Environmental and Economic Impact of the Antifreeze Agents in Geothermal Heat Exchangers

Borehole heat exchangers (BHEs) generally employ water-antifreeze solutions to allow working fluid temperatures to fall below 0 °C. However, some local regulations have forbidden antifreeze additives (even non-toxic ones) to avoid groundwater pollution in case of pipe leakage. This paper presents a techno-economic and environmental analysis of four different fluids: propylene glycol at 25% and 33% weight concentrations, calcium chloride at 20% weight concentration (CaCl2 20%), and pure water. Thermal loads from 36 case studies in six different climate zones are used to perform BHE sizing and compare the abovementioned fluids from the economic, operational, and environmental points of view. The economic analysis and the carbon footprint assessment are performed on a life cycle of 25 years considering the installation (BHE drilling, fluid) and operation (heat pump and ground-side circulation pump energy demand, fluid replacement) of the simulated GSHPs. Results highlight that using pure water as a heat carrier fluid is convenient for cooling-dominated buildings but, for heating-dominated buildings, this choice leads to a noticeable increase of the BHE needed length which is not compensated by the lower operational costs. On the other hand, avoiding the use of antifreeze additives generally leads to a reduction of the lifetime carbon footprint, with a few exceptions in very cold climates. CaCl2 20% proves to be a good choice in most cases, both from the economic and the environmental points of view, as it allows a strong reduction of the installed BHE length in cold climates with a low additional cost and carbon footprint

Integrated envelope design process: innovative materials and technologies for a sustainable refurbishment of the existing building stock

The research project seeks to investigate and promote a new energy efficient architectural strategy for the refurbishment of existing building stock, by proposing innovative and sustainable envelope solutions based on process by-products concept and bio-mimetic approach. The project aims optimizing the exploitation of innovative sustainable materials and technologies to develop a continuous and adaptive fa\ue7ade system that could guarantee high performance, by using a new class of materials (AAM), obtained through the alkali-activation process of ceramic industrial waste

Enhancing PFI Prediction with GDS-MIL: A Graph-based Dual Stream MIL Approach

Whole-Slide Images (WSI) are emerging as a promising resource for studying biological tissues, demonstrating a great potential in aiding cancer diagnosis and improving patient treatment. However, the manual pixel-level annotation of WSIs is extremely time-consuming and practically unfeasible in real-world scenarios. Multi-Instance Learning (MIL) have gained attention as a weakly supervised approach able to address lack of annotation tasks. MIL models aggregate patches (e.g., cropping of a WSI) into bag-level representations (e.g., WSI label), but neglect spatial information of the WSIs, crucial for histological analysis. In the High-Grade Serous Ovarian Cancer (HGSOC) context, spatial information is essential to predict a prognosis indicator (the Platinum-Free Interval, PFI) from WSIs. Such a prediction would bring highly valuable insights both for patient treatment and prognosis of chemotherapy resistance. Indeed, NeoAdjuvant ChemoTherapy (NACT) induces changes in tumor tissue morphology and composition, making the prediction of PFI from WSIs extremely challenging. In this paper, we propose GDS-MIL, a method that integrates a state-of-the-art MIL model with a Graph ATtention layer (GAT in short) to inject a local context into each instance before MIL aggregation. Our approach achieves a significant improvement in accuracy on the ``Ome18'' PFI dataset. In summary, this paper presents a novel solution for enhancing PFI prediction in HGSOC, with the potential of significantly improving treatment decisions and patient outcomes

Post-traumatic infection of the lower limb caused by rare Enterobacteriaceae and mucorales in a young healthy male.

Summary Enterobacter amnigenus and Leclercia adecarboxylata are Gram-negative aerobic bacilli of the family Enterobacteriaceae that have been isolated from water and, rarely, from various clinical specimens. Absidia is a filamentous fungus of the class Zygomycetes that is ubiquitous in nature and can cause infection, primarily in immunocompromised hosts. Here, we describe an infection of the left lower limb caused by E. amnigenus and L. adecarboxylata with subsequent isolation of Absidia spp. in a patient with multiple traumatic injuries after a major motor vehicle accident. The severity of the clinical picture made amputation necessary, despite aggressive anti-infective therapy with both antibacterial and antifungal agents. Prompt diagnosis and management are mandatory in order to minimize morbidity and even mortality, and reduce the social and economic cost

A data-driven analysis of the current debate on the linkages between performance and strategy studies

This paper focuses on how the relations between performance management and measurement (PMM) and strategy are considered by scholars. These relations are crucial in building a comprehensive body of knowledge of a complex and multifaceted phenomenon which attracts scholars pertaining to different management disciplines. The results obtained by adopting quantitative methodologies (descriptive statistics and text-mining analysis) on a sample of articles recently published in the most influential international 'business, and management accounting' journals, contribute to extant literature by providing evidence that several connections exist between key-concepts which are usually considered an exclusive heritage of single management disciplines, such as strategy, organisation, management control, and so forth. For that reason, an integration of competences and methodologies is needed to support further research in the field. We also find evidence suggesting that the organisational perspective should be particularly considered when investigating the relations between strategy, management control systems and PMM

Prevalence, molecular epidemiology and intra-hospital acquisition of Klebsiella pneumoniae strains producing carbapenemases in an Italian teaching hospital from January 2015 to September 2016.

Objectives: We described Klebsiella pneumoniae producing carbapenemase (CPKP) spread from 01/01/2015 to 13/09/16 in a tertiary level hospital. Methods: The first positive surveillance rectal swab (SRS) or clinical sample (CS) collected in the medical department (MD), surgical department (SD) and intensive care department (ICD) were included in the study. A validated in-house Real-Time PCR method was used to detect carbapenemases; multilocus sequence typing (MLST) was used for further characterization of the strains. Results: 21535 patients were included: 213 CPKP strains from surveillance rectal swab (SRS) and 98 from clinical samples (CS) were collected. The percentage of CPKP detected in SRS with respect to CS increased in the medical MD from 2015 to 2016 (p = 0.01) and in ICD from 2012 to 2015 (p = 0.0001), while it decreased in SD from 2014 to 2016 (p = 0.003); 68.5% of the positive SRS had a previous negative SRS; CPKP was more frequently identified in CS than in SRS in MD. Twelve strains harboured more than one carbapenemase gene. Many other species harbouring a carbapenemase gene were collected. Conclusions: MDs need more inclusive surveillance criteria. The late detection of positive SRS underlined the risk of colonization during hospitalization

Prevalence of Klebsiella pneumoniae strains producing carbapenemases and increase of resistance to colistin in an Italian teaching hospital from January 2012 To December 2014

The aim of this study was to characterize the spread of carbapenemase-producing Klebsiella pneumoniae (CPKP) in a tertiary level hospital using ongoing active surveillance with rectal swab cultures. Furthermore, this study analyzed the presence of CPKP in the clinical samples (CS) of a single patient as well as the evolution of Colistin-sensitive strains (CoS) to Colistin-resistant strains (CoR)

Randomised controlled trial combining vitamin E-functionalised chocolate with physical exercise to reduce the risk of protein-energy malnutrition in predementia aged people: study protocol for Choko-Age

Objective: Protein-energy malnutrition and the subsequent muscle wasting (sarcopenia) are common ageing complications. It is knowing to be also associated with dementia. Our programme will test the cytoprotective functions of vitamin E combined with the cortisol-lowering effect of chocolate polyphenols (PP), in combination with muscle anabolic effect of adequate dietary protein intake and physical exercise to prevent the age-dependent decline of muscle mass and its key underpinning mechanisms including mitochondrial function, and nutrient metabolism in muscle in the elderly. Methods and analysis: In 2020, a 6-month double-blind randomised controlled trial in 75 predementia older people was launched to prevent muscle mass loss, in respond to the 'Joint Programming Initiative A healthy diet for a healthy life'. In the run-in phase, participants will be stabilised on a protein-rich diet (0.9-1.0 g protein/kg ideal body weight/day) and physical exercise programme (high-intensity interval training specifically developed for these subjects). Subsequently, they will be randomised into three groups (1:1:1). The study arms will have a similar isocaloric diet and follow a similar physical exercise programme. Control group (n=25) will maintain the baseline diet; intervention groups will consume either 30 g/day of dark chocolate containing 500 mg total PP (corresponding to 60 mg epicatechin) and 100 mg vitamin E (as RRR-alpha-tocopherol) (n=25); or the high polyphenol chocolate without additional vitamin E (n=25). Muscle mass will be the primary endpoint. Other outcomes are neurocognitive status and previously identified biomolecular indices of frailty in predementia patients. Muscle biopsies will be collected to assess myocyte contraction and mitochondrial metabolism. Blood and plasma samples will be analysed for laboratory endpoints including nutrition metabolism and omics. Ethics and dissemination: All the ethical and regulatory approvals have been obtained by the ethical committees of the Azienda Ospedaliera Universitaria Integrata of Verona with respect to scientific content and compliance with applicable research and human subjects' regulation. Given the broader interest of the society toward undernutrition in the elderly, we identify four main target audiences for our research activity: national and local health systems, both internal and external to the project; targeted population (the elderly); general public; and academia. These activities include scientific workshops, public health awareness campaigns, project dedicated website and publication is scientific peer-review journals. Trial registration number: NCT05343611