Numerical investigation of CSP air cooled condenser fan

CSP power plants are usually installed in desert regions due to the high availability of direct normal irradiance during the year. This usually entails the unavailability of water to be used for condensation in Rankine cycle and the consequent choice of air-cooled condensers (ACCs) [1]. When dealing with ACCs the main mechanical component is the fan, that drives fresh air towards the heat exchangers driving all the process. The main characteristic of this fan is its size that spans from 7 to 13 m of external diameters, thus resulting in a series of technical problems to be addressed. Such high-volume and low speed fans present critical problem during the testing phase [2]. This dissertation focuses on the certification of fan performance, that follows ISO 5801 [3]

Structural fat grafting in complex reconstructive surgery.

The use of adipous tissue transfer for the correction of maxillo-facial defects was reported for the first time at the end of the 19 century and has been the subject of numerous studies. Grafted fat tissue has been used for years as an excellent filler during facial enhancement and recontouring. Several techniques have been proposed for harvesting and grafting the fat. However, due to the damage caused by excessive adipose tissue during these maneuvers, the results were not satisfying. The situation required a larger amount of fat to be harvested even for small corrections. In 1988, the American plastic surgeon Sydney R. Coleman personally developed a technique called Structural Fat Grafting (SFG), which allows the fat to be harvested and injected with minimal risk of necrosis and reabsorption

Bone marrow evaluation according to the PVSG and WHO criteria in 90 essential thrombocythemia (ET) patients treated with PEG interferon alpha-2b. Preliminary results

Ninety ET patients diagnosed according to the PVSG criteria were enrolled in a phase II study (sponsored by the Schering-Plough Company) designed to evaluate the efficacy, safety and tolerability of a two years treatment with PEG Interferon alpha-2 b (PEG Intron). The patients, observed in 16 Italian Centres belonging to the GIMEMA Cooperative Group and judged at high risk, had been previously treated with cytoreductive (97%) and antiplatelet (91%) drugs. At the study start the patients, 60 F and 30 M, mean age 45 years, showed splenomegaly in 22% of cases. The Hematological Response (HR: PLT<500 x109/L) was observed in 64/81 (79%) and 48/55 (87%) of the patients on PEG Intron treatment at the end of the first and second year, respectively; the spleen enlargement disappeared in 75% of cases. The Bone Marrow data reported in the study CRFs document that the baseline increase of cellularity, of granulopoyesis, of megakaryocytes (MK) number, size and ploidy significantly decreased during PEG Intron treatment, while the MK displasia and fibrosis rate globally increased. In these patients a revision of the Bone Marrow biopsy slides was blindly performed by an Expert Pathologist Panel by applying the WHO criteria. The evaluation of two-thirds of cases showed the following distribution at the baseline: true ET (23%), IMF-0 (pre-MF 17%), IMF-1 (early MF 40%), IMF-2/3 (classical MF 3%), MPD-U (17%). Interestingly, the true ET patients never showed spleen enlargement that, otherwise, was present in IMF-0 (20%) and IMF-1/2/3 (42%) patients. The patients with true ET did not show any bone marrow evolution during the PEG Intron treatment, while the IMF-1/2/3 picture significantly increased. Moreover, the rate of the HR at the end of the first year was higher in true ET(93%) respect to the IMF-0 (60%) and IMF-1/2(71%) patients. These preliminary data show that the patients classified as true ET (WHO Criteria) are not splenomegalic, have no myelofibrotic evolution and reach a better response to the IFN treatment

Italian recommendations for influenza and pneumococcal vaccination in adult patients with autoimmune rheumatic diseases

OBJECTIVES: To provide evidence-based recommendations for vaccination against influenza virus and S. pneumoniae in patients with autoimmune rheumatic diseases (ARDs). METHODS: A Consensus Committee including physicians with expertise in rheumatic and infectious diseases was established by two Italian scientific societies, Societ\ue0 Italiana di Reumatologia (SIR) and Societ\ue0 Italiana di Malattie Infettive e Tropicali (SIMIT). The experts were invited to develop evidence-based recommendations concerning vaccinations in ARDs patients, based on their clinical status before and after undergoing immunosuppressive treatments. Key clinical questions were formulated for the systematic literature reviews, based on the clinical pathway. A search was made in Medline (via PubMed) according to the original MeSH strategy from October 2009 and a keyword strategy from January 2016 up to December 2017, updating existing EULAR recommendations. Specific recommendations were separately voted and scored from 0 (no agreement with) to 100 (maximal agreement) and supporting evidence graded. The mean and standard deviation of the scores were calculated to determine the level of agreement among the experts' panel for each recommendation. Total cumulative agreement 6570 defined consensus for each statement. RESULTS: Nine recommendations, based on 6 key clinical questions addressed by the expert committee, were proposed. The aim of this work is to integrate the 2011 EULAR recommendations on vaccination against influenza and S. pneumoniae in ARDs patients. An implementation plan was proposed to improve the vaccination status of these patients and their safety during immunosuppressive treatments. CONCLUSIONS: Influenza and pneumococcus vaccinations are effective and safe in patients with ARDs. More efforts should be made to translate the accumulated evidence into practice

High rate of recurrent venous thromboembolism in patients with myeloproliferative neoplasms and effect of prophylaxis with vitamin K antagonists

The optimal duration of treatment with vitamin K antagonists (VKA) after venous thromboembolism (VTE) in patients with Philadelphia-negative myeloproliferative neoplasms (MPNs) is uncertain. To tackle this issue, we retrospectively studied 206 patients with MPN-related VTE (deep venous thrombosis of the legs and/or pulmonary embolism). After this index event, we recorded over 695 pt-years 45 recurrences, venous in 36 cases, with an incidence rate (IR) of 6.5 per 100 pt-years (95% confidence interval (CI): 4.9-8.6). One hundred fifty-five patients received VKA; the IR of recurrent thrombosis per 100 pt-years was 4.7 (95% CI: 2.8-7.3) on VKA and 8.9 (95% CI: 5.7-13.2) off VKA (P=0.03). In patients receiving VKA, the IR of recurrent thrombosis per 100 pt-years was 5.3 (95% CI: 3.2-8.4) among 108 patients on long-term VKA and 12.8 (95% CI: 7.3-20.7) after discontinuation among the 47 who ceased treatment (P=0.008), with a doubled risk of recurrence after stopping VKA (hazard ratio: 2.21, 95% CI: 1.19-5.30). The IR of major bleeding per 100 pt-years was 2.4 (95%: CI: 1.1-4.5) on VKA and 0.7 (95% CI: 0.08-2.5) off VKA (P=0.08). In conclusion, in MPN patients with VTE recurrent thrombosis is significantly reduced by VKA and caution should be adopted in discontinuation; however, the incidence of recurrence on treatment remains high, calling for clinical trials aimed to improve prophylaxis in this setting

Tribology of confined Fomblin-Z perfluoropolyalkyl ethers: Role of chain-end chemical functionality

Strong dependence of the tribological response upon the nature of the polar end groups of perfluorinated linear chains was observed for Fomblin-Z perfluoropolyalkyl ethers of similar length and composition but terminated by a different polar group at both chain ends. The number-average molecular weight of the polymers was M-n approximate to 2000 g mol(-1) and the chain-end functionality was either carboxylic acid, hydroxyl, piperonyl, or the p-phenoxyanilinium salt of a carboxylic acid. The method of investigation was a surface forces apparatus modified for dynamic oscillatory shear at variable frequency and effective shear rate. Differences were observed as concerns not only the shear forces but also the minimum thickness to which the films could be compressed under a given normal load and the adhesion measured on separation of the surfaces after prior compression. The shear forces were studied at normal pressures of 1 and 3 MPa, both in the linear viscoelastic regime and at high shear amplitudes corresponding to shear rates of 10(-2)-10(5) s(-1). The carboxylic acid terminated polymer displayed solidlike responses to shear, possibly reflecting dimerization owing to hydrogen bonding. This contrasted with the more fluidlike shear rheology of the hydroxyl- and piperonyl-terminated polymers, in which the association from hydrogen bonding and polar interactions is believed to be weaker and result in a different structure. The sample comprised of the p-phenoxyanilinium salt of a carboxylic acid could not be compressed to less than an exceptionally large film thickness, around 100 Angstrom, and did not appear to solidify at the pressures studied. This study suggests that not only the affinity of the functionalized chain ends to a solid surface but also the self-association of polar end groups in the nonpolar environment of fluorinated chains influences the lubricating performance of these films