Graphical Analysis and Revamping of Crude Distillation Units under Variable Operational Scenarios

Energy Cost Represents a Significant Part of the Total Operating Costs of Many Processing Units. Crude Distillation is an Energy Intensive Process. Energy Integration is a Typical Solution to Reduce Heating and Cooling Utilities through Maximizing the Target Temperature of Crude Oil Streams Before Entering the Furnace. over the Past Few Decades, Significant Progress Has Been Made in Energy Integration Methods Including Pinch Technology and Mathematical Programming Approaches. Very Recently, Graphical Techniques Have Been Developed for Revamping Studies and Energy Analysis. Such Diagrams Are Valuable in Energy Targeting to Identity Energy Inefficiencies and Are Key to Potential Modifications for Maximum Energy Integration. the Current Research Applies the Recent Graphical Revamping Methodology on an Existing Crude Atmospheric Distillation Unit. the Unit is Located in North of Egypt (Suez Region) and is Operated under Two Different Operational Modes; (1) Without Naphtha Stabilizer; the Process Reformer is in Operation to Reform All Naphtha Streams Without Stabilization and (2) with Naphtha Stabilizer; LPG is Separated from Naphtha Stream. a Graphical-Based Revamping Methodology is Applied to Retrofit the Existing Preheat Train. the Revamping Procedure Starts by Simulating the Existing HEN Data, Followed by Validation Against the Real Data. the Current Performance of the HEN is Analyzed using the Graphical Axes of Thot-Tcold Diagrams. the Graphical Method is Then Used to Identify Exchangers Across the Pinch and Recognize the Potential Modifications to Improve the Energy Performance and Reduce Fuel Consumption. Implementing the Graphical Identified Modifications on the Plant Resulted in the Following Benefits: (1) When Stabilizer is in Operation, Energy Savings Are Achieved by 21.1% with Additional Capital Investment of 0.81 MM$and Annual Energy Savings of 0.82 MM$, with a Payback Period of One Year. (2) When Reformer is in Operation, the Energy Savings Are 0.42 MM$with Capital Investment of 0.33 MM$. the Methodology Results Provide a Flexibility in Refineries Operations

Graphical Revamping Of A Crude Distillation Unit Under Two Variable Operational Scenarios - Naphtha Stabilizer And Reformer Operated

Energy costs represent significant parts of the total operating costs of crude refining industries. Energy integration is a typical solution to reduce heating and cooling utilities in crude refining plants through maximizing the target temperature of crude oil streams before entering the furnace. Over the past few decades, a significant progress has been made in energy integration methods including Pinch technology and mathematical programming approaches. Example of these is a graphical technique which plots Thot versus Tcold for energy analysis and revamping studies. The current research employs the Thot - Tcold diagrams in an algorithm to retrofit an existing crude atmospheric distillation unit (CDU) located in north of Egypt (Suez region). This real CDU unit is operated under two different operational modes: (i) without naphtha stabilizer; the process reformer is in operation to reform all naphtha streams without stabilization, and (ii) with naphtha stabilizer; LPG is separated from naphtha stream. The performance of the current HEN is analyzed using the graphical axes of Thot - Tcold diagrams. The graphical method is used to identify exchangers across the Pinch and recognize the potential modifications to improve the energy performance and reduce fuel consumption. Implementing the graphical identified modifications on the existing plant resulted in: (1) stabilizer scenario; energy savings are achieved by 21.1% with additional capital investment of 0.81 MM$and annual energy savings of 0.82 M$, (2) reformer scenario; the energy savings are 0.42 MM$with capital investment of 0.33 M$

Elevated serum neutrophil elastase is related to prehypertension and airflow limitation in obese women

<p>Abstract</p> <p>Background</p> <p>Neutrophil elastase level/activity is elevated in a variety of diseases such as atherosclerosis, systolic hypertension and obstructive pulmonary disease. It is unknown whether obese individuals with prehypertension also have elevated neutrophil elastase, and if so, whether it has a deleterious effect on pulmonary function. Objectives: To determine neutrophil elastase levels in obese prehypertensive women and investigate correlations with pulmonary function tests.</p> <p>Methods</p> <p>Thirty obese prehypertensive women were compared with 30 obese normotensive subjects and 30 healthy controls. The study groups were matched for age. Measurements: The following were determined: body mass index, waist circumference, blood pressure, lipid profile, high sensitivity C-reactive protein, serum neutrophil elastase, and pulmonary function tests including forced expiratory volume in one second (FEV₁), forced vital capacity (FVC) and FEV₁/FVC ratio.</p> <p>Results</p> <p>Serum neutrophil elastase concentration was significantly higher in both prehypertensive (405.8 ± 111.6 ng/ml) and normotensive (336.5 ± 81.5 ng/ml) obese women than in control non-obese women (243.9 ± 23.9 ng/ml); the level was significantly higher in the prehypertensive than the normotensive obese women. FEV1, FVC and FEV1/FVC ratio in both prehypertensive and normotensive obese women were significantly lower than in normal controls, but there was no statistically significant difference between the prehypertensive and normotensive obese women. In prehypertensive obese women, there were significant positive correlations between neutrophil elastase and body mass index, waist circumference, systolic blood pressure, diastolic blood pressure, total cholesterol, triglyceride, low density lipoprotein cholesterol, high sensitivity C-reactive protein and negative correlations with high density lipoprotein cholesterol, FEV1, FVC and FEV1/FVC.</p> <p>Conclusion</p> <p>Neutrophil elastase concentration is elevated in obese prehypertensive women along with an increase in high sensitivity C-reactive protein which may account for dyslipidemia and airflow dysfunction in the present study population.</p

GIZA 11 AND GIZA 12; TWO NEW FLAX DUAL PURPOSE TYPE VARIETIES

Sixteen flax genotypes {13 promising lines and 3 check varieties viz., Giza 8 (oil type), Sakha 1 (dual purpose type) and Sakha 3 (fiber type)} were evaluated for straw, seed, oil yields and their related traits under twelve different environments; four locations (Sakha, Etay El-Baroud, Ismailia and Giza Exp. Stations through three successive seasons (2011/12, 2012/13 and 2013/14). These materials were evaluated in a randomized complete blocks design with three replications at the twelve above-mentioned environments. The analysis of variance revealed highly significant differences among genotypes (G), environments (E) and G x E interaction for all studied traits except straw weight per plant, indicating a wide range of variation among genotypes, environments and these genotypes exhibited differential response to environmental conditions. The significant variance due to residual for all characters except both straw weight per plant and oil yield per fad indicated that genotypes differed with respect to their stability suggesting that prediction would be difficult, which means that mean performance alone would not be appropriate. Interaction component of variance (σ2ge) was less than the genotypic variance (σ2g) for all characters, indicating that genotypes differ in their genetic potential for these traits. This was reflected in high heritability and low discrepancy between phenotypic (PCV) and genotypic (GCV) coefficients of variability values for these traits indicating the possibility of using each of long fiber percentage, plant height and technical stem length as selection indices for improving straw weight per plant, as well as, using 1000-seed weight and capsules number per plant as selection indices for improving seed weight per plant. Yield stability (YSi) statistic indicated that S.541-C/3 and S.541-D/10 gave high mean performance and stability for straw, fiber, seed and oil yields per fad in addition to oil percentage, capsules number per plant and 1000-seed weight. Therefore, the two genotypes well be released under the name Giza 11 and Giza 12, respectively. These newly released varieties are of dual purpose type for straw, fiber, seed and oil yield. They may replace the low yielding cultivars Giza 8, Sakha 1 and Sakha 3

Antimicrobial resistance among migrants in Europe: a systematic review and meta-analysis

BACKGROUND: Rates of antimicrobial resistance (AMR) are rising globally and there is concern that increased migration is contributing to the burden of antibiotic resistance in Europe. However, the effect of migration on the burden of AMR in Europe has not yet been comprehensively examined. Therefore, we did a systematic review and meta-analysis to identify and synthesise data for AMR carriage or infection in migrants to Europe to examine differences in patterns of AMR across migrant groups and in different settings. METHODS: For this systematic review and meta-analysis, we searched MEDLINE, Embase, PubMed, and Scopus with no language restrictions from Jan 1, 2000, to Jan 18, 2017, for primary data from observational studies reporting antibacterial resistance in common bacterial pathogens among migrants to 21 European Union-15 and European Economic Area countries. To be eligible for inclusion, studies had to report data on carriage or infection with laboratory-confirmed antibiotic-resistant organisms in migrant populations. We extracted data from eligible studies and assessed quality using piloted, standardised forms. We did not examine drug resistance in tuberculosis and excluded articles solely reporting on this parameter. We also excluded articles in which migrant status was determined by ethnicity, country of birth of participants' parents, or was not defined, and articles in which data were not disaggregated by migrant status. Outcomes were carriage of or infection with antibiotic-resistant organisms. We used random-effects models to calculate the pooled prevalence of each outcome. The study protocol is registered with PROSPERO, number CRD42016043681. FINDINGS: We identified 2274 articles, of which 23 observational studies reporting on antibiotic resistance in 2319 migrants were included. The pooled prevalence of any AMR carriage or AMR infection in migrants was 25·4% (95% CI 19·1-31·8; I2 =98%), including meticillin-resistant Staphylococcus aureus (7·8%, 4·8-10·7; I2 =92%) and antibiotic-resistant Gram-negative bacteria (27·2%, 17·6-36·8; I2 =94%). The pooled prevalence of any AMR carriage or infection was higher in refugees and asylum seekers (33·0%, 18·3-47·6; I2 =98%) than in other migrant groups (6·6%, 1·8-11·3; I2 =92%). The pooled prevalence of antibiotic-resistant organisms was slightly higher in high-migrant community settings (33·1%, 11·1-55·1; I2 =96%) than in migrants in hospitals (24·3%, 16·1-32·6; I2 =98%). We did not find evidence of high rates of transmission of AMR from migrant to host populations. INTERPRETATION: Migrants are exposed to conditions favouring the emergence of drug resistance during transit and in host countries in Europe. Increased antibiotic resistance among refugees and asylum seekers and in high-migrant community settings (such as refugee camps and detention facilities) highlights the need for improved living conditions, access to health care, and initiatives to facilitate detection of and appropriate high-quality treatment for antibiotic-resistant infections during transit and in host countries. Protocols for the prevention and control of infection and for antibiotic surveillance need to be integrated in all aspects of health care, which should be accessible for all migrant groups, and should target determinants of AMR before, during, and after migration. FUNDING: UK National Institute for Health Research Imperial Biomedical Research Centre, Imperial College Healthcare Charity, the Wellcome Trust, and UK National Institute for Health Research Health Protection Research Unit in Healthcare-associated Infections and Antimictobial Resistance at Imperial College London

Surgical site infection after gastrointestinal surgery in high-income, middle-income, and low-income countries: a prospective, international, multicentre cohort study

Background: Surgical site infection (SSI) is one of the most common infections associated with health care, but its importance as a global health priority is not fully understood. We quantified the burden of SSI after gastrointestinal surgery in countries in all parts of the world. Methods: This international, prospective, multicentre cohort study included consecutive patients undergoing elective or emergency gastrointestinal resection within 2-week time periods at any health-care facility in any country. Countries with participating centres were stratified into high-income, middle-income, and low-income groups according to the UN's Human Development Index (HDI). Data variables from the GlobalSurg 1 study and other studies that have been found to affect the likelihood of SSI were entered into risk adjustment models. The primary outcome measure was the 30-day SSI incidence (defined by US Centers for Disease Control and Prevention criteria for superficial and deep incisional SSI). Relationships with explanatory variables were examined using Bayesian multilevel logistic regression models. This trial is registered with ClinicalTrials.gov, number NCT02662231. Findings: Between Jan 4, 2016, and July 31, 2016, 13 265 records were submitted for analysis. 12 539 patients from 343 hospitals in 66 countries were included. 7339 (58·5%) patient were from high-HDI countries (193 hospitals in 30 countries), 3918 (31·2%) patients were from middle-HDI countries (82 hospitals in 18 countries), and 1282 (10·2%) patients were from low-HDI countries (68 hospitals in 18 countries). In total, 1538 (12·3%) patients had SSI within 30 days of surgery. The incidence of SSI varied between countries with high (691 [9·4%] of 7339 patients), middle (549 [14·0%] of 3918 patients), and low (298 [23·2%] of 1282) HDI (p < 0·001). The highest SSI incidence in each HDI group was after dirty surgery (102 [17·8%] of 574 patients in high-HDI countries; 74 [31·4%] of 236 patients in middle-HDI countries; 72 [39·8%] of 181 patients in low-HDI countries). Following risk factor adjustment, patients in low-HDI countries were at greatest risk of SSI (adjusted odds ratio 1·60, 95% credible interval 1·05–2·37; p=0·030). 132 (21·6%) of 610 patients with an SSI and a microbiology culture result had an infection that was resistant to the prophylactic antibiotic used. Resistant infections were detected in 49 (16·6%) of 295 patients in high-HDI countries, in 37 (19·8%) of 187 patients in middle-HDI countries, and in 46 (35·9%) of 128 patients in low-HDI countries (p < 0·001). Interpretation: Countries with a low HDI carry a disproportionately greater burden of SSI than countries with a middle or high HDI and might have higher rates of antibiotic resistance. In view of WHO recommendations on SSI prevention that highlight the absence of high-quality interventional research, urgent, pragmatic, randomised trials based in LMICs are needed to assess measures aiming to reduce this preventable complication

Evaluation of a Functional Time Series Model for Forecasting Inflation in Uganda

Inflation is a major economic problem in emerging market economies and requires accurate models to avoid high volatility and long periods of inflation. This paper is aimed at evaluating a Functional Time Series (FTS) model as compared to other models in forecasting inflation in Uganda. The monthly Time Series (TS) data for the general Consumer Price Index (CPI) was used during the period of Jul-2005 to Jun-2020. Box-Jenkins’ Auto Regressive Integrated Moving Average (ARIMA) and Seasonal Autoregressive Integrated Moving Average (SARIMA) methodologies are explored to evaluate the FTS method of forecasting the general CPI where their accuracies are compared and validated using Mean Squared Error (MSE), Root Mean Square Error (RMSE), Akaike Information Criterion (AIC), and Bayesian Information Criterion (BIC) criteria. Existing inflation models in Uganda are outdated by structural changes in the economy igniting the need for a novel accurate model for forecasting inflation. FTS technique is overall considered accurate and particularly used to model high-frequency data such as Uganda general CPI data modeled as a functional observation after smoothing by kernel smoothing methods compared to traditional methods. Business operations and consumers normally base their decisions on modeled and forecasted inflation with their decisions affected by inflation uncertainties that hinder their motivations to invest and save in a given country as they try to avoid inflation-related risks. Findings therefore show FTS having great accuracies and recommended the method for forecasting Uganda inflation. This opens a new framework for extending the Box and Jenkin’s methodology to the functional setting

The potential therapeutic effect of melatonin in gastro-esophageal reflux disease

Abstract Background Gastro-Esophageal Reflux Disease (GERD) defined as a condition that develops when the reflux of stomach contents causes troublesome symptoms and/or complications. Many drugs are used for the treatment of GERD such as omeprazole (a proton pump inhibitor) which is a widely used antiulcer drug demonstrated to protect against esophageal mucosal injury. Melatonin has been found to protect the gastrointestinal mucosa from oxidative damage caused by reactive oxygen species in different experimental ulcer models. The aim of this study is to evaluate the role of exogenous melatonin in the treatment of reflux disease in humans either alone or in combination with omeprazole therapy. Methods 36 persons were divided into 4 groups (control subjects, patients with reflux disease treated with melatonin alone, omeprazole alone and a combination of melatonin and omeprazole for 4 and 8 weeks) Each group consisted of 9 persons. Persons were subjected to thorough history taking, clinical examination, and investigations including laboratory, endoscopic, record of esophageal motility, pH-metry, basal acid output and serum gastrin. Results Melatonin has a role in the improvement of Gastro-esophageal reflux disease when used alone or in combination with omeprazole. Meanwhile, omeprazole alone is better used in the treatment of GERD than melatonin alone. Conclusion The present study showed that oral melatonin is a promising therapeutic agent for the treatment of GERD. It is an effective line of treatment in relieving epigastric pain and heartburn. However, further studies are required to confirm the efficacy and long-term safety of melatonin before being recommended for routine clinical use. Trial Registration QA13NCT00915616</p

Efficacy of precede model-based educational program on women's knowledge and practice regarding cervical cancer prevention

Cervical cancer affects about half a million women every year, and the disease claims nearly 300,000 lives worldwide. The disease is largely preventable. Cervical cancer is the second most common cancer in women worldwide and is a major public health problem in poor countries. Aim: To determine the effect of PRECEDE Model-based educational program on women's Knowledge and practice regarding cervical cancer prevention. Design: Quasi-experimental research design pre-post-test was used to achieve the aim of this study. Settings: The study was applied in the gynecological outpatient clinics at Beni-Suef University Hospitals. Sample: A purposive sample of 100 pregnant women was recruited from the selected settings. Tools: Four tools were used: (1) a Structured interviewing questionnaire, (2) Predisposing, Enabling, and Reinforcing Questionnaire (PRECEDE model questionnaire), (3) a pregnant women’s reported practices questionnaire on cervical cancer, and (4) pregnant women’s attitude questionnaire regarding cervical cancer prevention. Results: The current results revealed that the mean score of knowledge, enabling factors, and reinforcing factors have been increased with statistical significance immediately and after one month of the educational program. Pregnant women had adequate practices toward cervical cancer preventive measures post-intervention compared to the pre-educational program