IntroductionCongestive heart failure (CHF) is associated with high mortality and a heavy financial and healthcare burden in the dialysis population. Determining which dialysis modality is associated with a higher risk of developing CHF might facilitate clinical decision making and surveillance programs in the dialysis population.MethodsUsing the Taiwan National Health Insurance Database, we recruited all incident dialysis patients during the period from January 1, 1998 to December 31, 2010. The propensity score matching method was applied to establish the matched hemodialysis (HD) and peritoneal dialysis (PD) cohort. Incidence rates and cumulative incidence rates of CHF-related hospitalization were first compared for the HD and PD patients. Multivariable subdistribution hazards models were then constructed to control for potential confounders.ResultsAmong a total of 65,899 enrolled dialysis patients, 4,754 matched pairs of HD and PD patients were identified. The incidence rates of CHF in the matched HD and PD patients were 25.98 and 19.71 per 1000 patient-years, respectively (P = 0.001). The cumulative incidence rate of CHF was also higher in the matched HD patients (0.16, 95% confidence interval (CI)(0.12–0.21)] than in the corresponding PD patients (0.09, 95% CI [0.08–0.11])(P<0.0001). HD was consistently associated with an increased subdistribution hazard ratio (HR) of CHF compared with PD in the matched cohort (HR: 1.45, 95% CI [1.23–1.7]). Similar phenomenons were observed in either the subgroup analysis stratified by selected confounders or in the HD and PD group without matching.ConclusionsHD is associated with a higher risk of developing CHF-related hospitalization than PD. The surveillance program for CHF should differ in patients receiving different dialysis modalities.
Pollutant emission is becoming a serious environmental issue nowadays. Stringent legislations were introduced in several countries to limit the permissible levels of pollutant particle emission in major combustion systems such as burners and furnaces that have been widely used in industrial application. In this study, a numerical study of laminar coflow diffusion flame was performed in a model combustor using the commercial software ANSYS Fluent 19.1. The main focus of this study is to understand the effect of the variation of flow characteristics in the coflow diffusion flame on the prediction of NO x and soot emissions. A comparison study of the pollutant formation was performed with different hydrocarbon gaseous fuels (methane, ethylene, ethane, propane, and n-butane) with detailed high-temperature reaction mechanisms. In addition, the Moss−Brookes model was adopted to obtain the soot emission data. Variation of the flow characteristics on the pollutant formation was performed by examining the change in fuel inlet velocity, i.e., 0.5u ̅ 0 , u ̅ 0 , 1.5u ̅ 0 , 2u ̅ 0 with u ̅ 0 the mean fuel inlet velocity of baseline condition, and the effect of nozzle heating condition, i.e., 298 and 403 K. The results showed that ethylene flame produced higher NO x and soot compared to other hydrocarbon fuels. It was observed that the increase of the fuel inlet velocity promoted the formations of NO x and soot. Besides that, the nozzle heating condition increased the overall adiabatic temperature of the flame, where the relative effect was more pronounced on the alkane fuels, especially the lighter fuel compared to alkene fuel (ethylene).
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