Synthesis and Optimal Operation of Smart Microgrids Serving a Cluster of Buildings on a Campus with Centralized and Distributed Hybrid Renewable Energy Units

Micro-district heating networks based on cogeneration plants and renewable energy technologies are considered efficient, viable and environmentally-friendly solutions to realizing smart multi-energy microgrids. Nonetheless, the energy production from renewable sources is intermittent and stochastic, and cogeneration units are characterized by fixed power-to-heat ratios, which are incompatible with fluctuating thermal and electric demands. These drawbacks can be partially overcome by smart operational controls that are capable of maximizing the energy system performance. Moreover, electrically driven heat pumps may add flexibility to the system, by shifting thermal loads into electric loads. In this paper, a novel configuration for smart multi-energy microgrids, which combines centralized and distributed energy units is proposed. A centralized cogeneration system, consisting of an internal combustion engine is connected to a micro-district heating network. Distributed electric heat pumps assist the thermal production at the building level, giving operational flexibility to the system and supporting the integration of renewable energy technologies, i.e., wind turbines, photovoltaic panels, and solar thermal collectors. The proposed configuration was tested in a hypothetical case study, namely, a University Campus located in Trieste, Italy. The system operation is based on a cost-optimal control strategy and the effect of the size of the cogeneration unit and heat pumps was investigated. A comparison with a conventional configuration, without distributed heat pumps, was also performed. The results show that the proposed configuration outperformed the conventional one, leading to a total-cost saving of around 8 %, a carbon emission reduction of 11 %, and a primary energy saving of 8 %

A step towards digital operations -- A novel grey-box approach for modelling the heat dynamics of Ultra-low temperature freezing chambers

Ultra-low temperature (ULT) freezers store perishable bio-contents and have high energy consumption, which highlight a demand for reliable methods for intelligent surveillance and smart energy management. This study introduces a novel grey-box modelling approach based on stochastic differential equations to describe the heat dynamics of the ULT freezing chambers. The proposed modelling approach only requires temperature data measured by the embedded sensors and uses data from the regular operation periods for model identification. The model encompasses three states: chamber temperature, envelope temperature, and local evaporator temperature. Special attention is given to the local evaporator temperature state, which is modelled as a time-variant system, to characterize the time delay and dynamic variations in cooling intensity. Two ULT freezers with different operational patterns are modelled. The unknown model parameters are estimated using the maximum likelihood method. The results demonstrate that the models can accurately predict the chamber temperature measured by the control probe (RMSE < 0.19 {\deg}C) and are promising to be applied for forecasting future states. In addition, the model for local evaporator temperature can effectively adapt to different operational patterns and provide insight into the local cooling supply status. The proposed approach greatly promotes the practical feasibility of grey-box modelling of the heat dynamics for ULT freezers and can serve several potential digital applications. A major limitation of the modelling approach is the low identifiability, which can potentially be addressed by inferring model parameters based on relative parameter changes

Comparison between hospitalized patients affected or not by COVID-19 (RESILIENCY study)

Dear Editor, in the recent report of Munblit and coworkers [1], authors observed that the combination of clinical features was sufficient to diagnose COVID-19 indicating that laboratory testing is not critical in real-life clinical practice. To date, all patients admitted to Emergency Department with acute respiratory failure and/or fever should be considered as a suspected SARS-CoV-2 infection [2-3], and an early recognition of etiology and the prompt therapeutic management are crucial to improve survival [4-5]. From March to July 2020, we performed a prospective, multicenter study (RESILIENCY study). During the study period, all patients hospitalized for suspected or confirmed COVID-19 were prospectively recruited in 3 large hospitals in Rome, Italy. All patients with suspected SARS-CoV-2 infection, admitted to the hospital in case of fever and/or hypoxemic respiratory failure (PaO2 &lt;60 mmHg at rest in ambient air) or of exacerbation of underlying diseases or severe symptoms not manageable outside the hospital, were evaluated according to a predefined protocol (see Figure 1). Overall, 653 patients were included in the study: 309 (47.3%) patients with confirmed COVID-19 and 344 (52.7%) without COVID-19, hospitalized for other causes. Baseline characteristics and outcomes of the study population showed that the main causes of hospitalization among patients without COVID-19 were: acute heart failure (47%), bacterial pneumonia (38.5%), and pulmonary embolism (9.2%). Overall, 67 (21.7%) patients of COVID-19 group and 45 (13.1%) hospitalized for other causes were admitted to intensive care unit; 30-day mortality was observed in 59 (19%) patients of COVID-19 group and 62 (18%) of non-COVID-19 group. The multivariate analysis about risk factors for COVID-19 etiology at time of hospitalization showed that dry cough (OR 3.76, CI 95% 1.98-7.92, P&lt;0.001), duration of fever&gt;3 days (OR 5.21, CI 95% 2.34-9.21, P&lt;0.001), lymphocytopenia (OR 1.98, CI 95% Downloaded from https://academic.oup.com/cid/advance-article/doi/10.1093/cid/ciaa1745/5989494 by Sapienza Università di Roma user on 01 December 2020 Accepted Manuscript 3 1.27-4.22, P=0.002) and PaO2/FiO2 ratio&lt;250 (OR 4.98, CI 95% 2.22-9.71, P&lt;0.001) were independently associated with COVID-19 etiology, while procalcitonin value&gt;1 ng/ mL (OR 0.21, CI 95% 0.08-0.82, p&lt;0.001), and lactate&gt;2 mmol/L (OR 0.41, CI 95% 0.15-0.77, p&lt;0.001) were associated with non-COVID-19 etiology. Finally, analysis about predictors of 30-day mortality showed that age (per-year increase OR 1.33; CI 95% 1.11-2.10; p&lt;0.001), cardiovascular disease (OR 4.58; CI 95% 2.07-8.25; p&lt;0.001), and ICU admission (OR 2.1; CI 95% 1.48-4.4; p&lt;0.001) were independently associated with all-cause 30-day mortality, while the use of low-molecularweight heparin (OR 0.22, CI 95% 0.03-0.45, p=0.002) was associated with survival. The findings of the present study can be summarized as follows:1) the prompt identification of specific clinical characteristics (like dry cough or duration of fever&gt;3 days), and laboratory findings (like lymphocytopenia, PaO2/FiO2 ratio&lt;250, procalcitonin value&gt;1 ng/ mL, and lactate&gt;2 mmol/L) can help physicians to distinguish rapidly between COVID19 or other etiologies [6]; 2) the application of a standard approach to management of patients with acute respiratory failure and/or fever associated with the knowledge of clinical and laboratory characteristics of COVID-19 can early drive physicians to therapeutic choices; and 3) age, cardiovascular disease, and ICU admission show an independent association with all-cause 30-day mortality [7], while the use of low-molecular-weight heparin was associated with survival [8]. In conclusion, COVID-19 syndrome is characterized by a heterogeneous clinical, laboratoristic, and radiological presentation, especially at its onset [9]. However, the application of a standard approach to management of patients with acute respiratory failure and/or fever and the knowledge of clinical and laboratory characteristics of COVID-19 can early drive therapeutic choic

Significant coronary stenosis detected by coronary computed angiography in asymptomatic HIV infected subjects

Objectives: increased incidence of acute coronary events, high rate of abnormal surrogate markers of atherosclerosis and increased amount of coronary calcium have been described in HIV infected population. To expand knowledge on coronary artery disease (CAD) in HIV patients, cardiac CT scan was performed in asymptomatic subjects with low cardiovascular (CV) risk. Methods: A cross-sectional study using dual-source CT (MDCT) coronary angiography. was conducted in HIV-infected subjects with the following characteristics: Framingham Risk Score (FRS) <= 10, absence of metabolic syndrome, negative echocardiographic and ECG stress-test. A luminal narrowing exceeding 50% was defined as a clinically significant coronary stenosis. Calcium score was quantified using the Agatston Calcium Score method. Results: Fifty-five subjects were enrolled. Significant coronary stenoses, requiring coronary angiography, were found in 16/55 (29.1%). At multivariate analysis older age was the only variable independently associated with the presence of significant luminal narrowing (p = 0.011). Conclusions: MDCT showed an unexpected, age-associated high rate of significant coronary stenosis in asymptomatic HIV positive subjects with low CV risk. These findings suggest that aggressive screening programs for coronary artery disease may be appropriate in this population; further studies are recommended to assess the appropriateness of MDCT for this purpose. (C) 2011 The British Infection Association. Published by Elsevier Ltd. All rights reserved

The role of teicoplanin in the treatment of SARS-CoV-2 infection: a retrospective study in critically ill COVID-19 patients (Tei-COVID Study)

Teicoplanin has a potential antiviral activity expressed against SARS-CoV-2 and was suggested as a complementary option to treat COVID-19 patients. In this multicentric, retrospective, observational research the aim was to evaluate the impact of teicoplanin on the course of COVID-19 in critically ill patients

Arterial and venous thrombosis in coronavirus 2019 disease (Covid-19):relationship with mortality

BACKGROUND: Patients with coronavirus disease 2019 (Covid-19) may experience venous thrombosis while data regarding arterial thrombosis are sparse. METHODS: Prospective multicenter study in 5 hospitals including 373 patients with Covid-19-related pneumonia. Demographic data, laboratory findings including coagulation tests and comorbidities were reported. During the follow-up any arterial or venous thrombotic events and death were registered. RESULTS: Among 373 patients, 75 (20%) had a thrombotic event and 75 (20%) died. Thrombotic events included 41 venous thromboembolism and 34 arterial thrombosis. Age, cardiovascular disease, intensive care unit treatment, white blood cells, D-dimer, albumin and troponin blood levels were associated with thrombotic events. In a multivariable regression logistic model, intensive care unit treatment (Odds Ratio [OR]: 6.0; 95% Confidence Interval [CI] 2.8–12.6; p < 0.001); coronary artery disease (OR: 2.4; 95% CI 1.4–5.0; p = 0.022); and albumin levels (OR: 0.49; 95% CI 0.28–0.87; p = 0.014) were associated with ischemic events. Age, sex, chronic obstructive pulmonary disease, diabetes, heart failure, coronary heart disease, intensive care unit treatment, in-hospital thrombotic events, D-dimer, C-reactive protein, troponin, and albumin levels were associated with mortality. A multivariable Cox regression analysis showed that in-hospital thrombotic events (hazard ratio [HR]: 2.72; 95% CI 1.59–4.65; p < 0.001), age (HR: 1.035; 95% CI 1.014–1.057; p = 0.001), and albumin (HR: 0.447; 95% CI 0.277–0.723; p = 0.001) predicted morality. CONCLUSIONS: Covid-19 patients experience an equipollent rate of venous and arterial thrombotic events, that are associated with poor survival. Early identification and appropriate treatment of Covid-19 patients at risk of thrombosis may improve prognosis

Malaria in an asylum seeker paediatric liver transplant recipient: diagnostic challenges for migrant population

Transplanted patients are particularly exposed to a major risk of infectious diseases due to prolonged immunosuppressive treatment. Over the last decade, the growing migration flows and the transplant tourism have led to increasing infections caused by geographically restricted organisms. Malaria is an unusual event in organ transplant recipients than can be acquired primarily or reactivation following immunosuppression, by transfusion of blood products or through the transplanted organ. We report a rare case of Plasmodium falciparum infection in a liver transplanted two years-old African boy who presented to one Italian Asylum Seeker Center on May 2019. We outlined hereby diagnostic challenges, possible aetiologies of post-transplantation malaria and finally we summarized potential drug interactions between immunosuppressive agents and antimalarials. This report aims to increase the attention to newly arrived migrants, carefully evaluating patients coming from tropical areas and taking into consideration also rare tropical infections not endemic in final destination countries

Parietal resting-state EEG alpha source connectivity is associated with subcortical white matter lesions in HIV-positive people

Objective Parietal resting-state electroencephalographic (rsEEG) alpha (8–10 Hz) source connectivity is abnormal in HIV-positive persons. Here we tested whether this abnormality may be associated with subcortical white matter vascular lesions in the cerebral hemispheres. Methods Clinical, rsEEG, and magnetic resonance imaging (MRI) datasets in 38 HIV-positive persons and clinical and rsEEG datasets in 13 healthy controls were analyzed. Radiologists visually evaluated the subcortical white matter hyperintensities from T2-weighted FLAIR MRIs (i.e., Fazekas scale). In parallel, neurophysiologists estimated the eLORETA rsEEG source lagged linear connectivity from parietal cortical regions of interest. Results Compared to the HIV participants with no/negligible subcortical white matter hyperintensities, the HIV participants with mild/moderate subcortical white matter hyperintensities showed lower parietal interhemispheric rsEEG alpha lagged linear connectivity. This effect was also observed in HIV-positive persons with unimpaired cognition. This rsEEG marker allowed good discrimination (area under the receiver operating characteristic curve &gt; 0.80) between the HIV-positive individuals with different amounts of subcortical white matter hyperintensities. Conclusions The parietal rsEEG alpha source connectivity is associated with subcortical white matter vascular lesions in HIV-positive persons, even without neurocognitive disorders. Significance Those MRI-rsEEG markers may be used to screen HIV-positive persons at risk of neurocognitive disorders

Clinical Characteristics and Outcome of Patients with Suspected COVID-19 in Emergency Department (RESILIENCY Study II)

COVID-19 may show no peculiar signs and symptoms that may differentiate it from other infective or non-infective etiologies; thus, early recognition and prompt management are crucial to improve survival. The aim of this study was to describe clinical, laboratory, and radiological characteristics and outcomes of hospitalized COVID-19 patients compared to those with other infective or non-infective etiologies. We performed a prospective study from March 2020 to February 2021. All patients hospitalized for suspected or confirmed COVID-19 were prospectively recruited. All patients were evaluated according to a predefined protocol for diagnosis of suspected SARS-CoV-2 infection. The primary endpoint was evaluation of clinical, laboratory, and radiological characteristics associated or not with COVID-19 etiology at time of hospitalization in an emergency department. A total of 1036 patients were included in the study: 717 (69%) patients with confirmed COVID-19 and 319 (31%) without COVID-19, hospitalized for other causes. The main causes of hospitalization among non-COVID-19 patients were acute heart failure (44%) and bacterial pneumonia (45.8%). Overall, 30-day mortality was 9% among the COVID-19 group and 35% in the non-COVID-19 group. Multivariate analysis showed variables (fever > 3 days, dry cough, acute dyspnea, lymphocytes 250 ng/mL) independently associated with COVID-19 etiology. A decision tree was elaborated to early detect COVID-19 patients in the emergency department. Finally, Kaplan-Meier curves on 30-day survival in COVID-19 patients during the first wave (March-May 2020, n = 289 patients) and the second wave (October-February 2021, n = 428 patients) showed differences between the two study periods (p = 0.021). Patients with confirmed diagnosis of COVID-19 may show peculiar characteristics at time of hospitalization that could help physicians to distinguish from other infective or non-infective etiologies. Finally, a different 30-day mortality rate was observed during different periods of the pandemic