Impact of blue-collar vs. white-collar occupations on disease burden in psoriatic arthritis patients: A Swiss clinical quality management in rheumatic diseases cohort study.

Biomechanical stress may exacerbate inflammation in psoriatic arthritis (PsA). This study aimed to investigate disease activity, work disability, and drug response/retention rates in PsA patients among two different occupation's types: blue-collar workers (BCol) with manual labor versus white-collar workers (WCol) with sedentary occupations. PsA patients registered in the Swiss cohort (SCQM) were classified as BCol or WCol workers and assessed at the initiation of a biologic or targeted synthetic disease-modifying anti-rheumatic drug (b-/tsDMARD). We compared the baseline characteristics at treatment start and the DAS28-CRP for the 1-year remission. Treatment retention was investigated using Kaplan-Meier curves and Cox regression analysis. Multivariable models were adjusted for potential confounders. Of 564 patients, 29% were BCol, and 71% were WCol workers. Baseline disease activity was comparable between both groups. BCol workers were predominantly male (79.8%) and more work disabled at baseline (84.0% vs. 27.9%; p < 0.01). One hundred seventy-four treatment courses (TCs) of 165 PsA patients were included for longitudinal analysis. Occupation did not significantly influence the achievement of DAS28-CRP remission at 1 year. Kaplan-Meier analysis (n = 671) indicated longer retention for BCol workers (mean retention duration: 3.15 years vs. 2.15 years, (p = 0.006). However, adjusted Cox regression analysis did not corroborate these findings. This study indicates that physically demanding occupations correlate with increased rates of work disability among PsA patients, while treatment response seems to be unaffected by the patients' occupation type. Additional research is required to thoroughly comprehend the relationship between physical workload, disease activity, and treatment outcomes. Key Points • This study indicates that physically demanding occupations correlate with increased rates of work disability among PsA patients. • The treatment response among of PsA patients seems unaffected by the patients' occupation type

Economic Evaluation of Renewable Hydrogen Integration into Steelworks for the Production of Methanol and Methane

This work investigates the cost-efficient integration of renewable hydrogen into steelworks for the production of methane and methanol as an efficient way to decarbonize the steel industry. Three case studies that utilize a mixture of steelworks off-gases (blast furnace gas, coke oven gas, and basic oxygen furnace gas), which differ on the amount of used off-gases as well as on the end product (methane and/or methanol), are analyzed and evaluated in terms of their economic performance. The most influential cost factors are identified and sensitivity analyses are conducted for different operating and economic parameters. Renewable hydrogen produced by PEM electrolysis is the most expensive component in this scheme and responsible for over 80% of the total costs. Progress in the hydrogen economy (lower electrolyzer capital costs, improved electrolyzer efficiency, and lower electricity prices) is necessary to establish this technology in the future

Echo-state neural networks forecasting steelworks off-gases for their dispatching in CH4 and CH3OH syntheses reactors

In the era of European Green Deal, steelworks are committed to reduce their CO2 emissions by preserving their competitiveness. One of the options to achieve such aim is the valorization of process off-gases. Methane and Methanol production can be obtained by coupling novel reactors with an advanced control system that dispatches these gases after enrichment with green hydrogen. Knowing in advance the gases availability and composition is fundamental. The paper present Echo State Networks based-models that are applied to this aim and achieve adequate forecasting accuracy also in case of highly dynamic processes.European Union (EU), Research Fund for Coal and Steel: Integrated and intelligent upgrade of carbon sources through hydrogen addition for the steel industry - i3upgrade, grant No. 800659

Economic Evaluation of Renewable Hydrogen Integration into Steelworks for the Production of Methanol and Methane

This work investigates the cost-efficient integration of renewable hydrogen into steelworks for the production of methane and methanol as an efficient way to decarbonize the steel industry. Three case studies that utilize a mixture of steelworks off-gases (blast furnace gas, coke oven gas, and basic oxygen furnace gas), which differ on the amount of used off-gases as well as on the end product (methane and/or methanol), are analyzed and evaluated in terms of their economic performance. The most influential cost factors are identified and sensitivity analyses are conducted for different operating and economic parameters. Renewable hydrogen produced by PEM electrolysis is the most expensive component in this scheme and responsible for over 80% of the total costs. Progress in the hydrogen economy (lower electrolyzer capital costs, improved electrolyzer efficiency, and lower electricity prices) is necessary to establish this technology in the future

Hydrogen role in the valorization of integrated steelworks process off-gases through methane and methanol syntheses

The valorization of integrated steelworks process off-gases as feedstock for synthesizing methane and methanol is in line with European Green Deal challenges. However, this target can be generally achieved only through process off-gases enrichment with hydrogen and use of cutting-edge syntheses reactors coupled to advanced control systems. These aspects are addressed in the RFCS project i3upgrade and the central role of hydrogen was evident from the first stages of the project. First stationary scenario analyses showed that the required hydrogen amount is significant and existing renewable hydrogen production technologies are not ready to satisfy the demand in an economic perspective. The poor availability of low-cost green hydrogen as one of the main barriers for producing methane and methanol from process off-gases is further highlighted in the application of an ad-hoc developed dispatch controller for managing hydrogen intensified syntheses in integrated steelworks. The dispatch controller considers both economic and environmental impacts in the cost function and, although significant environmental benefits are obtainable by exploiting process off-gases in the syntheses, the current hydrogen costs highly affect the dispatch controller decisions. This underlines the need for big scale green hydrogen production processes and dedicated green markets for hydrogen-intensive industries, which would ensure easy access to this fundamental gas paving the way for a C-lean and more sustainable steel production

Valorizing Steelworks Gases by Coupling Novel Methane and Methanol Synthesis Reactors with an Economic Hybrid Model Predictive Controller

To achieve the greenhouse gas reduction targets formulated in the European Green Deal, energy- and resource-intensive industries such as the steel industry will have to adapt or convert their production. In the long term, new technologies are promising. However, carbon capture storage and utilization solutions could be considered as short-term retrofitting solutions for existing steelworks. In this context, this paper presents a first experimental demonstration of an approach to the utilization of process off-gases generated in a steelworks by producing methane and methanol in hydrogen-intensified syntheses. Specifically, the integration of two methane synthesis reactors and one methanol synthesis reactor into a steel plant is experimentally simulated. An innovative monitoring and control tool, namely, a dispatch controller, simulates the process off-gas production using a digital twin of the steel plant and optimizes its distribution to existing and new consumers. The operating states/modes of the three reactors resulting from the optimization problem to be solved by the dispatch controller are distributed in real time via an online OPC UA connection to the corresponding experimental plants or their operators and applied there in a decentralized manner. The live coupling test showed that operating values for the different systems can be distributed in parallel from the dispatch controller to the test rigs via the established communication structure without loss. The calculation of a suitable control strategy is performed with a time resolution of one minute, taking into account the three reactors and the relevant steelworks components. Two of each of the methane/methanol synthesis reactors were operated error-free at one time for 10 and 7 h, respectively, with datasets provided by the dispatch controller. All three reactor systems were able to react quickly and stably to dynamic changes in the load or feed gas composition. Consistently high conversions and yields were achieved with low by-product formation

Hydrogen intensified synthesis processes to valorise process off-gases in integrated steelworks

Integrated steelworks off-gases are generally exploited to produce heat and electricity. However, further valorization can be achieved by using them as feedstock for the synthesis of valuable products, such as methane and methanol, with the addition of renewable hydrogen. This was the aim of the recently concluded project entitled “Intelligent and integrated upgrade of carbon sources in steel industries through hydrogen intensified synthesis processes (i3upgrade)”. Within this project, several activities were carried out: from laboratory analyses to simulation investigations, from design, development and tests of innovative reactor concepts and of advanced process control to detailed economic analyses, business models and investigation of implementation cases. The final developed methane production reactors are, respectively, an additively manufactured structured fixed-bed reactor and a reactor setup using wash-coated honeycomb monoliths as catalyst; both reactors reached almost full COx conversion under slightly over-stoichiometric conditions. A new multi-stage concept of methanol reactor was designed, commissioned, and extensively tested at pilot-scale; it shows very effective conversion rates near to 100% for CO and slightly lower for CO2 at one-through operation for the methanol synthesis. Online tests proved that developed dispatch controller implements a smooth control strategy in real time with a temporal resolution of 1 min and a forecasting horizon of 2 h. Furthermore, both offline simulations and cost analyses highlighted the fundamental role of hydrogen availability and costs for the feasibility of i3upgrade solutions, and showed that the industrial implementation of the i3upgrade solutions can lead to significant environmental and economic benefits for steelworks, especially in case green electricity is available at an affordable price

Subgrouping suicidal ideations: An ecological momentary assessment study in psychiatric inpatients

**Background.** Suicidal ideations (SI) are amongst the strongest predictors for suicide attempts, yet reliable prediction models for suicide risk are still lacking. One challenge is that SI may vary when indexed over time. This could be due to SI subgroups that might hold crucial information for suicide risk prediction. We aimed to expand on prior approaches that averaged across the SI trajectories and instead use an approach that respects the temporal nature of SI. **Methods.** First, we applied longitudinal clustering to ecological momentary assessment SI data (5 assessments/day over 28 days) of 51 psychiatric patients (61% female, mean age = 35.26, *SD* = 12.54). Specifically, we used KmlShape, an algorithm that takes the SI raw scores and measurement occasion index as input. Second, we regressed each subgroup on established clinical SI risk factors (i.e., history of suicidal thoughts and behaviors, hopelessness, diagnosis of depression, diagnosis of anxiety disorder, and history of abuse). **Results.** We identified four subgroups with distinct SI patterns: (1) “Episodic intensity SI” (high mean, high variability), (2) “Consistent low average SI” (lowest mean, lowest variability), (3) “Chronic moderate average SI” (low mean, low variability), and (4) “Intermittent high SI” (highest mean, highest variability). Further, the subgroups were meaningfully associated with clinical characteristics, i.e., the least severe SI subgroup (“Consistent low average SI”) entailed the least hopeless individuals (beta = -0.95, 95% CI = -1.04, -0.86), and the most severe SI subgroup (“Intermittent high SI”) the most hopeless (beta = 0.84, 95% CI = 0.72, 0.95). **Conclusion.** Applying longitudinal clustering to EMA collected from patients with SI allows to identification of valid and reliable SI subgroups with more distinct clinical characteristics, an important step towards a better understanding of SI and a basis for improving prediction and prevention. **Trial Registration.** 10DL12_183251