bluuebunny/crossref_metadata_2025_split huggingface dataset:
Performance assessment of integrated energy systems for the production of renewable hydrogen energy carriers
Authors: Lonis Francesco , Tola Vittorio , Cau Giorgio 
Published: October 2020

To guarantee a smooth transition to a clean and low-carbon society without abandoning all of a sudden liquid fuels and products derived from fossil resources, power-to-liquids processes can be used to exploit an excess of renewable energy, producing methanol and dimethyl ether (DME) from the conversion of hydrogen and recycled CO2. Such a system could behave as an energy storage system, and/or a source of fuels and chemicals for a variety of applications in several industrial sectors.
This paper concerns the conceptual design, performance analysis and comparison of small-scale decentralised integrated energy systems to produce methanol and DME from renewable hydrogen and captured CO2. Renewable hydrogen is produced exploiting excess RES. Water electrolysis is carried out considering two different technologies alternatively: commercially mature low temperature alkaline electrolysers (AEL) and innovative high temperature solid oxide electrolysers (SOEC). A first conversion of hydrogen and CO2 takes place in a catalytic reactor where methanol is synthesised through the hydrogenation process. Methanol is then purified in a distillation column. Depending on the final application, methanol can be further converted into DME through catalytic dehydration in another catalytic reactor. The chemical (either methanol or DME) is stored at ambient conditions and used as necessary.
To predict the performance of the main components and of the overall system, numerical simulation models were developed using the software Aspen Plus. The performance and efficiencies of each section and of the overall systems were evaluated through extensive mass and energy balances. Globally, the overall power-to-liquids efficiency was found to be above 0.55 for all the different configurations, both considering a powerto-methanol or a power-to-DME process.
Historical analysis and refurbishment proposal of the “Red schools” in Viterbo
Authors: Romano Giada , Pennacchia Elisa , Agostinelli Sofia 
Published: October 2020

To hinder climate change, EU legislation requires that by 2020 each European state achieves the objectives set by the 2020 Climate and Energy Package. Particular attention is paid not only to new constructed buildings, the so-called Near Zero Energy Buildings, but also to the existing building stock: in Italy in fact, in addition to the National Action Plan to increase the NZEB buildings (PANZEB), the Strategy for Energy Renewal of the National Real Estate Park (STERPIN) is planned. The aim of the thesis work is a primary school built in 1938 within the historical centre of Viterbo. The work touched on three different areas of design: the design of the internal and external spaces, annexed to the school building, finding solutions for a flexible and functional distribution in line with the theories of modern pedagogy, moving from a school of homologation to a school of diversity enhancement.
This was joined by a study concerning the original elevations and constructive features, bearers of historical and aesthetic values, which resulted in the proposal for conservative restoration of the Terranova plaster and the original iron-window profiles.
Finally, attention was paid to energy upgrading and efficiency, in line with regulatory provisions.
The interventions did not only concern the building envelope (through a thermal upgrading of the original iron-windows, the insulation of the flat roof and the indoor thermal coat of the perimeter walls), but also the system (through the replacement of the boiler with a heat pump, integrated with the photovoltaic system placed on the roof, the inclusion of thermostatic valves and lighting design with the replacement of fluorescent lamps with LED ones).
Standard and consistent Detached-Eddy Simulation for turbulent engine flow modeling: an application to the TCC-III engine
Authors: Krastev Vesselin Krassimirov , Di Ilio Giovanni , Iacovano Clara , d’Adamo Alessandro , Fontanesi Stefano 
Published: October 2020

Multidimensional modeling of Cycle-to-Cycle Variability (CCV) has become a crucial support for the development and optimization of modern direct-injection turbocharged engines. In that sense, the only viable modeling options is represented by scale-resolving approaches such as Large Eddy Simulation (LES) or hybrid URANS/LES methods.Among other hybrid approaches, Detached-Eddy Simulation (DES) has the longest development story and is therefore commonly regarded as the most reliable choice for engineering-grade simulation. As such, in the last decade DESbased methods have found their way through the engine modeling community, showing a good potential in describing turbulence-related CCV in realistic engine configurations and at reasonable computational costs.In the present work we investigate the in-cylinder modeling capabilites of a standard two-equation DES formulation, compared to a more recent one which we call DESx. The DESx form differs from standard DES in the turbulent viscosity switch from URANS to LES-like behavior, which for DESx is fully consistent with Yoshizawa’s one-equation sub-grid scale model. The two formulations are part of a more general Zonal-DES (ZDES) methodology, developed and validated by the authors in a series of previous publications. Both variants are applied to the multi-cycle simulation of the TCC-III experimental engine setup, using sub-optimal grid refinement levels in order to stress the model limitations in URANS-like numerical resolution scenarios. Outcomes from this study show that, although both alternatives are able to ouperform URANS even in coarse grid arrangements, DESx emerges as sligthly superior and thus it can be recommended as the default option for in-cylinder flow simulation.
Calcium Looping technology demonstration in industrial environment: the CLEANKER project and status of the CLEANKER pilot plant
Authors: Fantini Martina , Spinelli Maurizio , Magli Francesco , Consonni Stefano 
Published: October 2020

The CLEANKER (CLEAN clinKER production by calcium looping process) project got EC support from October 2017 to September 2021 under the Horizon 2020 call LCE 29 – 2017. CLEANKER (www.cleanker.eu) aims at demonstrating at TRL7 (Technology Readiness Level) the Calcium Looping (CaL) concept in a configuration highly integrated with the cement production process, making use of entrained flow reactors.
There are currently no feasible methods to produce clinker, and thus cement, without releasing CO2 from CaCO3, and, given the lifetime of a cement plant, the technologies to be developed have to be retrofittable. In addition to oxyfuel combustion and post-combustion solvent-based capture technologies, which have attracted most of the research efforts up to now, Calcium Looping is recognized as another very promising emerging technology for CO2 capture in cement plants.
The core activity of the project is the design, construction and operation of a CaL demonstration system including the entrained-flow carbonator (the CO2 absorber) and the entrained-flow oxyfuel calciner (the sorbent regenerator). This demonstration system, connected to the Buzzi Unicem kiln of the Vernasca cement plant (Italy), will capture the CO2 from a portion of the flue gases of the kiln, using as CO2 sorbent the same raw meal that is used for clinker production.
The CLEANKER implementation plan spans four years from October 2017 to September 2021.The project is in its crucial phase: the erection of the demo plant is going to be completed by the end of August 2020 and the experimental campaigns will start immediately after.
Investigation of a Radial Turbines Compatibility for Small Rocket Engine
Authors: Leto Angelo 
Published: October 2020

In the radial turbine preliminary design for an expander rocket engine, a comparison was made with axial turbine used in Pratt & Whitney RL10 engine.
One of the primary requirements of a liquid propellant rocket engine is the generation of a high thrust, which depends on both the mass flow rate of the propellant and the pressure in the thrust chamber.
In expander-cycle engines, which are the subject of the present study, the liquid propellant is first compressed using centrifugal turbo-pumps, then it is used to cool the combustion chamber and the nozzle and, once vaporized, it flows through the turbines used to drive the turbo-pumps.
The aim was to demonstrate the greater efficiency of the radial turbine with a reduction of the pressure ratio with respect to the axial turbine.
Safety and efficacy of endoscopic ultrasound-guided gastroenterostomy using double balloon occlusion methods: a clinical retrospective study in 36 patients with malignant gastric outlet obstruction
Authors: Xu Guifang , Shen Yonghua , Lv Ying , Zhou Xiaoliang , Li Wen , Wang Yi , Hassan Shahzeb , Wang Lei , Zou Xiaoping 
Published: October 2020

Abstract
Background and study aims Gastric outlet obstruction (GOO) is common in the late stage of many malignant tumors of the digestive system. Endoscopic ultrasound (EUS)-guided gastroenterostomy (EUS-GE) is commonly used for palliative treatment of malignant GOO. The objective of this study was to investigate the safety, efficacy, and prognosis of EUS-GE in treatment of malignant GOO in Chinese patients.
Patients and methods This was a retrospective, single-center study with 36 consecutive patients with malignant GOO who were treated with EUS-GE. The main outcome measures were technical success rate, clinical success rate, incidence of adverse events (AEs), and median survival time.
Results A total of 36 patients with malignant GOO underwent double-balloon-assisted EUS-GE between March 2017 and June 2019 in our hospital. GOO occurred mainly in elderly men (mean age 69.0 years, M:F 0.89). The most common etiology of GOO was pancreatic cancer (41.7 %). The most common obstruction site was the second part of the duodenum (63.9 %). The technical success rate was 100 % (36/36). The clinical success rate was 94.4 % (34/36). Median time for the total procedure was 52 minutes (range 34 – 156 min). Median time for determination of puncture site was 20 minutes (range 15 – 28 min). Median time between puncture and successful delivery of the stent was 38 minutes (range 19 – 128 min). The GOOSS score was 0.2 before EUS-GE. The GOO Scoring System (GOOSS) score was 2.2 at 15 days after the EUS-GE (P = 0.001). The GOOSS score was still higher than 2 during a median follow-up period of 89 days. AEs were observed in nine patients (25.0 %) and 13 total AEs occurred. One patient died as a result of delayed stent migration and bleeding. Mean length of hospital stay was 5.8 ± 4.7 days. The median survival period was 103 days. The rate of GOO recurrence was 2.7 % (1/36).
Conclusion EUS-GE was associated with increased safety and efficacy for treatment of malignant GOO in Chinese Mainland.
Challenges in Detecting Clinically Relevant Heparin-Induced Thrombocytopenia Antibodies
Authors: Warkentin Theodore E. 
Published: October 2020

AbstractHeparin-induced thrombocytopenia (HIT) is an antibody-mediated hypercoagulable state featuring high thrombosis risk and distinct pathogenesis involving immunoglobulin G-mediated platelet activation. The target of the immune response is a cationic “self” protein, platelet factor 4 (PF4), rendered antigenic by heparin. A key problem is that only a minority of anti-PF4/polyanion antibodies induced by heparin are pathogenic, i.e., capable of causing platelet activation and thereby clinical HIT. Since thrombocytopenia occurs frequently in hospitalized, heparin-treated patients, testing for “HIT antibodies” is common; thus, the problem of distinguishing between pathogenic and nonpathogenic antibodies is important. The central concept is that those antibodies that have platelet-activating properties demonstrable in vitro correlate well with pathogenicity, as shown by platelet activation tests such as the serotonin-release assay (SRA) and heparin-induced platelet activation assay. However, in most circumstances, immunoassays are used for first-line testing, and so it is important for clinicians to appreciate which immunoassay result profiles—in the appropriate clinical context—predict the presence of platelet-activating antibodies (Bayesian analysis). Clinicians with access to rapid, on-demand HIT immunoassays (e.g., particle gel immunoassay, latex immunoturbidimetric assay, chemiluminescent immunoassay) can look beyond simple dichotomous result interpretation (“negative”/“positive”) and incorporate semiquantitative interpretation, where, for example, a strong-positive immunoassay result (or even combination of two immunoassays) points to a greater probability of detecting platelet-activating antibodies, and hence supporting a diagnosis of HIT. Recent recognition of “SRA-negative HIT” has increased the importance of semiquantitative interpretation of immunoassays, given that strong immunoassay reactivity is a potential clue indicating possible HIT despite a (false) negative platelet activation assay.
Massive Hemorrhage: The Role of Whole Blood Viscoelastic Assays
Authors: Scala Emmanuelle , Marcucci Carlo 
Published: October 2020

AbstractViscoelastic whole blood tests are increasingly used to guide hemostatic therapy in bleeding patients in the perioperative, trauma, and obstetric settings. Compared with standard laboratory tests of hemostasis, they have a shorter turnaround time and provide simultaneous information on various aspects of clot formation and lysis. The two available brands TEG (thromboelastography) and ROTEM (rotational thromboelastometry) provide devices that are either manually operated or fully automated. The automation allows for the assays to be used as point-of-care tests increasing their usefulness in massively bleeding patients with rapidly changing hemostatic profiles. While the number of research papers on the subject and the number of published treatment algorithms increase rapidly, the influence of the use of these devices on patient outcome needs yet to be established. In this article, we first review the technology of these devices and the parameters provided by the assays. Next, we present the problems encountered when choosing cut-off values that trigger intervention. Furthermore, we discuss the studies examining their influence on clinical outcomes, and finally, we briefly highlight some of the most important limitations and pitfalls inherent to these assays.
Safety and outcomes of endoscopic ultrasound-guided drainage for malignant biliary obstruction using cautery-enabled lumen-apposing metal stent
Authors: Chin Jerry Yung-Lun , Seleq Samir , Weilert Frank 
Published: October 2020

Abstract
Background and study aims There is increasing evidence to suggest that EUS-guided biliary drainage (EUS-BD) is a safe and effective treatment alternative for patients with malignant biliary obstructions (MBOs) after failed endoscopic retrograde cholangiopancreatography.
Patients and methods We performed a retrospective analysis of data prospectively collected from patients with MBO who underwent choledochoduodenostomy (CDS) or gallbladder drainage (GBD) between August 2016 and June 2020 using the electrocautery-enabled lumen-apposing metal stents (ECE-LAMS). The primary endpoint was technical and clinical success. Secondary endpoints were adverse events (AEs) and reinterventions.
Results A total of 60 patients were included in the study, with 56 CDS and 4 GBD. Median age was 76 years with 57 % male (34/60). The most common indication for EUS-BD was pancreatic cancer (78 %). Technical success was achieved in 100 % of cases, with a clinical success rate of 91.7 %. Mean total bilirubin pre-procedure was 202 umol/L (normal < 20 umol/L) and 63.8 umol/L post procedure (P < .001). Twenty-one patients had bilirubin recorded at 2 weeks post EUS-BD with 20 of 21 patients demonstrating > 50 % reduction in bilirubin (mean bilirubin reduction 75 %). AEs occurred in 12 of 60 patients (20 %), all of which were mild. The reintervention rate was 11.7 % (7/60). Stent occlusion occurred in 10 of 60 patients (16.7 %) with a mean time to stent occlusion of 46.2 days (3–133). Stent patency of 83.3 % was observed with a mean follow up of 7.9 months.
Conclusion EUS-CDS and GBD using ECE-LAMS are effective EUS-based techniques for managing patients with MBO. AEs are usually mild and resolved by reintervention.
Efficacy and safety of endoscopic ultrasound-guided pancreatic duct drainage (EUS-PDD): A systematic review and meta-analysis of 714 patients
Authors: Chandan Saurabh , Mohan Babu P. , Khan Shahab R. , Kassab Lena L. , Ponnada Suresh , Ofosu Andrew , Bhat Ishfaq , Singh Shailender , Adler Douglas G. 
Published: October 2020

AbstractBackground and study aims Endoscopic ultrasound guided pancreatic duct drainage (EUS-PDD) is a minimal-invasive therapeutic option to surgery and in patients with failed endoscopic retrograde pancreatography (ERP). The aim of this review was to quantitatively appraise the clinical outcomes of EUS-PDD by meta-analysis methods.Methods We searched multiple databases from inception through March 2020 to identify studies that reported on EUS-PDD. Pooled rates of technical success, successful drainage of pancreatic duct, clinical success, and adverse events were calculated. Study heterogeneity was assessed using I2% and 95 % prediction interval.Results A total of 22 studies (714 patients) were included. The pooled rate of technical success in EUS-PDD was 84.8 % (95 % CI 79.1–89.2). The pooled rate of successful PD drained by EUS-PDD was 77.5 % (95 % CI 63.1–87.4). The pooled rate of clinical success of EUS-PDD was 89.2 % (95 % CI 82.1–93.7). The pooled rate of all adverse events was 18.1 % (95 % CI 14.2–22.9). On sub-group analysis, the pooled technical success and clinical success of EUS-PDD from Japanese data were considerably superior (91.2 %, 83–95.6 & 92.5 %, 83.9–96.7, respectively). The pooled rate of post EUS-PDD acute pancreatitis was 6.6 % (95 % CI 4.5–9.4), bleeding was 4.1 % (95 % CI 2.7–6.2), perforation and/or pneumoperitoneum was 3.1 % (95 % CI 1.9–5), pancreatic leak and/or pancreatic fluid collection was 2.3 % (95 % CI 1.4–4), and infection was 2.8 % (95 % CI 1.7–4.6).Conclusion EUS-PDD demonstrates high technical success and clinical success rates with acceptable adverse events. Technical success was especially high for anastomotic strictures.
Definiert das Alter den geriatrischen Patienten?
Authors: Hofmann Britt , Simm Andreas 
Published: October 2020

ZusammenfassungÄltere Menschen stellen einen wachsenden Anteil unserer täglich medizinisch und chirurgisch zu versorgenden Patienten dar. Allerdings definiert das kalendarische Alter alleine den älteren Patienten nur unzureichend. Vielmehr scheint das biologische Alter oder das Maß an Gebrechlichkeit entscheidend für die Charakterisierung zu sein. Auch der Prozentsatz der Menschen, die gebrechlich sind, ist in den letzten Jahrzehnten stetig gestiegen. Gebrechlichkeit oder Frailty ist ein geriatrisches Syndrom, welches durch verringerte physische und psychische Reserven zur Kompensation gekennzeichnet ist. Die beiden am häufigsten genutzten Ansätze zur Definition von Gebrechlichkeit sind der phänotypische Ansatz und der Ansatz der Defizitakkumulation. Für ältere Patienten haben sich in diesem Zusammenhang 2 Interventionspunkte in der klinischen Praxis herauskristallisiert: 1. die präinterventionelle/operative Identifizierung von Hochrisikopatienten, um sowohl die Patientenerwartungen
als auch die chirurgische Entscheidungsfindung zu steuern, und 2. periinterventionelle/operative Optimierungsstrategien für gebrechliche Patienten. Noch fehlt ein mit vertretbarem Zeitaufwand in der klinischen Praxis umsetzbarer, objektiver Goldstandard zur Analyse der Frailty.
Adenoma detection rate as a quality indicator for colonoscopy: a descriptive cross-sectional study from a tertiary care hospital in Pakistan
Authors: Yousaf Mian Shah , Shafqat Shameel , Gill Roger Christopher , Khursheed Asfia Arham , Parkash Om 
Published: October 2020

AbstractBackground and study aims Adenoma detection rate (ADR) is validated for measuring quality of colonoscopy, however there is lack of colorectal cancer (CRC) screening program in South Asia. The purpose of this study is to analyze and review the polyp detection rate (PDR) and ADR and provide insight into the factors that influence them in Pakistan.Patients and methods This retrospective, cross-sectional study was performed at the Aga Khan University Hospital, Karachi, Pakistan, on patients ≥ 18 years, who underwent colonoscopy between January 1, 2017 and June 30, 2018.Results Of 1985 patients, 59 % were male and 41 % female, with mean age of 47.8 ± 16.2 years. The most common indication for colonoscopy was bleeding-per-rectum (28.0 %) and overall PDR and ADR were 17.9 % and 9.9 %, respectively. There was no significant difference between genders for either PDR (P = 0.378) or ADR (P = 0.574). Significantly higher PDR and ADR were found for patients ≥ 50 years (P < 0.001), as well as for suboptimal bowel preparation [PDR (25.7 %; P = 0.007) and ADR (18.6 %; P = 0.014)]. Interestingly, endoscopists with < 500 colonoscopy-procedural-experience reported a higher PDR (21.6 %; P = 0.020) and ADR (14.4 %; P = 0.049), corresponding to a significantly higher PDR (20.6 %; P = 0.005) and ADR (11.7 %; P = 0.02) for endoscopists in practice for ≤ 10 years.Conclusions We have noticed low PDR and ADR, which require further investigation and research. In addition, we believe there should be a different baseline ADR and PDR as a quality indicator for colonoscopy in our region, where no internationally recommended colonoscopic screening programs have been implemented.
Effect of anticoagulants on the risk of delayed bleeding after colorectal endoscopic submucosal dissection
Authors: Ogiyama Hideharu , Inoue Takuya , Maekawa Akira , Yoshii Shunsuke , Yamaguchi Shinjiro , Nagai Kengo , Yamamoto Masashi , Egawa Satoshi , Horimoto Masayoshi , Ogawa Hiroyuki , Nishihara Akihiro , Komori Masato , Kizu Takashi , Tsutsui Shusaku , Tsujii Yoshiki , Hayashi Yoshito , Iijima Hideki , Takehara Tetsuo 
Published: October 2020

AbstractBackground and study aims In patients receiving antithrombotic therapy, the risks of delayed bleeding after endoscopic procedures for gastrointestinal neoplasms become a major problem. Few reports have shown the effects of delayed bleeding in patients taking anticoagulants after colorectal endoscopic submucosal dissection (ESD). This study aimed to evaluate the delayed bleeding events after colorectal ESD in patients receiving anticoagulant therapy.Patients and methods We retrospectively analyzed 87 patients taking anticoagulants who underwent colorectal ESD from April 2012 to December 2017 at 13 Japanese institutions participating in the Osaka Gut Forum. Among these patients, warfarin users were managed with heparin bridge therapy (HBT), continued use of warfarin, a temporary switch to direct oral anticoagulation (DOAC), or withdrawal of warfarin, and DOAC users were managed with DOAC discontinuation with or without HBT. We investigated the occurrence rate of delayed bleeding and compared the rates between warfarin and DOAC users.Results The delayed bleeding rate was 17.2 % among all patients. The delayed bleeding rate was higher in DOAC users than in warfarin users (23.3 % vs. 11.4 %, P = 0.14), although no statistically significant difference was observed. In DOAC users, the delayed bleeding rates for dabigatran, rivaroxaban, apixaban, and edoxaban users appeared similar (30 %, 18.2 %, 22.2 %, and 25 %, respectively). The onset of delayed bleeding in both warfarin and DOAC users was late, averaging 6.9 and 9.4 days, respectively.Conclusions Among patients taking anticoagulants, the risk of delayed bleeding after colorectal ESD was relatively high and the onset of delayed bleeding was late.