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1.
AIAA AVIATION 2022 Forum ; 2022.
Article in English | Scopus | ID: covidwho-1993729

ABSTRACT

This paper study suggests the specifications for high-efficiency, short-haul utility aircraft. This class of aircraft is used extensively in the multinational express package delivery service. Concurrent with the COVID 19 pandemic upending passenger travel, there has been a broad increase in the demand for air cargo. We forecast a need for more efficient short and medium range aircraft that offer route time savings and lower operating costs. Using current market planes designed with similar mission requirements, payloads, and engines – a general plane was created and optimized around the operating model of the present-day FedEx package delivery feeder fleet. The modification and optimization process was completed using a Model-Based-Systems-Engineering (MBSE) approach utilizing Phoenix Integration’s ModelCenter, Excel, MATLAB, and SOLIDWORKS. The final design achieved 40% improvement in fuel efficiency over the current fleet, and improvements in speed, payload, and range while in compliance with FAA regulations as a class E cargo aircraft certified under 14 CFR Part 25. © 2022, American Institute of Aeronautics and Astronautics Inc, AIAA. All rights reserved.

2.
Pakistan Journal of Medical & Health Sciences ; 15(6):1176-1179, 2021.
Article in English | Web of Science | ID: covidwho-1323547

ABSTRACT

Aim: To observe the frequency, severity and susceptibility to develop the severe symptoms of acute respiratory distress syndrome in confirmed and suspected cases of COVID-19. Study design: Cross sectional observational study. Place and duration of study: Lahore General Hospital, Lahore. Methodology: After Ethical Committee approval in 164 patients of confirmed or suspected COVID-19 who underwent the complication of ARDS were enrolled, admitted in department of Medicine and Intensive Care Unit at Lahore General Hospital, Lahore. After taking consent we studied different features in these patients like age, gender, comorbidities, symptoms, their radiological findings, SATS, PO2/FIO2 ratio, serum ferritin, CRP, LDH and d-dimer levels, and results were analyzed. Result: Out of 164 patients, 103 were COVID-19 positive. Mostly middle aged to old males developed the complications of ARDS. The most common symptoms observed were fever, cough and shortness of breath. Most common comorbidities present in the patients were diabetes and hypertension. HRCT was done in severe cases and 25 out of 35 patients had either unilateral or bilateral lung opacities. On chest X-ray 76% patients had bilateral lung infiltrates and 12% patients were having unilateral infiltrates. Inflammatory markers such as CRP, serum LDH, serum Ferritin, D-dimers were raised in most of the patients who developed moderate to severe ARDS. Conclusion: We concluded that the middle aged to old males with comorbidities like diabetes and hypertension are more likely to undergo ARDS. They can present with shortness of breath alone or in combination with fever and cough. Their X-ray usually showed bilateral patchy infiltrates and their ferritin, CRP, LDH and d- dimer levels are usually high.

3.
Diabetic Medicine ; 38(SUPPL 1):49-50, 2021.
Article in English | EMBASE | ID: covidwho-1238407

ABSTRACT

Background: Hyperglycaemia during admission with covid- 19 is associated with worse outcomes. Dexamethasone is used in severe covid-19. The national guidance suggests using prn quick acting insulin followed by twice daily intermediate acting insulin (0.3 units/kg) if blood glucose continues >12 mmol/L. Aim: To evaluate insulin requirements in inpatients with covid-19 and treated with steroids. Methods: Four rapid iterative quality improvement cycles evaluated the strategy for initiating insulin for patients with persistent hyperglycaemia (>11 mmol/L) and given steroids in an inner city teaching hospital trust. We identified consecutive referrals to the inpatient diabetes team. Exclusions include <7 days of steroids course, admission to intensive care or intravenous insulin. Electronic records were reviewed. Results are mean±SD. Results: Thirty-two referrals identified (63% male), type 2 diabetes 78%/22% no history of diabetes, 66 ± 11 years old, weight 90 ± 24 kg, HbA1c 75 ± 2.8 mmol/mol. covid-4C score 11/21 indicating high-risk patients. Seven days cumulative dexamethasone (or equivalent) dose was 48±23 mg. Admission glucose was 11.5 ± 5.7 mmol/L peaking on day 2 of steroids course (15.2 ± 4.4 mmol/L) and declining to nadir of 11.7 ± 4.2 mmol/L on day 6. Total daily insulin requirements rose rapidly from 0.07 ± 0.18 units/kg (day 1) to a peak of 0.72 ± 0.8 units/kg (day 4) and nadir of 0.64±0.7 units/kg (day 7). Conclusions: We found insulin requirements suggested in the national guidance to be a conservative estimate. In our cohort it is more than doubled in a short period of time requiring rapid titration. Learnings from this work informed the rapid adaptation of the local guidance by advocating early introduction of scheduled intermediate acting insulin when pre-steroids blood glucose is ≥11 mmol/L.

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