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      • Use of Computational Fluid Dynamics for the Design and Analysis of Gas Turbine Combustors

        Niveditha Krishnamoorthy,Piyush Thakre,Yongzhe Zhang,Richard Clayton,Graham Goldin,Rajesh Rawat 한국추진공학회 2015 한국추진공학회 학술대회논문집 Vol.2015 No.11

        The use of computational fluid dynamics (CFD) for the design and analysis of the flow and combustion in gas turbine combustors is considered to be a cost effective alternative to time-consuming and expensive design of experiments studies. With stringent emission regulations being enforced for these combustion systems, efforts towards optimization of the combustor geometry, and its operating conditions to minimize fuel consumption, emissions, and cost are also being undertaken using CFD. Reacting flow modeling in gas turbine combustors is a multi-scale, multi-physics process which requires an adequate representation of the flow, chemistry, and heat transfer mechanisms taking place in these systems. The models/approximations used in simulating gas turbine combustors directly influence the predictive capability of the simulations. In this study, the commercial software STAR-CCM+ is used model all the processes taking place in a gas turbine combustor. STAR-CCM+ solves the Navier-Stokes equation using the finite volume formulation. The choice to represent the combustion chemistry via global reactions, tabulated methodology, or detailed kinetic modeling is available for premixed, non-premixed and partially premixed combustion regimes. The combustion model selection is typically driven by the intended purpose of the simulation. Radiative heat transfer is modeled using the discrete ordinates methodology. In order to study the mechanical durability of various components in these systems, a full conjugate heat transfer (CHT) analysis is also performed where, the liner and other solids are explicitly modeled in the fully-coupled simulation. In this investigation, both the Reynolds Averaged Simulation (RANS) methodology and the Large-Eddy Simulation (LES) methodology are explored and the results are summarized.

      • KCI등재

        Contamination Rates in Duodenoscopes Reprocessed Using Enhanced Surveillance and Reprocessing Techniques: A Systematic Review and Meta-Analysis

        Shivanand Bomman,Munish Ashat,Navroop Nagra,Mahendran Jayaraj,Shruti Chandra,Richard A Kozarek,Andrew Ross,Rajesh Krishnamoorthi 대한소화기내시경학회 2022 Clinical Endoscopy Vol.55 No.1

        Background/Aims: Multiple outbreaks of multidrug-resistant organisms have been reported worldwide due to contaminatedduodenoscopes. In 2015, the United States Food and Drug Administration recommended the following supplemental enhancedsurveillance and reprocessing techniques (ESRT) to improve duodenoscope disinfection: (1) microbiological culture, (2) ethyleneoxide sterilization, (3) liquid chemical sterilant processing system, and (4) double high-level disinfection. A systematic review andmeta-analysis was performed to assess the impact of ESRT on the contamination rates. Methods: A thorough and systematic search was performed across several databases and conference proceedings from inceptionuntil January 2021, and all studies reporting the effectiveness of various ESRTs were identified. The pooled contamination rates ofpost-ESRT duodenoscopes were estimated using the random effects model. Results: A total of seven studies using various ESRTs were incorporated in the analysis, which included a total of 9,084 post-ESRTduodenoscope cultures. The pooled contamination rate of the post-ESRT duodenoscope was 5% (95% confidence interval [CI]:2.3%–10.8%, inconsistency index [I2]=97.97%). Pooled contamination rates for high-risk organisms were 0.8% (95% CI: 0.2%–2.7%,I2=94.96). Conclusions: While ESRT may improve the disinfection process, a post-ESRT contamination rate of 5% is not negligible. Ongoingefforts to mitigate the rate of contamination by improving disinfection techniques and innovations in duodenoscope design toimprove safety are warranted.

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        Use of abdominal compression device in colonoscopy: a systematic review and meta-analysis

        Yousaf Zafar,Ahmed Mustafa Rashid,Syed Sarmad Javaid,Ahmed Kamal Siddiqi,Adnan Zafar,Arsalan Zafar Iqbal,Jagpal Singh Klair,Rajesh Krishnamoorthi 대한소화기내시경학회 2023 Clinical Endoscopy Vol.56 No.4

        Background/Aims: Colonoscopy for screening is associated with unpleasant experiences for patients, and abdominal compression devices have been developed to minimize these problems. However, there is a paucity of data supporting the therapeutic benefits of this strategy. This study examined the effects of using an abdominal compression device during colonoscopy on the cecal intubation time (CIT), abdominal compression, patient comfort, and postural changes. Methods: We searched PubMed and Scopus (from inception to November 2021) for randomized controlled trials that assessed the effects of an abdominal compression device during colonoscopy on CIT, abdominal compression, patient comfort, and postural change. A random-effects meta-analysis was performed. Weighted mean differences (WMDs) and Mantel-Haenszel odds ratios (ORs) were calculated. Results: Our pooled analysis of seven randomized controlled trials revealed that abdominal compression devices significantly reduced CIT (WMD, –0.76 [–1.49 to –0.03] minutes; p=0.04), abdominal compression (OR, 0.52; 95% confidence interval [CI], 0.28–0.94; p=0.03), and postural changes (OR, 0.46; 95% CI, 0.27–0.78; p=0.004) during colonoscopy. However, our results did not show a significant change in patient comfort (WMD, –0.48; 95% CI, –1.05 to 0.08; p=0.09) when using an abdominal compression device. Conclusions: Our findings demonstrate that employing an abdominal compression device may reduce CIT, abdominal compression, and postural change but have no impact on patient comfort.

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        Safe implementation of transoral incisionless fundoplication as a new technique in a tertiary care center

        Shivanand Bomman,Sofya Malashanka,Adil Ghafoor,David J. Sanders,Shayan Irani,Richard A. Kozarek,Andrew Ross,Michal Hubka,Rajesh Krishnamoorthi 대한소화기내시경학회 2022 Clinical Endoscopy Vol.55 No.5

        Background/Aims: Transoral incisionless fundoplication (TIF) is an accepted anatomic treatment for gastroesophageal reflux disease in selected patients. In this report, we analyze our institution’s programmatic allocation of resources during the safe implementation of TIF as a new procedure. Methods: A retrospective analysis of all patients who underwent TIF from January 2020 to February 2021 at our institution was per- formed. The process of initially allocating the operating room (OR) with overnight admission and postoperative esophagram for added safety, and subsequently transitioning TIF to the endoscopy suite (ES) as an outpatient procedure was described. Patient safety and out- comes were evaluated during transition. Results: Thirty patients who underwent TIF were identified. The mean age was 51.2±16.0 years. TIF was performed in an OR in nine patients (30%) and 21 (70%) in the ES. All the OR patients were admitted overnight and had routine esophagogram. In contrast, four (19%) from the ES group required clinically-indicated admission and three (14.2%) required esophagram. The mean procedure dura- tion was significantly lower in the ES group (65.7 min vs. 84 min, p=0.02). Conclusions: A stepwise, resource-efficient process was described that allowed safe initiation of TIF as a new technique and its effec- tive transition to a fully outpatient procedure.

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