional masks offer better protection than cloth masks. These protection measures are especially relevant to health care workers, when performing endotracheal intubation, but the risk from non-invasive ventilation and nebulizing treatment seems to be moderate.

This study investigates the importance of using engineering ventilation in healthcare settings, especially during widespread disease outbreaks such as COVID-19. Ventilation can be used to improve indoor air quality in care homes, hospitals, and quarantine locations. In the research, two scenarios of engineering ventilation are simulated using a Fire Dynamic Simulator (FDS), with sulfur hexafluoride employed as the contaminant emitted by the patient in the hospital room. The volume of the room selected for the present study is 60 m3, and the ventilation mode is designed according to the American Society of Heating, Refrigerating and Air-Conditioning Engineers (ASHRAE), with 12 air changes per hour and negative pressure. The mean concentration of the pollutants is estimated for both scenarios, giving concentrations in the range of 920 ± 397 to 1260±580 ppm. The estimated indoor air quality (IAQ) values varied from 2.06 to 2.90. According to the obtained results, ventilation plays a critical role in eliminating pollutants, indicating that suitably engineered ventilation strategies can reduce the impact of COVID-19 spread in closed buildings. © 2021

We perform a sensitivity study on the ventilation effect of large hydrometeors, namely, raindrops, snow aggregates, and hail in a cloud-resolving model. The ventilation effect could accelerate the heat and mass transfer rates between vapor and falling hydrometeors. It causes the falling hydrometeors to grow (in a supersaturated environment) and dissipate (in a subsaturated environment) faster than the stationary ones. The parameterizations of the ventilation effect on hydrometeors in a cloud model is critical as it could dramatically alter the structure and the lifespan of the simulated storm. Enhancing the ventilation coefficients of falling hydrometeors leads to a longer-lived storm featured by apparent storm splitting. The temporal evolution of hail density fluctuates greater than the default case (the control case) indicating both stronger deposition and sublimation in hail microphysical processes. However, both rainfall and hailfall become less intense than the control run. In contrast, reducing the ventilation effect causes moderate evaporation of raindrops as they fall through subsaturated air. Consequently, the concentration and precipitation rate of raindrops increase near the surface. Strong downdraft accompanying the heavy rainfall cuts off the low-level inflow of unstable moist air into the storm and results in early dissipation of the storm.

The airborne transmission of the COVID-19 virus has been suggested as a major mode of transmission in recent studies. In this context, we studied the spatial transmission of COVID-19 vectors in an indoor setting representative of a typical office room. Computational fluid dynamics (CFD) simulations were performed to study the airborne dispersion of particles ejected due to different respiratory mechanisms, i.e., coughing, sneezing, normal talking, and loud talking. Number concentration profiles at a distance of 2 m in front of the emitter at the ventilation rates of 4, 6, and 8 air changes per hour (ACH) were estimated for different combinations of inlet-outlet positions and emitter-receptor configurations. Apart from respiratory events, viz., coughing and sneezing characterized by higher velocity and concentration of ejected particles, normal as well as loud talking was seen to be carrying particles to the receptor for some airflow patterns in the room. This study indicates that the ″rule of thumb based safe distance approach″ cannot be a general mitigation strategy for infection control. Under some scenarios, events with a lower release rate of droplets such as talking (i.e., asymptomatic transmission) can lead to a high concentration of particles persisting for long times. For better removal, the study suggests ″air curtains″ as an appropriate approach, simultaneously highlighting the pitfalls in the ″higher ventilation rate for better removal″ strategy. The inferences for talking-induced particle transmissions are crucial considering that large populations of COVID-19-infected persons are projected to be asymptomatic transmitters.

Difficult lung isolation or separation in patients undergoing thoracic surgery using one-lung ventilation might be attributed to upper airway difficulty or abnormal anatomy of the lower airway. Additionally, adequate deflation of the surgical lung can impair surgical exposure. The coronavirus disease 2019 (COVID-19) has a harmful consequence for both patients and anesthesiologists. Management of patients with difficult lung isolation can be challenging during the COVID-19 pandemic. Careful planning and preparation, preoperative routine testing, protective personal equipment, standard safety measures, proper preoxygenation, and individualize the patients care are required for successful lung separation. A systematic approach for management of difficult lung separation is centered around securing the airway and providing adequate ventilation using either a blocker or double-lumen tube. Several measures are described to expedite lung collapse.

The COVID-19 pandemic has generated many concerns about cross-contamination risks, particularly in hospital settings and Intensive Care Units (ICU). Virus-laden aerosols produced by infected patients can propagate throughout ventilated rooms and put medical personnel entering them at risk. Experimental results found with a schlieren optical method have shown that the air flows generated by a cough and normal breathing were modified by the oxygenation technique used, especially when using High Flow Nasal Canulae, increasing the shedding of potentially infectious airborne particles. This study also uses a 3D Computational Fluid Dynamics model based on a Lattice Boltzmann Method to simulate the air flows as well as the movement of numerous airborne particles produced by a patient’s cough within an ICU room under negative pressure. The effects of different mitigation scenarii on the amount of aerosols potentially containing SARS-CoV-2 that are extracted through the ventilation system are investigated. Numerical results indicate that adequate bed orientation and additional air treatment unit positioning can increase by 40% the number of particles extracted and decrease by 25% the amount of particles deposited on surfaces 45s after shedding. This approach could help lay the grounds for a more comprehensive way to tackle contamination risks in hospitals, as the model can be seen as a proof of concept and be adapted to any room configuration.

Airway management and ventilation are essential components of cardiopulmonary resuscitation to achieve oxygen delivery in order to prevent hypoxic injury and increase the chance of survival. Weighing the relative benefits and downsides, the best approach is a staged strategy; start with a focus on high-quality chest compressions and defibrillation, then optimize mask ventilation while preparing for advanced airway management with a supraglottic airway device. Endotracheal intubation can still be indicated, but has the largest downsides of all advanced airway techniques. Whichever stage of airway management, ventilation and chest compression quality should be closely monitored. Capnography has many advantages and should be used routinely. Optimizing ventilation strategies, harmonizing ventilation with mechanical chest compression devices, and implementation in complex and stressful environments are challenges we need to face through collaborative innovation, research, and implementation.

A solar chimney is a renewable energy system used to enhance the natural ventilation in a building based on solar and wind energy. It is one of the most representative solar-assisted passive ventilation systems attached to the building envelope. It performs exceptionally in enhancing natural ventilation and improving thermal comfort under certain climate conditions. The ventilation enhancement of solar chimneys has been widely studied numerically and experimentally. The assessment of solar chimney systems based on buoyancy ventilation relies heavily on the natural environment, experimental environment, and performance prediction methods, bringing great difficulties to quantitative analysis and parameterization research. With the increase in volume and complexity of modern building structures, current studies of solar chimneys have not yet obtained a unified design strategy and corresponding guidance. Meanwhile, combining a solar chimney with other passive ventilation systems has attracted much attention. The solar chimney-based integrated passive-assisted ventilation systems prolong the service life of an independent system and strengthen the ventilation ability for indoor cooling and heating. However, the progress is still slow regarding expanded applications and related research of solar chimneys in large volume and multi-layer buildings, and contradictory conclusions appear due to the inherent complexity of the system.

Background Nasopharyngeal tubes are useful in pediatric anesthesia for insufflating oxygen and anesthetics. During nasopharyngeal tube‐anesthesia, gas insufflation provides some positive oropharyngeal pressure that differs from the proximal airway pressure owing to the flow‐dependent pressure drop across the nasopharyngeal tube (ΔPNPT). Aims This study aimed to investigate whether ΔPNPT could be used for calculating oropharyngeal pressure during nasopharyngeal tube‐assisted anesthesia. Methods In a physical model of nasopharyngeal tube‐anesthesia, using Rohrer's equation, we calculated ΔPNPT for three nasopharyngeal tubes (3.5, 4.0, and 5.0 mm inner diameter) under oxygen and several sevoflurane in oxygen combinations in two ventilatory scenarios (continuous positive airway pressure and intermittent positive pressure ventilation). We then calculated oropharyngeal pressure as proximal airway pressure minus ΔPNPT. Calculated and measured oropharyngeal pressure couples of values were compared with the root mean square deviation to assess accuracy. We also investigated whether oropharyngeal pressure accuracy depends on the nasopharyngeal tube diameter, flow rate, gas composition, and leak size. Using ΔPNPT charts, we tested whether ΔPNPT calculation was feasible in clinical practice. Results When we tested small‐diameter nasopharyngeal tubes at high‐flow or high‐peak inspiratory pressure, proximal airway pressure measurements markedly overestimated oropharyngeal pressure. Comparing measured and calculated maximum and minimum oropharyngeal pressure couples yielded root mean square deviations less than 0.5 cmH2O regardless of ventilatory modality, nasopharyngeal tube diameter, flow rate, gas composition, and leak size. Conclusion During nasopharyngeal tube‐assisted anesthesia, proximal airway pressure readings on the anesthetic monitoring machine overestimate oropharyngeal pressure especially for smaller‐diameter nasopharyngeal tubes and higher flow, and to a lesser extent for large leaks. Given the importance of calculating oropharyngeal pressure in guiding nasopharyngeal tube ventilation in clinical practice, we propose an accurate calculation using Rohrer's equation method, or approximating oropharyngeal pressure from flow and pressure readings on the anesthetic machine using the ΔPNPT charts.

Objectives Although jet ventilation is frequently used during surgery for airway stenosis, little is known about distal airway pressures during jet ventilation. The objective of the study is to determine how jet pressure, flow rate, and position of the ventilation needle relate to distal airway pressure magnitude and homogeneity. Methods Two 3D models of the first five generations of the human airway tree were created. One is a duplicate of a human airway from a 15‐year‐old healthy male's computed tomography scan, and the other is an idealized symmetric model of human lung morphometry. Pressure transducers measured fifth‐generation distal airway pressures in both models. A computer‐controlled jet needle positioning system was used to ventilate the lung casts. The effects of jet needle position, jet pressure, and jet flow rate on distal airway pressure and homogeneity were measured. Results Total entrained jet flow rate was the most reliable predictor of distal airway pressure. Pressure supplied to the jet ventilation needle had a positive linear relationship with distal airway pressure; however, this relationship was dependent on the jet needle flow resistance. As the ventilation needle moved closer to the tracheal wall, ventilation homogeneity decreased. Depth into the trachea was positively correlated with sensitivity of the needle to the tracheal wall. Conclusion In this model, total entrained jet flow rate is a more robust predictor of distal airway pressure than jet inlet pressure. More homogeneous ventilation was observed in our model with the ventilation needle centered in the proximal region of the trachea., Xxx.

Following non-anatomical resection of lung parenchyma with a Nd:YAG laser, a coagulated surface remains. As ventilation starts, air leakage may occur in this area. The aim of the present study was to investigate, whether additional coagulation either before or after ventilation has an additional sealing effect. Freshly slaughtered porcine heart-lung blocks were prepared. The trachea was connected to a ventilator. Using a Nd:YAG laser (wavelength: 1320 nm, power: 60 W), round lesions (1.5 cm in diameter) with a depth of 1.5 cm were applied to the lung using an 800-μm laser fiber (5 s per lesion). Group 1 (n = 12) was control. Additional coagulation was performed in group 2 (n = 12) without and in group 3 (n = 12) with ventilation restarted. Air leakage (ml) from the lesions was measured. The thickness of each coagulation layer was determined on histological slices. Differences between individual groups were analyzed by one-way ANOVA (significance p < 0.05). After resection, 26.2 ± 2.7 ml of air emerged from the lesions per single respiration in group 1. Air loss in group 2 was 24.6 ± 2.5 ml (p = 0.07) and in group 3 23.7 ± 1.8 ml (p = 0.0098). In comparison to groups 1 and 2 thickness of the coagulation layers in group 3 was significantly increased. After non-anatomical porcine lung resection with a Nd:YAG laser, additional coagulation of the ventilated resection area can reduce air leakage.

Mean airway pressure (Pmean) is a common pressure monitoring parameter of mechanical ventilators that is closely correlated with mean alveolar pressure and represents stresses applied to the lung parenchyma during ventilation. Pmean is determined by the peak inspiratory pressure, positive end-expiratory pressure (PEEP), and inspiratory-to-expiratory time ratio with dynamic and real-time characteristics, which represents mechanical power affected by the ventilator mode. Additionally, Pmean is an important parameter that affects hemodynamics. Tidal forces and PEEP increase pulmonary vascular resistance (PVR) in direct proportion to their effects on Pmean. Therefore, Pmean is increasingly considered to be related to the prognosis of patients on mechanical ventilation. We propose a 3P strategy (Pmean, central venous pressure [CVP], and perfusion index [PI]) which is indicated to achieve circulation protection mechanical ventilation with flow priority. Titrating the appropriate CVP and meeting PI to ensure tissue perfusion with a lower Pmean are the core purposes. Pmean links the circulatory and respiratory systems and is expected to become a potential parameter for intelligent ventilation.

The effect of the rate of change of fresh air inside passengers' wagons for Underground Metro on the spreading of airborne diseases like COVID-19 is investigated numerically. The study investigates two extreme scenarios for the location of the source of infection within the wagon with four different air change rates for each. The first scenario considers the source of infection at the closest point to the ventilation system while the other places the infection source at the farthest point from the wagon ventilation system. The effect of the wagon windows' status (i.e. closed or open) is also studied. It is found that under all conditions, open windows are always favored to decrease the infection spreading potential. A higher air change rate also decreases the infection spreading up to a certain value, beyond which the effect is not noticeable. The location of the infection source was found to greatly affect the infection spreading as well. The paper gives recommendations on the minimum air change rate to keep the infection spreading potentials to a minimum considering different times the passengers stay in the wagon.

Fire protection is one of important issues to ensure safety and reduce risks of nuclear power plants (NPPs). While robust programs to shut down commercial reactors in any fires have been successfully maintained, the concept and associated regulatory requirements are constantly changing or strengthening by lessons learned from operating experiences and information all over the world. As part of this context, it is necessary not only to establish specific fire hazard assessment methods reflecting the characteristics of research reactors and educational reactors but also to make decisions based on advancement encompassing numerical analyses and experiments. The objectives of this study are to address fire simulation in the control room of an educational reactor and to discuss integrity of digital console in charge of main operation as well as analysis results through comparison. Three electrical fire scenarios were postulated and twenty-four thermal analyses were carried out taking into account two turbulence models, two cable materials and two ventilation conditions. Twelve supplementary thermal analyses and six subsequent structural analyses were also conducted for further examination on the temperature and heat flux of cable and von Mises stress of digital console, respectively. As consequences, effects of each parameter were quantified in detail and future applicability was briefly discussed. On the whole, higher profiles were obtained when Deardorff turbulence model was employed or polyvinyl chloride material and larger ventilation condition were considered. All the maximum values considered in this study met the allowable criteria so that safety action seems available by sustained integrity of the cable linked to digital console within operators’ reaction time of 300 s.

Aims To determine the prevalence, characteristics of EM activities, the relationship between level of activity and mode of ventilation and adherence rate of EM protocol. Background Mobilizing ICU patients remains a challenge, despite its safety, feasibility and positive short‐term outcomes. Design A cross‐sectional point prevalence study. Methods All patients who were eligible and admitted to the adult ICUs during March 2018 were recruited. Data were analysed by using the Statistical Package for Social Sciences version 24 for Windows. Results The prevalence of EM practice was 65.6%. The most frequently reported avoidable and unavoidable factors inhibit mobility were deep sedation and vasopressor infusion, respectively. Level II of activity was the most common level of activity performed in ICU patients. The invasive ventilated patient had 12.53 the odds to stay in bed as compared to non‐invasive ventilated patient. An average adherence rate of EM protocol was 52.5%.

Introduction: Emergency department (ED) patients are frequently ventilated with excessively large tidal volumes for predicted body weight based on height, which has been linked to poorer patient outcomes. We hypothesized that supplying tape measures to respiratory therapists (RT) would improve measurement of actual patient height and adherence to a lung-protective ventilation strategy in an ED-intensive care unit (ICU) environment. Methods: On January 14, 2019, as part of a ventilator-associated pneumonia prevention bundle in our ED-based ICU, we began providing RTs with tape measures and created a best practice advisory reminding them to record patient height. We then retrospectively collected data on patient height and tidal volumes before and after the intervention. Results: We evaluated 51,404 tidal volume measurements in 1,826 patients over the 4 year study period; of these patients, 1,579 (86.5%) were pre-intervention and 247 (13.5%) were post-intervention. The intervention was associated with a odds of the patient’s height being measured were 10 times higher post-intervention (25.1% vs 3.2%, P

To assess potential exposure of non-users to exhaled constituents from pod and cartridge electronic nicotine delivery systems (ENDS) products, an environmental clinical study was conducted with (n = 43) healthy adult smokers. Room air concentrations of 34 selected constituents (nicotine, propylene glycol, glycerin, 15 carbonyls, 12 volatile organic compounds, and 4 trace metals) and particle number concentration (0.3 to 25 µm) were compared from use of two ENDS products and conventional cigarettes using room ventilations representative of a residential, an office or a hospitality setting over a 4-h. exposure period. Products used were JUUL ENDS, Virginia Tobacco flavor (Group I), VUSE Solo, Original flavor (Group II) (5.0 and 4.8% nicotine by weight, respectively) and subjects’ own conventional cigarettes (Group III). Cumulative 4-h room air sampling and particle counting were performed during prescribed (Groups I and II) and ad libitum product use (all Groups). Conventional cigarette use resulted in significantly more constituents detected and higher 4-h cumulative constituent concentrations compared to use of the ENDS products tested, except for the predominant ENDS ingredients, propylene glycol and glycerin. Use of conventional cigarettes also resulted in greater total particle number concentration than either prescribed or ad libitum use of either of the ENDS used in this study.

Nowadays, the city’s rapid growth of industrialisation, population, human activities, vehicular traffic density, unplanned urbanisation with poor ventilation contributes to increasing large amount of pollutants concentration. Atmospheric Boundary Layer (ABL) height is a basic parameter to define the pollution carrying capacity of any area in a big city. In the time series analysis and prediction of ABL height, the existing models use linear (AR, ARMA, ARIMA etc.) and non-linear (ANN, ANFIS etc) algorithms, but these models less capable of identifying the hidden pattern and underlying dynamics of ABL patterns. This paper presents a Long Short-Term Memory (LSTM) model using deep learning-based algorithms for temporal/seasonal and annual ABL height prediction and identified the latent dynamics of the ABL height pattern. The results of the model have been compared with the measurements made by SOnic Detection And Ranging (SODAR) system. LSTM model is used for prediction and to analyse their performance affected by the model. The observed ABL height data and model data are used to predict the ABL height by applying the neural network of LSTM. It is observed from the analysis that the optimal results can be achieved when the number of neurons is equal to 32, an epoch is equal to 500. To obtain the acceptable accuracy of prediction, various error-based performance indices have been calculated. Mean Absolute Percentage Error (MAPE) and relative Root Mean Square Error (rRMSE) have been calculated for the updated network with predicted values 17.3% and 7.33%, and, for the updated network with observed values 10.62% and 5.95%, respectively. Also, the performance of the proposed model has been estimated for the annual and seasonal prediction of ABL height. The results depict rRMSE values (7.49% and 5.59%) as lowest during post-monsoon for seasonal prediction and (10.29% and 5.86%) highest for annual prediction.

Background Clinical management of COVID-19 requires close monitoring of lung function. While computed tomography (CT) offers ideal way to identify the phenotypes, it cannot monitor the patient response to therapeutic interventions. We present a case of ventilation management for a COVID-19 patient where electrical impedance tomography (EIT) was used to personalize care. Case presentation The patient developed acute respiratory distress syndrome, required invasive mechanical ventilation, and was subsequently weaned. EIT was used multiple times: to titrate the positive end-expiratory pressure, understand the influence of body position, and guide the support levels during weaning and after extubation. We show how EIT provides bedside monitoring of the patient´s response to various therapeutic interventions and helps guide treatments. Conclusion EIT provides unique information that may help the ventilation management in the pandemic of COVID-19.

In recent years, the mining technology of ″roof cutting and pressure releasing″ has appeared in China. It is called China’s third mining revolution. The technology of ″roof cutting and pressure releasing″ has changed the traditional working face ventilation system and the boundary conditions of a goaf. The law of air leakage in the goaf has changed, resulting in changes in the distributions of CO and other disaster gases. In order to ensure the promotion of this advanced mining technology safely, research on the distributions of CO and other disaster gases is very necessary. By installing CO sensors in the air intake lanes, gob-side entry retaining, and goaf, the distribution of CO in the goaf during the advancement of the working face under the ″roof cutting and pressure releasing″ mining method is studied. The concentration of CO in the upper corners of the working face under the traditional mining method and the ″roof cutting and pressure releasing″ mining method was compared and analyzed. The results show that the CO in the experimental working face mainly comes from the oxidation of the residual coal; after analysis, the CO concentration in the goaf is divided into three areas: the slowly increasing area, sharply increasing area, and attenuation area; the CO concentration in the upper corner of the working face of Y-shaped ventilation with ″roof cutting and pressure releasing″ mining is much lower than that in the upper corner of the working face of U-shaped ventilation in the traditional mining; In order to prevent the oxidation and heating of the residual coal in the goaf to produce CO, comprehensive prevention measures for CO escape in the goaf have been adopted. After actual production verification, the prevention and control measures show good effects to ensure the safe and effective production of the working face.

Background: Endotracheal tube (ETT) intracuff pressure (PINTRACUFF) monitoring is not a mandatory part of daily anesthetic practice in many countries. Correct PINTRACUFF is required to ensure adequate ventilation, to prevent aspiration, and to avoid complications. The aim of this study was to objectively measure the PINTRACUFF in ETTs among patients from an Australian tertiary hospital to define the range of PINTRACUFF values seen in a setting without the use of routine objective monitoring. Patients and Methods: A prospective single-center audit of PINTRACUFF of 268 elective and emergency surgical patients undergoing general anesthesia with an ETT was performed. PINTRACUFF values were measured with a calibrated cuff manometer following the induction of anesthesia. Patient characteristics were compared between three patient groups of measured PINTRACUFF values: 20 cmH2O, 20–30 cmH2O, and >30 cmH2O. Results: To estimate the PINTRACUFF, only the auditory method was used among 66.0% of the patients, the tactile method was used in 18.3%, and the remainder used both or other methods. Following induction of anesthesia, the mean PINTRACUFF was 31.0 cmH2O (±standard deviation 16.4). The PINTRACUFF was 30 cmH2O had a marginally higher body mass index (BMI) compared to patients with a PINTRACUFF

The aim of the study is to develop a design of an air-heating recuperator for a purge ventilation system of a building inbuilt for the purpose of utilizing lower-grade heat from ventilation gases and emissions with the associated production of thermoelectricity. An experimental design of an air-heating recuperator as part of an experimental purge unit has been developed. It includes a thermoelectric source of electromotive difference, which operates as a result of the associated conversion of heat into electricity, which allows utilizing lower-potential heat of ventilation releases from 40°C to 60°C.

Background Modern neonatal ventilators allow the downloading of their data with a high sampling rate. We wanted to develop an algorithm that automatically recognises and characterises ventilator inflations from ventilator pressure and flow data. Methods We downloaded airway pressure and flow data with 100 Hz sampling rate from Drager Babylog VN500 ventilators ventilating critically ill infants. We developed an open source Python package, Ventiliser, that includes a rule-based algorithm to automatically discretise ventilator data into a sequence of flow and pressure states and to recognise ventilator inflations and an information gain approach to identify inflation phases (inspiration, expiration) and sub-phases (pressure rise, pressure plateau, inspiratory hold etc.). Results Ventiliser runs on a personal computer and analyses 24 h of ventilation in 2 min. With longer recordings, the processing time increases linearly. It generates a table reporting indices of each breath and its sub-phases. Ventiliser also allows visualisation of individual inflations as waveforms or loops. Ventiliser identified >97% of ventilator inflations and their sub-phases in an out-of-sample validation of manually annotated data. We also present detailed quantitative analysis and comparison of two 1-hour-long ventilation periods. Conclusions Ventiliser can analyse ventilation patterns and ventilator-patient interactions over long periods of mechanical ventilation. Impact We have developed a computational method to recognize and analyse ventilator inflations from raw data downloaded from ventilators of preterm and critically ill infants. There have been no previous reports on the computational analysis of neonatal ventilator data. We have made our program, Ventiliser, freely available. Clinicians and researchers can use Ventiliser to analyse ventilator inflations, waveforms and loops over long periods. Ventiliser can also be used to study ventilator-patient interactions.